In/dependent Collaborations: Perceptions and Experiences of African Scientists in Transnational HIV Research

Data as scientific currency: Challenges experienced by researchers with sharing health data in sub-Saharan Africa

Innovative information-sharing techniques and rapid access to stored research data as scientific currency have proved highly beneficial in healthcare and health research. Yet, researchers often experience conflict between data sharing to promote health-related scientific knowledge for the common good and their personal academic advancement. There is a scarcity of studies exploring the perspectives of health researchers in sub-Saharan Africa (SSA) regarding the challenges with data sharing in the context of data-intensive research. The study began with a quantitative survey and research, after which the researchers engaged in a qualitative study. This qualitative cross-sectional baseline study reports on the challenges faced by health researchers, in terms of data sharing. In-depth interviews were conducted via Microsoft Teams between July 2022 and April 2023 with 16 health researchers from 16 different countries across SSA. We employed purposive and snowballing sampling techniques to invite participants via email. The recorded interviews were transcribed, coded and analysed thematically using ATLAS.ti. Five recurrent themes and several subthemes emerged related to (1) individual researcher concerns (fears regarding data sharing, publication and manuscript pressure), (2) structural issues impacting data sharing, (3) recognition in academia (scooping of research data, acknowledgement and research incentives) (4) ethical challenges experienced by health researchers in SSA (confidentiality and informed consent, commercialisation and benefit sharing) and (5) legal lacunae (gaps in laws and regulations). Significant discomfort about data sharing exists amongst health researchers in this sample of respondents from SSA, resulting in a reluctance to share data despite acknowledging the scientific benefits of such sharing. This discomfort is related to the lack of adequate guidelines and governance processes in the context of health research collaborations, both locally and internationally. Consequently, concerns about ethical and legal issues are increasing. Resources are needed in SSA to improve the quality, value and veracity of data-as these are ethical imperatives. Strengthening data governance via robust guidelines, legislation and appropriate data sharing agreements will increase trust amongst health researchers and data donors alike.

Unfair knowledge practices in global health: a realist synthesis

Unfair knowledge practices easily beset our efforts to achieve health equity within and between countries. Enacted by people from a distance and from a position of power ('the centre') on behalf of and alongside people with less power ('the periphery'), these unfair practices have generated a complex literature of complaints across various axes of inequity. We identified a sample of this literature from 12 journals and systematized it using the realist approach to explanation. We framed the outcome to be explained as 'manifestations of unfair knowledge practices'; their generative mechanisms as 'the reasoning of individuals or rationale of institutions'; and context that enable them as 'conditions that give knowledge practices their structure'. We identified four categories of unfair knowledge practices, each triggered by three mechanisms: (1) credibility deficit related to pose (mechanisms: 'the periphery's cultural knowledge, technical knowledge and "articulation" of knowledge do not matter'), (2) credibility deficit related to gaze (mechanisms: 'the centre's learning needs, knowledge platforms and scholarly standards must drive collective knowledge-making'), (3) interpretive marginalization related to pose (mechanisms: 'the periphery's sensemaking of partnerships, problems and social reality do not matter') and (4) interpretive marginalization related to gaze (mechanisms: 'the centre's learning needs, social sensitivities and status preservation must drive collective sensemaking'). Together, six mutually overlapping, reinforcing and dependent categories of context influence all 12 mechanisms: 'mislabelling' (the periphery as inferior), 'miseducation' (on structural origins of disadvantage), 'under-representation' (of the periphery on knowledge platforms), 'compounded spoils' (enjoyed by the centre), 'under-governance' (in making, changing, monitoring, enforcing and applying rules for fair engagement) and 'colonial mentality' (of/at the periphery). These context-mechanism-outcome linkages can inform efforts to redress unfair knowledge practices, investigations of unfair knowledge practices across disciplines and axes of inequity and ethics guidelines for health system research and practice when working at a social or physical distance.

Exploring equity in global health collaborations: a qualitative study of donor and recipient power dynamics in Liberia

IntroductionGlobal health collaborations between individuals from high-resource and low-resource settings are complex and often built on hierarchical structures and power differentials that are difficult to change. There have been many calls and frameworks developed to facilitate more equity within these collaborations, yet little is known about the lived experiences of global health donors and recipients working within such collaborations and how those experiences can facilitate more equitable collaboration. Liberia, a postconflict, post-Ebola country, provides an ideal setting to study lived experiences of global health collaborations.MethodsOur qualitative analysis used key informant interviews representing the perspectives of those working on behalf of the Liberian government, Liberian academics, foreign donors and non-governmental organisations and implementing partners. Thematic analysis guided this analysis to explore topics such as financial control, accountability and decision making.ResultsThe first phase of the analysis mapped the existing patterns of priority setting. Priority-setting power was most strongly held by those with financial control (donors), and implementation plans tended to be built on metrics that aim to meet donor expectations. The second phase of the analysis explored the interplay between underlying factors that we identified in our data associated with driving collaborative inequity: history of prior of engagement, level of transparency and patterns of accountability.ConclusionsOur findings highlight that global health collaborations in Liberia are structured to hinder equitable partnerships. The power structure tied to financial ownership offers little space for recipients to have an equitable role in collaborations, which maintains dependence on external aid and ensures that weak systems remain weak. While our study is limited to Liberia, we anticipate that these dynamics are common elsewhere and reinforce the importance of intentional efforts to ensure equitable decision making and power structures in similar settings worldwide.

Ineffective responses to unlikely outbreaks: Hypothesis building in newly-emerging infectious disease outbreaks

Over the last 30 years, there has been significant investment in research and infrastructure aimed at mitigating the threat of newly emerging infectious diseases (NEID). Core epidemiological processes, such as outbreak investigations, however, have received little attention and have proceeded largely unchecked and unimproved. Using ethnographic material from an investigation into a cryptic encephalitis outbreak in the Brong-Ahafo Region of Ghana in 2010-2013, in this paper we trace processes of hypothesis building and their relationship to the organizational structures of the response. We demonstrate how commonly recurring features of NEID investigations produce selective pressures in hypothesis building that favor iterations of pre-existing "exciting" hypotheses and inhibit the pursuit of alternative hypotheses, regardless of relative likelihood. These findings contribute to the growing anthropological and science and technology studies (STS) literature on the epistemic communities that coalesce around suspected NEID outbreaks and highlight an urgent need for greater scrutiny of core epidemiological processes.

Self-interestedness in Research Collaboration and its Association with Career Stage and Nature of Collaboration: A Survey of Zimbabwean Researchers

During collaboration in research, it may happen that some researchers become involved in behaviours that reflect so-called 'self-interestedness', which means that they pursue their personal interest or benefit without considering others. This study examined how researchers in Zimbabwe perceive instances of self-interestedness among research collaborators, and how these perceptions differ according to their career stage and the nature of collaboration. An online survey of researchers in Zimbabwe was conducted to gather information about six instances of self-interestedness among research collaborators. The results show that Zimbabwean researchers involved exclusively in national collaboration reported greater degrees of collaborator self-interestedness than Zimbabwean researchers involved in international collaboration. However, early-career researchers and established researchers did not differ significantly regarding their experiences of collaborator self-interestedness. Measures aimed at capacitating research organisations and research teams in developing countries in the African context, to counter collaborator self-interestedness, are recommended.

Health Research Collaborations by Academic Entities: A Systematic Review

PURPOSE

To review the literature on health research collaborations by academic entities and to identify the main phases, components, and concepts of these research collaborations.

METHOD

The authors conducted a systematic review of the literature, searching 4 databases in March 2022 for studies on health research collaboration between an academic entity (individual, group, or institution) and any other entity included. They excluded non-health-related studies and studies in which collaboration was not for the purpose of research. From included studies, reviewers abstracted data about the 4 main phases of research collaborations (initiation, conduct, monitoring, and evaluation) and synthesized their corresponding components and concepts using thematic analysis method.

RESULTS

A total of 59 studies met inclusion criteria. These studies described building research collaborations between an academic entity and other academic entities (n = 29; 49%), communities (n = 28; 47%), industry (n = 7; 12%), and/or governmental entities (n = 4; 7%). Of the 59 studies, 22 addressed 2 phases of collaboration, 20 addressed 3 phases, and 17 addressed all 4 phases. All included studies described at least 1 of the components relevant to the initiation phase and at least 1 relevant to the conduct phase. Team structure was the most common component discussed in relation to the initiation phase (n = 48; 81%), and team dynamics was the most common component discussed in relation to the conduct phase (n = 55; 93%). At least 1 of the components relevant to the monitoring phase was reported in 36 studies, and at least 1 component relevant to the evaluation phase was reported in 28 studies.

CONCLUSIONS

This review provides important information for groups aiming to engage in collaborative research. The synthesized list of collaboration phases and their components can serve as a road map for collaborators at different steps of their research.

Making morbidity multiple: History, legacies, and possibilities for global health

Multimorbidity has been framed as a pressing global health challenge that exposes the limits of systems organised around single diseases. This article seeks to expand and strengthen current thinking around multimorbidity by analysing its construction within the field of global health. We suggest that the significance of multimorbidity lies not only in challenging divisions between disease categories but also in what it reveals about the culture and history of transnational biomedicine. Drawing on social research from sub-Saharan Africa to ground our arguments, we begin by describing the historical processes through which morbidity was made divisible in biomedicine and how the single disease became integral not only to disease control but to the extension of biopolitical power. Multimorbidity, we observe, is hoped to challenge single disease approaches but is assembled from the same problematic, historically-loaded categories that it exposes as breaking down. Next, we highlight the consequences of such classificatory legacies in everyday lives and suggest why frameworks and interventions to integrate care have tended to have limited traction in practice. Finally, we argue that efforts to align priorities and disciplines around a standardised biomedical definition of multimorbidity risks retracing the same steps. We call for transdisciplinary work across the field of global health around a more holistic, reflexive understanding of multimorbidity that foregrounds the culture and history of translocated biomedicine, the intractability of single disease thinking, and its often-adverse consequences in local worlds. We outline key domains within the architecture of global health where transformation is needed, including care delivery, medical training, the organisation of knowledge and expertise, global governance, and financing.

Who funds the production of globally visible research in the Global South?

There exist large disparities globally when it comes to knowledge production with very small proportions of publications from the majority world penetrating the global science system. This paper examines the Scopus data on the funders of publications (co-)authored by individuals based in the Caucasus or Central Asia. The analysis shows that in the conditions of scarce local funding for research, research activity has been fuelled by international funding. The funding has been rather diverse and originated from 98 countries across North America, Europe, Asia, Latin America, the Middle East, and Australia. The two countries most frequently mentioned in the funding acknowledgements are the United States and the Russian Federation, cumulatively accounting for approximately 20% of funding acknowledgements. Different types of organisations have funded globally visible research produced by authors based in the Caucasus and Central Asia, most notably bilateral agencies (68% of all funding acknowledgements), followed by philanthropies (7%), and multilateral organisations (5%). This paper offers evidence to question the viability of the narrative of North–South divisions in the global science system. While higher education and research are shaped within territorially bounded, self-contained, and discrete spaces of nation-states, the global science system rests on the extensive flows of funding and knowledge which extend well beyond the nation state.

Review of authorship for COVID-19 research conducted during the 2020 first-wave epidemic in Africa reveals emergence of promising African biomedical research and persisting asymmetry of international collaborations

OBJECTIVES

The contribution of African authors to the biomedical literature is small. We evaluated the African and non-African scientific production published in the international literature on the COVID-19 in Africa during the first year of the epidemic (2020).

METHODS

Papers on COVID-19 in Africa were extracted from the Medline (PubMed) database for bibliometric analysis including the proportions of three leading and last authors by study type, study country, authors' and laboratories/institutions' countries of affiliation and journal ranking.

RESULTS

A total of 160 articles fulfilling the inclusion criteria were analysed. The majority (91.3%) was produced by half (53.7%) of African countries, with important regional disparities, and generally without sources of funding mentioned. The majority (>85.0) of authors in lead positions (first, second, third and last authors) were Africans. Only a small number (8.7%) of studies on COVID-19 in Africa were carried out by laboratories not on the African continent (mainly Europe, USA and China) and generally received funding. The last and first authors were more frequently of non-African origin in journals with an Impact Factor ranking ≥1, and more frequently of African origin in journals with a lower ranking (< 1). The first and last non-African authors tended to report their studies in high ranking ≥1 journals.

CONCLUSIONS

Our study demonstrates that the emergence of promising African research capable of publishing in indexed but low-impact factor medical journals and reveals the persistence of a North-South asymmetry in international cooperation in biomedical research with Africa.

Considering equity in global health collaborations: A qualitative study on experiences of equity

International collaborations have become the standard model for global health research and often include researchers and institutions from high income countries (HICs) and low- and middle-income countries (LMICs). While such collaborations are important for generating new knowledge that will help address global health inequities, there is evidence to suggest that current forms of collaboration may reproduce unequal power relations. Therefore, we conducted a qualitative study with scientists, researchers and those involved in research management, working in international health collaborations. Interviews were conducted between October 2019 and March 2020. We conducted 13 interviews with 15 participants. From our findings, we derive three major themes. First, our results reflect characteristics of equitable, collaborative research relationships. Here we find both relational features, specifically trust and belonging, and structural features, including clear contractual agreements, capacity building, inclusive divisions of labour, and the involvement of local communities. Second, we discuss obstacles to develop equitable collaborations. These include exclusionary labour practices, donor-driven research agendas, overall research culture, lack of accountability and finally, the inadequate financing of indirect costs for LMIC institutions. Third, we discuss the responsibilities for promoting science equity of funders, LMIC researchers, LMIC institutions, and LMIC governments. While other empirical studies have suggested similar features of equity, our findings extend these features to include local communities as collaborators in research projects and not only as beneficiaries. We also suggest the importance of funders paying for indirect costs, without which the capacity of LMIC institutions will continually erode. And finally, our study shows the responsibilities of LMIC actors in developing equitable collaborations, which have largely been absent from the literature.

Toxic remains: Infrastructural failure in a Ugandan molecular biology lab

This article complicates romances of infrastructural improvisation by describing infrastructural failures that expose researchers to hazardous chemicals in a Ugandan molecular biology lab. To meet project deadlines, to make careers and to participate in transnational collaborative projects, Ugandan biologists have to stand in for decaying or absent infrastructures with their bodies. Ugandan biologists hide such sacrifices from their international scientific partners and direct the blame elsewhere. An unclear culpability results precisely from the ways in which power works and is distributed across transnational scientific infrastructures.

Mapping experiences and perspectives of equity in international health collaborations: a scoping review

BACKGROUND

Whilst global health research often involves international collaborations, achieving or promoting equity within collaborations remains a key challenge, despite established conceptual approaches and the development of frameworks and guidelines to promote equity. There have also been several empirical studies documenting researchers' experiences of inequity and views on what is required to advance equity in global health collaborations. While these empirical studies provide critical insights, there has been no attempt to systematically synthetize what constitutes equity and how it can be achieved. To address this gap, we conducted a scoping review of qualitative studies, opinion and editorial pieces about what equity is and how it can be promoted in international collaborations.

METHODS

We conducted a scoping review to explore domains of equity in international health collaborations. This review included qualitative studies and opinion pieces or editorial pieces on equity in international health collaborations. We mapped the data and identified common themes using a thematic analysis approach.

RESULTS

This initial search retrieved a total of 7611 papers after removing duplicates. A total of 11 papers were included in this review, 10 empirical studies and 1 editorial piece. We conducted our search between October - November 2019. We identified 10 key domains which are important for promoting equity in international collaborations: funding; capacity building; authorship; sample ownership and export; trust; research agreement; acknowledging inequality; recognition and communication.

DISCUSSION

Our findings suggest that for international collaborations to be considered more equitable, it must at least consider the 10 domains we highlighted. The 10 domains map onto five key aspects of social justice theory, namely avoiding unequal power relations like subordination, group recognition and affirmation, promoting the well-being of all, inclusion in decision-making and ensuring self-development.

Who is telling the story? A systematic review of authorship for infectious disease research conducted in Africa, 1980-2016

Introduction

Africa contributes little to the biomedical literature despite its high burden of infectious diseases. Global health research partnerships aimed at addressing Africa-endemic disease may be polarised. Therefore, we assessed the contribution of researchers in Africa to research on six infectious diseases.

Methods

We reviewed publications on HIV and malaria (2013–2016), tuberculosis (2014–2016), salmonellosis, Ebola haemorrhagic fever and Buruli ulcer disease (1980–2016) conducted in Africa and indexed in the PubMed database using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Papers reporting original research done in Africa with at least one laboratory test performed on biological samples were included. We studied African author proportion and placement per study type, disease, funding, study country and lingua franca.

Results

We included 1182 of 2871 retrieved articles that met the inclusion criteria. Of these, 1109 (93.2%) had at least one Africa-based author, 552 (49.8%) had an African first author and 41.3% (n=458) an African last author. Papers on salmonellosis and tuberculosis had a higher proportion of African last authors (p<0.001) compared with the other diseases. Most of African first and last authors had an affiliation from an Anglophone country. HIV, malaria, tuberculosis and Ebola had the most extramurally funded studies (≥70%), but less than 10% of the acknowledged funding was from an African funder.

Conclusion

African researchers are under-represented in first and last authorship positions in papers published from research done in Africa. This calls for greater investment in capacity building and equitable research partnerships at every level of the global health community.

Contemporary issues in north-south health research partnerships: perspectives of health research stakeholders in Zambia

Background

The late 1990s and early 2000s have seen a growth in north–south health research partnerships resulting from scientific developments such as those in genetic studies and development of statistical techniques and technological requirements for the analysis of large datasets. Despite these efforts, there is inadequate information representing the voice of African researchers as stakeholders experiencing partnership arrangements, particularly in Zambia. Furthermore, very little attention has been paid to capturing the practice of guidelines within partnerships. In this paper, we present achievements and highlight challenges faced by southern partners in north–south health research partnerships.

Methods

A qualitative inquiry was employed using in-depth interviews developed using the Bergen Model of Collaborative Functioning with 20 key informants in Lusaka district in Zambia purposively sampled from a wide range of health research partnerships.

Results

Partnerships produce benefits for southern partners, including evidence generation to influence policy, improved service delivery, infrastructure development and designing interventions to improve the healthcare of populations in greatest need. Most importantly, through partnerships, there is availability of financial resources to accomplish partnership goals. For success to be achieved, there must be effective communication and leadership, values and accountability that go into the process of partnership functioning. Trust interacts with different elements that create partnerships where there is co-ownership of study rewards. Challenging aspects of the interaction are largely due to funding mechanisms where 90% of the funding for health research is from northern partners. This funding mechanism results in power imbalances that lead to publication challenges, dictation of research agenda and ownership of samples and data leading to a general lack of motivation to collaborate.

Conclusion

Mistrust has implications on joint working such that partners find it difficult to work together and produce results greater than their individual efforts. Property rights and resource sharing must be resolved early in the partnership and each partner’s contributions recognised. These findings highlight areas that partnerships need to focus on to make the most of guidelines on research partnership with developing countries.

Championing Equity, Empowerment, and Transformational Leadership in (Mental Health) Research Partnerships: Aligning Collaborative Work With the Global Development Agenda

Through a narrative synthesis of existing literature on research partnerships, the paper underscores four core values championed in public policy and practice: equity, empowerment, transformational leadership, and treating mental health research as a cooperative inquiry. Building on these values, the author maps the challenges before mental health researchers in forging resilient, egalitarian, and committed Global North-South partnerships within the context of current global development agenda. Reports appraising the UN Millennium Development Goals lament how the goal of developing global partnerships to combat health, gender, and economic inequities has remained under-realized. Emphasis has been placed on the great need to augment Sustainable Development Goals (SDG) in ways where partnership processes would drive development and human rights agenda for the most afflicted, under-resourced, and marginalized in the world. Global North-South partnerships result in fewer lasting benefits to Global South-a regressive trend that is critically analyzed. The need for Global North to adopt ethical and responsible stances while creating/curating new knowledge is discussed. Being responsible is not only imperative for Global North researchers; it is imperative for both North and South researchers to adopt a dialogical approach in clarifying and sharing roles, responsibilities, access, and leadership in developing scholarship and praxis in mental health. The importance of de-centering hierarchies, valuing reciprocity in one another, improving communication, demonstrating empathy, and sharing resources and benefits are found to be key components in the narrative synthesis towards achieving greater empowerment and equity. The paper reflects on the potential problems in engagement and development of de-centered and transformational leadership in partnerships and implications for research ethics in the context of lower-and-middle-income countries. Lastly, the author in a bid to encourage global partnerships suggests that engaging in transparent and bi-directional conversations regarding these issues and realigning research priorities along the four core values will contribute to greater success in research collaborations (across cultural contexts) and more so in the global mental health field.

The Binds of Global Health Partnership: Working out Working Together in Sierra Leone

Global health partnerships (GHPs) are the conceptual cousin of partnerships in the development sphere. Since their emergence in the 1990s, the GHP mode of working and funding has mainly been applied to single-disease, vertical interventions. However, GHPs are increasingly being used to enact Health Systems Strengthening and to address the global health worker shortage. In contrast to other critical explorations of GHPs, we explore in this article how the fact, act, and aspiration of binding different actors together around the ideology and modes of partnership working produces the perpetual state of being in a bind. This is an original analytical framework drawing on research in Sierra Leone and London. We offer new insights into the ways in which GHPs function and are experienced, showing that along with the successes of partnership work, such arrangements are often and unavoidably tense, uncomfortable, and a source of frustration and angst.

Made in Denmark: Scientific mobilities and the place of pedagogy in global health

Transnational Global Health programmes planned and financed in the North and executed in the Global South usually involve some transfer of capacity between sites or capacity building in place. Capacity investment in the form of skills, knowledge, experience and equipment is often assumed to 'flow' between countries, laboratories and institutions, following the trajectories of mobile subjects in the knowledge economy. Drawing on in-depth interviews with Danish and East African scientists, this paper considers the mobilities that underpin scientific capacity building, drawing attention to the paradoxical in ways in which these programmes produce stasis and fixity, as well as mobility and exchange.

Equity in international health research collaborations in Africa: Perceptions and expectations of African researchers

Introduction and method

Africa is currently host to a number of international genomics research and biobanking consortia, each with a mandate to advance genomics research and biobanking in Africa. Whilst most of these consortia promise to transform the way international health research is done in Africa, few have articulated exactly how they propose to go about this. In this paper, we report on a qualitative interviewing study in which we involved 17 genomics researchers in Africa. We describe their perceptions and expectations of international genomics research and biobanking initiatives in Africa.

Results

All interviewees were of the view that externally funded genomics research and biobanking initiatives in Africa, have played a critical role in building capacity for genomics research and biobanking in Africa and in providing an opportunity for researchers in Africa to collaborate and network with other researchers. Whilst the opportunity to collaborate was seen as a benefit, some interviewees stressed the importance of recognizing that these collaborations carry mutual benefits for all partners, including their collaborators in HICs. They also voiced two major concerns of being part of these collaborative initiatives: the possibility of exploitation of African researchers and the non-sustainability of research capacity building efforts. As a way of minimising exploitation, researchers in Africa recommended that genuine efforts be made to create transparent and equitable international health research partnerships. They suggested that this could be achieved through,: having rules of engagement, enabling African researchers to contribute to the design and conduct of international health projects in Africa, and mutual and respectful exchange of experience and capacity between research collaborators. These were identified as hallmarks to equitable international health research collaborations in Africa.

Conclusion

Genomics research and biobanking initiatives in Africa such as H3Africa have gone some way in defining aspects of fair and equitable research collaborations in Africa. However, they will need to strive at achieving equitable health research collaborations if they truly aim at setting a gold standard for how international health research should be conducted in Africa.

The 'indirect costs' of underfunding foreign partners in global health research: A case study

This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a case study of a research collaboration between Mbarara University of Science and Technology (MUST) in Mbarara, Uganda, and originally the University of California San Francisco (UCSF), but now Massachusetts General Hospital (MGH). Our case study is based on three of the authors' experiences directing and working with this partnership from its inception in 2003 through 2015. The collaboration established an independent Ugandan non-profit to act as a local fiscal agent and grants administrator and to assure compliance with the Ugandan labour and tax law. This structure, combined with low indirect cost reimbursements from U.S. federal grants, failed to strengthen institutional capacity at MUST. In response to problems with this model, the collaboration established a contracts and grants office at MUST. This office has built administrative capacity at MUST but has also generated new risks and expenses for MGH. We argue that U.S. fiscal administrative practices may drain rather than build capacity at African universities by underfunding the administrative costs of global health research, circumventing host country institutions, and externalising legal and financial risks associated with international work.

ABBREVIATIONS

MGH: Massachusetts General Hospital; MUST: Mbarara University of Science and Technology; NIH: National Institutes of Health; UCSF: University of California San Francisco; URI: Uganda Research Institute.

Broadening Participation in the Sciences within and from Africa: Purpose, Challenges, and Prospects

Many of Africa's challenges have scientific solutions, but there are fewer individuals engaged in scientific activity per capita on this continent than on any other. Only a handful of African scientists use their skills to capacity or are leaders in their disciplines. Underrepresentation of Africans in scientific practice, discourse, and decision making reduces the richness of intellectual contributions toward hard problems worldwide. This essay outlines challenges faced by teacher-scholars from sub-Saharan Africa as we build scientific expertise. Access to tertiary-level science is difficult and uneven across Africa, and the quality of training available varies from top-range to inadequate. Access to science higher education needs to increase, particularly for female students, first-generation literates, and rural populations. We make suggestions for collaborative initiatives involving stakeholders outside Africa and/or outside academia that could extend educational opportunities available to African students and increase the chance that Africa-based expertise is globally available.

A home for science: The life and times of Tropical and Polar field stations

A 'halfway house' between the generic, purified space of the laboratory and the varied and particular spaces of the field, the field station is a controlled yet uncontained setting from which nature can be accessed and anchored. As living quarters for visiting scientists, field stations are also enmeshed in the routine and rhythms of everyday domestic life, and in longer cycles of habitation, wear, and repair. This introduction considers the empirical and conceptual significance of Polar and Tropical field stations as homes for scientific work and scientific lives. The field station's extra-territorial yet intimate character affects the credibility and circulation of knowledge along science's frontiers. The challenge of making a home in the (non-temperate) field and the mundane experiences of expatriation and appropriation establish particular political dynamics of knowledge-making in these locations. They bring into focus the imaginaries of nature and science that drive transnational research and put into relief the aesthetic and affective dimensions of work and life in these distant homes for science. All these themes are pursued and amplified in a different medium by the artists who contributed to our research and are also featured in this special issue.

Seeking exposure: conversions of scientific knowledge in an African city

Transnational medical research has become a common feature in many parts of Africa. This paper explores the contribution such activity makes to the social and economic lives of those involved, including both trial subjects and local staff. By considering the value of the 'exposure' that involvement brings to staff and research participants, we reflect on the conversion of scientific knowledge into practical knowledge and its value to sustaining precarious livelihoods in an economically fragile city. We consider the interplay between science and sociality and argue for a need to take seriously the circulation of scientific knowledge beyond the confines of expert spaces.

A mixed methods contribution to the study of health public policies: complementarities and difficulties

The use of mixed methods (combining quantitative and qualitative data) is developing in a variety of forms, especially in the health field. Our own research has adopted this perspective from the outset. We have sought all along to innovate in various ways and especially to develop an equal partnership, in the sense of not allowing any single approach to dominate. After briefly describing mixed methods, in this article we explain and illustrate how we have exploited both qualitative and quantitative methods to answer our research questions, ending with a reflective analysis of our experiment.

STUCK IN RUINS, OR UP AND COMING? THE SHIFTING GEOGRAPHY OF URBAN PUBLIC HEALTH RESEARCH IN KISUMU, KENYA

Since the Second World War, the Kenyan city of Kisumu has been an important site of medical research and public health interventions - on malaria and other vector-borne diseases, and lately on HIV and related infections. This article compares the work and lives of two generations of local workers in public health research, each central to science in the city at their time: staff of the Ministry of Health's Division of Vector Borne Disease (DVBD) in the decades after independence, and temporary employees of the Kenyan Medical Research Institute (KEMRI) in its collaboration with the US government's Centers for Disease Control and Prevention (CDC) in the early twenty-first century. Against the backdrop of changes to the city, which stagnated during the 1970s and 1980s, became an epicentre of the East African AIDS epidemic, and underwent an economic boom of sorts from the late 1990s - at least partly driven by HIV research and intervention programmes - the article examines the spaces and movements of health research workers, and their experience of the city in time. The now elderly DVBD workers' accounts are pervaded by memories of anticipated progress and the convergence of life and work in the civic wholes of nation and city; by chagrin about decay; and by nostalgia for lost hopes. Today's young KEMRI/CDC workers' short-term contracts, and the fragmented city they inhabit and study, make for less bounded and predictable spaces and temporalities. Their urban lives and work take shape between remainders and remembrances of past projects, the exhaustion of everyday struggles to make a living and a meaningful life, and the search for new forms of urban order and civic purpose.