Epistemic communities and experts in health policy-making.

Olga Löblová

doi:10.1093/eurpub/cky156

Abstract

The role of evidence and expertise in policy-making has been of interest to public health professionals and political scientists alike. The public health community often sees its efforts as part of a linear knowledge transfer process and tends to blame itself for inadequate communication or translation of its arguments to policy-makers’ language when its efforts fail. Political science, especially theories of the policy process, offer alternative perspectives to explain the success or failure of experts’ preferred policy goals. This paper focuses on the concept of epistemic communities (groups of experts with a common policy goal derived from their shared knowledge) in policy-making, drawing on examples from the field of health technology assessment in Europe. By combining the parsimony and the central focus on experts of the linear knowledge transfer model with the recognition of complexity of political science, the epistemic communities concept provides a useful structure for the public health community to analyze its efforts to influence policy.

Highlights

Knowledge, evidence and expert advice are crucial for rational policy-making in the modern state
This paper focuses on a particular conceptualization of experts as epistemic communities: groups of experts with a common policy goal derived from their shared knowledge.[3]
The epistemic communities concept has the advantage of being relatively similar to the ‘hero’s journey’ linear model of science– policy interaction often used by the public health community

Summary

Introduction

Evidence and expert advice are crucial for rational policy-making in the modern state. The key scope conditions under which scientists can be expected to influence decision-makers’ preferences have originally been formulated as uncertainty and complexity surrounding the issue.[32] They can be extended to include decision-makers’ demand for expert input, which can have different reasons: solving a pressing problem, gaining legitimacy by invoking evidence, supporting particular policy positions, etc.[4,16] In the case of European HTA, this would mean that relevant policy-makers (in the Commission, the European Parliament or in the member states) had possibly not felt the need to listen to the HTA epistemic community—there had not been any crises or urgent problems which would require advice of experts proposing HTA, or perhaps not at the EU level Which of these hypotheses are the most plausible to explain the long road to EU HTA is a matter for empirical research. The epistemic communities concept provides a structure that social scientists, and the HTA community itself, can use to guide their analysis of past events, and their expectations of future developments

Conclusion

Key points