Closing the door on parachutes and parasites
Authors: None The Lancet Global Health
Journal: The Lancet Global Health (2018)

No one likes a parachute researcher: the one who drops into a country, makes use of the local infrastructure, personnel, and patients, and then goes home and writes an academic paper for a prestigious journal. At The Lancet Global Health, we look extremely unfavourably on papers submitted by authors who have done primary research in another country (particularly a low-income or middle-income country) but not included any author from that nation. For research involving patient recruitment, treatment in existing facilities, and follow-up, the notion that no locally based individuals made a “substantial contribution” (per authorship criteria) to the acquisition of data is pure fiction. Perhaps, as events played out, none of those individuals additionally fulfilled the criteria of a substantial contribution to the design of the study or writing of the report, but then perhaps they were not given the opportunity. Perhaps if they had, the design would have been more appropriate to the setting and the contextual interpretation more realistic. Most would agree that “parasitic” research of this nature has no future in global health. But what about secondary data analysis? The Lancet Global Health also receives a good volume of submissions that use publicly available data collected locally in another country, perhaps by means of a Demographic and Health Survey (DHS) or Health and Demographic Surveillance System (HDSS). The author may never even visit the country. Should he or she be similarly obliged to include locally based researchers on the author line even though he or she did not appropriate any local resources or knowledge in the collection of the data? We polled our International Advisory Board on this question and the results were interesting. They ranged from “Of course!”, to “Not really”, to “It's difficult…” In the “Of course!” corner, one member wrote: “I do not draw a distinction between primary or secondary data analysis for authorship rules. Someone [locally] did all the hard work to collect the data, knows its practical challenges and understands its context. How can someone sitting somewhere distant be so presumptuous as to reanalyse and reinterpret these data without having any clue about the quality of the data collection on the ground and the context within which to interpret the numbers?” Meanwhile in the “Not really” camp, another member noted: “If these [papers] are based on open-access datasets then I don't think you can [ban] those which do not involve authors from the source country. This is the entire basis of open-access data. The question of context and interpretation is one which the reviewers could be explicitly asked to address.” A further member suggested that: “Sometimes the [high-income-country] researchers bring research skills that are hard to come by in-country. Sometimes countries have collected data that are not analysed. In these instances, having someone from outside analyse it can be a real contribution. If the research could make a difference to health and wellbeing, it would be a lost opportunity not to consider publishing it.” But there is an ethical dimension too, said another: “Although the DHS and HDSS data are freely available, it doesn't look good for our colleagues in the North to author papers without involving partners in the specific countries they are writing about.” Another went further: “Such partnering is a service to developing connections and scholarship opportunities for Southern colleagues.” The solution is to make collaboration a condition of data use, suggested a board member from a middle-income country. “For example, researchers from the North who want to use our data are required to include our local researchers who produced the data. Before sharing our datasets, we demand that they visit [our setting] to get a feel for the environment and population about which they will be writing.” Yet we need to be careful not to enter the realm of tokenism or “gift” authorship, warned one respondent. “Even myself, based in [a middle-income country], find situations where I could not point to a colleague/name to join a paper.” We would like to thank our International Advisory Board for their frank and insightful input. The issue is clearly not straightforward, especially in this era of open data, and that an outright “ban” on submissions without author representation from the country of study may have unintended consequences. However, we strongly encourage those embarking on secondary analyses to recruit, and involve at all stages of the research and publication process, suitably qualified local researchers. We invite readers who have successfully negotiated this process to share their experiences and to help us develop future policies and expectations. Parasitic and parachute research in global healthThe Lancet Global Health (June 2018)1 wrote an Editorial on fly-in, fly-out researchers and data sharing and invited readers to share their experiences on the topic. The new model for global health partnerships and international research collaborations is closing the door to parachutes and parasites. The biggest funders of health research in Africa, including the EU, through the European & Developing Countries Clinical Trials Partnership (EDCTP), the Wellcome Trust, the Medical Research Council, and the Bill and Melinda Gates Foundation (BMGF) are more inclined to support long-term collaborative research based on equity between collaborators in North-South consortia. Full-Text PDF Open AccessSecondary analysis and participation of those at the data sourceYour Editorial Closing the door on parachutes and parasites (June 2018)1 offers poignant insight on key issues in authorship of manuscripts resulting from secondary data analysis. As global health researchers who believe in the ethical and scientific imperative to maximise health gains from existing data, we strongly support the need to get this right. The discourse is not only important to develop sound publication practice, but also to promote equity, effectiveness, and sustainability of global health research collaboration. Full-Text PDF Open AccessParasitic and parachute research in global healthIn their Editorial, the Editors of The Lancet Global Health discuss two categories of research: primary and secondary research using open-access data.1 Most global health researchers are motivated to improve the health of vulnerable populations. As Tedros Adhanom Ghebreyesus voiced at the 71st World Health Assembly, “ultimately, the people we serve are not the people with power; they're the people with no power”.2 However, with increasing pressures of academic models that incentivise a culture of publish or perish and when resources to undertake applied research are limited, sustainable development of public health might become a secondary objective and contribute to the authorship debate. Full-Text PDF Open AccessParasitic and parachute research in global healthWe read the Editorial1 about parasitic research in The Lancet Global Health with great interest. As a group of malnutrition researchers based in and outside Malawi, we would like to share our journey towards establishing a sustainable programme that builds on local talent and the model we have developed to prevent parasitic research. Full-Text PDF Open AccessParasitic and parachute research in global healthGlobal health advocates often speak the language of eradication. It is reassuring to see the Editors of The Lancet Global Health turn their attention to another eradication effort: that of so-called parachute researchers and parasitic research (June issue).1 The Editors raise the important issue of exploitative research activities, from which individuals from predominantly high-income countries extract data and knowledge from predominantly low-income and middle-income countries without due acknowledgment of local partners and collaborators. Full-Text PDF Open AccessDiversity and inclusion: from priority setting to publicationWorld Mental Health Day saw the publication of the Lancet Commission on global mental health and sustainable development. Acknowledging the central principle of the Sustainable Development Goals that no one be left behind, the Commission aims to broaden the global mental health agenda. Its strategy includes the mobilisation of the voices of people with lived experience of mental disorders. Although it refers to “the demand for meaningful participation by patients and family members in all aspects of shaping mental health policies”, the Commission mainly addresses service user involvement in treatment and care planning. Full-Text PDF