Erik Millstone

A Collaboratively-Derived Science-Policy Research Agenda

The need for policy makers to understand science and for scientists to understand policy processes is widely recognised. However, the science-policy relationship is sometimes difficult and occasionally dysfunctional; it is also increasingly visible, because it must deal with contentious issues, or itself becomes a matter of public controversy, or both. We suggest that identifying key unanswered questions on the relationship between science and policy will catalyse and focus research in this field. To identify these questions, a collaborative procedure was employed with 52 participants selected to cover a wide range of experience in both science and policy, including people from government, non-governmental organisations, academia and industry. These participants consulted with colleagues and submitted 239 questions. An initial round of voting was followed by a workshop in which 40 of the most important questions were identified by further discussion and voting. The resulting list includes questions about the effectiveness of science-based decision-making structures; the nature and legitimacy of expertise; the consequences of changes such as increasing transparency; choices among different sources of evidence; the implications of new means of characterising and representing uncertainties; and ways in which policy and political processes affect what counts as authoritative evidence. We expect this exercise to identify important theoretical questions and to help improve the mutual understanding and effectiveness of those working at the interface of science and policy.

BSE : risk, science, and governance

1. Introduction 2. Analysing the role of science in public policy-making 3. The evolution of UKs agriculture and food policy regimes 4. A new cattle disease 5. The Southwood Working Party 6. Regulatory rigor mortis 7. BSE policy in Continental Europe 8. The aftermath of 20 March 1996 9. BSE and the partial reform of food policy making 10. Summary and conclusions Bibliography Index

Context for the PorGrow study: Europe’s obesity crisis

The Policy Options for Responding to the Growing Challenge of Obesity Research Project (PorGrow) study was conducted at a time when the prevalence levels of overweight and obesity among both adults and children had been rising for over a decade in most countries in Europe. The reasons are assumed to be related to changes in dietary patterns and in patterns of physical activity, and may be linked to economic as well as socio‐environmental influences on behaviour. Inequalities in the distribution of obesity across different socio‐economic groups are also apparent. The demographic and secular trends have led to increasing concern among policymakers over the costs of obesity‐related disease to the health services and to the economy generally. In response, a series of policy initiatives have been considered among the countries participating in the PorGrow study.

The PorGrow project: overall cross-national results, comparisons and implications.

European policymakers need more information on policy responses to obesity that stakeholders judge effective and acceptable. The Policy Options for Responding to the Growing Challenge of Obesity Research Project gathered such intelligence by interviewing key stakeholder groups in nine countries. Interviews used an innovative multi‐criteria mapping (MCM) methodology that gathers quantitative and qualitative information on the stakeholders’ perceptions and judgements. Aggregating across all participants, a comprehensive portfolio of policy measures, integrated into a coherent programme, would be well‐supported by broad coalitions of stakeholders. Those portfolios should include measures (i) to provide improved educations in schools and to the general adult population; (ii) measures to improve access to and incentives for physical activity; (iii) measures to improve information about both foods and physical activity and (iv) changes to the supply of and demand for foodstuffs. There was little support for fiscal measures and technological ‘fixes’; they were judged ineffective and unacceptable. Significant differences were found across European regions, and across different stakeholder perspectives, but not across genders. There is a strong case for improved monitoring of body mass index levels, dietary habits and physical activity. An MCM study can effectively cover several countries, rather than being confined to just one, and generate both national and cross‐national policy analyses and proposals.

Politics of expert advice: Lessons from the early history of the BSE saga

This paper analyses the dynamics of the interactions between scientific and non-scientific considerations in providing scientific advice to policy, focusing on the first scientific committee to advise on BSE (bovine spongiform encephalopathy) policy-making in the UK and the political and social roles it was expected to play, and in practice played, in policy-making. The paper argues that the Committee was both deliberately and inadvertently utilised to provide spurious scientific legitimation for policy decisions which government officials believed ministers, other government departments, the meat industry and the general public might not otherwise accept. It demonstrates how those social roles rendered the spectrum of policy choices available on BSE opaque, allowed officials to undermine the democratic accountability of ministers, and contributed to making a very serious problem considerably worse. Some practical lessons are outlined for the organisation of scientific expertise in political affairs. Copyright , Beech Tree Publishing.

Beyond skeptical relativism: evaluating the social constructions of expert risk assessments

Constructivist analyses of risk regulation are typically agnostic about what should count as robust or reliable knowledge. Indeed, constructivists usually portray competing accounts of risk as if they were always equally contingent or engaged with different and incommensurable issues and problem definitions. This article argues that assumptions about the equal reliability of competing accounts of risk deserve to be, and sometimes can be, examined empirically. A constructivist approach grounded in epistemological realism is outlined and applied empirically to a particular comparative U.S./U.K. case study of pesticide regulation. The article argues that while the scope for interpretative flexibility when addressing risk issues is clearly extensive, it is not unconstrained. By scrutinizing the structure and coherence of particular risk assessments and policy decisions by reference to both empirical evidence and commonly held robust standards of interpretation, the article argues that the U.K. evaluation was not only less precautionary than its U.S. equivalent, but it was also less well constructed and therefore less reliable. Several social and institutional characteristics of U.S. and U.K. policy making are highlighted that appear variously to facilitate or inhibit the production of reliable knowledge and the making of prudent policy decisions.

A crisis of trust: for science, scientists or for institutions?

Stem cell research, xenotransplantation and somatic and germ line gene therapy are examples of emerging technologies that, if successful, will forever change the way we live. But how well does the public understand the benefits and risks of these technologies, and whose responsibility is it to communicate them? Here, Erik Millstone and Patrick van Zwanenberg of the University of Sussex, UK, discuss whether science is suffering because of a lack of transparency in presenting scientific information to its main consumer group—the general public.

Methodology for obtaining stakeholder assessments of obesity policy options in the PorGrow project

The Policy Options for Responding to the Growing Challenge of Obesity Research Project (PorGrow) study provided a unique opportunity to develop a large‐scale application of a semi‐quantitative technique for exploring interviewees’ views on options to tackle obesity, using multi‐criteria mapping. This ‘heuristic’ approach utilizes the advantages of a structured interviews framework by predefining a set of options for appraisal, while leaving interviewees free to select their own criteria for making their judgements. Additional information can be gleaned from the interview transcripts and related materials to set the appraisals in their policy context, and allowing interviewees to express their views on the options presented and their own appraisals. The PorGrow study team agreed a predefined set of 20 options for appraisal, and interviewed sets of stakeholders representing more than 20 aspects of policy development in each of the nine participating countries. The details of the methodology adopted are set out in this paper.

Policy options for responding to the growing challenge from obesity in the United Kingdom

The aim of this study was to map and analyse how key stakeholders evaluated options for dealing with the rising incidence of obesity in the UK, as part of a wider cross‐national study in nine European countries. Multi‐criteria mapping was used to capture the ways in which different policy options were evaluated by a variety of key stakeholders. ‘Positive societal benefits’ was among the criteria most often selected by participants to assess the options and was generally considered more important than costs. Of the seven pre‐defined options that all participants appraised, those related to increasing opportunities for physical activity received the highest rankings, and fiscal measures the lowest. Educational measures fared best among the remaining 13 discretionary options while technological measures performed poorly. No one option, or group of options, was considered sufficient to address the obesity problem. Rather, a general consensus was evident in support of mutually reinforcing measures related to education, information, healthier food and physical activity. Although obesity policies are currently emerging in these different areas in the UK, there is a need for them to be better coordinated, and for improved surveillance to estimate their effectiveness in reversing the trend in obesity.

Developing national obesity policy in middle-income countries: a case study from North Africa

Background The prevalence of overweight and obesity is a rapidly growing threat to public health in both Morocco and Tunisia, where it is reaching similar proportions to high-income countries. Despite this, a national strategy for obesity does not exist in either country. The aim of this study was to explore the views of key stakeholders towards a range of policies to prevent obesity, and thus guide policy makers in their decision making on a national level. Methods Using Multicriteria Mapping, data were gathered from 82 stakeholders (from 33 categories in Morocco and 36 in Tunisia) who appraised 12 obesity policy options by reference to criteria of their own choosing. Results The feasibility of policies in practical or political terms and their cost were perceived as more important than how effective they would be in reducing obesity. There was most consensus and preference for options targeting individuals through health education, compared with options that aimed at changing the environment, i.e. modifying food supply and demand (providing healthier menus/changing food composition/food sold in schools); controlling information (advertising controls/mandatory labelling) or improving access to physical activity. In Tunisia, there was almost universal consensus that at least some environmental-level options are required, but in Morocco, participants highlighted the need to raise awareness within the population and policy makers that obesity is a public health problem, accompanied by improving literacy before such measures would be accepted. Conclusion Whilst there is broad interest in a range of policy options, those measures targeting behaviour change through education were most valued. The different socioeconomic, political and cultural contexts of countries need to be accounted for when prioritizing obesity policy. Obesity was not recognized as a major public health priority; therefore, convincing policy makers about the need to prioritize action to prevent obesity, particularly in Morocco, will be a crucial first step.