Wicked problems in a post-truth political economy: a dilemma for knowledge translation

The paper traces the origins and evolution of knowledge translation (KT) from two traditions: (1) a positivist-empiricist, evidence-based medicine/practice (EBM/EBP) view that emphasizes linear transfer of rigorously produced evidence into practice, privileging randomized trials, observational studies and syntheses; and (2) a sociological view, rooted in diffusion of innovations, that understands uptake through social systems, norms, communication and negotiation among stakeholders. Early EBM/EBP approaches established knowledge hierarchies and prescriptive authority, prompting critiques of scientism and delays in translation. In response, KT thinking has increasingly adopted complexity- and systems-informed perspectives that recognize culture, values, and plural forms of knowledge, exemplified by models such as the KT Complexity Network Model (KT-cnm), CICI, NASSS, and SHIFT-Evidence. The authors set out to examine emerging critiques of science’s role in policy and KT, relate them to the emerging KT perspective using the KT-cnm as a case example, and argue that in a post-truth sociopolitical climate KT must still create scope for scientific evidence to hold appropriate epistemic primacy to address urgent wicked problems (e.g., pandemics, climate change).

The paper reviews critiques at the science–policy nexus that challenge the privileging of scientific expertise and call for pluralism, engagement, and attention to sociopolitical and ethical dimensions. It discusses positions ranging from pragmatic pluralism (e.g., Lohse and Bschir’s epistemic pluralism in pandemic policy) to more contentious poststructuralist and relativist approaches (e.g., Engebretsen et al., Latour’s ANT), and calls for a pragmatist turn (Greenhalgh and Engebretsen). The authors note debates about the provisional and contested nature of science, claims of epistemic equivalence among knowledge forms, and the tension between inclusivity and maintaining epistemic standards. They situate these critiques within KT and highlight integrative, complexity-informed KT frameworks (KT-cnm, CICI, NASSS, SHIFT-Evidence) that emphasize dynamic interactions among stakeholders, negotiation, and co-adaptation.

This is a conceptual and theoretical analysis. The authors: (1) synthesize and critique strands of scholarship from medical humanities, philosophy of science, sociology of knowledge, and KT; (2) use the KT Complexity Network Model (KT-cnm) as a case example to illustrate how complexity and network concepts inform KT processes (problem identification, knowledge creation, synthesis, implementation, evaluation) within complex adaptive systems across sectors; (3) analyze the current sociopolitical context—particularly post-truth dynamics—drawing on Habermas’s theory of the public sphere and historical transformations under capitalism, mass media, and digital platforms; and (4) advance a normative argument that KT should enable scientific evidence to have appropriate epistemic primacy in public discourse, and propose strategic directions (education, media health, champions/public intellectuals) to foster basic consensus on elementary facts and values. No empirical data were collected or analyzed.

- KT has evolved toward a complexity-informed, sociologically grounded, and inclusive perspective (e.g., KT-cnm) that emphasizes interconnectivity, negotiation, and co-adaptation among stakeholders across systems. - A central dilemma arises: embracing pluralism and pragmatism can undermine the capacity to act swiftly on wicked problems (e.g., COVID-19, climate change) when basic consensus is lacking in a post-truth environment. - The authors argue KT must preserve scope for scientific evidence to occupy an appropriate position of epistemic primacy—recognizing science’s provisional nature while distinguishing its methods and evidentiary standards from other viewpoints. - The contemporary public sphere, transformed by market forces, mass and social media, partisanship, and algorithmic amplification, fosters fragmentation, misinformation, and erosion of trust, impeding KT’s effectiveness. - Proposed directions include: early educational interventions to build scientific literacy, critical thinking, and civic education; fostering citizen science and local leadership; strengthening public-interest journalism and media health; and encouraging public engagement by qualified experts and intellectuals as champions. Supporting data points cited in context: - Only around 50% of people receive care aligned with evidence-based guidelines in practice. - Translational lags in health research to practice have been estimated at about 17 years. - Systematic reviews support effectiveness of standardized public health measures for COVID-19 mitigation. - IPCC assessments underscore urgency and evidence for anthropogenic climate change.

The analysis addresses how KT can reconcile inclusive, complexity-aware practices with the need for timely, coordinated action on wicked problems in a polarized, post-truth context. The authors contend that while pluralistic engagement is essential, it presupposes a minimal consensus on basic facts and shared values; absent this, co-adaptive KT processes stall. By clarifying the epistemic status of scientific evidence—as methodologically disciplined and best-suited for discerning particular kinds of facts—KT can both honor sociocultural considerations and enable decisive policy action. The discussion highlights the erosion of the public sphere and trust in institutions as critical barriers to KT, arguing for systemic efforts that cultivate communicative rationality, reduce fragmentation, and re-establish conditions where evidence can inform deliberation. This reframing positions KT not merely as implementation within health systems, but as an active contributor to rebuilding public discourse infrastructure necessary for evidence-informed democracy.

The paper concludes that emergent KT frameworks rightly recognize complexity, negotiation, and inclusion, but may be insufficient or counterproductive for urgent, large-scale problems without a foundational consensus on facts and values. The authors argue KT should advocate epistemic standards that allow scientific evidence to assume appropriate primacy in public discourse. Tailoring KT approaches to remediate the current sociopolitical climate—through education, improved media ecosystems, and championing by public intellectuals—can help establish the preconditions for effective KT. This stance does not aim to privilege science unilaterally, but to counter post-truth dynamics that undermine democratic outcomes and the public good.

The work is a conceptual and normative analysis with no empirical data collection or evaluation. Conclusions are theoretical and depend on the interpretation of existing literature, models (e.g., KT-cnm), and socio-historical analysis, which may limit generalizability and empirical validation.