The increasing use of evidence-based interventions in humanitarian relief efforts had significantly improved outcomes, Burnet director Professor Michael Toole AM wrote in The Lancet this month.
But he cautioned humanitarians in the medical and public health arenas to remember their aim was to provide the ‘most effective interventions for the most vulnerable’, not to produce evidence.
Professor Toole and co-writer Ronald J. Waldman from the Milken Institute School of Public Health in Washington DC, were writing in an editorial for a new Lancet Series on health in humanitarian crises.
They referenced early writing about humanitarian emergencies on the 1947 partition of Pakistan and India, and later the East Bengal cyclone of 1970, saying that while relief supplies poured in, the scale or geographic distribution of need was unknown.
“Impressions, best intentions, and customary practices were the rule at the time, and health interventions were rarely supported by epidemiological or clinical studies.”
Decades later, ‘the transition from [relief] based on anecdotal evidence to methods that prioritize hard data has led to astonishing improvements in performance’, they wrote. However anecdote remained too often the basis for health interventions.
“Two fundamental questions should underlie all evidence-generating activities: which interventions of established effectiveness in non-emergency settings remain effective in emergencies and, if the established means of delivering those interventions need to be modified, what is the best way to ensure that the population in need derives maximum benefit from them?”
Political interests, available funding, and other non-scientific factors would always be part of the humanitarian decision-making process, they wrote.
“Yet, our work can only be accomplished if the evidence-based principles that are so fundamental to medicine and public health are given the greatest possible consideration in determining what gets done.”
Read the full text at The Lancet.