Embedding collaborative priority-setting and adaptation in WHO’s evidence ecosystem

Authors: Trudy D Leong¹, Emmanuel Effa², Nyanyiwe Mbeye³, Claire Glenton⁴ and Tamara Kredo¹

1. Health System Research Unit, South African Medical Research Council, Cape Town, South Africa
2. Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
3. Evidence Informed Decision-making Centre, Department of Community and Environmental Health, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
4. Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway

Evidence is powerful—but only if it can be translated into action. For many countries, particularly in low- and middle-income contexts, the challenge is not a lack of global evidence, but rather making that evidence relevant, feasible and sustainable at the local level. 

This World EBHC Day, we reflect on how collaboration across countries, ministries, researchers and global institutions is helping to close this gap. A key initiative is the Global Evidence, Local Adaptation (GELA) Project, a three-year project working alongside Ministries of Health in South Africa, Nigeria and Malawi.

Why Global Evidence Needs Local Collaboration

The World Health Organization (WHO) has invested in key tools to support evidence-informed health policy:

• EVIPNet: building institutional capacity for knowledge translation.
• WHO-CHOICE: providing comparative cost-effectiveness analysis.
• ADOPT/ADAPT Framework: supporting the contextualisation of guidelines.
• WHO Guidelines: ensuring methodological rigour.
• WHO Ethics Guidance (2025): embedding justice, transparency and inclusivity in decision-making.

Each tool is valuable, but they are often used in isolation, reactively and within short project cycles. This limits their long-term impact and often leaves ministries with fragmented rather than integrated support.

This is where collaboration becomes critical, not just among global and local partners, but also across tools, processes and programs.

GELA: Building bridges, not duplicates

The GELA Project (2022–2025) takes a distinctive approach. Instead of waiting for global evidence to ‘trickle down,’ GELA starts with national priority-setting, co-led by Ministries of Health.

Examples of GELA’s work include:

• South Africa: prioritising anaemia prevention and post-discharge family support.
• Nigeria: improving feeding practices for low birthweight infants and hand hygiene among health workers.
• Malawi: enhancing nutrition in critically ill children.

Beyond identifying priorities, GELA brings together multiple streams of evidence (clinical, economic, contextual and implementation data) using tools like the GRADE Evidence-to-Decision framework and the TRANSFER approach. Crucially, it embeds capacity-building and mentorship over several years, ensuring ministries are not just recipients of evidence but co-producers.

Perhaps most distinctively, GELA explicitly attempts to operationalise ethical principles such as justice, inclusivity and transparency, reflected in structured, documented and equitable decision-making processes.

Collaboration in action: A synergised ecosystem

When seen together, the WHO tools and GELA methods are not competitors but complementary approaches. The evidence-to-policy process can be conceptualised as a continuous, collaborative cycle: 

1. Priority setting with Ministries of Health (GELA + WHO Ethics Guidance).

2. Economic modelling for cost-effectiveness (WHO-CHOICE).

3. Guideline contextualisation (ADOPT/ADAPT Framework + digital platforms).

4. Institutional translation into policies and briefs (EVIPNet).

5. Monitoring, evaluation and adaptation (GELA’s iterative approach).

This integrated workflow attempts to transform fragmented use of evidence into a cohesive, ongoing, iterative, inclusive, collaborative ecosystem. It also creates space for global standards to align with local realities, while maintaining rigour, equity and sustainability.

What this means for policy and practice

Collaboration is not just a theme; it’s a practical necessity.

• For WHO: possibly promote integrated toolkits that combine existing initiatives with GELA’s structured, cyclical approach.
• For Ministries of Health: the priority is to invest in sustained, ethical evidence processes, not just one-time projects.
• For donors: the opportunity lies in supporting long-term systems that build national capacity and ensure lasting impact.

Conclusion: Collaboration as the key element

The GELA Project illustrates that the future of evidence-informed policy is not just about inventing new tools – it’s about collaboration. The GELA approach is still a work in progress and will benefit from continued refinement and learning through implementation. However, by embedding priority-setting, adaptation and ethical principles of engagement, inclusivity and legitimacy into the WHO’s broader ecosystem, GELA offers a pragmatic bridge between global evidence and local action.

On this World EBHC Day, we are reminded that collaboration is the cornerstone of equity and sustainability in health policy. The real opportunity ahead lies in working together – governments, donors, researchers and global institutions – to embed and synergise what we already have. Because when collaboration is at the centre, evidence can effectively transform health systems and support universal health coverage.

References

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To link to this article - DOI: https://doi.org/10.70253/LBSU2398 

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The views expressed in this World EBHC Day Blog, as well as any errors or omissions, are the sole responsibility of the author and do not represent the views of the World EBHC Day Steering Committee, Official Partners or Sponsors; nor does it imply endorsement by the aforementioned parties.