Governing Knowledge: Understanding the Evidence Ecosystem for Health Policy in Switzerland

Evidence-informed policymaking (EIPM) is a central objective of contemporary health governance, yet the ways in which research evidence is produced, mobilized, and institutionalized within policy processes remain uneven and contested. This paper conceptualizes evidence use in Switzerland as a matter of knowledge governance, examining how interest groups and other organized actors, institutions, and practices collectively shape the production, translation, and utilization of health research in policy decisions. Using situational analysis, the study maps the Swiss health evidence ecosystem, including public and private funders, professional and advocacy organizations, research institutions, intermediaries, science communicators, and policymakers. Data collection combines semi-structured interviews and a survey, developed with guidance from established instruments such as ODI’s RAPID Context, Evidence, Links framework and the Staff Assessment of enGagement with Evidence (SAGE) tool. These instruments inform the design of survey and interview questions; analysis explores how knowledge governance arrangements distribute authority and influence among organized actors, shaping whose evidence is heard in health policy debates. Science and technology studies concepts, including boundary work and translation, aim to gain a deeper understanding of how knowledge moves across organizations and institutions. The paper addresses two complementary research aims: (1) descriptive mapping of the actors, relationships, and processes that structure the Swiss health evidence ecosystem; and (2) analytical exploration of governance dynamics, including how institutional arrangements, actor interactions, and knowledge translation practices influence the routine use of evidence in health policymaking. Preliminary findings from 24 interviews indicate that evidence use in the Swiss health evidence ecosystem is structured by uneven institutional and financial infrastructures, producing stratified access to scientific knowledge and centering the role of intermediaries and science communicators as key epistemic knowledge brokers. Interviewees further describe how political receptiveness and dominant societal priorities shape which forms of evidence become actionable, with important implications for whose knowledge and whose health concerns are rendered visible in policy. Additional findings aim to identify strengths, gaps, and opportunities for strengthening knowledge governance mechanisms for EIPM in health. In a fragmented and corporatist health system like Switzerland’s, evidence production and translation are deeply intertwined with interest holder competition, policy priorities, resources, and regulatory authority. By situating Switzerland as a case of a democratic knowledge system, the paper contributes to broader debates in the Knowledge and Governance literature, highlighting how the organization and governance of knowledge shape evidence-informed policy, interest groups and organized actor influence, and the legitimacy of expert authority in contemporary health systems.