On November 22nd a group of politicians, NGO representatives, academics and a few lucky students from LSHTM gathered in the Houses of Parliament for the launch of ‘Using Research Evidence in the Humanitarian Sector: A Practice Guide’. We were welcomed by Baroness Sheehan, the Liberal Democrat spokesperson for International Development, who expressed her support for the guide explaining that, “the Lib Dems are about nothing, if not evidence based policy”.
The guide was co-authored by three organisations: LSHTM’s Health in Humanitarian Crises Centre; Evidence Aid, and Nesta. The guide also received input from other humanitarian including NGOs such as Save the Children, Christian Aid, and the ICRC; government bodies such as DfID and Public Health England; and universities such as the Liverpool School of Tropical Medicine. It is intended to advise on what works, where, why and for whom when delivering interventions in humanitarian crises and to help organisations avoid repeating the failures of others.
Ben Heaven Taylor, Evidence Aid CEO, spoke about the challenges facing the humanitarian sector, given the enormity of the scale of need in humanitarian crises. With the UK currently spending 0.7% of it’s GNP on Overseas Development Aid (the UN target for developed countries) it is essential to strive towards delivering the highest quality aid possible – which would ideally be based on the highest quality evidence. However, the evidence base for humanitarian interventions is patchy, with a lot more focus on some areas (like infectious diseases) than others like chronic conditions.
Furthermore, while different organisations working in the field might be collecting evidence, this might not be pulled together in a systematic way and may not be available to the public or the academic community. What academic evidence does exist may then be hidden behind paywalls in journals that are only read by academics, and not necessarily by the frontline workers who are on the ground in humanitarian crises. There are also ethical and practical dilemmas involved in carrying out research in humanitarian settings, for instance the challenges in working ethically with vulnerable populations or keeping researchers safe in unstable situations.
Creating access to high quality evidence is crucial, as what happens on the ground often challenges prevailing wisdom about which interventions work. The practice guide emphasises the importance of ‘triangulating data’ by using multiple sources of evidence to inform decisions on aid delivery to avoid relying solely on professional opinion.
“We need to be more like the much admired John Snow”, Ben explained, ”who, after his famous pump handle intervention during a cholera epidemic outbreak in Soho, doubted whether his intervention had in fact prevented the spread of disease!”
By constantly questioning the importance of our interventions, we can strive to ensure they are based on the best quality evidence.
Professor Bayard Roberts, Director for the Centre of Chronic Conditions and steering committee member of the Health in Humanitarian Crises Centre, explored which public health interventions in humanitarian crises are driven by particularly weak data. He emphasised that we need to know more than simply whether an intervention is effective or not. We need to know how and why an intervention is effective to assess whether actions that were effective in one crisis will work in others, how cost-effective the intervention was, and whether it is designed to make it feasible to scale up.
However, despite these limitations, Roberts said that the quality and quantity of evidence in the humanitarian sector has increased over the last decade and will continue to do so, particularly if the international community strengthens research capacity and commits to accountability.
Director of Nesta Jonathan Breckon also spoke on the guide, commenting it could be “a manifesto for how we think aid can benefit from evidence.”
He said that successful policy-making can be found at the intersection of politics, delivery and evidence, but cautioned against slavish responses to evidence that did not value context or listen to affected communities. Rather, he argued we should move towards a system where those in the humanitarian sector “feel that research is part of their being,” so that people can feel confident choosing and triangulating data to come up with the best interventions.
There was then time for questions from the students, NGO representatives and politicians, with more nuanced discussion on the challenges facing the humanitarian sector. For instance, the challenge of building research capacity in the global south, applying evidence from past crises to current ones, and the ethics of performing randomised control trials in crises settings.
To me, a clear message from the morning is that the responsibility lies both with academic researchers and with organisations implementing interventions in the field to ensure that research is conducted quickly and in response to need, and that this is then incorporated into programming and policy to make humanitarian aid as effective as possible.
In 2019, it is likely that we will see many humanitarian crises getting even worse. We begin the year with the highest number of displaced people ever recorded, increasing climate change related natural disasters and worsening conflict in many parts of the world. As the need for humanitarian aid grows, I am hopeful that this guide will help to ensure that the tireless work done by people on the ground in crisis situations goes further and makes more of a difference.