Building authentic partnerships across regions and disciplines to overcome global health threats

This journal article, co-authored by Unlimit Health Chief Executive Officer Dr Wendy Harrison and Professor Margaret Gyapong, who both serve as Joint Presidents of the Royal Society of Tropical Medicine and Hygiene, was originally published in International Health — the official journal of the Royal Society of Tropical Medicine and Hygiene, published by Oxford University Press.

Global health is dynamic and not confined to singular, isolated events but spans borders and transcends national boundaries. As the world becomes increasingly interconnected, so too does the complexity of the health challenges we face. Over the last decade we have experienced the devastating impacts of Ebola, coronavirus disease 2019 and mpox. Recent years have also highlighted the growing global health threats of climate change, antimicrobial resistance, migration, urbanisation, conflict and humanitarian crises. These issues are not restricted to one part of the world but affect the most marginalised populations everywhere, especially the poor. While these issues are not new, their urgency has never been greater.

Interdisciplinary partnerships

The complexities of these challenges are multifaceted, demanding a response that draws on the strengths and insights of diverse disciplines, sectors and regions. Our collaborations must evolve—blending public health with economics, environmental science with anthropology or veterinary medicine with ethnographic approaches—to create interdisciplinary partnerships where mutual benefit is not an aspiration but a lived reality.

Evidence suggests, however, that equitable partnership remains an aspiration in some areas of global health.¹ For example, a recent analysis by the National Cancer Institute showed that publications with first authors from low- and middle-income countries (LMICs) make up only 15% of all research from these regions, with just 10% having LMIC-affiliated last authors.² This underrepresentation raises concerns about who controls the narrative and who is excluded. It also highlights other challenges, including authorship rules where only intellectual contributions count, sidelining those who collect data; language barriers, with English being the predominant language for publications; funding issues; and economic disparities where scientists from high-income countries have more opportunities for international travel and to obtain visas.

Often seen as inherently beneficial, global health partnerships require a critical reassessment. While they aim to support the Global South, they can reinforce inequitable power dynamics, even within South–South collaborations. These imbalances in power, resources and knowledge hinder our collective goals. The solutions we seek can only be found in spaces where the exchange of knowledge, resources and expertise flows equally in both directions, recognising that each individual holds one small part of the larger global health puzzle. We must therefore confront these inequities to create authentic partnerships that drive meaningful change.

Embrace a new mindset

Global health solutions must be tailored to the specific needs of geographic regions, sociopolitical contexts and cultural landscapes for lasting, positive effects. Humility is at the core of this approach. It requires the ‘learners’ of the past to become the ‘teachers’ of the present and vice versa. Embracing this mindset will help us open ourselves to new ways of thinking and to learn from those who have historically been considered the ‘subjects’ of research or intervention, acknowledging that they hold invaluable knowledge to guide us to more effective, sustainable outcomes.

As we continue to build these partnerships, we must broaden our understanding of what valuable contributions mean in practice. Too often, we default to measuring the success of a partnership based on financial investment. Yet, expertise, historical context, community trust and lived experience are crucial in building effective global health initiatives. These non-financial resources are often the most critical components for long-term success and deserve equal recognition.

We consider the following principles to be important for transforming inequities in global health partnerships:

Build solutions together

True partnerships involve all voices—especially local expertise from community leaders, health workers and citizens. Co-creation means more than just inviting these voices to the table; it means ensuring they play a central role in shaping the solutions so that partners, at every level, are integral to the design, implementation and evaluation of programs.

Trust and transparency

Building trust requires open, honest dialogue, particularly when power dynamics and competing agendas might not be visible to all partners. Clear communication at the outset of every partnership sets the stage for candid conversations and overcoming tensions.

Authorship: clarify expectations early

Equitable authorship in global health partnerships is essential for shared ownership and preventing future resentment. We must clarify expectations early, not just for academic or institutional outputs, but for policy briefs and other media that drive health system change.

Share knowledge

Research findings should be shared broadly and inclusively, especially with the contributing communities. Dissemination should not be seen as the final step, but rather an opportunity to gather feedback, reflect on lessons learned and make adaptations for the future.

Listen to local expertise

Local experts—researchers, community leaders and citizens—bring invaluable insights that can enhance our understanding and improve the likelihood of success. Listening means being willing to learn and acknowledge that our approaches may need to change. No one partner, institution or country has a monopoly on solutions. It takes all of us—working together, learning from one another and challenging each other in constructive ways—to address the threats we face.

Build future leaders

Young scientists, particularly women, face challenges balancing work, family and academic ambitions. As mentors, we must invest in leadership, teamwork, equity and other skills, supporting the next generation of global health leaders.

Role of the Royal Society of Tropical Medicine and Hygiene (RSTMH)

In 2023, the RSTMH began implementing a new strategy to enhance the skills, networks and impact of our members and fellows, particularly in low-resource settings and within the global health community.

RSTMH’s ongoing efforts reflect a long-standing commitment to addressing complex global health threats. Uniting academics, policymakers and practitioners across disciplines and regions fosters knowledge sharing, collaboration and partnerships. Through its expanding grants and mentoring programs, the RSTMH supports the development of a new generation of global health leaders who value partnership and the need for interconnected approaches to solve challenges and promote global health.

Creating authentic, equitable partnerships is a long-term effort. It requires working with humility, recognising that we are all part of the global health puzzle and that the best solutions come from collaboration. By building partnerships grounded in mutual respect, where every voice is valued, we can address health threats and lay the foundation for a future where health is a global good, accessible to all.