A group of young special guests in Liverpool…Who are they?
Since September 28, 2018, the city of Liverpool has been stormed by a group of young people coming from across five continents. I am not talking about the academic return of students who traditionally at this time of the year make alive this vibrant student city; nor do I speak of the thousands of tourists who come to admire the cultural and historical heritage of the Beatles city. I am referring to special guests, the kind of people who tomorrow will be part of international thinkers, policymakers, and experts who are influential in global health policies. This group of young special guests in Liverpool whose actions and positions taken should be closely monitored in the near future are called “Emerging Voices for Global Health” (EV4GH). It is a group of young professionals who, since 2010, have been meeting every two years as a prelude to the Global Symposium on Health Systems Research. I was fortunate enough to be part of the EV2018 cohort. As a public health policy analyst, this group caught my attention because it is presenting all the characteristics of an epistemic community. Having had the privilege of closely watching the deployment of the activities of this group, my intention in this blog is to support the idea that, without necessarily perceiving themselves as an epistemic community, the EV4GH group is actually an epistemic community in the making. This group has all the characteristics of an epistemic community and deserves the attention of researchers and analysts in Global Health.
Why and to what extent are the Emerging Voices for Global Health at the early stage of an epistemic community?
Before answering this question, it is first necessary to define what is meant by ‘epistemic community’. The concept of epistemic community has been popularised in public policy analysis by Peter Haas. This concept refers to a group of individuals structured around a shared narrative and beliefs about policy change; a shared causal belief and common validation criteria among its members and finally a common endeavour to influence and impact the policymaking process (Haas, 1992). This concept is used as a conceptual framework for understanding policy diffusion or policy transfer (Bossy and Evrard, 2014; Meyer and Molyneux-Hodgson, 2011). So, there are four types of identification criteria: Firstly, the group needs to have a common set of normative and principled beliefs; secondly, members share causal beliefs about the origins of policy issues and possible policy actions and desired outcomes; thirdly, they should have a shared notion of validity (that is, intersubjective, internally defined criteria for weighing and validating knowledge in the field of their expertise); and lastly, there is a common policy enterprise to influence the policymaking agenda out of the conviction that human welfare will be enhanced as a consequence.
When comparing these criteria with the group that makes up the EV4GH, one can see that this group fits the concept of epistemic community quite well. For instance, at the end of the 2018 edition of EV4GH here in Liverpool, a shared vision and set of normative principles, as well as shared causal beliefs about the origins of policy issues and possible policy actions and desired outcomes seem to ‘emerge’.
I will only pick on a few examples:
– The definition of health as a human right and not as a commodity;
– The need to include and work more closely with community health workers, but also pay them in a fair way;
– The importance of engaging with the private sector, in the pluralistic health systems in place in most LMICs now, while making sure that the Government protects the right to health of citizens;
– extending health coverage and care for all, including migrants and refugees;
– The need for global health researchers to make useful and relevant research, to engage with policymakers, the media and others with the aim of having an impact;
– The need to rethink the underlying relationships of domination both in the definition and implementation of the global health agenda, decoloniality and the integration of traditional and endogenous know-how, and knowledge of local communities;
– The role of ideology and values in the health systems reform debate;
– The importance of the context, everywhere, but certainly also in countries facing crises and conflicts.
Beyond these convictions and shared values, there are also shared validity criteria when it comes to health policy and systems research and the methodologies used. Above all, there is the will for this group to start to play a role of influence in global health policies [and sometimes politics], and to fight for the values they hold dear. EVs work at different levels and in different capacities. Some EVs focus their efforts on the country level, while others already intervene at the global level; there are also some of them who combine national and global expertise & influence. This diversity both in capacities and context of activity is a powerful leverage for an epistemic community to sell their ideas and impact policymaking processes. In other words, this group already has what it takes to operate as an epistemic community… even if there are still a few challenges. For instance, most of the members are young professionals at the early stage of their career and students still completing their PhD. But even so, when looking at the previous cohorts from 2010, merging these cohorts and building convergences across generations could be a way forward to speed up the process of formalising a rising epistemic community. Because of the the youthful, enthusiastic, sometimes even dreamy character of its members, EV4GH could bring a different tone and sing a different song in the larger community of Health Policy and Systems Research (HPSR).
From 2018 and onwards, going all the way and assuming the attributes of an epistemic community to effectively influence global health
The EV4GH network should be aware of its blossoming “epistemic community” nature and the role that such community can play not only in policy diffusion but most importantly in policy change and in driving the policy agenda towards their values and epistemic interests (Akrich, 2010; David Cross, 2013; Dunlop, 2012). However, they would probably need to pick one or two key policy issues that they hold dear and decide on what strategies they would use to influence both the agenda-setting and the policymaking process, and on which level(s) they would focus efforts. Also, they will need to develop (more) tools, activities and platforms that allow them to continue to work for the advent of the change they all want in global health, not just every two years when they gather as a prelude to the Global Health System symposium, but throughout the year. What about developing and consolidating research collaborations between members? What about having more institutionalised communication platforms beyond social media? What about defining the(ir) narrative that they would like to see incorporated into the global health agenda? What are the innovative policy ideas that the group wants to see implemented and disseminated at the country level or across development organisations? The diversity of EV4GH in terms of academic and professional background, geographical origin and institutional belonging are probably the main assets of this epistemic community in the making, and also a guarantee for its global impact.
These are questions for EVs2018 and EV Alumni to think about as we approach the close of the 2018 edition of this national and global health influencer “factory”. The EV secretariat in Bangalore, the governance team and EV4GH network of alumni have certainly taken steps forward in recent years, including in ensuring continuity and activity between ventures, but becoming a full-fledged ‘epistemic community’ is probably key to “taking EV4GH to the next level” in the years to come.