COVID-19 and the Future of Global Health Research Partnerships

 

Those of us working in global health research, like many others, have seen our work change dramatically in the past eight weeks. Travel, both the privilege and bane of our industry, has halted indefinitely. Our work moves exclusively online. Surveys abound!

Many of us are fortunate. Our work can transition online. Most of us are either in secure or relatively secure employment (early-career researchers aside). We are able to communicate through internet channels with relative ease and working-at-home is possible (if not always easy).

However, COVID-19 has created long-term challenges for how we conduct research, especially in the context of global health. Restrictions to travel may result in some benefits (reduced airline pollution, and more efficient use of time and resources), but will also fundamentally alter our international collaborations.

We all know that good, equitable relationships are essential to the production of high quality research (1–5). Gone are the days when it was acceptable for global health to be dominated by the global north. The language of partnerships can be seen everywhere, from the WHO to the Sustainable Development Goals. And yet, lingering imbalances remain within the field. Publications, one key metric, remain dominated by researchers at institutions in the global north. And scratch the surface and you’ll find many more insidious ways in which our field has yet to realise the ambition of genuine partnership. The crisis of COVID-19 leaves us with a decision to make, and both risks and opportunities.

In the new context of COVID-19 in which travel is restricted, the risk for our field is that we may embed the traditional and problematic dichotomy in which researchers from the global south collect data, and researchers from the global north analyse and publish data (6,7). Researchers from the global north, unable to travel, may justify their involvement in projects by taking (more) ownership of these important components of research.

The embedding of such a dichotomy will restrict the career progression of researchers in the global south, ensuring the major benefits of research (publications and funding) are further monopolised in the global north. It would also risk the quality of our outputs as researchers from the global north may lack the context-specific understanding to effectively design research projects and analyse data emerging from them.

The language of relationships and partnerships may also revert to lip service on grant applications. Genuine partnership simply may become too much effort for some. Relationships are harder to build and maintain online. The internet does not replace face-to-face conversations. Language barriers become higher. Internet connections are unreliable. Trust between new partners, often built socially on the fringes of our work, will be difficult to develop.

But, while there will be risks and challenges for our field going forward, there may also be opportunities. Maybe now is the time, amidst all this turmoil, to truly reform our field. We should use this pandemic, and the likely lengthy travel restrictions that will follow it, to empower and support colleagues in the global south to take genuine ownership of projects at all stages of the research process. This means more academic ownership and a greater share of funding. The majority of resources in a global health project should no longer be allocated to northern institutions. It’s not efficient, ethical nor necessary.

Researchers from the global north should continue to have genuine and deep involvement in research projects. Genuine collaboration brings immeasurable benefit for all involved. However, their role should focus on support and training across all stages of the process. This is not just an ethical point – it is our new reality. Without travel, we cannot lead global health from the global north.

For early-career researchers in the global north (like myself) this may be difficult as we will likely be more harshly judged for not leading on publications than more senior colleagues, and (like me!) a redirecting of resources to the global south may further reduce job security. We too need to train before we can support training others. We will require greater flexibility from the institutions who employ and fund us, and more flexible metrics of success. This will involve changes in mentality as much as in procedures.

Genuine, inverted partnerships will be needed for our new normal (8). The current context demands new approaches. If we revert to the traditional extractive dichotomy, the quality of our work and field will be irreconcilably damaged. But, if we use this opportunity to reform, we may come out of this a more robust, versatile and equitable field.

About the Author:

Chris Jenkins works at the Centre for Public Health at Queen’s University Belfast. His main areas of work include health systems strengthening in lower- and middle-income countries and studies to help improve access to diagnosis and treatment for cancer. He has current collaborations in Vietnam and Uganda. Twitter: @ChrisJenkins90

Competing Interests:

The author has no competing interests or conflicts to declare.

References

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  2. Eyben R. Making Relationships Matter for Aid Bureaucracies. In: Eyben R, editor. Relationships for Aid. London: Earthscan; 2006. p. 43–60.
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  4. Larkan F, Uduma O, Lawal SA, van Bavel B. Developing a framework for successful research partnerships in global health. Globalization and Health. 2016 May 6;12(1):17.
  5. THET. THET principles of partnership: Tropical Health and Education Trust [Internet]. 2019. Available from: https://www.thet.org/principles-of-partnership/
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  8. McCoy D, Mwansambo C, Costello A, Khan A. Academic partnerships between rich and poor countries. The Lancet. 2008;371(9618):1055–7.
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