What is the Role of Evidence in Public Policy?

Mounting evidence in support of harm reduction strategies has not translated to the government support needed in many countries to endorse the widespread adoption of proven HIV and STD prevention tools such as comprehensive sexual education programs, syringe exchange, and substitution therapy. In the session "Research-Based Public Policy:  Why is it not the Golden Standard?" a diverse panel discussed the data on harm reduction and why many policymakers refuse to be swayed by it.  

In his extensive reviews of sexual education programs targeted at young people between the ages of 19 and 25, Douglas Kirby, PhD, has produced convincing evidence that comprehensive sexual education programs are more effective at positively influencing the sexual behaviors of young people. Of the eight evaluations conducted of abstinence-only programs, only one was found to delay initiation of sexual activity. However, in 32 evaluations of comprehensive sexual education programs, 15 programs were effective at delaying sexual initiation. Dr. Kirby has presented his findings to some federal policymakers in the U.S. whose response is that the sexual education of young people should be driven by morals, not evidence. 

Maybe their response should not be so surprising. According to Gerry Stinson, executive director of the International Harm Reduction Association, policies are driven by many factors, including politics, funders, ideals, values, theories on human behaviors - but, in most cases, not evidence. As Stinson shared, "evidence is important, but only one small component of effective advocacy."   

Nandee Bandyopadhyay, an advocate for sex workers in India, agrees and questions whether the goals of public policy are for the public good as policies are created to appease competing constituent groups. Bandyopdhyay recommends defining "rights" rather than talking about what is right - using activism not just advocacy -- along with incorporating evidence into advocacy messages.  Unfortunately, the data does not speak for itself.