Global Health research abstracts: December ‘25

The last two decades have witnessed a growing acknowledgment of the importance of research on mental health in the global health context. The 1995 edited volume, World Mental Health [1], the 1996 publication of the Global Burden of Disease Study [2], and the 2001 World Health Report [3] powerfully utilized mental health data or underscored the role of research in achieving gains in mental health around the world. By 2007, the World Health Organization and the Global Forum for Health Research released their report on research capacity for mental health, demonstrating the dearth of mental health research from low- and middle-income countries, in particular, as well as the need to bridge the gap between research, practice, and policy [4]. That same year, the Lancet special issue on global mental health galvanized the global mental health community, outlining concrete actions to advance the field [5]. The series Call to Action underscored the importance of research as a means to expand the global evidence base and to make the case for mental health care delivery reform, especially in low-and middle-income countries (LMICs) [5]. At the time, however, medical students and residents from high-, middle-, and low-income countries, alike, would have noted a dearth of funding to support research training focused on global mental health themes. Despite this, by 2009, new global health programs at universities were rapidly appearing in the USA and providing more opportunities for training in global health [6], but few had well-developed mental health components—either research or clinically focused. At the National Institute of Mental Health (NIMH), a reevaluation of the institute’s role in global health research was also underway. By mid-2009, NIMH began reorganizing the Office for Special Populations and the Office of Global Mental Health to create the Office for Research on Disparities and Global Mental Health (ORDGMH) in 2010. Consistent with the NIMH mission, the new office underscored (1) the critical need to mount an inclusive global effort to expand research—and the capacity to conduct research—on preventing and treating mental illness, (2) the centrality of eliminating disparities as part and parcel of this effort, and (3) the value of recognizing that local contexts around the globe share commonalities that can provide insights into equitably reducing the suffering associated with mental illness. An explicit goal of ORDGMH was to create a research career path in global mental health for US investigators, while also supporting research capacity building in low- and middle-income countries as a route to building high-quality collaborative research. To achieve this goal, ORDGMH expanded collaborations with the Fogarty International Center (FIC)—the NIH center tasked with supporting and facilitating global health research and research training—and, where indicated, developed new targeted initiatives for research capacity development in mental health. In this article, we briefly describe NIMH activities in support of global mental health research training and future directions for research training in global mental health.

Reform of research funding processes could pave the way for progress in global health

BackgroundNetworks are increasingly regarded as essential in health research aimed at influencing practice and policies. Less research has focused on the role networking can play in researchers’ careers and its broader impacts on capacity strengthening in health research. We used the Canadian Coalition for Global Health Research (CCGHR) annual Summer Institute for New Global Health Researchers (SIs) as an opportunity to explore networking among new global health researchers.MethodsA mixed-methods exploratory study was conducted among SI alumni and facilitators who had participated in at least one SI between 2004 and 2010. Alumni and facilitators completed an online short questionnaire, and a subset participated in an in-depth interview. Thematic analysis of the qualitative data was triangulated with quantitative results and CCGHR reports on SIs. Synthesis occurred through the development of a process model relevant to networking through the SIs.ResultsThrough networking at the SIs, participants experienced decreased isolation and strengthened working relationships. Participants accessed new knowledge, opportunities, and resources through networking during the SI. Post-SI, participants reported ongoing contact and collaboration, although most participants desired more opportunities for interaction. They made suggestions for structural supports to networking among new global health researchers.ConclusionsNetworking at the SI contributed positively to opportunities for individuals, and contributed to the formation of a network of global health researchers. Intentional inclusion of networking in health research capacity strengthening initiatives, with supportive resources and infrastructure could create dynamic, sustainable networks accessible to global health researchers around the world.

The Department for Health and Social Care (DHSC) and National Institute for Health and Care Research (NIHR) established the Global Health Research (GHR) portfolio following the 2015 UK Aid Strategy. Its purpose is to support applied health research and training in low-and middle-income countries (LMICs), addressing unmet needs and strengthening research capabilities. An initial budget of £429.5m was allocated for the first phase of the portfolio (2016/17 -2020/21), complementing other Official Development Assistance (ODA) research funders and evolving over time to include 30 programmes that NIHR or external partners manage. The portfolio is diverse in terms of its health focus, geographical scope, and funding size and emphasises the NIHR's operating principles of impact, excellence, effectiveness, inclusion, and collaboration, as well as strengthening research capacity, equitable partnerships and community engagement and involvement (CEI). It has grown to encompass 17 thematic areas, operate in over 50 LMICs, and has funded 616 awards in the first phase. The GHR Portfolio's Theory of Change (ToC) outlines the NIHR's ambition to improve global health outcomes. It recognises that it may take 3-10 years for research outputs to influence policy, practice, and behaviour changes and 10-25 years for these changes to lead to strengthened health systems and increased capacity for health promotion and disease prevention. The DHSC commissioned Ecorys through the NIHR in December 2021 to undertake an evaluation of its first phase of activities (2016/17-20/21). The portfolio evaluation is delivered in four stages: inception, interim evaluation, final evaluation (due in December 2023) and a dissemination phase (due to be completed by March 2024). The evaluation utilises a theory-based approach to assess the contributions of the GHR Portfolio to the intended outputs, outcomes, and likely impact of investments. It focuses on assessing whether the portfolio is on track to deliver the expected results given the long-term nature of the research impact. The evaluation process involves testing the portfolio's ToC, including its assumptions and causal links, to determine the validity of the underlying theory using a contribution analysis (CA) approach. CA is an approach that allows recognition of the complexities of attribution, given a whole wide range of enabling and hindering factors (internal and external) producing a result. Findings are assessed against two dimensions:  Strength of evidencehow well triangulated a finding is and how much evidence there is to support it.  Plausibility of contribution -how likely is it that these activities and outputs will lead to the outcomes in the theory of change. Based on this, throughout the narrative, findings are expressed in terms of their strength of evidence (strong, moderate, limited, poor), but it should be noted that this relates to how much evidence the evaluators found to support a finding, rather than a judgement on the result. The evaluation framework and questions are organized around the Organisation for Economic Co-operation and Development's Development Assistance Committee (OECD-DAC) evaluation criteria, grouped into three pillars: relevance and coherence, effectiveness and efficiency, and sustainability and impact. The framework also includes questions related to adaptability and learning, community engagement and involvement (CEI), and value for money (VfM). The key methods comprise portfolio, programme and award documentation and data review; interviews with stakeholders at portfolio, programme and award levels; an online survey to all funded awards; a Social Network Analysis (SNA) to assess networks and interactions between funded institutions; and a Bibliometric Analysis (BA) to examine research collaboration to be conducted in the final evaluation phase. A purposive sampling approach to programmes and awards for in-depth review provides rich learning and insights against the Evaluation Questions (EQs). This report presents the interim findings of the evaluation of the first phase of the NIHR's GHR Portfolio. It provides early recommendations for improving the portfolio's impact and sustainability.

The United States (U.S.) has long played a central role in shaping global health governance, supporting United Nations agencies and funding vital programs and initiatives. However, recent political shifts, including, funding cuts, changing geopolitical priorities and a retreat from multilateralism, are threatening the stability of global health systems and research. This editorial examines the cascading consequences of these shifts, particularly for low- and middle-income countries (LMICs). The U.S. withdrawal is not just a budgetary adjustment, but a significant political disruption with unforeseen effects on global inequities. It also redirects research priorities towards security-driven agendas and undermines capacity-building efforts in LMICs. As the U.S. steps back, new actors will try to fill the vacuum, but the direction of this transition remains uncertain. Whether it paves the way for a more decentralised and equitable global health research ecosystem will depend on how global health stakeholders respond. Crucially, LMICs must seize this moment not only to replace lost funding, but to assert greater autonomy, reimagine health systems financing and build more sustainable, locally led models of research and policy leadership. This editorial calls for urgent diversification of funding sources, strengthened South-South collaborations and increased autonomy for LMICs in setting their own research priorities.

Faculty from the University of Calgary’s bachelor of health sciences (BHSc) Global Health Program argue for the development of global health research competencies to prepare students for international placements in low- and middle-income countries. These competencies include the ability to define and describe (a) how to use the concept of health research systems to investigate and describe health research activities in a given country, (b) the concept of health research capacity building, (c) the importance of building equitable and sustainable research partnerships, and (d) the role of knowledge mobilization and translation in health research. This article begins by outlining a rationale for preparing students for global health research activities and the BHSc Global Health Research Program. It then outlines these competencies and provides practical guidance to assist faculty and mentors preparing students for international placements. Finally, a case study of a student-led investigation of the health research system in Ethiopia is presented.

Global Health has not featured as prominently in the European Union (EU) research agenda in recent years as it did in the first decade of the new millennium, and participation...

The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries.

IntroductionIn the past decade, global health research has seen a growing emphasis on research integrity and fairness. The concept of research integrity emerged in response to the reproducibility crisis in...

BackgroundGlobal health research is essential for development. A major issue is the inequitable distribution of research efforts and funds directed towards populations suffering the world's greatest health problems. This imbalance is fostering major attempts at redirecting research to the health problems of low and middle income countries. Following the creation of the Coalition for Global Health Research – Canada (CGHRC) in 2001, the Canadian Society for International Health (CSIH) decided to review the role of non-governmental organizations (NGOs) in global health research. This paper highlights some of the prevalent thinking and is intended to encourage new thinking on how NGOs can further this role.ApproachThis paper was prepared by members of the Research Committee of the CSIH, with input from other members of the Society. Persons working in various international NGOs participated in individual interviews or group discussions on their involvement in different types of research activities. Case studies illustrate the roles of NGOs in global health research, their perceived strengths and weaknesses, and the constraints and opportunities to build capacity and develop partnerships for research.HighlightsNGOs are contributing at all stages of the research cycle, fostering the relevance and effectiveness of the research, priority setting, and knowledge translation to action. They have a key role in stewardship (promoting and advocating for relevant global health research), resource mobilization for research, the generation, utilization and management of knowledge, and capacity development. Yet, typically, the involvement of NGOs in research is downstream from knowledge production and it usually takes the form of a partnership with universities or dedicated research agencies.ConclusionThere is a need to more effectively include NGOs in all aspects of health research in order to maximize the potential benefits of research. NGOs, moreover, can and should play an instrumental role in coalitions for global health research, such as the CGHRC. With a renewed sense of purpose and a common goal, NGOs and their partners intend to make strong and lasting inroads into reducing the disease burden of the world's most affected populations through effective research action.

Background In Global Health Research (GHR), funding policies inform how health research is approached and structured, serving to distribute power and resources in ways that can either reinforce or take action on inequities. In essence, these policies incentivize the focus of GHR and are therefore among the political/structural determinants of health. Despite broad recognition of the need for equity in GHR, the role of funders receives relatively little scrutiny. We sought to better understand the place of equity across the international landscape of GHR funders. Methods Publicly accessible, current strategic (those that set the vision, mission and goals of funding) and operational (those that set the implementation rules and compliance requirements for funded research) policies were harvested from 23 purposely selected Global North and philanthropic funding agencies. Content and discourse analysis were used to examine the portrayal of GHR in inequitable contexts, declarations of equity intentions, and to assess alignment to the six CCGHR equity-centred principles. Results Funding agencies across the Global North made clear declarations on the importance of equity in GHR; however, operationalization was largely absent or incompatible with the best scientific evidence on advancing health equity. Most philanthropic funding agencies failed to make policies public meaning equity action remains unclear. Alignment with equity-centred principles presented in different forms from varying agencies, though no single agency demonstrated good alignment to all six principles. Conclusions Funder discourses suggest equity is a central priority in GHR. Given that funder policies are themselves determinants of equity, stronger alignment between strategic policies, intentions, and action on inequity (e.g., investing in interventional research that acts on upstream determinants) are critically needed for funders of GHR, specifically, and public health research, broadly. Key messages • Funding policy can determine equity possibilities, both in research processes and outcomes. • Coherence between strategic intentions and operational policies is possible, and would promote more equity-advancing research.

In spring of 2012, students and staff at the First Faculty of Medicine at Charles University in Prague invited distinguished public health stakeholders and experts to engage in a Global Health Forum. The forum lasted an afternoon, was academically and clinically engaging and offered students and medical faculty a venue to discuss the most pressing global public health concerns. Main outcomes from the forum included describing outstanding public issues in public health policy and prevention, infectious disease and public health systems raised by the speakers, stakeholders and attendees. One major result of this forum is the establishment of the Prague Center for Global Health - an interdepartmental and interdisciplinary research collaborative to further the discussion and much needed field and academic research in global public health. The Prague Center for Global Health will include multiple international research centers and main function and results will include new courses at the university, publications based on best practices and research and a venue to learn, share and create in the academic space.

BackgroundThe concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya.MethodsWe conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.ResultsOur study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research.ConclusionThis study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings.

Weill Cornell Medical College of Cornell University

Community and public engagement (CPE) is increasingly becoming a key component in global health research. The National Institute for Health Research (NIHR) is one of the leading funders in the UK of global health research and requires a robust CPE element in the research it funds, along with CPE monitoring and evaluation. But what does “good” CPE look like? And what factors facilitate or inhibit good CPE? Addressing these questions would help ensure clarity of expectations of award holders, and inform effective monitoring frameworks and the development of guidance. The work reported upon here builds on existing guidance and is a first step in trying to identify the key components of what “good” CPE looks like, which can be used for all approaches to global health research and in a range of different settings and contexts. This article draws on data collected as part of an evaluation of CPE by 53 NIHR-funded award holders to provide insights on CPE practice in global health research. This data was then debated, developed and refined by a group of researchers, CPE specialists and public contributors to explore what “good” CPE looks like, and the barriers and facilitators to good CPE. A key finding was the importance, for some research, of investing in and developing long term relationships with communities, perhaps beyond the life cycle of a project; this was regarded as crucial to the development of trust, addressing power differentials and ensuring the legacy of the research was of benefit to the community.