Asymétrie de pouvoir dans les partenariats de recherche en santé mondiale : une étude qualitative auprès de chercheurs au Bénin et en Côte d’Ivoire

The current context of global health research is characterized by the development of north-south partnerships that engage multidisciplinary teams around common goals, including, among others, the improvement of health equity for the benefit of communities. Based on the principles of equality, shared responsibility and inclusion, those partnerships presents several interests for research, particularly contributing to the mutual reinforcement of skills and to highlighting innovations resulting from scientific discoveries. However, partnership governance mechanisms as well as the practices of some of the actors of those partnerships are likely to reinforce inequalities in global health research between the North and South. In this thesis, we are interested in the challenges of asymmetry of power resulting from these inequalities among researchers in two countries of the South. Although this phenomenon has been widely discussed in the literature, particularly in academic studies, little empirical data is available on the related challenges that are raised in developing countries.  We therefore conducted a qualitative study to evaluate the factors and the mechanisms of power asymmetry in north-south partnerships from the perspective of Southern researchers. Data collection was conducted among 5 researchers in Benin and 19 researchers in Côte d'Ivoire. All participants pursued a career in university teaching and research, including 20 clinicians at the University Hospital Center and 4 non-clinical researchers. Semi-structured interviews were performed to assess their perceptions of the factors that influence power asymmetry and the mechanisms by which they operate. The main themes emerging from our data analysis are the following: the challenges of funding research, the complexity of the social and institutional contexts, the tensions in interpersonal relationships between researchers, and the risks of vulnerability.  Our results show that the pressure over the access to financial resources contributes to the deterioration of the conditions under which partnerships are implemented. In addition, the research funding modalities make it particularly difficult to develop genuine partnerships, allowing therefore for various forms of collaboration between researchers. Further, the institutional research setting shows subordination relationships that pose risks to the autonomy of young researchers as well as to the integrity of their work. Finally, the experience of power asymmetry and its consequences do not always seem to be related to the north-south character of the partnership. Rather, local initiatives, whether partnership-based or not, fosters more asymmetrical relationships between researchers.  The asymmetry of power in partnerships is a phenomenon including complex mechanisms. We suggest carrying out further analyzes, based on mixed methodologies approaches, to measure its consequences that are deemed to be both unfair and avoidable. Future research could also include an in-depth assessment of the accountability and the professional integrity dimensions of these south-south partnerships

Keyphrases: north-south partnership, global health research, equity and justice, power asymmetry, vulnerability