Challenges to Evidence-Informed Decision-Making in the Context of Pandemics: The Case of COVID-19

Background: Evidence-informed decision-making (EIDM), while implied by name to be “science-led”, is not always a clear and straightforward approach to policy making. This is especially pronounced during pandemics when rapidly evolving research continues to emerge and when decision-makers are faced with policy decisions that are reliant upon emerging, incomplete, or inconsistent evidence. Based on interviews with experts informing COVID-19 response, this paper uses COVID-19 as a case to discuss challenges to evidence-informed decision-making during a pandemic. Methods: Data for this paper were generated using one-on-one in-depth interviews with 27 experts across four WHO regions, representing 11 countries. Findings: Findings from this study indicate multiple overarching challenges reported by experts across multiple countries and WHO regions. These include: the speed and influx of new, evolving, and at times conflicting evidence; concerns about scientific integrity and misinterpretation of evidence; the limited capacity to assess and produce evidence, as well as adapting evidence from other contexts; multiple forms of evidence and perspectives needed for evidence-informed decision-making; the need to make decisions quickly and under conditions of uncertainty; and a lack of transparency in how decisions are ultimately made. Interpretation: Findings produced from our interview data suggest the urgent needs for a global evidence-informed decision-making framework that countries can adapt for in-country decisions as well as coordinated global response to future pandemics.Funding Information: This publication has been supported by German Federal Ministry of Health (BMG) COVID-19 Research and Development funding to WHO. Study sponsor provided funding support for data collection, analysis, interpretation of data, and publication. The sponsor did not contribute directly to these activities.Declaration of Interests: None to report. Ethics Approval Statement: This research was reviewed by the University of Washington Human Subjects Division, which determined that this research qualified for exempt status (Category 2) on October 19, 2020.All interviewees agreed to be recorded and consented to participate following narration of a verbal informed consent document that was also provided via email before the start of the interview. Following our informed consent language, interviewees and their respective affiliations have been kept anonymous.