The Alliance Lift is a series that spotlights the journeys of Alliance alumni shaping health systems around the globe. In this Q&A, Mr Jeffrey Knezovich, a Techincal Officer at the Alliance, talks with with Ms Racha Fadlallah, a Senior Scientific Officer at the Knowledge to Policy (K2P) Center at the American University of Beirut and co-founder of the SPARK Centre for systematic reviews in health policy and systems research. Beyond Lebanon, she also serves on the Board of Health Systems Global and contributes to the strategic direction of WHO’s Evidence-Informed Policy Network (EVIPNet).
Jeffrey spoke with Racha about her path into health policy and systems research, her work strengthening evidence-informed decision-making in Lebanon and globally, how crises and change shape the way evidence is used today, and her hopes and expectations for next year’s Ninth Global Symposium on Health Systems Research.
In this interview, also available as a video and podcast, she shared how her early experiences shaped her commitment to making evidence accessible, what it means to work in a context of political and economic instability, and how to make the case for evidence-informed policy-making.
Learning from the past
Q: You began in biology before shifting to public health and eventually health policy and systems research. How did those early choices guide you into the field?
I always knew I wanted to work in health, but a personal tragedy changed how I understood my role. A close friend was in a car accident outside the city, and delays and fragmentation in the emergency and health systems meant he didn’t receive timely care. He slipped into a coma and passed away the next day. That experience made me realize that even the best clinical skills aren’t enough without the right systems in place. Growing up in Lebanon, I saw firsthand how politics, instability and inequities shape health care, and I became more interested in the bigger system than the clinical encounter.
Moving into public health opened my eyes to the idea that health is a right, not a privilege. That, along with the holistic system thinking at the heart of HPSR – looking at governance, financing, people and policy – really resonated. When I encountered the Alliance methodology reader, it gave me the language for the questions I was already asking: Why does something work here but not there? Why are decisions being done that way? What works under what circumstances? All of these questions were pushing me into health policy and systems research. That intersection of rigorous research and real-world complexity has guided my career ever since.
Q: Was there a moment that pushed you to rethink how we communicate evidence?
Very early in my career at the K2P Center, I saw the gap between evidence and how decisions were actually made. It became clear that evidence alone doesn’t lead to change – relationships, timing, packaging and context matter just as much. My first major project was an Alliance-supported initiative on policy-relevant evidence synthesis, which eventually led to co-founding the SPARK Center for systematic reviews in HPSR.
While this experience showed me that evidence production has to be aligned with policy needs – it also revealed that the way we communicate evidence can fundamentally reshape how it is valued. This is where the role of K2P Center became fundamental. We leveraged policy-relevant systematic reviews as a starting point; packaged and contextualized the evidence via knowledge translation products; timed the evidence communication; and engaged policy-makers and stakeholders in deliberative dialogues and other uptake activities to effectively and inform decision-making and achieve impact.
Q: You also worked on another Alliance-supported project, Building Institutional Capacity for Health Policy and Systems Research and Delivery Science, or, the BIRD programme. What did that teach you about supporting institutions to use evidence effectively?
BIRD came at exactly the right time. We had strong tools and products, but we needed sustained capacity strengthening. BIRD pioneered a South–South institutional mentorship model, showing that building individual skills is not enough – you also need supportive organizational structures, incentives, databases and leadership to enable people to apply what they learn.
Through BIRD, we strengthened both individual and institutional capacities, and we saw mentees become mentors in their own regions. It also transformed K2P’s own capacity-strengthening programme into one recognized globally. It remains a landmark project because it demonstrated what sustainable capacity-building really looks like.
Living in the present
Q: A former BIRD grantee mentioned how much the work with you and the director of the K2P Centre, Fadi El Jardali, really meant to them. They talked about the new skills and new connections that opened up. But, the current reality is that their centre is down-sizing and struggling to maintain the momentum built during BIRD. How do we make this work more sustainable?
Sustainability begins with demonstrating the value of evidence-informed policy-making. Policy-makers need to see that evidence is not an add on, it’s central – it makes decisions more efficient and more effective. At K2P, we dedicated significant effort to building their awareness and capacities early on, but we also needed to show what evidence could do in practice.
That proof of concept came a few years ago when Lebanon faced a major influx of Syrian refugees and uncertainty about how to respond. We produced policy briefs on mental health and coordination of care and brought all stakeholders together for a national policy dialogue. Policy-makers told us it was the first time they saw evidence feeding directly into collective problem-solving. That was the turning point. But sustainability is ongoing: you must stay flexible, adapt tools and continue co-producing solutions with decision-makers.
Levelling up for the future
Q: The Ninth Global Symposium on Health Systems Research, or HSR2026, will be held physically for the first time in the Eastern Mediterranean Region. What does this moment mean for the region and the global HPSR community?
It’s a defining moment. Many countries in our region struggle with universal health coverage, workforce shortages and financing challenges, all within contexts marked by conflict and instability. At the same time, HPSR remains underdeveloped and under-recognized across much of the region.
Hosting the Symposium here brings regional voices, concerns and realities into the global space and has the potential to create real momentum. We hope it will build demand for HPSR, strengthen capacities and foster new collaborations – all while signalling that the region is central to the future of health systems research.
Q: Submissions for HSR2026 are now open – with organized and capacity strengthening sessions due on 14 January 2026, and individual abstracts due on 13 March 2026. What should contributors keep in mind as they prepare submissions under the Symposium’s four sub-themes?
Today’s health systems operate amid intersecting disruptions – conflicts, climate shocks, geopolitical shifts, pandemics and rapid digital transformation. Strengthening health systems means understanding these wider forces. The four Ps of our sub-themes: politics and polycrises; plurality and partnerships; platforms and participation; pathways and planet – reflect the ingredients needed for transformative, future-focused systems.
We’re looking for bold, solution-oriented ideas that cross sectors and disciplines. Contributors can engage through individual abstracts, organized sessions or capacity-strengthening workshops. Whatever the format, we hope to see work that pushes conventional thinking and offers practical ways forward in such a rapidly changing world.
Q: Before we close, is there anything else you’d like to share? A final thought or message?
Today’s world is shaped by conflict, climate extremes, shrinking resources and technologies that are evolving faster than our governance systems. And this is exactly why health systems research matters more than ever: because we are the field that asks not only what is happening, but how we can respond with wisdom, with equity and with perseverance. We tend to be stubborn in this field; we don’t give up easily. Amid everything unfolding around us, I believe health systems remain our greatest promise. They remind us that everyday life still matters. And it is truly a privilege to be part of this community.
