Obligations under global health partnerships in LMICs should be contractual
Authors: Bolajoko O Olusanya, Robert O Opoka
Journal: The Lancet Global Health (2017)

We applaud the Comment by David Beran and colleagues (June, 2017)1Beran D Byass P Gbakima A et al.Research capacity building-obligations for global health partners.Lancet Glob Health. 2017; 5: e567-e568Summary Full Text Full Text PDF PubMed Scopus (77) Google Scholar on the challenges and remedies for enhancing research capacity in low-income and middle-income countries (LMICs). The absence of a clear-cut vision for sustainable research capacity and ownership in LMICs is arguably a missed opportunity under the Millennium Development Goals' mandate.2Sheikh K Bennett SC El Jardali F Gotsadze G Privilege and inclusivity in shaping Global Health agendas.Health Policy Plan. 2017; 32: 303-304PubMed Google Scholar We therefore consider this initiative as timely within the context of the UN's Sustainable Development Goals. However, we wish to highlight a few oversights that need to be clarified to ensure effective knowledge and skill transfer, based on our research experience in Africa. First, the sole emphasis on partnerships between universities appears to belittle the enormous potential and contributions of non-governmental and humanitarian organisations to research capacity in LMICs.3National Institutes of HealthNon-governmental Organizations (NGOs) working in global health research.https://www.fic.nih.gov/Global/Pages/NGOs.aspxGoogle Scholar The system of governance in many universities is heavily bureaucratic and inhibits productive and collaborative grassroot engagement with host communities. As a result, some funding agencies now equally encourage and support non-governmental organisations and individuals with proven core competences to undertake essential non-clinical, community-based research and intervention projects. Second, we share the view that international journals also have a vital role. For example, it is the editorial policy of some journals that studies making use of data, infrastructure, or personnel in a foreign country without involving at least one scientist from that country as an author will not be published. However, this policy is often not strictly enforced.4Greenwood B Greenwood A Bradley A Guinea worm infection in northern Nigeria: reflections on a disease approaching eradication.Trop Med Int Health. 2017; 22: 558-566Crossref PubMed Scopus (3) Google Scholar The responsibility for equitable authorship for research conducted in LMICs should, therefore, not be restricted to editors. The general readership could also serve as a watchdog for compliance. Last, mutual trust among the partners is essential, but should be reinforced with a formalised mechanism for accountability. It is not uncommon now for host institutions and local research collaborators to demand a memorandum of understanding in which the rights and obligations of the collaborators are spelt out clearly, to prevent abuses by any party. Typically, such a document will address issues of data ownership, sharing, use, and archiving equitably, and discourage unwholesome data mining by foreign collaborators, among others.5Al Shorbaji N Data colonialism: knowledge and management sharing. World Health Organization, Geneva2013https://www.youtube.com/watch?v=pP5OH9p3flgGoogle Scholar We believe that funding agencies, grant administrators, and institutional review boards have a duty of care to ensure that disbursement of grants are contingent on satisfactory compliance with the provisions of such memorandums. Ultimately, an international code of conduct for research projects in LMICs, championed by leading global health players, will be helpful in ensuring tangible and enduring research capacity. The time to act is now. We declare no competing interests. Both authors contributed equally to this submission. Research capacity building—obligations for global health partnersGlobal health continues to gain pace as a discipline, as is evident from the amount of funding available for challenges relevant to low-income and middle-income countries (LMICs)1,2 and the growth of journals in this field. This growth has been driven in no small part by the targets and indicators of the Millennium Development Goals. Successes towards achieving these goals, however, have often come from expertise, funding, and ideas flowing from high income countries (HICs) to LMICs; with HIC players being accused of parachuting in to LMICs to act or set up state of the art, HIC led and staffed facilities. Full-Text PDF Open Access