Global health in low-income and middle-income countries: a framework for action

I Olufadewa, M Adesina, T Ayorinde - The Lancet Global Health, 2021 - thelancet.com
The Lancet Global Health, 2021thelancet.com
Global health was founded on an egalitarian promise: improve health care for everyone,
everywhere. As an area of research, education, and practice that leverages interdisciplinary
collaboration and focuses on multinational health-care challenges and solutions, 1 global
health is a crucial area of discussion and development, especially to reduce the global
burden of pandemics, and to promote health equity. At this crucial moment in global health
with the COVID-19 pandemic exposing the weaknesses in our health systems, this …
Global health was founded on an egalitarian promise: improve health care for everyone, everywhere. As an area of research, education, and practice that leverages interdisciplinary collaboration and focuses on multinational health-care challenges and solutions, 1 global health is a crucial area of discussion and development, especially to reduce the global burden of pandemics, and to promote health equity. At this crucial moment in global health with the COVID-19 pandemic exposing the weaknesses in our health systems, this Comment takes an introspective and forward-looking approach to propose actionable solutions to global health inequalities in low-income and middle-income countries (LMICs) while building relationships between high-income countries (HICs) and LMICs. First, dismantling inequities in global health must involve bridging the huge capacity divide between professionals in HICs and LMICs. Analysis of 2292 studies done in LMICs from 2000 to 2012 show that authors from LMICs led only 26· 8% of systematic reviews and 29· 9% of modelling studies. 2 Fully armed with the knowledge that the people build the system and the system will eventually build the people, boosting the competence of researchers in LMICs should be prioritised to reposition them in the global knowledge economy. World-class infrastructure and training are needed to achieve this, especially for younger researchers. We have learnt from our experiences as early career researchers teaching younger colleagues across ten African countries in the Slum and Rural Health Initiative Research Academy3 and working with other researchers that young researchers are enthusiastic and open-minded; hence, we know that the right opportunities will strengthen their capacity to lead high-impact research.
Second, a culture of collaboration should be present in LMICs. Evidence from a World Bank report shows that collaboration between researchers in Africa ranges from 0· 9% in west and central Africa to 2· 9% in southern Africa. 4 More inter-African research networking events and fellowship programmes will promote a collaborative research culture within Africa. This strategy will also work for other LMICs. Better collaboration will boost research output, innovation, and quality of studies,
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