Bethany Hedt-Gauthier, Seye Abimbola, Collins Airhihenbuwa, Michele Barry, Kathryn Chu, Maureen Connelly, Eve Estrada, Rashi Jhunjhunwala, Keith Martin, Wendy Prudhomme-O’Meara, and Miriam Shuchman.
Background: Collaborative, interdisciplinary and intersectorial research is an important approach for better understanding issues leading to poor health outcomes and for identifying strategies to address these issues. In global health research, power imbalances between researchers and between research institutions, exacerbated by colonialism, historical injustices, geo-political interests, economic oppression, and persistent structural racism, have resulted in poor research practices. These include a failure of researchers from highly resourced institutions to meaningfully and equitably engage collaborators with fewer resources and less power, to support processes that fairly engage with collaborators and reward those collaborators for their contributions, and to support those collaborators’ institutional infrastructure for future research. This failure has been linked to policies at highly resourced institutions, including policies on academic promotion, that directly or indirectly shape research collaborations.
This position statement provides specific recommendations to academic institutions on changes to promotion review and other administrative policies with the goal of achieving equitable research collaborations. These recommendations are intended to support individuals striving for fair partnerships and will provide motivation for inclusive engagement and co-creation between collaborative partners.
The primary target for these recommendations are highly resourced academic institutions – institutions in positions of greater power relative to a collaborator’s institutions. Notably, academic institutions in high-income countries – institutions that have benefitted the most from power imbalances and have over the years codified some norms that perpetuate these inequities – are key players to adopt such recommendations to address these imbalances. However, these recommendations may be considered more broadly in the context of addressing inequities and imbalances that exist within South-South research collaborations and in community-engaged research in otherwise underserved and understudied communities everywhere.
Recommendations: Here, we use “promotion candidate” or “researcher” to refer to the individuals whose institutions are directly targeted by the recommendations below. Because these recommendations are to address power imbalances, we use “collaborating institution” to specify collaborator institutions in a disadvantaged community or institution relative to the “promotion candidate” or “researcher” institution.
Changes in promotion criteria:
- Include promotion candidate’s statements on efforts to pursue equitable collaborations as part of the dossier.
- Solicit feedback on the promotion candidate’s impact and engagement from individuals at the collaborating institution, at multiple ranks, and from institutional leaders outside of high-resource settings and outside of academia.
- Include metrics on collaboration and equity in the promotion process, including metrics that recognize the effort and time dedicated to nurturing collaborative partnerships. Some metrics are identified in Points 4-7 in this list.
- Value authorship lists, including non-first and non-senior authorship contributions by the promotion candidate, that create space for individuals from the collaborating institution. Expect authorship from individuals from the collaborating institution, including in the first and senior authorship positions. Give particular emphasis to authorship with an individual from the collaborating institution in a lead author position that was supported to lead the manuscript by the promotion candidate. Challenge the appropriateness of publications on research taking place in a setting that does not include co-authors from that setting.
- Value funding jointly obtained by the promotion candidate and individuals from the collaborating institution, including funding that is directly awarded to the collaborating institution.
- Value teaching and mentorship to all individuals engaged in the promotion candidate’s research, not just those based at the promotion candidate’s institution. Value the activities to strengthen long term capacity at the collaborating institutions, including human resources training and infrastructure support sought by such institutions. Recognize these efforts to build and sustain partnerships as a core part of the promotion candidate’s expected activities rather than the conventional nod given for ‘service’.
- Value the promotion candidate’s efforts to engage the government, public, or media on scientific issues, particularly in the setting of the research, to bridge the science-public policy gap.
Changes in administrative policies:
- Increase and individualize flexibility regarding the amount of time researchers can spend away from their home institution when building research collaborations.
- Allow tenure clock extensions, available at the request of the promotion candidate, if more time is needed to nurture collaborative partnerships.
- Fund extended residencies in the locations where the primary research is conducted. Facilitate individuals from the collaborating institution visiting the researcher’s home institution.
- Support teaching and mentoring at the collaborating institutions. This includes adapting policies that restrict outside teaching and/or recognizing such teaching as a core part of the researcher’s academic responsibilities. Researchers should be able to reuse teaching materials they developed at their home institutions for this purpose.
- Provide fair compensation to collaborating institution personnel who provide teaching or supervision to the researcher or to the researcher’s trainees. Compensate collaborating institutions for resources used by the researcher. Provide funding for human resources or infrastructure capacity building sought by the collaborating institution. Seek equity in overheads from donors; when not possible for equal indirect rates, budget to cover the same expenses at the collaborating institution as direct costs.
- Have an advocate in the Dean’s office versed in global and/or community-based collaborations that can advocate for faculty and departments leading this work.
Ways forward: This is the first of such recommendations from CUGH. While an important first step, these recommendations do not cover all areas that need to be addressed to reduce collaborative inequities in global health research. CUGH plans to undertake activities to advance this work, possibly including the following:
- Champion advocacy activities for relevant Consortium member institutions to adopt these recommendations.
- Develop: a) tools, such as templates for promotion candidate’s statements on efforts to pursue equitable collaborations, that will support adoption of these recommendations, and b) metrics that will evaluate the impact of adopting these recommendations.
- Collect and develop case studies and examples of best practices from institutions implementing these recommendations.
- Develop complementary recommendations targeting funding agencies and journals.
Further, it is critical to recognize that CUGH is comprised of many institutions, both highly resourced institutions and institutions with less resources and less power. While these current recommendations are targeting the highly resourced institutions, it will be important for the Consortium to prioritize activities and strategies that recognizes and continues to build the agency of individuals at lesser-resourced institutions. To that end, CUGH will continue, expand, and pursue activities that:
- Support the research strengthening and leadership building activities at these institutions.
- Improve partnership negotiations, including an ombudsman office to help resolve issues between CUGH partners.
- Collect and develop case studies of strong and inequitable partnerships as a learning tool.
It is only through engaging all institutions that the issues of inequity in collaborations can fully be addressed.