The Role of Science Advisory Boards in US Federal Health Policy
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In the context of scarce financial resources for government programs in both the United States and internationally, efforts to develop health policies that are informed by evidence may increase in the coming years. In the United States, policymakers repeatedly attempt to integrate research and evidence into the policy process by establishing federal advisory committees (FACs) under the purview of the Federal Advisory Committee Act (FACA) of 1972. Although FACA committees have existed for 40 years, are used frequently by the executive branch, and have accounted for $3.4 billion in government spending between 2002 and 2011, they remain “little-known [and] little-studied” (McApline and LeDonne, 1993). Two case studies were conducted for this dissertation using a multiple-case study design and a grounded theory approach to data analysis. The overall aim was to describe how FACs play a role in the policy process. The two cases were the science advisory board to the President’s Emergency Plan for AIDS Relief and the National Climate Assessment and Development Advisory Committee, established by the US Department of State and the Department of Commerce, respectively. Semi-structured interviews were conducted with purposively-selected FAC members and staff from government agencies and non-governmental organizations (NGOs). Interview transcripts were coded using Atlas/ti following the grounded theory method outlined by Charmaz. Documents from FAC proceedings were also analyzed. Data collection was concluded when theoretical saturation was achieved. Findings suggest that FACA committees are heterogeneous in their primary objectives, operating structures, decision-making processes, and methods of engaging with NGOs. In addition, ambiguity in the FACA language and the politically sensitive nature of selecting members complicates efforts to establish a FAC. However, in spite of the differences across FACA committees and the difficulties encountered by government agencies when establishing them, findings indicate that FACs can be effective as mechanisms for agencies to obtain specific and broad guidance from independent experts on scientific matters of concern to the agency. The extent to which recommendations from FACs are adopted by the establishing agency is influenced by the perspectives of the executive and legislative branches on the value of evidence-based policy, as well as the perspective of the agency administrator.