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Action to protect the independence and integrity of global health research
  1. Katerini T Storeng1,2,
  2. Seye Abimbola3,
  3. Dina Balabanova4,
  4. David McCoy5,
  5. Valery Ridde6,
  6. Veronique Filippi2,
  7. Sidsel Roalkvam1,
  8. Grace Akello7,
  9. Melissa Parker4,
  10. Jennifer Palmer4
  11. on behalf of the signatories
    1. 1Centre for Development and the Environment, University of Oslo, Oslo, Norway
    2. 2Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
    3. 3School of Public Health, University of Sydney, Sydney, New South Wales, Australia
    4. 4Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
    5. 5Centre for Primary Care and Public Health, Queen Mary University London, London, UK
    6. 6Institute for Research on Sustainable Development (IRD), CEPED (IRD-Université deParis), Université de Paris, ERL INSERM SAGESUD, Paris, France
    7. 7Department of Mental Health, Faculty of Medicine, Gulu University, Gulu, Uganda
    1. Correspondence to Katerini T Storeng; katerini.storeng{at}

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    In a recent Viewpoint in the Lancet, some of us shared our experience of censorship in donor-funded evaluation research and warned about a potential trend in which donors and their implementing partners use ethical and methodological arguments to undermine research.1

    Reactions to the Viewpoint—and lively debate at the 2018 Global Symposium on Health Systems Research—suggest that similar experiences are common in implementation and policy research commissioned by international donors to study and evaluate large-scale, donor-funded health interventions and programmes, which are primarily implemented in low resource settings. ‘We all have the same stories’, was one of the first comments on the Viewpoint, followed by many private messages divulging instances of personal and institutional pressure, intimidation and censorship following attempts to disseminate unwanted findings. Such pressure comes from major donors and from international non-governmental organisations (NGOs) obliged to have an external assessment but who then maintain a high degree of confidentiality and control.

    That such experiences are widespread reflects the deeply political nature of the field of ‘global health’ and the interconnections between priority setting, policy making and project implementation, which sit within a broader set of deeply entrenched power structures.2 3 Researchers in this field routinely find themselves working within—and studying—complex power relations and so experience challenges in negotiating their own position between interests of commissioning agencies and funders, implementers and country governments, as well as those of their own research institutions and their partnerships with other researchers spanning high-income, middle-income and low-income countries.4–7 They often receive research funding from major donor agencies like the UK Department of International Development (DFID), the US Agency for International Development (USAID), the Agence Française de Développement (AFD), UNITAID and the Bill and Melinda Gates Foundation,8 who commission evaluations for their own funded projects, even though they have …

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