When a deadly virus strikes, an earthquake erupts, or biological agents are released, governments respond. Officials develop solutions to the crisis because, as all can see, the need is evident. A better game plan: anticipate risks, even those not easily identifiable, and prepare beforehand.
Preparedness is the policy challenge posed by Rob DeLeo, Assistant Professor of Global Public Policy in the Department of Global Studies at Bentley University, in his new book, Anticipatory Policymaking: When Government Acts to Prevent Problems and Why It is So Difficult.
“We ask our public officials to help stave off threats but legislative policymakers leave them without the funding and means to prepare in advance of a crisis,” DeLeo said.
Policymakers often wait for a “focusing event”—a problem that blows up—to motivate an action plan. This remarkably untenable situation led DeLeo to the idea of “anticipatory policymaking.”
In order to anticipate rather than react, policymakers have to think differently, he said. The patterns of behavior within institutions—both political and administrative—must change. The first step involves getting policymakers to pay attention to issues they tend to avoid, which is not easy, said DeLeo.
Across most domains—public health, emerging technologies, disaster policy—spending on relief far outpaces spending on preparedness. Governments are reluctant to dedicate scarce resources to problems that may or may not exist. In the absence of a tangible threat, the issue is set aside, as with climate change or earthquake and hurricane preparedness.
The resistance is not just political and institutional. “There are cognitive barriers to thinking about the future and acting on the future,” he said. “In fairness to policymakers, there are a lot of pressing issues that we face in the present. We tend to think about the here and now.”
As a scholar, DeLeo has considered three main mechanisms that do indeed draw the attention of policymakers. One is a focusing event, which is, unfortunately, reactive; another is feedback, which is limited, in that it occurs only when existing policy is evaluated; but the third—the use of indicators—holds promise.
Indicators are simply the measures or metrics of a problem, such as annual smoking rates, economic fluctuations, and so on. When it comes to diseases, for example, indicators are relatively unambiguous: the number of cases, the number of deaths.
And, as DeLeo describes, indicators can be used to develop more complex types of awareness. Quantitative information allows experts to forecast emerging trends in disease, to look at patterns, and to make predictions as to how a disease is going to evolve and what must be done to prepare for it. If interpreted correctly, indicators can imply future trends.
“For example, indicators are critical to avian influenza—or bird flu—preparedness because without those measures of cases and deaths, you are operating blindly, more or less,” said DeLeo. “Avian influenza is but one of a number of emerging diseases. Zika and other viruses, such as SARS, are also deadly diseases with indicators that serve as warning signs.”
Indicators can move governments to recognize and acknowledge an issue—to pay attention—but only if they are defined as being emblematic of an emerging crisis. This is no small task, and DeLeo notes the political world is rife with competing narratives that seek to promote or block an issue’s ascent onto the crowded government agenda.
DeLeo also examined the difficulties involved in policy implementation, particularly the common political desire to see obvious results for resources spent. “When it comes to planning for an emerging disease, producing a clear cause and effect dynamic isn’t really possible,” said DeLeo. “Consider avian influenza. If you were to wonder how successful our pandemic planning was, you couldn't test that within the context of an outbreak because we didn't have one.”
In his book, DeLeo offers policy research and theory to counter that challenge, as he does many more, because, as he puts it: preparedness needs to happen everywhere.
“Preparedness is of course something that government institutions need to do but it's also something that needs to occur from the bottom up as well. It needs to happen on the national and state level—and the household level as well,” he said.
“When people begin to think about how to respond to these disasters, they are in a better position to weather the storms.”
Dr. Rob DeLeo is a member of Bentley’s Health Thought Leadership Network; an earlier version of this article first appeared on their site.