The politics of policy-making: 

gaining political backing for evidence-based policies

Why does it often happen that a well-written, soundly thought out policy draft ends up being a forgotten document in a desk drawer? What makes them not deserving of the political blessing needed to maneuver through the labyrinths of bureaucracy? 

A public policy is an intentionally chosen and relatively stable course of government action implemented to address collectively shared problems.[i] Governmental policies are aimed at having significant effects on the regulation of social behaviour, and the distribution and redistribution of services, resources and opportunities. Therefore, they have important political impacts on patterns of social conflict and cooperation.

Effective policy experts and managers must be aware of the benefits and constraints of government intervention.  The political analysis of policy-making offers them a methodology of applied research, aimed at developing practical solutions to conflict and negotiation problems, associated with policy-making. The systematic analysis of the challenges and opportunities presented by the politics of policy-making process aids health and drug policy experts to conceive and develop fruitful strategies for managing conflicts and steering situations toward collectively favourable outcomes.

Public policies are complex, evidence-based instruments that involve different government agencies and levels, along with policy activists, non-governmental organizations and other individual and collective stakeholders. They  demand a multidisciplinary problem-solving approach to:

1.    Set-up mandates and priorities, governance institutions, general guidelines, organizations, and the structure of incentives.

2.    Allocate resources for programs and services among different population groups and geographical regions.[ii]

The development of policies requires specialized skills and tools. Social and natural scientific teams are in charge of drafting the policy specifics, top government politicians approve, modify or reject the plan. Nonetheless, in other stages of the process, a large number and wide variety of governmental agencies, non-governmental associations, and international organizations lead the management of programs, projects, and activities necessary to deliver services and enforce regulations. Stakeholders and advocacy groups take a stand for or against the proposed policy, which might have an impact on politicians' preferences and decisions. 

The policy-making cycle

Policy analysts portray the process as a cycle of distinct phases, as shown in Figure 1. In the real world, policy-making undoubtedly is an intricate process. However, it is not a sequence of clearly demarcated stages, nor a messy amalgamation of arbitrary actions. The process can be ideally represented by a simplified model, even recognizing that policy stages can overlap each other and the lines between them tend to be blurred.[iii]

The policy analysis framework offered in this chapter guides policy-makers, decision-makers, implementing agencies and stakeholders in the processes of describing problematic situations, producing evidence-based solutions, implementing interventions, and analyzing reliable information about programme performance.

Policy-making is a continuous process that starts with the diagnosis of the status quo, taking into account the effects of previous interventions or decisions on not to intervene.  After the diagnosis, policy experts produce a precise definition of the problem and propose a set of evidence-based interventions. The experts’ proposal is then presented to involved stakeholders. If the project is supported and approved by key decision-makers, it is ready to be implemented.  Nonetheless, day-to-day practices, resources available at the implementing agencies, and other unforeseen circumstances may lead to different results than those expected. Monitoring and evaluation help to ensure that programs remain on track. Assessments also feed into further decisions on redesigning or maintaining the policy.

Figure 1. Policy-making cycle

 

Crucial aspects of policy making

1.      The making of public policies is dependent on political willingness. Policies only can be designed, approved, implemented and evaluated if the corresponding government agencies are committed and proactive.

2.      Policy formulation should be conducted by a multidisciplinary and multi-sectoral team of experts, exploiting synergies to address the multiple dimensions of the drug problem.

3.      To increase the chances of approval and long-term sustainability, the proponents should create a broad coalition of government agencies, influential individuals and social organizations supporting the policy. 

4.      Policy implementers need to embrace a flexible approach. They must be prepared to adjust time-frames as needed to make the most efficient employment of resources, reduce resistance, and build consensus.

5.      Policies should be firstly implemented in relatively well-known and amenable regions or social sectors to ensure impact and visibility. Early success increases the chances of further support. 

6.      All policies should be regularly monitored, reviewed, and updated after rigorous cost-effectiveness evaluations.

7.      Policy team members should be monitored, informed, encouraged and mentored to achieve targeted results and develop their skills.

 

Problem formulation and agenda-setting

Public policy is what the government decides to do or not to do about problems that require intervention. From the very viewpoint of policy-makers, not all problems deserve being addressed. There are three streams of problems: urgency, political context and policy expertise. When these streams meet, the problem captures the attention of policy-makers and the public. [iv]  

Emergencies garner immediate public attention and generally are addressed straightaway with large-scale government interventions. The management of urgencies should be differentiated from the “fire-fighting” style of crisis management, which just reacts instead of responding to unforeseen problems. The former requires the development of predefined contingency plans. The latter leads to a sequence of improvised and uncoordinated responses, which may end up hampering the effectiveness of well-intentioned interventions. In short, effective public policies are thoughtful, not reactive, responses to urgent problems.

The political context makes some problems more visible than others. The mood of the public towards an issue, advocacy activities of interested parties, upcoming elections or changes in the balance of power among branches of the government, and the role played by influential stakeholders, give more salience to some problems than others. Like the previous one, this approach is reactive. Policies are prompted by the ever-shifting political climate.

Contrastingly, proactive policy experts draw on qualitative, statistical and experimental research for problem definition, solution generation, and evaluation. Based on scientific evidence, they develop recommendations on how to implement effective interventions. However, scientific studies alone do not lead to self-evident conclusions about the importance of an issue. Problems need to be pushed into the public spotlight to get involvement and action from the public and decision makers.

Responsive Policymakers must put together a multidisciplinary team of experienced policy designers –including international experts who have participated in policy-making in comparable countries, to carry out a diagnosis of the situation. The team should hold rounds of examination and analysis of reliable data and scientific approaches to address the problem. Before producing the final draft of the proposal, the team of experts must conduct a series of consultations with multi-sectoral stakeholders.

There is no mechanical procedure to identify and assign priority to a particular policy formulation. Nonetheless, the team of experts might find useful the following rule of thumb:

1.    Identify relevant problems: focus on questions with answers that are relevant for the country (or region of the country) and the period under consideration.

2.    Consider the social relevance, ethical and legal concernment, and technical manageability of the issue. Experts should take into account that:

a.    A problem is socially relevant if it has a substantial impact on a relatively large number of people.

b.    A problem is politically challenging if there is a need to balance the needs, interests, concerns and expectations of different social groups, stakeholders and decision-makers.

c.     A problem is ethically and legally concerning if fundamental liberties and human rights (such as the right to health) are being denied or violated.

d.    A problem is manageable if there is a reliable and affordable way to solve or cope with it.

3.    Set up a system for timely collection of reliable and relevant data, built into the day-to-day routine of the implementing organizations –such as public health units, social service agencies, law enforcement departments, and involved NGOs. An effective system of data collection requires trained staff, adequate equipment and supervision.

4.    Collect only relevant information and apply methods to extract usable data (qualitative and quantitative data mining). If too much information is gathered and reported, data analysis and interpretation will become a time-consuming and expensive process, and their results will probably be less accurate.

5.    Avoid unproven pseudoscientific interventions that inadvertently worsen the problematic situation, funnel scarce resources, and produce undesired side-effects.

Public health, for instance, policies should be rooted in scientific evidence and systematic data collection and rigorous analysis, which is both demanding and time-consuming. Notwithstanding the truth of these premises, timing is urgent. The public and policy-makers often want to see immediate actions and results, and problems do not need to wait for full information to be addressed. Therefore, policy designers have to make rational decisions based on limited information. Drawing on the best information available, the experts produce a thorough draft of the policy, which addresses issues like the following: [v]

1.    Detailed situation analysis based on the best information available on:

a.     Quantitative extension and qualitative relevance of the problem.

b.    Social and economic the unsolved problem.

c.     Current capacities of government agencies, the private sector and non-governmental organizations to implement the policy.

d.    Human rights situation of drug users.    

2.    Precise identification of evidence-based intervention programs, best practices, and expected goals.

3.    Estimation of implementation costs compared to the health, economic and social effects of no intervention.

4.    Assessment of the management capacities and systems of monitoring and control.

5.    The setting of a time frame for achieving specific goals.

Once a proposal has been completely formulated, it should be included on the policy agenda. Policy experts, third-party advocates and supporting activists highlight the visibility of the negative effects of the problem –such as health consequences, medical costs, lost earnings and productivity, social violence, crime and accidents. Advocacy activities raise awareness of the risks associated with the problem to encourage prioritization of public interventions, among the other issues that strive to engage the public and decision-makers. In so doing, policy promoters need to engage in agenda-setting activities such as:

1.      Produce a brief, clear-cut and appealing problem statement so decision-makers and the public can have a precise picture of the objectives of the policy and its expected outcomes. The quality of information available to politicians and the public is crucial to the prospects for “selling” the adoption and implementation of the new policy.

2.      Grab any window of opportunity to influence, persuade and convince stakeholders and decision-makers.

3.      Communicate favourable opinions of national policy experts and respected public figures to influence mass media and social networks and, and consequently, make the public and politicians more confident that the policy will be beneficial.

4.      The weakest and poorly organized beneficiaries, who have little voice in the policy-making process, can be activated and empowered to support the policy. Advocacy groups and organized communities can be crucial in building support to develop and manage effective and popular supported policies.

5.      Policy supporters must identify opponents’ positions and arguments, and perform tactics to engage in win-win negotiations. For example, some public agencies and public influencers may hesitate to back the development a policy due to misinformation, conflict of interests or skepticism. Opportune and precise information may help to ease their concerns and increase their willingness to cooperate.

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References

[i] William N. Dunn (2011). Public Policy Analysis. Pearson Education Inc. New York, NY, p. 3-4. Nicole F. Bernier, Carole Clavier; Public health policy research: making the case for a political science approach, Health Promotion International, Volume 26, Issue 1, 1 March 2011, Pages 109–116, https://doi.org/10.1093/heapro/daq079

[ii] Cf. Theodore J. Lowi (1972).”Four Systems of Policy, Politics, and Choice”. Public Administration Review, 32 (4): 298-310.

[iii] Jos C. N. Raadschelders (2015). Government: A Public Administration Perspective. Routledge, New York, NY, p. 254.

[iv] Kingdon J. Agendas, Alternatives and Public Policies. New York, Haper-Collins Publishers, 1995.

[v] Ver Arnošt Veselý. “Problem Delimitation in public policy analysis.” Central European Journal of Public Policy. 1 (1), 2007: 81-101.