Equitable Global Health Partnerships Initiative

The Equitable Global Health Partnerships Initiative (EGHPI)’s mission is to drive the structural changes needed to create a more equal, transparent and mutually respectful collaborative environment among partners aiming to advance health worldwide.

Our Approach

As an institution, we want to address the existing long-standing inequities and disparities in collaborations between global stakeholders involved in health research, education and programming. In 2022, a group of leaders from the University of California, San Francisco’s Bixby Center for Global Reproductive Health and the Institute for Global Health Sciences (IGHS) launched an effort to build more equitable partnerships between UCSF stakeholders and our global collaborating institutions and individuals.

Honoring the expertise and experiences of our partners ensures that the Initiative is grounded in fairness, transparency, and mutual respect. UCSF hosted an in-person meeting with sub-Saharan African partners in Nairobi, Kenya, to build community, establish priorities, and develop action plans for ensuring equity in existing global partnerships. As determined and prioritized by global partners, five domains were identified as areas requiring action:

• Relationship Building
• Education, Training and Mentorship
• Knowledge Production and Authorship
• Equity in Financial Management
• Ethics and Community Involvement

Our Work

The path to more equitable partnerships is built on four key pillars that serve as the foundation of this initiative:

1. Strength in collaborative research — Given the shift towards localization by US government and other donors, it is a priority for UCSF to strengthen its partnerships with LMIC institutions and enhance local research capacity, and promote knowledge sharing with global partners.
2. Opportunity for inclusive practices — There is always opportunity for inclusive practices – usually large organizations like UCSF tend to work in silos domestically and globally. There is potential to strengthen our partnerships by ensuring local voices shape research agendas and health solutions and by bringing in key UCSF stakeholders and faculty engaged in global work to be engaged in this initiative.
3. Framework for systemic change — Accountability and transparency are critical for respectful strong partnerships. Several action items implemented by this group have led to systemic change and we hope we can continue with this work to reduce systemic barriers and prevent exploitative dynamics in collaborations.
4. Equitable decision-making processes — this needs to be a reminder to us all as we engage with our global partners. It is easy sometimes to forget but the lack of equitable decision-making processes really hampers partnerships.

Given the overarching foundational pillars, here’s a summary of action items completed under each of the action groups:

Relationship Building

• A campus standards and principles document to guide equitable global partnerships. This document is under review for approval by UCSF leadership.
• Revised international agreement templates to reflect equitable language and enhance transparency for global partners.
• Developed a Research Equity Toolkit outlining best practices for partnerships, including governance, project design, implementation, recruitment and hiring, authorship/publications, and financial management.

Education, Training, and Mentorship

• Training module on “Decolonizing Global Health” developed and pilot tested and is ready for rollout.
• Integrate new equity training into UCSF medical and global health education programs.
• Ongoing work on operationalizing bi-directional clinical exchanges by a) identifying and addressing visa, clinical licensing, and campus bottlenecks; b) conducting process mapping for hosting clinical trainees; c) developing equitable clinical exchange strategy and evaluations guide.

Authorship and Knowledge Production

• Develop a guidance MyCV document outlining how mentoring of researchers in global partner institutions can be factored into faculty advancement and programs.
• Provide authorship guidance for CVs and Biosketches for highlighting authorship and grants with researchers and mentees in global partner institutions.

Equity in Financial Management

• Review all contractual templates for collaborations (subcontracts) for biased language and remove verbiage like “high risk,” etc.
• Removed the “Hardship Letter” for global partners to request an advance.
• Increased advance amount to 25% of the international subcontract budget.
• Subaward Partner Package – budget development and standards guidelines for backup documentation and exchange rate reconciliation are being developed.

Ethics and Community Involvement

• Update CTSI resources on community partnership and adapt to global context
• Pilot project for IRB reliance agreements with two long-standing global partner organizations: Makarere University and Kenya Medical Research Institute

Resources

• The Consortium of Universities for Global Health (CUGH) – Global Health Competencies Toolkit
• Clinical and Translational Science Institute (CTSI) – Mentor Training Program
• International Students and Scholars Office
• Office of Research

Who We Are

The initiative is being co-led by the UCSF Bixby Center, the UCSF Institute for Global Health Sciences, and our global partners in Africa. However, we would like to expand to partners in other regions as well.

Working Groups

Some of these individuals may no longer be participating in these action groups.

Publications