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Global Health Econ Sustain Decolonization of health care

experiences of local health-care providers offers valuable clinical arenas. A reduction in the often-excessive author
insight into how care can be improved elsewhere. Specific processing charges levied by many journals has recently
examples include learning about the healing properties been widely adopted for authors from LMICs, which is a
of banana leaves in the treatment of burns and the use of welcome move in the right direction.
mucuna beans in the treatment of Parkinson’s disease.
6. Strategies to address academic
5. Academic challenges and changes challenges
The situation in academic medicine has placed Africans at The majority of funders for research in LMICs are based
a distinct disadvantage for decades. Not only do non-native in higher-income countries (HICs). Until recently, many
English speakers take longer to read and write scientific funders required grants to be led by the HIC partner,
papers (Amano et al., 2023), but preprints from the African which meant that LMIC partners had to be approached
continent are over 50% less likely to be published as full by HIC partners or seek out interested HIC partners to
peer-reviewed papers (Eckmann & Bandrowski, 2023). submit a bid. This situation presented challenges as LMIC
This discrepancy is consistent with reduced resources partners often lacked the necessary experience and support
and editorial bias. In one instance, a paper authored by an for such endeavors. However, several grant calls have
African was rejected from a prominent journal solely due recently specified that bids can be led by LMICs and do
to the African address provided, yet the same paper was not necessarily require a HIC partner. For example, there
accepted with minimal corrections when submitted from are now six National Institute of Health Research Global
the UK (Rasheed, 2023). While academic output was never Health Research Groups (GHRG) led by LMIC partners.
our priority, we have published eight articles documenting While this represents only a small proportion of the
our collaboration across several clinical domains. With the overall GHRGs, it is certainly a step in the right direction.
equality, diversity, inclusivity, and justice (EDIJ) agenda Furthermore, two of the authors of this paper are presently
visibly linked to decolonization, it is worth noting that undertaking PhDs with direct support from academic
60% of our authors are African, with 57% being female. institutions in the Global North. This initiative has already
Furthermore, the majority of the first authors are African, resulted in several publications that will contribute to the
and the last authors are female, which is important
considering the historical underrepresentation of female development and sustainability of clinical services in East
African doctors. Encouragingly, there is a need to actively Africa.
promote publishing such work in African journals by However, too many publications using data from
increasing their value and visibility. Africa are still published in journals from Global North

Funders in the Global North (who are the major by researchers who do not include those who collected the
supporters of funding programs) usually dictate the data or to whom the data relates. In addition to placing
priorities for funding opportunities that impact health Africans at an academic disadvantage, this approach
care in Africa. Consequently, these funding opportunities reduces the likelihood of a change in approach as those
often focus on what the Global North perceives as needs most affected are less likely to receive appropriate feedback.
in Africa. This practice amounts to neocolonialism and For example, a recent paper on the microbiome of hunter-
poses a significant issue. Decolonizing health care in gatherers in Tanzania excluded those who collected the
Africa and other parts of the Global South requires a shift data and offered no feedback to the tribe who had agreed
away from priorities such as national security that heavily to produce the samples in exchange for scientific advice
influence Global North-driven funding. Instead, the focus (Carter et al., 2023). However, equitable access to grant
should be redirected toward addressing issues that result funding and authorship for Africans is entirely feasible
in significant morbidity and mortality globally, such as and should be the rule rather than the exception. A cross-
NCDs and mental health. As highlighted in the BMJ sectional multi-center study is underway to investigate
podcast series, journal editors wield significant influence sickle cell disease mutational burden across Uganda
in this area. The development of a “global health” BMJ and Tanzania, with ethnically matched controls in the
and Lancet acknowledges “that you give equal weight United States of America and the UK. This study has
to the quality of life and to the rights of all populations” the potential to unlock gene therapy for this devastating
(Rasheed, 2023, p. 383). However, true “partnerships must condition (Igbineweka et al., 2023). It is self-evident that
be built on humility, a willingness to learn, and a shift in an academic environment where success is judged on
of power to individuals and institutions”’ in the Global the quality and quantity of published papers in tandem
South (Chandanabhumma & Narasimhan 2020, p. 833). with grant funding achieved, African researchers should
This philosophy should extend to both academic and have equitable access to grant funding and should be

Volume 2 Issue 2 (2024) 5 https://doi.org/10.36922/ghes.2299