Lancet GH: The way forward in decolonising global health

5 July, 2023

Dear HIFA colleagues,

Citation, extracts and a comment from me below.

CITATION: The way forward in decolonising global health

Sudeep Adhikari et al.

The Lancet Global Health. Open Accessc Published:July, 2023




We envision a utopian future wherein health-care providers and researchers, regardless of country of residence or origin, receive equal opportunities in recognition; research and publishing; training; access to international travel for conferences and work; and salaries and incentives, so that every LMIC expert is considered equivalent to their high-income country (HIC) counterparts. We ultimately hope for a future in which people from every country have equal access to quality health care, fulfilling the aspiration of universal health coverage proposed by WHO.

The Lancet Global Health May issue editorial highlighted the severe scarcity of health workers in most LMICs... Retaining health workers should be the highest priority in LMICs, and it should be a joint global effort.

The next priority should be to improve LMIC research capacity through two steps. First: via LMIC research culture. Governments should allocate a substantial budget to health research, and they should encourage researchers to lead impactful clinical trials, with fast-track proposal acceptance and revising policies that hinder trial conduct. Second: globalising clinical trials...

Inadequate inclusion of LMIC researchers and participants in impactful clinical trials has led to dependence upon clinical guidelines from HIC settings. Using such guidelines can be inappropriate or even harmful in LMIC contexts. Early involvement of LMIC health experts in trial design would allow creation of guidelines that serve multiple contexts. High-impact international journals can provide a platform for publishing such guidelines and, hence, give them international recognition. The Lancet group is now in the best position to effect such an initiative through the Lancet Regional Health titles, which can encourage preparation of region-specific guidelines.


COMMENT (NPW): HIFA is a campaign partner for Evidence Based Health Care Day 2023, and our theme this year is 'Evidence and global health equity'. The issues are many, but perhaps the most important is how to strengthen the global evidence ecosystem so that it delivers universal health caverage - better quality health care for everyone, underpinned by improved availability and use of reliable healthcare information. Improving the availability of information depends on better coordination and communication among stakeholders; understanding of information needs and how to meet them; and advocacy.

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: