The International Institue of Environment and Development (IIED) has a theory of change (TOC) which is based on the creation and application of knowledge in real-world settings. As such, it needs to acknowledge the impact of power relations on decision making processes. Its TOC depends on the engagement of both powerful and powerless groups in the creation and use of knowledge, in developing spaces in which dialogue can be productive and in evaluating progress. This web page, provides an overview of their vision and of how the agency monitors and evaluates progress. Linked pages give more detail on the TOC and on the actual methods used in M&E. The research of the agency focusses more on policy and knowledge application than academic biology. It could be argued that similar processes affect the pathways through which biomedical discovery translates into health policy and services.