Image: Billy Miaron [CC BY 2.0], via Flickr
Everyone in research should understand their role in making it more equitable, says Catherine Kyobutungi
Research will truly have been decolonised when communities everywhere, but especially in low- and middle-income countries (LMICs), have the autonomy to determine what questions are important to them and the power to fully use the findings of research done on and for them.
In the interim, the aim should be for health research projects in these places to be based solely on locally determined priorities. From formulation to implementation, they should be led by scientists in that locality and answer questions directed at its real-life problems, with input from policy actors and communities.
Some research funders in the UK and the US have taken steps towards this goal. They have clear policies and guidelines for involving LMIC researchers in grant applications and project delivery, and for the involvement of study communities and policy actors. Their assessment criteria for grant applications examine contributions by all named investigators, budget allocation and pathways to impact.
But awareness about equitable partnerships is not evenly distributed and is not enough on its own. One need not look far to see the same old disrespectful behaviour—from researchers in high-income countries predetermining the contribution of colleagues in LMICs, to projects and budgets being assigned without consultation. Without changed incentives, enforcement mechanisms and an empowering culture in global health research, awareness will not necessarily translate into a change in behaviour.
There are also barriers to equitable research partnerships within LMICs themselves. When governments fail to provide adequate resources for R&D, they leave their researchers at the mercy of exploitative funding and partnership arrangements. When universities fail to be strategic in forging partnerships and in prioritising research in their institutional strategies, they fail to provide an environment in which their own researchers can thrive and be globally competitive.
A role for everyone
In global health research, everyone involved at every stage needs to have a common understanding of the current system, how inequitable it is and their role in making it more equitable.
Equitable partnerships require high-capacity individuals and institutions in LMICs. Funders have a role to play in this and should take a long-term view of individual and institutional capacity strengthening. They can adapt their funding models to the capacity needs of institutions, shifting from support for skills building alone to a more comprehensive model that includes hiring to fill skills gaps and core funding.
In LMICs, research managers and administrators must enforce the parameters of partnerships. They need clear guidelines on what true partnerships are and visible cost structures that their researchers are aware of.
They should also develop standard templates for contracts and agreements that enshrine the principles of equitable partnership. These should include non-negotiables such as adequately providing for indirect costs and minimum level of effort, budget approval procedures during the grant application process, and policies around data ownership and sharing.
The same applies for research managers in high-income countries, but their role is to ensure that their colleagues in research adhere to the principles of equitable partnerships.
Researchers in high-income countries can do things in the short to medium term that have long-term impact. These include ensuring equity in the delivery and benefits of projects and embedding equitable capacity strengthening in project design. This requires a deliberate effort to build capacity across the board: providing fellowships, short courses and opportunities to publish and to attend conferences for researchers in LMICs, and assigning them progressively higher roles in future joint initiatives.
Researchers in wealthy countries have a responsibility to advocate for investment in the institutional infrastructure of their LMIC partners. They also need to understand the barriers colleagues from LMICs face: where events are held, for example, should depend partly on considerations around visas—the place most convenient for some may not be somewhere that will grant entry to everyone who should be present.
At the global level, progress towards equitable research partnerships will be seen in who leads, who speaks and who makes decisions. It will result in global health initiatives designed with impact in mind and leading to more equitable health outcomes. It will also manifest in intentional measures to dismantle the careerism in global health research and practice that lies behind much of the continuing inequity.
Catherine Kyobutungi is presenting her work at the Inorms 2023 conference in Durban this week. Research Professional News is media partner for the event.
Catherine Kyobutungi is executive director of the African Population and Health Research Center in Nairobi
This article also appeared in Research Fortnight