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The problem of ‘trickle-down science’ from the Global North to the Global South
  1. Daniel D Reidpath1,2,
  2. Pascale Allotey3
  1. 1Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
  2. 2South-East Asia Community Observatory (SEACO), Monash University Malaysia, Bandar Sunway, Malaysia
  3. 3International Institute for Global Health (UNU-IIGH), United Nations University, Cheras, Malaysia
  1. Correspondence to Professor Pascale Allotey; pascale.allotey{at}

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  • Countries in the Global South continue to struggle to train and retain good researchers and practitioners to address local, regional and global health challenges. As a result, there is an ongoing reliance on the Global North for solutions to local problems and an inability to develop alternative approaches to problem solving that take local (non-northern) contexts into account.

  • Current paradigms of scientific advancement provide no long-term models to challenge the status quo or privilege knowledge that is generated primarily in the Global South. This has major impacts on access to funding which perpetuates the problem.

  • There needs to be a concerted and demonstrable shift to value and promote the development of research and scientific traditions that are borne out of the reality of local contexts that complement knowledge and evidence generated in the Global North.

Trickle-down economics holds that the way to lift the poor out of poverty is to support wealth creation in those who are already rich.1 The underlying assumption is that as the wealth of the rich grows, they will purchase more goods and services, creating opportunities for the less well-off to benefit. The theory is in direct contrast to one that actively redistributes wealth. The analogy in science is that the way to improve science in the less developed parts of the world (the Global South) is to concentrate the intellectual gravitas, the resources and the opportunities into the Global North. The concentration will produce the best science which will trickle methods, theories, and insights down to the Global South.

Ten years ago, Nigel Crisp observed, with respect to the healthcare workforce that ‘the global health system is characterised by an import–export business in which rich countries export the ideology of Western scientific medicine and aid predicated on this ideology to poor countries. In return, …

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