Any meaningful change comes with new risks. The merit of the change depends on the balance of benefits and risks that the change offers. Ideas that deliver essential value that cannot be obtained elsewhere may well easily justify the risks that are incurred. Deducting the risk against potential benefit can offer a way of visualising if an intervention can be justified or not.
Humanitarian innovators have become increasingly aware of the risks associated with new creative processes, services and products. These risks are of concern when they are borne by already vulnerable people. In particular, technology change has the unintended potential to create widely distributed ripple effects that are often not immediately visible. Understanding these consequences can be daunting in their scope, as illustrated by the 2018 ICRC report “Doing No Harm in the Digital Era”, which catalogued over 100 pages of digital risks in the humanitarian context. The current humanitarian discourse is to do no harm. But is doing no harm possible when also innovating?
The Dilemma - Risk as a Barrier to Beneficial Change
The range of innovation risks is not limited to digital technologies. Drones, robotics, and even construction projects all inevitably create new risks when they change the status quo. Considering risks is an essential step in any proposed innovation, particularly one that affects people with limited resources or resilience. However, a too narrow focus on risk can bring even valuable change to a standstill.
Whilst it is clearly wrong to needlessly expose people to risks and harm, it is also unreasonable to deny communities of potentially beneficial innovations that could substantially improve overall wellbeing.
The risks and benefits of an innovation should be assessed and measured using the same scale and common indicators as status quo programming, helping the innovators to compare, contrast and make an informed decision on whether this idea is taking acceptable risk. This is especially important as there can be a tendency to veto innovation proposals based on small risks due to perception biases. For example, risks are perceived as irrationally high when:
The risk taken is involuntary.
Prevalence and reach of the innovation increase to affect more people.
An innovation is particularly novel.
Overall, this inherently tips the scale in favor of the status quo when dealing with innovations even though more good may be achieved through the means of innovation at equal or lesser risk as the status quo.
And what type of risk? Usually, we don’t go further in depth during risk assessments. Any sort of ‘harm’ closes the door and the idea is put ‘on hold’ indefinitely. ‘Risk’ as a general term is vague and abstract: harm needs to be considered on relative levels if it is life-threatening, financial, legal or if it is compromising the future plan of a specific person. This needs to be entered into the calculation before pausing a new idea.
Within the humanitarian and development space also there is an added imperative to include financial risk within this calculation: money spent on an innovation that fails, could have been spent on proven methods such as vaccinations or supplies instead. This seems a legitimate points, but this is not the whole picture. As a new report from Elrha will detail, there are financial resources available to humanitarians, outside of an organisation’s operational budget i.e. through organisations like Grand Challenge Canada, foundations and impact investment grants. Through this, the level of financial risk can be mitigated.
Finally, on how risk is assessed, we reach the problem of individual prestige. Identifying such risks in projects is a profession. Ensuring that there are people there to raise risks where they have been missed is undoubtedly important. However, such assessments often have a clear leaning towards detail, rather than the bigger picture and, as such, can lead to excessive scrutiny and stop a project in its tracks.
Comparing risk and benefit on the same scale
The relative weighing of benefit — or utility from a philosophical standpoint — is something that harks back to political philosophers of the past. John Stuart Mill – an ardent support of individual liberty — famously described the correct use of weighing utility as:
"that actions are right in the proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness."
Mill is one of the founders of modern liberalism, widely regarded as underpinning many of the foundational principles of the current world governance. Therefore, why would we choose not to apply this principle in the case of humanitarian innovation when it’s good enough for the operation of modern democracy?
Ultimately, the benefit and risk of two whole systems need to be compared. For example, the mortality rates for women undergoing childbirth in remote areas can be dramatically reduced through the use of drone deliveries of blood supplies. The first system - unassisted childbirth - is the status quo, which has substantial unmitigated risks of death. The second system leverages the delivery of blood supplies by drone. This system offers strong medical benefits that are amplified by the lack of other effective alternatives. Yet, drones also come with concerns associated with safe operation in a shared airspace. These whole systems need to be compared and contrasted with each other.
If, as often happens, the questions around privacy or the risk of crashing a drone are seen in isolation, it’s easy to understand why permissions are difficult to obtain. Yet, if you’re to consider the possible gains of an overall system in terms of lives or disability-adjusted life year’s (DALYs), then the situation can look significantly different.
When deciding on whether the risks of a clinical trial are acceptable, an Ethical Review Board will consider the possible improved patient outcomes in a relative manner. It seems odd this luxury is rarely extended to innovation projects, often dealing less directly with patients. Indeed, many innovation projects are deemed unacceptable because of a perceived risk to privacy or data management. Whilst this is a significantly less serious risk than the risk of side-effects in a clinical trial, it is given a disproportionately high prescience.
Finally, when considering potential harms, it’s important to consider how we each operate within the social norms of our societies. Engaging with beneficiaries’ points of view is commonly accepted as best practice. Yet, there lies significant contradictions when considering the normative nature of humanitarian and development work. One classic example is identity and privacy. For those operating from Europe and North America, there is a tendency to see the right to privacy as fundamentally essential. Take the UK public’s resistance to identity cards, or the French law prohibiting the collection of ethnographic data for example. However, for many other regions, especially where having a recognised official identity can lead to greater access to social service provision, there is less concern for hiding personal details. Whilst this may be based on the levels of trust in government, the debate is far from definitive. Given the decolonisation of aid narrative in the humanitarian and development space, these cultural differences seem to rarely be accounted for.
Using Systems to Support Responsible Innovation Tradeoffs
Discussions surrounding risk and harm need to be based on a broader view of the opportunity for change. This does not imply there is a blank check for change: a rigorous review of the benefits and harms alongside a consideration of alternative systems should be done for any proposed innovative change.
A well-reasoned discussion can only be had with a big picture of both the current situation and an open mind to the proposed new combination of benefit and risk. The work that has already been done to identify potential sources of risk has laid a solid foundation on which to take this next step in analysis.
It is now time to routinely embrace taking a more holistic view of status quo challenges and the alternative systems that are proposed to replace them. This whole systems view would not only allow a more balanced view of the value of change, it would also offer a broader range of alternatives for mitigating potential risks, or at the very least make them better understood to those involved.
About the authors and Outsight International
Dan McClure, Lucie Gueuning, Denise Soesilo, Monique Duggan, Louis Potter for Outsight International
Outsight International provides services to the humanitarian and development sector in an efficient and agile way. Outsight International builds on the range of expertise offered by a network of Associates in order to deliver quality results adapted to the specific tasks at hand. If you’d like to discuss working with the Outsight team, please get in touch or follow us on LinkedIn for regular updates.