What is wrong with global health? So-called glorified data collectors in low-income regions
Authors: Emmanuel Nene Odjidja
Journal: The Lancet Global Health (2021)

In a conversation with a friend (a well qualified epidemiologist, who trained at one of the top institutions in the world and is currently based at an institution in Africa), he acknowledged the power imbalances present in global health, describing his position of local research coordinator as a so-called glorified data collector. Through a deep reflection of the descriptive details he gave, I realised I might have also been a so-called glorified data collector at one point in time. To understand how these power asymmetries between researchers in high-income regions and glorified data collectors in low-income regions play out, let us take one hypothetical situation as an example. A group of researchers from a high-income country secure a multi-million US dollar, multi-country research grant. They recruit local lead professionals, possibly with a master's degree or a PhD, to coordinate activities in each country. The lead research team is based in a high-income country, comprising a principal investigator, research fellows, and assistants. The role of each country's lead coordinator is restricted to securing ethical clearance from the local authority, reviewing tools for data collection, and coordinating field work. In addition to remuneration for their professional services, they are offered co-authorship (with their names usually positioned in the middle of the author list) of published research articles. During the preparation of such articles, advanced analyses and methodology are decided and conducted by the lead research team, with the local coordinator only reviewing the manuscript and, in most instances, ensuring that it is culturally and politically acceptable. This hypothetical example represents the reality of many global health professionals coordinating such partnerships. It is therefore unsurprising that bibliometric studies published in 2014–18, show deep disparities in the proportion of first authors from low-income and middle-income countries.1Kelaher M Ng L Knight K Rahadi A Equity in global health research in the new millennium: trends in first-authorship for randomized controlled trials among low-and middle-income country researchers 1990–2013.Int J Epidemiol. 2016; 45: 2174-2183Crossref PubMed Scopus (50) Google Scholar, 2Cash-Gibson L Rojas-Gualdrón DF Pericàs JM Benach J Inequalities in global health inequalities research: a 50-year bibliometric analysis (1966–2015).PLoS One. 2018; 13e0191901Crossref PubMed Scopus (69) Google Scholar, 3Chersich MF Blaauw D Dumbaugh M Local and foreign authorship of maternal health interventional research in low-and middle-income countries: systematic mapping of publications 2000–2012.Global Health. 2016; 12: 1-15Crossref PubMed Scopus (11) Google Scholar Having been awarded the Emerging Leader for the Royal Society of Tropical Medicine and Hygiene in 2020,4The Royal Society of Tropical Medicine & Hygiene2020 Emerging Leaders Award recipient.https://rstmh.org/medals-awards/emerging-leaders-awardDate: 2020Date accessed: July 26, 2021Google Scholar I have interacted with several emerging professionals in low-income regions, and I acknowledge that analysing the situation through an intersectional lens reveals stark differences in the experiences of these professionals. Many young and emerging scholars working with local institutions in sub-Saharan Africa are directly involved in the administration of such research grants, yet their efforts go unacknowledged. They receive meagre salaries and are excluded from strategic activities, such as research publication activities. Important discussions are held between their superiors and the lead research team based in the high-income country, with their role restricted to only following instructions, even though they are qualified to contribute. Their contracts are short term, and their employment is dependent on continued grant funding. In such environments, career advancement opportunities are absent and there is no job security. The time is now to recognise the so-called glorified data collectors as the respected and relevant local researchers that they are. Opportunities for equal participation in research activities should be provided to local researchers, including in the preparation of manuscripts for publication in academic journals. Talented young and emerging professionals should be identified, recognised, and promoted in the global arena. Research grants awarded to groups with partnerships between low-income and high-income regions should include a prespecified plan for capacity enhancement and opportunities for career growth for young and emerging professionals. Sustainability plans for such grants should include one for retaining human resources. If research partnerships between low-income and high-income regions are to reflect local realities and needs, young professionals, who are involved in the daily management of the grant at the local level, should also be invited to contribute to important discussions and decisions. I declare no competing interests. All opinions expressed herein are my own.