Research collaborations between institutions in the North and institutions in the South often show a scientific and power imbalance. In the context of growing concerns about this issue, initiatives are being developed to increase fairness in research partnerships. In particular, the Research Fairness Initiative, providing a reporting system for institutions is gaining traction, according to speakers at the Geneva Health Forum this week.

The 2018 edition of the Geneva Health Forum took place from 10-12 April. The general 2018 theme is the impact of the digital revolution in health practices.

One of the panels of the forum looked at how to increase fairness and impact of research partnerships.

David Beran, researcher at the Geneva University Hospitals and the University of Geneva in the Division of Tropical and Humanitarian Medicine, said global health is all about partnerships, however, approaches to partnerships depend on models adopted by different institutions.

Scientific Imbalance, 11 Principles, 7 Questions

Jon-Andri Lys, of the Swiss Commission for Research Partnerships with Developing Countries (KFPE), talked about the “scientific imbalance” between high-income countries and low- and middle-income countries.

Between 1995 and 2013, the Organisation for Economic Co-operation and Development (OECD) countries spent about 8 times more on research than most countries of the world, according to the United Nations Educational, Scientific and Cultural Organisation (UNESCO), he said. The UNESCO Institute for Statistics (UIS) has an interactive tool to assess how much is spent on research and development (R&D) by each country.

Lys remarked that in many countries, there is a lack of research infrastructure and no data on how much is spent on R&D is available.

This asymmetry and power imbalances are the reasons why KFPE developed a Guide for Transboundary Research Partnerships. The guide contains 11 principles and 7 questions, Lys said. According to the KFPE website, the guide is intended for researchers considering to engage “in fair and equal partnership towards common goals.” It is also aims at funding agencies designing programmes, and for policymakers aiming at establishing “an enabling environment for effective and intercultural research collaboration.”

Sound research collaborations should be based on mutual interests, according to Lys, and different objectives should be possible through such collaborations. Expectations and added value should also be discussed, he added.

Research Fairness Initiative

Prof. Carel IJsselmuiden, executive director of the Council on Health Research for Development (COHRED), described the goals of the Research Fairness Initiative (RFI). The initiative was developed by COHRED to create a “reporting system that encourages governments, business, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation,” according to the website. The initiative presently focuses on health research and innovation.

According to IJsselmuiden, although some of the KFPE guide principles are known around the world, many institutions have to reinvent collaboration arrangements. This is time consuming, can create potential conflicts, and might give way to power imbalance, he said.

On the international scene, only the Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from their Utilization to the Convention on Biological Diversity “in a very limited environment,” requires the negotiating of equitable partnerships, in terms of sharing genetic and biogenetic information, he said.

However, the protocol’s implementation is “incredibly complex” for many developing countries, he said, involving “legal capacities” on both sides of contract. He cited Africa as an example where lawyers able to negotiate contracts with the pharmaceutical industry are very scarce (except for South Africa).

“Everyone talks about partnerships,” he said, and reports on progress are issued, but there are no metrics for indicating what happens to the capability of partner institutions to take over the lead role, for example.

As a key example he said global health research often means funding and expertise comes from the North, the problem is in the South, it is then jointly solved, but when she issue is solved, the technical power, the start-up industries, the pharmaceuticals, the technologies go back to the North. The economic benefit to the country where the problem was is virtually zero. “There might be a new technology, diagnostic, vaccine” he said, but the development of the country is missing from the current view of global health research.

According to the RFI website, “Low investment in health research and development generally perpetuates the reliance on a small number of exceptionally well-resourced public funders, private philanthropies, and private industry, which gives them disproportionate power to shape the global research and development agenda.”

“In addition, the wealthiest and best-equipped institutions and organizations have a significant advantage in their competitiveness for research funding, and for exercising control over the goals and terms of research partnerships,” it says.

The RFI wants to establish a reporting structure for all key stakeholders, and focuses on three areas: Fairness of opportunity, fair process, and fair sharing of benefits, costs, and outcomes, IJsselmuiden said.

He added that RFI is currently being used by Senegal, and serious expressions of interest have come from institutions such as the University of Lisbon, Portugal; Institut de Recherche pour le Développement, France; Fiocruz, Brazil; Emory University, United States; and the national Public Health Research Authority, Zambia.

Joint UN initiative Scores Well

RFI is also being used by TDR, the Special Programme for Research and Training in Tropical Diseases, said Robert Terry of TDR, which recently issued its TDR Research Fairness Initiative Report 2018 [pdf].

TDR is hosted by the World Health Organization and is sponsored by UNICEF, the UN Development Programme, the World Bank, and the WHO. According to the report, TDR is an early adopter of RFI.

The report explored the three areas of the RFI (fairness of opportunity, fair process, and the fair sharing of benefits, costs, and outcome), and found that TDR scored well on the fairness of opportunity, which includes improving the participation of all stakeholders at relevant stages of research development.

TDR also scored well on fair process the report found. However, on the fair sharing of benefits, costs and outcomes, the report found that the development of good practice is at an early stage and should improve.