Abstract
BackgroundGlobal health conceives the notion of partnership between North and South as central to the foundations of this academic field. Indeed, global health aspires to an equal positioning of Northern and Southern actors. While the notion of partnership may be used to position the field of global health morally, this politicization may mask persisting inequalities in global health. In this paper, we reflect on global health partnerships by revisiting the origins of global health and deconstructing the notion of partnership. We also review promising initiatives that may help to rebalance the relationship.Results and DiscussionHistorical accounts are helpful in unpacking the genesis of collaborative research between Northerners and Southerners – particularly those coming from the African continent. In the 1980s, the creation of a scientific hub of working relationships based on material differences created a context that was bound to create tensions between the alleged “partners”. Today, partnerships provide assistance to underfunded African research institutions, but this assistance is often tied with hypotheses about program priorities that Northern funders require from their Southern collaborators. African researchers are often unable to lead or contribute substantially to publications for lack of scientific writing skills, for instance. Conversely, academics from African countries report frustrations at not being consulted when the main conceptual issues of a research project are discussed. However, in the name of political correctness, these frustrations are not spoken aloud. Fortunately, initiatives that shift paternalistic programs to formally incorporate a mutually beneficial design at their inception with equal input from all stakeholders are becoming increasingly prominent, especially initiatives involving young researchers.ConclusionSeveral concrete steps can be undertaken to rethink partnerships. This goes hand in hand with reconceptualizing global health as an academic discipline, mainly through being explicit about past and present inequalities between Northern and Southern universities that this discipline has thus far eluded. Authentic and transformative partnerships are vital to overcome the one-sided nature of many partnerships that can provide a breeding-ground for inequality.
Highlights
Global health conceives the notion of partnership between North and South as central to the foundations of this academic field
Authentic and transformative partnerships are vital to overcome the one-sided nature of many partnerships that can provide a breeding-ground for inequality
Embracing the popular social justice discourse that is inherent to ethics, global health aspires to an equal positioning of Northern and Southern actors
Summary
Revisiting the origins of global health Deconstructing implies “examin[ing] in order to reveal the basis or composition of often with the intention of exposing biases, flaws, or inconsistencies” [8]. Academics from the North, heads of North-based research centres, and managers of funding institutions need to understand the history of global health This would primarily involve knowing and valuing local specificities as well as past and present public health experiences and practices, recognizing material differences in equipment and living standards, acknowledging the legacy of paternalistic tropical medicine and international health practices, and understanding how Southern people’s memories of colonialist medicine still affect how they perceive global health projects. From meso and micro perspectives, re-integrating into traditional discipline curricula in sub-Saharan African universities may be difficult for Southern researchers trained in the North [44] Because their salaries are often lower than expected and/or because older researchers already hold senior positions, these young academics are often tempted to work as consultants for international projects or undertake political careers in government ministries [45]. Sub-Saharan Africa-based researchers need to engage with policy-makers and raise awareness on this issue
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