Governance Level: state & provincial

Four steps to precision public health

Curated on Posted on by Stefaan Verhulst
Scott F. Dowell, David Blazes & Susan Desmond-Hellmann at Nature: “When domestic transmission of Zika virus was confirmed in the United States in July 2016, the entire country was not declared at risk — nor even the entire state of Florida. Instead, precise surveillance defined two at-risk areas of Miami-Dade County, neighbourhoods measuring just 2.6 and 3.9 square kilometres. Travel advisories and mosquito control focused on those regions. Six weeks later, ongoing surveillance convinced officials to lift restrictions in one area and expand the other.

By contrast, a campaign against yellow fever launched this year in sub-Saharan Africa defines risk at the level of entire nations, often hundreds of thousands of square kilometres. More granular assessments have been deemed too complex.

The use of data to guide interventions that benefit populations more efficiently is a strategy we call precision public health. It requires robust primary surveillance data, rapid application of sophisticated analytics to track the geographical distribution of disease, and the capacity to act on such information1.

The availability and use of precise data is becoming the norm in wealthy countries. But large swathes of the developing world are not reaping its advantages. In Guinea, it took months to assemble enough data to clearly identify the start of the largest Ebola outbreak in history. This should take days. Sub-Saharan Africa has the highest rates of childhood mortality in the world; it is also where we know the least about causes of death…..

The value of precise disease tracking was baked into epidemiology from the start. In 1854, John Snow famously located cholera cases in London. His mapping of the spread of infection through contaminated water dealt a blow to the idea that the disease was caused by bad air. These days, people and pathogens move across the globe swiftly and in great numbers. In 2009, the H1N1 ‘swine flu’ influenza virus took just 35 days to spread from Mexico and the United States to China, South Korea and 12 other countries…

The public-health community is sharing more data faster; expectations are higher than ever that data will be available from clinical trials and from disease surveillance. In the past two years, the US National Institutes of Health, the Wellcome Trust in London and the Gates Foundation have all instituted open data policies for their grant recipients, and leading journals have declared that sharing data during disease emergencies will not impede later publication.

Meanwhile, improved analysis, data visualization and machine learning have expanded our ability to use disparate data sources to decide what to do. A study published last year4 used precise geospatial modelling to infer that insecticide-treated bed nets were the single most influential intervention in the rapid decline of malaria.

However, in many parts of the developing world, there are still hurdles to the collection, analysis and use of more precise public-health data. Work towards malaria elimination in South Africa, for example, has depended largely on paper reporting forms, which are collected and entered manually each week by dozens of subdistricts, and eventually analysed at the province level. This process would be much faster if field workers filed reports from mobile phones.

Sources: Ref. 8/Bill & Melinda Gates Foundation

…Frontline workers should not find themselves frustrated by global programmes that fail to take into account data on local circumstances. Wherever they live — in a village, city or country, in the global south or north — people have the right to public-health decisions that are based on the best data and science possible, that minimize risk and cost, and maximize health in their communities…(More)”

21st Century Enlightenment Revisited

Curated on Posted on by Stefaan Verhulst

Matthew Taylor at the RSA: “The French historian Tzvetan Todorov describes the three essential ideas of the Enlightenment as ‘autonomy’, ‘universalism’ and ‘humanism’. The ideal of autonomy speaks to every individual’s right to self-determination. Universalism asserts that all human beings equally deserve basic rights and dignity (although, of course, in the 18th and 19th century most thinkers restricted this ambition to educated white men). The idea of humanism is that it is up to the people – not Gods or monarchs – through the use of rational inquiry to determine the path to greater human fulfilment….

21st Century Enlightenment 

Take autonomy; too often today we think of freedom either as a shrill demand to be able to turn our backs on wider society or in the narrow possessive terms of consumerism. Yet, brain and behavioural science have confirmed the intuition of philosophers through the ages genuine autonomy is something we only attain when we become aware of our human frailties and understand our truly social nature. Of course, freedom from oppression is the base line, but true autonomy is not a right to be granted but a goal to be pursued through self-awareness and engagement in society.

What of universalism, or social justice as we now tend to think of it? In most parts of the world and certainly in the West there have been incredible advances in equal rights. Discrimination and injustice still exist, but through struggle and reform huge strides have been made in widening the Enlightenment brotherhood of rich white men to women, people of different ethnicity, homosexuals and people with disabilities. Indeed the progress in legal equality over recent decades stands in contrast to the stubborn persistence, and even worsening, of social inequality, particularly based on class.

But the rationalist universalism of human rights needs an emotional corollary. People may be careful not to use the wrong words, but they still harbour resentment and suspicion towards other groups. …

Finally, humanism or the call of progress. The utilitarian philosophy that arose from the Enlightenment spoke to the idea that, free from the religious or autocratic dogma, the best routes to human fulfilment could be identified and should be pursued. The great motors of human progress – markets, science and technology, the modern state – shifted into gear and started to accelerate. Aspects of all these phenomena, indeed of Enlightenment ideas themselves, could be found at earlier stages of human history – what was different was the way they fed off each other and became dominant. Yet, in the process, the idea that these forces could deliver progress often became elided with the assumption that their development was the same as human progress.

Today this danger of letting the engines of progress determine the direction of the human journey feels particularly acute in relation to markets and technology. There is, for example, more discussion of how humans should best adapt to AI and robots than about how technological inquiry might be aligned with human fulfilment. The hollowing out of democratic institutions has diminished the space for public debate about what progress should comprise at just the time when the pace and scale of change makes those debates particularly vital.

A twenty first century enlightenment reinstates true autonomy over narrow ideas of freedom, it asserts a universalism based not just on legal status but on empathy and social connection and reminds us that humanism should lie at the heart of progress.

Think like a system act like an entrepreneur

There is one new strand I want to add to the 2010 account. In the face of many defeats, we must care as much about how we achieve change as about the goals we pursue. At the RSA we talk about ‘thinking like a system and acting like an entrepreneur’, a method which seeks to avoid the narrowness and path dependency of so many unsuccessful models of change. To alter the course our society is now on we need more fully to understand the high barriers to change but then to act more creatively and adaptively when we spot opportunities to take a different path….(More)”

Saving Science

Curated on Posted on by Stefaan Verhulst

Daniel Sarewitz at the New Atlantis: “Science, pride of modernity, our one source of objective knowledge, is in deep trouble. Stoked by fifty years of growing public investments, scientists are more productive than ever, pouring out millions of articles in thousands of journals covering an ever-expanding array of fields and phenomena. But much of this supposed knowledge is turning out to be contestable, unreliable, unusable, or flat-out wrong. From metastatic cancer to climate change to growth economics to dietary standards, science that is supposed to yield clarity and solutions is in many instances leading instead to contradiction, controversy, and confusion. Along the way it is also undermining the four-hundred-year-old idea that wise human action can be built on a foundation of independently verifiable truths. Science is trapped in a self-destructive vortex; to escape, it will have to abdicate its protected political status and embrace both its limits and its accountability to the rest of society.

The story of how things got to this state is difficult to unravel, in no small part because the scientific enterprise is so well-defended by walls of hype, myth, and denial. But much of the problem can be traced back to a bald-faced but beautiful lie upon which rests the political and cultural power of science. This lie received its most compelling articulation just as America was about to embark on an extended period of extraordinary scientific, technological, and economic growth. It goes like this:

Scientific progress on a broad front results from the free play of free intellects, working on subjects of their own choice, in the manner dictated by their curiosity for exploration of the unknown.

 

….The fruits of curiosity-driven scientific exploration into the unknown have often been magnificent. The recent discovery of gravitational waves — an experimental confirmation of Einstein’s theoretical work from a century earlier — provided a high-publicity culmination of billions of dollars of public spending and decades of research by large teams of scientists. Multi-billion dollar investments in space exploration have yielded similarly startling knowledge about our solar system, such as the recent evidence of flowing water on Mars. And, speaking of startling, anthropologists and geneticists have used genome-sequencing technologies to offer evidence that early humans interbred with two other hominin species, Neanderthals and Denisovans. Such discoveries heighten our sense of wonder about the universe and about ourselves.

And somehow, it would seem, even as scientific curiosity stokes ever-deepening insight about the fundamental workings of our world, science managed simultaneously to deliver a cornucopia of miracles on the practical side of the equation, just as Bush predicted: digital computers, jet aircraft, cell phones, the Internet, lasers, satellites, GPS, digital imagery, nuclear and solar power. When Bush wrote his report, nothing made by humans was orbiting the earth; software didn’t exist; smallpox still did.

So one might be forgiven for believing that this amazing effusion of technological change truly was the product of “the free play of free intellects, working on subjects of their own choice, in the manner dictated by their curiosity for exploration of the unknown.” But one would be mostly wrong.

Science has been important for technological development, of course. Scientists have discovered and probed phenomena that turned out to have enormously broad technological applications. But the miracles of modernity in the above list came not from “the free play of free intellects,” but from the leashing of scientific creativity to the technological needs of the U.S. Department of Defense (DOD).

The story of how DOD mobilized science to help create our world exposes the lie for what it is and provides three difficult lessons that have to be learned if science is to evade the calamity it now faces.

First, scientific knowledge advances most rapidly, and is of most value to society, not when its course is determined by the “free play of free intellects” but when it is steered to solve problems — especially those related to technological innovation.

Second, when science is not steered to solve such problems, it tends to go off half-cocked in ways that can be highly detrimental to science itself.

Third — and this is the hardest and scariest lesson — science will be made more reliable and more valuable for society today not by being protected from societal influences but instead by being brought, carefully and appropriately, into a direct, open, and intimate relationship with those influences….(More)”

Future of e-government: learning from the past

Curated on Posted on by Stefaan Verhulst

Special issue of SOCRATES edited by Manoj Dixit: “We are living in an era of digitization thus moving towards a digital government. The use of ICT in public-administration is beneficial and it is not mere a coincidence that the top 10 countries in e-government implementation (according to UN E-Government Survey 2016) are flourishing democracies. There has been a sharp rise in the number of countries using e-government to provide public services online through one stop-platform. According to the 2016 survey, 90 countries now offer one or more single entry portal on public information or online services, or both and 148 countries provide at-least one form of online transaction services. More and more countries are making efforts through e-government to ensure and increase inclusiveness, effectiveness, accountability and transparency in their public institutions. Across the globe, data for public information and security is being opened up. The 2016 survey shows that 128 countries now provide data-sets on government spending in machine readable formats. E-government and innovation seems to have provided significant opportunities to transform public administration into an instrument of sustainable development. The governments around the globe are rapidly transforming. The use of information and communication technology in public administration – combined with organizational change and new skills- seems to be improving public services and democratic processes and strengthening support to public policies. There has been an increased effort to utilize advanced electronic and mobile services that benefits all. Fixed and wireless broadband subscriptions have increased unevenly across regions, with Europe leading, but Africa still lagging behind. We have to focus on these substantial region disparities and growing divide. All countries agreed, in SDG 9, that a major effort is required to ensure universal access to internet in the least developed countries. The rise of Social media and its easy access seems to have enabled an increasing number of countries moving towards participatory decision making, in which developed European countries are among the top 50 performers. But, the issues of diminishing collective thinking and rising Individual thinking are some rising issues that we will have to deal with in the future. There are more sensitive issues like the new classification of citizens into literate-illiterate, e-literate and e-illiterate, that the governments need to look upon. It is a good sign that many developing countries are making good progress. Enhanced e-participation can support the realization of the SDGs by enabling more participatory decision making, but the success of e-government will ultimately depend upon our ability and capability to solve the contrasting issues raised due to this transition with sensitivity.

In this issue of SOCRATES we have discussed, this new era of Digital Government. We have focused on what we have learned from the past and the future we want. From discussions on the role of e-governance within the local government settings in a modern democratic state to the experience of an academia with online examination, we have tried to include every possible aspect of e-government….(More)”

Toward Evidence-Based Open Governance by Curating and Exchanging Research: OGRX 2.0

Curated on Posted on by Stefaan Verhulst

Andrew Young and Stefaan Verhulst at OGRX : “The Open Governance Research Exchange (OGRX) is a platform that seeks to identify, collect and share curated insights on new ways of solving public problems. It was created last year by the GovLab, World Bank Digital Engagement Evaluation Team and mySociety. Today, while more than 3000 representatives from more than 70 countries are gathering in Paris for the Open Government Partnership Summit, we are launching OGRX 2.0 with new features and functionalities to further help users identify the signal in the noise of research and evidence on more innovative means of governing….

What is new?

First, the new OGRX Blog provides an outlet for more easily digestible and shareable insights from the open governance research community. OGRX currently features over 600 publications on governance innovation – but how to digest and identify insights? This space will provide summaries of important works, analyses of key trends in the field of research, and guest posts from researchers working at the leading edge of governance innovation across regions and domains. Check back often to stay on top of what’s new in open governance research.

Second, the new OGRX Selected Readings series offers curated reading lists from well-known experts in open governance. These Selected Readings will give readers a sense of how to jumpstart their knowledge by focusing on those publications that have been curated by those in the known about the topics at hand. Today we are launching this new series with the Selected Readings on Civic Technology, curated by mySociety’s head of research Rebecca Rumbul; and the Selected Readings on Policy Informatics, curated by Erik Johnston of the MacArthur Foundation Research Network on Opening Governance and director of the Arizona State University Center for Policy Informatics. New Selected Readings will be posted each month, so check back often!…Watch this space and #OGRX to stay abreast of new developments….”

Fighting Exclusion, Inequality and Distrust: The Open Government Challenge

Curated on Posted on by Stefaan Verhulst

Remarks by Manish Bapna delivered at the Open Government Partnership Global Summit: “To the many heads of state, ministers, mayors, civil society colleagues gathered in this great hall, this is an important moment to reflect on the remarkable challenges of the past year.

We have seen the rise of various forms of populism and nationalism in the United States, Britain, the Philippines, Italy, and many other countries. This has led to surprise election results and an increase in anti-immigrant and anti-government movements.

We have seen the tragic results of conflict-driven migration, as captured in the iconic image of a three-year-old boy whose body washed up on the Turkish shore.

We have seen governments struggle to respond to the refugee crisis. Some open their arms while others close their doors.

We have seen deadly terrorist attacks in cities around the world – including this one — that have forced governments to walk a fine line between the need to protect their people and the risk of infringing on their civil liberties.

And we continue to confront two inter-linked challenges: the moral challenge of 700 million people in extreme poverty, living on less than $2 a day, and the existential challenge of a changing climate.

All of these point to a failure of governance and, if we are honest, to a lack of open government that truly connects, engages and meets the needs of all people.

World’s Problems Can’t Be Solved Without Open Government

The crux of the matter is this: While open government alone can’t fix the world’s problems, they can’t be solved without it.

Too many people feel excluded and marginalized. They believe that only elites reap the benefits of growth and globalization. They feel left out of decision-making. They distrust public institutions.

How we collectively confront these challenges will be OGP’s most important test….

Here are five essential steps we can take – we, the people here today – to help accelerate the shift toward open government.

The first step: We must protect civic space – the rights to free speech, assembly and association – because these bedrock rights are at the heart of a functioning society. Serious violations of these rights have been recently reported by CIVICUS in over 100 countries. In 25 active OGP countries, these rights are repressed or obstructed….

The second step: We must foster citizen-centered governance.

We cherish OGP as a unique platform where government and civil society are equal partners in a way that amplifies the concerns of ordinary citizens.

We commend the many OGP countries that have made significant strides. But we recognize that for others, this remains a major struggle.

As heads of state and ministers, we need you to embrace the concept of co-creation. …

The third step: We must make changes that are transformational, not incremental.

Drawing on our commitment to open government and the urgency of this moment, we must be willing to go further, faster…..

Transforming government brings us to the fourth step.

We need to make a real difference in people’s lives.

This is our Partnership’s ultimate aim. Because when open government works, it improves every facet of people’s lives.

• This means giving all people safe drinking water and clean air.
• It means reliable electricity so children can have light to do homework and play.
• It means health clinics where the sick can go to get quality care, where medicines are available
• And it means building trust in public officials who are untainted by corruption….

The fifth and final step: We need to reinvigorate the Partnership’s political leadership….(More)”

‘’Everyone sees everything’: Overhauling Ukraine’s corrupt contracting sector

Curated on Posted on by Stefaan Verhulst

Open Contracting Stories: “When Yuriy Bugay, a Maidan revolutionary, showed up for work at Kiev’s public procurement office for the first time, it wasn’t the most uplifting sight. The 27-year-old had left his job in the private sector after joining a group of activists during the protests in Kiev’s main square, with dreams of reforming Ukraine’s dysfunctional public institutions. They chose one of the country’s most broken sectors, public procurement, as their starting point, and within a year, their project had been adopted by Ukraine’s economy ministry, Bugay’s new employer.

…The initial team behind the reform was made up of an eclectic bunch of several hundreds volunteers that included NGO workers, tech experts, businesspeople and civil servants. They decided the best way to make government deals more open was to create an e-procurement system, which they called ProZorro (meaning “transparent” in Ukrainian). Built on open source software, the system has been designed to make it possible for government bodies to conduct procurement deals electronically, in a transparent manner, while also making the state’s information about public contracts easily accessible online for anyone to see. Although it was initially conceived as a tool for fighting corruption, the potential benefits of the system are much broader — increasing competition, reducing the time and money spent on contracting processes, helping buyers make better decisions and making procurement fairer for suppliers….

In its pilot phase, ProZorro saved over UAH 1.5 billion (US$55 million) for more than 3,900 government agencies and state-owned enterprises across Ukraine. This pilot, which won a prestigious World Procurement Award in 2016, was so successful that Ukraine’s parliament passed a new public procurement law requiring all government contracting to be carried out via ProZorro from 1 August 2016. Since then, potential savings to the procurement budget have snowballed. As of November 2016, they stand at an estimated UAH 5.97 billion (US$233 million), with more than 15,000 buyers and 47,000 commercial suppliers using the new system.

At the same time, the team behind the project has evolved and professionalized….(More)”

Scaling accountability through vertically integrated civil society policy monitoring and advocacy

Curated on Posted on by Stefaan Verhulst

Working paper by Jonathan Fox: “…argues that the growing field of transparency, participation and accountability (TPA) needs a conceptual reboot, to address the limited traction gained so far on the path to accountability. To inform more strategic approaches and to identify the drivers of more sustainable institutional change, fresh analytical work is needed.

The paper makes the case for one among several possible strategic approaches by distinguishing between ‘scaling up’ and ‘taking scale into account’, going on to examine several different ways that ‘scale’ is used in different fields.

It goes on to explain and discuss the strategy of vertical integration, which involves multi-level coordination by civil society organisations of policy monitoring and advocacy, grounded in broad pro-accountability constituencies. Vertical integration is discussed from several different angles, from its roots in politcal economy to its relationship with citizen voice, its capacity for multi-directional communication, and its relationship with feedback loops.

To spell out how this strategy can empower pro accountability actors, the paper contrasts varied terms of engagement between state and society, proposing a focus on collaborative coalitions as an alternative to the conventional dichotomy between confrontation and constructive engagement.

The paper continues by reviewing existing multi-level approaches, summarising nine cases – three each in the Philippines, Mexico and India – to demonstrate what can be revealed when TPA initiatives are seen through the lens of scale.

It concludes with a set of broad analytical questions for discussion, followed by testable hypotheses proposed to inform future research agendas.(Download the paper here, and a short summary here)…(More)”

Maybe the Internet Isn’t a Fantastic Tool for Democracy After All

Curated on Posted on by Stefaan Verhulst

 in NewYork Magazine: “My favorite story about the internet is the one about the anonymous Japanese guy who liberated Czechoslovakia. In 1989, as open dissent was spreading across the country, dissidents were attempting to coordinate efforts outside the watchful eye of Czechoslovak state security. The internet was a nascent technology, and the cops didn’t use it; modems were banned, and activists were able to use only those they could smuggle over the border, one at a time. Enter our Japanese guy. Bruce Sterling, who first told the story of the Japanese guy in a 1995 Wired article, says he talked to four different people who’d met the quiet stranger, but no one knew his name. What really mattered, anyway, is what he brought with him: “a valise full of brand-new and unmarked 2400-baud Taiwanese modems,” which he handed over to a group of engineering students in Prague before walking away. “The students,” Sterling would later write, “immediately used these red-hot 2400-baud scorcher modems to circulate manifestos, declarations of solidarity, rumors, and riot news.” Unrest expanded, the opposition grew, and within months, the Communist regime collapsed.

Is it true? Were free modems the catalyst for the Velvet Revolution? Probably not. But it’s a good story, the kind whose logic and lesson have become so widely understood — and so foundational to the worldview of Silicon Valley — as to make its truth irrelevant. Isn’t the best way to fortify the town square by giving more people access to it? And isn’t it nice to know, as one storied institution and industry after another falls to the internet’s disrupting sword, that everything will be okay in the end — that there might be some growing pains, but connecting billions of people to one another is both inevitable and good? Free speech will expand, democracy will flower, and we’ll all be rich enough to own MacBooks. The new princes of Silicon Valley will lead us into the rational, algorithmically enhanced, globally free future.

Or, they were going to, until earlier this month. The question we face now is: What happens when the industry destroyed is professional politics, the institutions leveled are the same few that prop up liberal democracy, and the values the internet disseminates are racism, nationalism, and demagoguery?

Powerful undemocratic states like China and Russia have for a while now put the internet to use to mislead the public, create the illusion of mass support, and either render opposition invisible or expose it to targeting…(More)”

Making the Case for Evidence-Based Decision-Making

Curated on Posted on by Stefaan Verhulst
Jennifer Brooks in Stanford Social Innovation Review: “After 15 years of building linkages between evidence, policy, and practice in social programs for children and families, I have one thing to say about our efforts to promote evidence-based decision-making: We have failed to capture the hearts and minds of the majority of decision-makers in the United States.

I’ve worked with state and federal leadership, as well as program administrators in the public and nonprofit spheres. Most of them just aren’t with us. They aren’t convinced that the payoffs of evidence-based practice (the method that uses rigorous tests to assess the efficacy of a given intervention) are worth the extra difficulty or expense of implementing those practices.

Why haven’t we gotten more traction for evidence-based decision-making? Three key reasons: 1) we have wasted time debating whether randomized control trials are the optimal approach, rather than building demand for more data-based decision-making; 2) we oversold the availability of evidence-based practices and underestimated what it takes to scale them; and 3) we did all this without ever asking what problems decision-makers are trying to solve.

If we want to gain momentum for evidence-based practice, we need to focus more on figuring out how to implement such approaches on a larger scale, in a way that uses data to improve programs on an ongoing basis….

We must start by understanding and analyzing the problem the decision-maker wants to solve. We need to offer more than lists of evidence-based strategies or interventions. What outcomes do the decision-makers want to achieve? And what do data tell us about why we aren’t getting those outcomes with current methods?…

None of the following ideas is rocket science, nor am I the first person to say them, but they do suggest ways that we can move beyond our current approaches in promoting evidence-based practice.

1. We need better data.

As Michele Jolin pointed out recently, few federal programs have sufficient resources to build or use evidence. There are limited resources for evaluation and other evidence-building activities, which too often are seen as “extras.” Moreover, many programs at the local, state, and national level have minimal information to use for program management and even fewer staff with the skills required to use it effectively…

 

2. We should attend equally to practices and to the systems in which they sit.

Systems improvements without changes in practice won’t get outcomes, but without systems reforms, evidence-based practices will have difficulty scaling up. …

3. You get what you pay for.

One fear I have is that we don’t actually know whether we can get better outcomes in our public systems without spending more money. And yet cost-savings seem to be what we promise when we sell the idea of evidence-based practice to legislatures and budget directors….

4. We need to hold people accountable for program results and promote ongoing improvement.

There is an inherent tension between using data for accountability and using it for program improvement….(More)”

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