Notes on War on Science Debate
Sorry that there is no Conservative here tonight.... you need to
know that in Alberta when the CONS refuse to show at debate
... they put a rubber chicken on the clearly Empty Chair
Maxim of the renown Sydney Brenner ( 2 Gairdners and a
Nobel):
"Science is the best tool available to man to solve human
problems".
10 years ago when visiting Atlanta I remember being appalled
to HIV/AIDS researchers were advised to remove the words:
condom, gay, prostitute from grant applications because the
govt would not fund things that weren’t govt policy…
It seemed outrageous
I was then truly saddened in 2010 at the Women Deliver
Conference on Maternal Child Health in Washington to have Dr.
Cohen from the Guttmacher Institute referring to Canada as an
‘evidence-free zone’. She said that they now had a ‘science
President’ but Canada had clearly moved to policies based upon
ideology instead of evidence.
Thank Chris Turner for his excellent chronicle of the
Conservative Government’s War on Science …
Hope that I can reflect on the way forward – the phoenix risingWhat a govt committed to evidence-based policy and the
importance of research and science to solve the challenges of
Canada and the world.
Three Areas
Structure
Processes / Funding
Communication
Structure
Start at the top
EXECUTIVE BRANCH
Reinstate the Science Advisor to PM
Advisory bodies to Ministers
Modelled after COSEWIC (Committee on Status of Endangered
Wild Life Canada)
Transparent Advice to Minister
Clear the scientists decide which species are in danger
Advise the Minister in transparent way
Eg Scientists decide that 11 species should be listed
One of the SAR is a potato beetle – that if listed would destroy
the economy of NB and PEI
Minister decides to list 10 species
It then is clear that the science was the science
And that the Ministers decision was based upon science AND
politics AND economics
But at no time does the Minister try to pretend that the
scientists advised to list only 10
When Munir Sheikh resigned from Statistics Cda .. it was
because the Minister misrepresented the advice he had
received
I believe that for example
eg Science Advicosry Board at Health Canada should be reestablished…not only to advise the Minister on the emerging
issues of the day, but should be mandated to strike appropriate
advisory panels to ensure that the panels are free of bias,
conflict and therefore their advice will be free from criticism
and able to provide the best possible evidence-based policy
that Canadians will be able to trust.
Previous Advisory Panels eg on HIV, Seniors gave only quiet
‘Advice to Minister’ that was protected from ATIP and could
often be totally ignored.
PARLIAMENT
There is no questions that not only do we need more
Parliamentarians with a background in science, but we need
better science advice to Parliamentarians.
As we still have many many lawyers in Parliament, we need to
explain that ‘evidence’ is not OJ Simpson’s glove.
Critical appraisal of studies – questions about sample size and
who paid should be routine for all MP’s and Senators.
The Library of Parliament needs to attract excellent scientists
who are encouraged and supported to keep up to date. When
Dr. Yves Morin and I chaired the Joint Committee on the Library
of Parliament , we suggested that policy analysts should be
given the resources and the time to attend conferences and
take sabatticals. We were impressed by the Science Fellowship
programme in the US that provided scientists for a year right in
the offices of Congressmen and Senators. Their offices being
much larger staff – often 40+ in comparison to the staff of an
MP or Senator in Canada of 4-5, it seemed that that fellowships
in Canada would be better placed in the Library of Parliament
Research Department serving Committees and responding to
requests for advice from all Parliamentarians.
PUBLIC SERVICE
In my experience as Minister of State (Public Health), I was
impresssed to find out that at the National Microbiology Lab in
Winnipeg many of the scientists there had cross-appointments
at the University of Manitoba and were participating in perereviewed research supported by CIHR grants and were authors
of important publications.
In my quest to put the public back into PUBLIC HEALTH, I often
thought the the amazing social scientists at Carleton and
University of Ottawa could be involved in the citizen
engagement challenges that we faced, but also that some of
the public servants at PHAC could also have crossappointments. I often thought that an audit of the # of crossappointments would be an important metric to track.
PROCESS
One of the huge challenges in getting anything done in
government is the complexity. Governments operate in silos
and there are silos within the silos.
We need to adopt a ‘Whole of Government’ approach where
there is accountability for results across all government
departments. Cabinet committees can help.
Eg We have often talked about the need for Health Impact
Analysis – like Health in All Policies in Finland or Bill 54 in
Quebec. It would mean that all policies, programmes and
budget items would have to be subjected to the HIA BEFORE
they went to cabinet. But who would do it ? Could we have
that capacity built into the PHAC if it was operating in a truly
arms-length manner ?
We need Health Canada to be a better coordinator of its
agencies and bodies. They have to talk to one another in order
to create the knowledge for better public policy and research.
PHAC
Infoway
Health
Canada
CIHI
CIHR
Infoway needs to lay the track so that CIHI can track the data
that CIHR can use to provide evidence for Health Canada and
PHAC and the Government of Canada as a whole.
Evidence Ideology
Evidence-based systems approaches require complex adaptive
systems
Measure – adapt - measure again
There are 3 pillars ...Research – Policy –Practice
Research requires Knowledge Translation to get to better
Policy....
Policy requires Political Will (sometimes law suits) to get to
better Practice
Practice requires Applied Research that gets to better
Research questions that ensure that this complex adaptive
system .... the virtuous circle continues to generate the best
possible public policy and practice
There is no questions if the process is embedded in meaningful
citizne engagement ... that citizens will generate the motivation
to ensure that the virtuous cycle moves more quickly .... and
that governments are held accountable for not putting the
research into better policy and practice
Folic acid in the flour
Iodine in the salt
Child care
Climate change
Disease prevention, health promotion
There is no question that legitimacy in complex adaptive
systems requires stable and predictable funding ....
Was so impressed last week at the breakfast honouring Dr.
Feinberg of the Institute on Medicine, this years recipient of
the coveted Henry Friesen Prize -Friends of CIHR
He talked about 3 imperatives...
1.Health Care access to those who need it
2.Prevention – highlighting the need for social science
3.Research ..research.. research.... social science, basic science,
therapeutics, health care delivery.... EVIDENCE !!!
We can’t underestimate the role of the Media in our challenge
....
Media relies upon Conflict
It is imperative that scientists play a role in helping the media
understand that once evidence has been established ...
Eg climate change
Child care...
That the conflict that should be debated on their ‘panel’ should
be about what we do about it .... NOT whether it exists ..
I believe that my new favourite word in civic literacy to
Canadians should be ‘metanalysis’
Not that they’ve mastered isotopes and prorogation....
On to metanalysis ..
That is
Is 99 studies show X ... and one study shows Y
Canadians and Media should understand that the debate
should be about what we do about the results of the 99 studies
.... not have us endure an ongoing debate about what’s clearly
already been proven....
The Science Community has a role to play too....The
60 Minutes segment on Science --- profiled the researchers that
had denied the evidence on 2nd Hand Smoke... were reprofiled
denouncing the evidence on Climate Change... the same guys
Mercenaries ???
Academics..... you need to Reel in your bad guys !!
Later notes for Q & A’s
Thailand ‘Xray’ programme ... at our Pandemic Preparedness
mtg in Ottawa in 2005..... Sec Leavitt from the US and WHO
SecGen Jomg-wook Lee
Committing SOCIOLOGY !!!!
Identify the ‘most-trusted person’ in every community by
sociogram...
Send that person to ‘mini-MedSchool’ 2x/year
To learn about the importance of immunization
To understand the need for farmers who take theri
chickens/live produce to market ....must ensure that they are
killed before returning to their community because of the risk
of bringing ‘germs’ back to their community...
The lessons from developing countries ..... the importance to
them of evidence in what works in ‘keeping people well’ !!!
15 years ago as the ALAMES conference in Cuba I was
astounded to learn that every Family doc had to report
annually
How many smokers in your practice ?
How many stopped smoking this year ?
How many obese ?
How many sedentary ?
How many with hypertension out of control ?
How many with lipids out of control ?
On my return a few years ago I learned that every Polyclinic has
a staff statistician and a staff epidemiologist ...
They are measuring as they go .. real time ... we need to do so
too..
The ‘measurers’ and the ‘analysts’ of that data need to be
made essential parts of our Canadian Health Human Resources
teams ....
Benediciton:
Scientists need to RUN for public office
You need to consider a Vetting Process ... of ‘Science-Friendly’
candidates .. like the Arts and other communities do
You need to ensure that your all are writing and getting
published ...Op-eds
Here at U of T ...
Thrilled by Rob Steiner’s programme at Munk Centre –
Fellowships on Global Journalism ... taking in academics and
professionals to journalism ‘boot camp’ - how to write and get
published in their areas of expertise...
Also Massey College’s journalism fellows ... taking time to learn
and write about important issues
And suggesting Shari Graydon’s @informedopinions teaching
women profs how to write op-eds that will get published ..
Allons-y !!
Evidence-based policy ... not policy-based evidence