Equity in Global Health Research: Success or Failure?

A recent article published in the International Journal of Epidemiology has shed a light on trends of first authorship in global health research.

The study found that post-2000s research on low- and middle- income countries (LMICs) is largely led by authors from higher income countries (HICs), due to funding policies within the system.

“Extending research in low and middle-income countries is extremely important,” said Professor Margaret Kelaher, lead author and Head of the Evaluation and Implementation Science Unit in the Centre for Health Policy.

“Developing research capacity has been proven to be key in developing international health programs and health research that are beneficial in lower income countries.”

In the past few decades, there has been a global push towards capacity building in research in LMICs. However, the findings of this study indicate that these global efforts have been falling short.

The study reviewed research articles in HIV/AIDS, malaria and tuberculosis conducted in LMICs between 1990 and 2013. It found a disproportion of authors from LMICs to HICs post- 2000s in global health research.

After the millennium, primary authors came from HICs, mainly North America, despite actual research being carried out in lower-income countries that are suffering these fatal diseases.

Articles published before 2000 had 74% of primary authors coming from LMICs such as Brazil, India, Ethiopia, and Nigeria. However, post-2000 this figure fell by 23% with only 46% of authors coming from LMICs.

In a total of 1,593 articles published between 1990 and 2013, nearly 50% of authors were from LMICs. However, the comparison to the growth of authors from HICs after the millennium is important.

While the number of authors from LMICs increased dramatically, authors writing from higher-income countries had a growth rate four times greater than those writing from lower- income countries after 2000.

The growth of authors from higher- income countries occurred where research was also funded from high income countries. Where funding was either fully or in part from lower income countries, authorship from those countries increased.

“The research findings indicate that these trends were strongly influenced by funders, “ said Professor Kelaher.

“Developing research capacity is evidently an important part of enabling low and middle-income Countries to strengthen their health systems.

We believe that active effort and support accompanied by rigorous evaluation is required in order to allow the control of research to shift to the lower-income countries where the research is conducted. These findings highlight the importance of funders in developing research leadership in these countries.”

The article is available to read online.