Why partnership is a design problem
Chapter 2: Build Collaborations — Video 1
https://ghrbook.com/videos/partnership-as-a-design-problem/

[Slide 1] Global health research is a team effort. This video is about why collaboration is a design problem for the field, and about the history that shapes who gets to collaborate with whom.
[Slide 2] If you've ever dreaded a group project, you're not alone. But here's the reality. Solo-authored research papers are rare in our field, even for secondary analyses of existing data. The issues that we choose to study are complex, which makes collaboration essential. Teams often span time zones, disciplinary backgrounds, levels of training and seniority, nationalities, cultures, and perspectives. That makes collaboration rewarding, and our science is better for it, but being a good collaborator takes effort and practice.
[Slide 3] Today's global health emphasizes equity in healthcare access and health outcomes. But we can trace some of its lineage back through international health and tropical medicine to European colonization and colonial medicine — back to a time when the motivation was protecting colonial rulers and promoting national interests, not equity. Global health has come a long way since then, as has the health and wellbeing of people everywhere.
[Slide 4] But some argue that our approach to collaboration in global health has not fully parted ways with its colonial influences. This is because many collaborations in global health have been, and continue to be, an unequal venture, not a true partnership. In the previous chapter, I noted that the global health research agenda is, in large part, set and carried out by the wealthy.
[Slide 5] Less than one percent of funding for biomedical research goes directly to scientists in low-income countries. And consequently, authors from the Global North are over-represented in scientific publications.
[Slide 6] Calls to decolonize global health are not new, but we've witnessed a new urgency in recent years, with students and trainees often leading the way.
[Slide 7] Some scholars frame the aims of the movement this way. To decolonize global health is to remove all forms of supremacy within all spaces of global health practice — within countries, between countries, and at the global level. Supremacy is not restricted to White supremacy or male domination. It concerns what happens between people from high-income and lower-income countries, and also what happens between groups and individuals within them. It is there, glaringly, in how global health organizations operate, who runs them, where they are located, who holds the purse strings, who sets the agenda, and whose views, histories, and knowledge are taken seriously.
[Slide 8] There is a compelling argument that says the only path to decolonization is radical transformation of institutions. Efforts to improve diversity and inclusion are welcome, but they are not a substitute for dismantling a system that was designed to benefit those with power.
[Slide 9] Time will tell whether this moment will lead to institutional reforms. But as individuals we don't need to wait to reform how we approach collaborations. I suspect student readers wouldn't have it any other way.
[Slide 10] It's important to get this right because most modern science, and global health research in particular, is a never-ending series of group projects. The National Cancer Institute of the NIH defines team science as a collaborative effort to address a scientific challenge that leverages the strengths and expertise of professionals, oftentimes trained in different fields.
[Slide 11] Teams span a continuum, from small investigator-led labs to large, highly integrated groups of professionals sharing leadership responsibilities. Increasingly, given the complexity of today's research problems and a trend toward specialization in research expertise and methods, teams bring together people from different disciplines and different locations. And while the payoff of creating more diverse and skilled teams can be substantial, so are the challenges.
[Slide 12] Recognizing the growing importance of team science, researchers established a new field of inquiry in 2006 called the Science of Team Science, to study what makes scientific teams click. Many of the findings have made their way into Collaboration and Team Science: A Field Guide, a handbook published by the NIH in 2010 and updated in 2018. In the next two videos, I'll walk you through its top ten takeaways.
[Slide 13] The ultimate form of team science might be community-based participatory research. Here, research teams join with community members to define the vision, generate knowledge, and create change. In one example, a US-based team partnered with twenty community members in rural Kenya — church leaders, healthcare staff, teachers, village chiefs — to co-design an HIV prevention intervention, from needs assessment all the way through a pilot trial.
[Slide 14] This chapter will help you become a good collaborator. We started with the hard conversation, about global health's colonial roots and the ongoing calls to decolonize how we work together. From here we draw on the science of team science to explore what makes collaborations thrive: vision, trust, communication, leadership, and more. The next video starts with vision, and with the question of whose vision gets funded.