Leaders of Africa

COVID-19: Evidence-based Decision Making and Public Policy

Decisions by governments during this COVID-19 pandemic underscore concerns regarding the reliability of the evidence informing public health policies.
Photo by Edward Jenner from Pexels

By James Kwesi Quarshie

COVID-19 has wreaked havoc in the world since the start of the year. Although scientists and public health experts have predicted the deadliness of the disease, they are still unsure about the virus’s transmission rate and the extent to which this pandemic will last. The disease, currently confirmed in 213 countries across the globe has left many in fear and panic. The ease and speed of information sharing in our interconnected world have brought to life the fact that COVID-19 is truly a common global experience and threat. In a few months, what began as an epidemic in the city of Wuhan, China transformed into an unprecedented global economic, political, and health crisis with a myriad of effects, including negatively influencing the mental health of people in different parts of the world. Doubtlessly, the virus has impacted heavily on our global economy and governance systems and has exposed the fragilities and weaknesses of our public policies and systems. The COVID-19 pandemic has presented a momentous challenge to governments and policymakers globally, especially when it comes to gathering and analyzing large datasets, managing resource allocation, as well as enacting policies to address the pandemic. Executing tasks like these requires evidence-based policy and data to guide decision-making. The formulation and implementation of COVID-19 response strategies also require real-time or historical data to inform decision-making. Throughout these uncertain times, evidence-based approaches to policy formation would affirm confidence in science and research and not the usual political imperative.

The Importance of Data

Policy development and implementation founded on robust evidence help to eliminate weaknesses and risks that may affect policy. Typically, all policies by governments are informed or should be informed by some data. However, evidence-based policy methods are not simply about decision-making being informed by some data. Rather, it describes a government decision-making process that brings together reliable data (scientific facts), analytical reasoning, and stakeholders’ opinion. The approach allows for greater accuracy and reliability of policies enacted by the state. Arguably, evidence-based policymaking is praised for producing better policies, and governments that practice it tends to achieve more success. They are able to design more probable scenarios for planning and ensure more optimal use of national resources. Similarly, governments stand greater chances of winning this battle against COVID-19 if strategies and policies in responding to this epidemic are rooted and validated by evidence. We, therefore, are in times when governments need to collaborate more with research institutes and medical laboratories in understanding the gravity of the situation at hand and work together on formulating and implementing sound policies that lessen the impact of the pandemic.

Questionable Strategies

There is no better time for governments to apply evidence-based policymaking than these critical times, considering the gravity of the health and economic crisis at hand. Presently, all governments claim their policies are guided by science and evidence. However, the real question is not about science, but the reliability of the science, and the communication of the policy evidence or science in an accurate, objective, and transparent manner. Policies that lack these may be deemed populist or “political.” For instance, the Prime Minister of the United Kingdom (UK), Boris Johnson’s initial strategy for handling the coronavirus outbreak reflected misguided policy advice. The government’s initial announcement was to follow a “herd immunity” strategy. The government claimed the decision was science-driven and argued the strategy was not intended to get rid of the virus completely, but to help minimize the spread and immediate impacts of the virus. Sir Patrick Vallance, the government’s scientific advisor, explained that they hoped the strategy would swiftly ‘flatten the curve’ and reduce possible transmission in the event of a winter resurgence of the virus.

However, several academics, researchers, experts, and public opinion leaders deemed the strategy problematic. The announcement of the strategy was met with heavy public criticism because the ‘acclaimed’ scientific evidence behind such a decision was not communicated, and thus could not be trusted or considered reliable. Dr. Michael Sheard of York University reasoned that the government would have encouraged the citizens’ trust if they shared the evidence behind their earlier strategies with researchers and the public. The fact that the UK government’s herd immunity strategy was criticized suggests there is a growing interest in how policymaking is corroborating with evidence.

In the African context, the government of Ghana’s decision to lift its 3-week lockdown was met with aspersion, since confirmed cases of the virus kept rising. Ghana lifted its lockdown when COVID-19 confirmed cases were 1,042. At 3,091 confirmed cases, the government announced the country had peaked the COVID-19 infection curve, based on data collated from across the country. Presently, Ghana has 26,125 total of COVID-19 cases. The World Health Organization found Ghana’s data reporting and claims alarming and commenced an investigation into the data behind such claims. Recently, the government decided to begin easing other restrictions imposed on social gatherings and schools. It can be contested that the earlier claims guided this decision by the government.

The above examples of the measures implemented in response to the COVID-19 pandemic have raised significant questions. For instance, are COVID-19 response policies evidence-based? Considering the fact that leaders are being forced to make quick decisions, what is the certainty that evidence or credible data guides most policies? Although some governments indicated that their decisions and policies were guided by available evidence, the feedback and outcome of their strategies generate concerns whether their evidence fits the components of compelling evidence for policy, i.e. objective scientific facts, analytical reasoning, and public or expert opinion.

The Politicization of the Virus

These concerns regarding the reliability of evidence do not only apply to policies during the COVID-19 pandemic but to all governments’ policies and decisions. In 2019, there was a disagreement between one of Africa’s reputed think tanks, IMANI Ghana, and Ghana’s incumbent New Patriotic Party (NPP) government regarding the government’s performance since January 2017. IMANI’s data and evidence showed that the ruling government had delivered only 48.78 percent of its 2016 manifesto promises as of December 2019. The government, however, disagreed and argued the government’s data indicated they had delivered over 72 percent of their campaign promises. This reverberates the existing competition and struggle between politics and objective research. It also validates the existing concerns about establishing transparency and objectivity of the evidence behind policies. We can consider that due to increasing political polarization, what government leaders may refer to as evidence for policy may lack accuracy, objectivity, or even be politicized. 

Despite these concerns and challenges, evidence-based policymaking proves rewarding if embraced. An evidence-based approach to policy lessens the uncertainties associated with the entire policymaking process. It also proves significant in garnering support from the public. Evidence-based policy methods, thus, leads to better decisions. For instance, a recent research by the Imperial College London helped the UK and the United States in navigating better strategies for containing the new coronavirus, and possibly saving more lives during the earlier stages of the pandemic. The modeling study, led by the professor and infectious diseases expert, Neil Ferguson, found that a ‘mitigation strategy’ would be more disastrous than a ‘suppression strategy.’ The study indicated that the absence of active restrictions to suppress infection rates would mean more infections and deaths, i.e. over 510,000 and 2.2 million deaths in Britain and the United States respectively. The study argued that the UK’s initial ‘herd immunity’ strategy, to only isolate suspected cases at their homes without nationwide restrictions on movement including other drastic suppressive measures, would have led to hundreds of thousands of deaths, while the country’s health system (particularly Intensive Care Units) would have been highly overwhelmed as the country has more people who are within the high-risk group.

The study generalizes these findings for the United States as well, predicting that the spread of the virus would be greater in the US than in the UK, due to its larger geographical scale. The study concluded that the epidemic suppression strategy was the most viable at the early stages of the virus’s insurgence in the UK, US, and other countries. This conclusion encouraged governments to revise and replace their initial pandemic response strategies with more viable ones. The new strategies proved viable as these countries initially began to contain the disease and, ultimately, save more lives. But, in both the US and UK, the embrace of evidence-based approaches was limited by political leadership, particularly in the US. The leadership in the US, such as the US president, largely views evidence-based approaches with significant skepticism, as does a large segment of the population. The leadership folly has resulted in an acceleration of COVID-19 cases in the US and burdens on the healthcare system.

The importance of evidence-driven decisions in determining the effectiveness of response strategies is heightened in the face with limited resources. This is a particularly significant concern for Africa countries. It is more imperative for governments of African countries to institute policies informed by accurate data because the judicious use of the continent’s limited resources in these critical times depends on it. African government leaders have to utilize their readily accessible resources prudently and effectively through a need-based approach to allocate resources. To achieve this, governments must curate and use reliable evidence and real-time data. Reliable evidence and independent sources of information and expertise are essential for balanced policymaking, particularly in an era of growing polarization, populism, and the politicization of public health. Objectivity must supersede efforts to gather evidence that serves a ‘political imperative.’ Evidence must also be communicated to the public with accuracy and without bias as this has proven to win the people’s trust and support in implementing formulated strategies. This may be difficult to do in the short-run with existing polarization, but it is something we need to acknowledge in our outreach efforts.

While the coronavirus pandemic presents a significant global threat, critical moments also present opportunities for learning and continuous innovation. Just like every other crisis, how effectively countries manage the COVID-19 epidemic will largely depend on government leaders’ reliance on accurate and real-time evidence for their strategies while engaging the entire society through effective communication of what is at stake and what needs to be done. Indeed, the COVID-19 outbreak has tested governance systems and proves that collaborative and evidence-based approaches to policy have the potential to shape governance and policymaking at the national and international levels.

James Kwesi Quarshie explores educational programming and the drivers of rural innovation toward sustainable social and economic development in African communities. He aims to bring together rigorous research and public policy to generate greater social impact and improve livelihoods in rural Africa. James was also a Scholar at the Leaders of Africa Institute in the Research Methods Program 2019.

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