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Science in society – politics, development and social justice.

Archive for the ‘Policy’ Category

Non-communicable diseases and the world’s government

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Non-communicable diseases or NCDs are the hot topic at the World Health Organisation (WHO) right now. NCDs, including diabetes, cardiovascular disease, some cancers and chronic pulmonary disease account for a large portion of morbidity and mortality in the world, and not just the developed bit. I am told it is Geneva’s big new thing and understandably so. A paper in the New England Journal of Medicine, published last year, said:

The prevalence and impact of noncommunicable diseases continue to grow. Chronic diseases account for 60 per cent of all deaths worldwide, and 80 per cent of these deaths occur in low- or middle-income countries, where the toll is disproportionate during the prime productive years of youth and middle age.

Bulletin, the WHO’s monthly public health journal, feature two editorials on the subject. One focused on how the UN is addressing the issue and the other focused on technical issues of balancing investment in treatment and prevention.

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Written by nascenthack

August 13, 2011 at 5:31 pm

Further dispatches from the Battle of Ideas

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Returning if you will to the subject of the previous post, I would like to recount something of what came out of the sixth annual Battle of Ideas (BoI).

Some panellists and audience members were in agreement that transparency and privacy are not in a polarised competition; some processes must be transparent but some details must be secret. It was suggested that private enterprise more than public life needs a more nuanced compromise between the two.

I do not think it is a question of transparency versus privacy at all. I believe it is a question of honesty versus dishonesty, clarity versus obfuscation. I believe this should apply to both public and private sections of society. As David Aaronovitch explained in the privacy versus transparency debate, to stringently demand full disclosure from the public figure only increases the privacy of the private figure. A Member of Parliament earns around £65,000 a year – how much do you know about the salary of a newspaper editor, TV executive(1) or director of a major corporation?

As is the nature of events like the BoI, I left with many questions bobbing around my rather punch-drunk brain. Do we need more transparency then? For example should policy decisions be made with all-encompassing transparency? Questioning the merits of evidence based policy is an area into which I had not previously ventured. As a trainee scientist I had always fancied the idea that science has or will have all the answers, if you give it time. For government to ignore research or disposes scientists of what I saw as their rightful place at the top of the intellectual heap seemed appalling and idiotic. Denigrate science will you? Who the hell do you think you are?

It was this that drove me to write a naïve if robustly worded comment piece for my student newspaper(2), calling for Alan Johnson’s head after he sacked Professor David Nutt.

I do not recant my call for Mr Johnson to be sacked, he was wrong to fire Professor Nutt, but I do wish to change my motives. I would like to replace my belief in the inviolable sanctity of scientific research with my understanding that this was an act of political cowardice by the present Shadow Chancellor.

At present, generally speaking, I think only those qualified as scientists are considered capable of casting judgement on the work of scientists. This excludes the ranks of journalists who call this their patch. The churning tendencies of the reporter, sifting through press releases and splurging out copy, that fulfils their primary goal of selling newspapers or gaining viewers makes them not quite apart from the establishment.

There is no room for the connoisseur in science, as Professor Steve Rayner of the University of Oxford put it from his seat on a BoI panel. Convenient for the research world that inherently requires a high degree of understanding. Understanding, it is presumed, that surpasses the ill-informed general public with their preconceptions and prejudice, who are kept out of the way of progress and the advance of knowledge. But a connoisseur is well informed by definition, and without the informed but removed judgement of the amateur there stands a professional hegemony. This leads to ‘Evidence’ being held in daunted awe as undeniable and unassailable.

To me this is to the detriment of both science and society. By excluding informed comment and raising ‘Evidence’ to a pedestal means the thorough scrutiny research must be subjected to will not come from all sections of society. If policy is to be formed from this evidence then the policy decision will join the research on which it is based, up on its glossy plinth. This can only be a bad thing.

All this reduces politics and science to policy and evidence. It places undue stress on scientists to provide the ‘bottom line’ figure. I believe science panders to the demands for certainty and absolute clarity in its answers which costs it, and scientists, the respect of the people (3).

As we are a democracy not a technocracy the will and feelings of the electorate must form part of the decision-making process of politicians. So too must evidence; it cannot be excluded as much as it cannot be the sole basis of decisions.

Returning to the case of Professor Nutt; the evidence and the considered opinion his committee provided should have formed one pillar of then Home Secretary Johnson’s decisions on the criminal status of controlled substances. But it had to stand alongside Johnson’s understanding of the views of the people and his appreciation of the wider ethical debate of individual freedoms. His final decision apparently defied the evidence and Johnson had to stand behind his decision and defend it in rational debate. He did not.

I think it is this lack of honesty that costs politicians our trust. I believe that there is a misunderstanding that science can provide answers and certainty and when this inevitably is disillusioned this costs scientists our trust.

I believe it is not a battle of transparency versus privacy but honesty and trust versus confusion and cowardice that underpins some of the important issues confronting us today. When science panders to demands of certainty and security it cannot provide and when politicians duck issues, we all notice.

  1. Excluding the BBC make of executive that is
  2. The Student: the oldest student newspaper in Britain which counts among its former editors Gordon Brown and William Gladstone. It does not count among its assets a proper online archive of articles so I cannot link you to my earlier forays into the hack’s realm
  3. An example of this could come from the 2001 Foot-and-Mouth Disease epidemic. Throughout the epidemic’s progress scientists were called upon to declare when it had reached its height, when it was likely to be over, even when Tony Blair could call an election. A graph was released by epidemiologists that plotted the decline in cases over time. The graph did not show the error bars for each data entry. That is the statistical range of each point where it could fall within. As such it was simple line graph that happened to show the end of the epidemic, the point where the number of cases was zero, falling on the day of the general election. Journalists call foul and science has egg on its face. This is as told to me by Professor Mark Woolhouse, University of Edinburgh Chair of Infectious Disease Epidemiology, in my final year epidemiology lectures. Alas I no longer hold the lecture slides on my computer, they are lost to the sands of time. I deleted them along with all the others when I purged my hard drive following graduation in an electronic equivalent of chucking all my notes in the air as I walk out the door. Oh foolish youth

Written by nascenthack

November 4, 2010 at 10:33 pm

The Battle of Ideas – commencement of polite and well-spoken hostilities

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This weekend sees the Royal College of Art in Kensington play host to the sixth annual Battle of Ideas Festival.

It is fitting that it should be held next door to the Royal Albert Hall, which was built from the proceeds of the Great Exhibition of 1851(1), a festival showcasing some great ideas.

An old print of Queen Victoria standing beneath a canopy in the Crystal Palace at the opening of the Great Exhibition of 1851

This year’s festival is focusing on the division between public and private, the decline of trust, ethics in medicine, and the importance of evidence in science.

Ethically I cannot withhold the following (in the interests of transparency and full disclosure): I only attended one hour of Saturday’s timetable. I apologise and can only say I had a good excuse. I promise to be front and centre for Sunday as the event moves into full-on science and policy mode. Topics to be covered on this Sabbath day will revolve around the general theme: ‘The Battle Over Scientific Evidence’. Read the rest of this entry »

Written by nascenthack

October 30, 2010 at 8:56 pm

The Comprehensive Spending Review – the axe has fallen

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It is said of budget announcements that the devil is in the detail; a cliché because it contains more than a grain of truth. The significance of Chancellor Osborne’s spending review will not become clear until the cuts heal clean and circulation returns, or the wound begins to fester into a social and economic sepsis (1).

Scientific research has not fared as badly as was first feared. Sighs of relief and words of warning have sounded across the research community. Read the rest of this entry »

Written by nascenthack

October 21, 2010 at 9:41 am

Science and the comprehensive spending review

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The comprehensive spending review is edging ever nearer, giving off jets of pure austerity1. Behind closed doors ministers are squirming to protect their portfolios while lining up out front like Bolsheviks of the Moscow Trials.

Dewlaps wobble and sabres rattle in the Ministry of Defence. Andrew Mitchell has been jetting off to Washington while the cabinet office siphons off his authority.

The silent majority is fit to burst with pent up indignation; child benefit cuts gravely threaten the sanctity of middle class family life.

All the while whet stones sound on steel and abacus beads skim at the Treasury. Read the rest of this entry »

Written by nascenthack

October 12, 2010 at 7:17 pm