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<h1> Global Health Research Needs More Than A Makeover</h1>
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<p>Owen Chambers</p>
<p>15 Sep, 2021</p>
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Healthcare
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<p>During the 1990s, I was doing my medical training in India. Those days, we had a steady stream of American and European students visiting our medical school. They would stay for a few weeks, work on short-term projects, and go back home to publish their research in international journals. None of us got to publish much, despite the fact that we (the locals) had lived experience in dealing with the problems under study, and had deeper insights than our visitors could have gained in a few weeks.
<br><br>
Have we come a long way since my training days? Not quite. Research shows that global health is still struggling to shed its colonial past. This is reflected in who drives the research agenda, who dominates authorship, and who edits the research.</p>
<h4>Who is driving the research agenda?</h4>
<p>The global health research agenda is driven largely by funders (e.g. US NIH, Bill & Melinda Gates Foundation, Wellcome Trust), major global health agencies (e.g. WHO, World Bank, USAID, Global Fund, US CDC, and universities). Nearly all of these are led or dominated by experts from the Global North. They set and drive the research agenda, on behalf of people in low- and middle-income countries (LMICs).</p>
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<p>But even when research is done collaboratively, there are issues with authorship and inclusion. In an analysis of research studies conducted in Africa on HIV, malaria, TB, salmonellosis, Ebola and Buruli ulcer, Mbaye and colleagues found that African authors are highly under-represented as first and last authors (authorship positions that often get the most visibility and credit).<br><br>
In a similar analysis, Hedt-Gauthier and colleagues found that over 50% of all coauthors and of first authors on papers about health in Africa were from the country of the paper’s focus. However, if any coauthors were from the USA, Canada or Europe, then overall representation of African authors dropped, particularly in the first and last author positions. This was most frequent when collaborators were from an American university.<br><br>
Trends from specific global health journals (e.g. Lancet Global Health), and specific areas of research (e.g. pediatrics, maternal health) confirm these findings of under-representation of authors from LMICs.</p>
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