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• Letter to the editor: “Conference equity in global health: are online conferences a solution?"
  Lotta Velin, Ulrick Kanmounye and Michelle Nyah Joseph
  Published on: 23 March 2021
• Conference equity in global health: are online conferences a solution?
  Thuan Phan, Kate Lightly and Andrew Weeks
  Published on: 28 February 2021

• Published on: 23 March 2021

  Letter to the editor: “Conference equity in global health: are online conferences a solution?"

  • Lotta Velin, Medical Student Program in Global Surgery and Social Change
  • Other Contributors:
    • Ulrick Kanmounye, Researcher
    • Michelle Nyah Joseph, Academic Trauma and Orthopaedic Surgeon

  Lotta Velin1,2, Ulrick Sidney Kanmounye1,3, Michelle Nyah Joseph1,4

  1. Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
  2. WHO Collaborating Center for Surgery and Public Health, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
  3. Department of Neurosurgery, University of Kinshasa Faculty of Medicine, Kinshasa, Congo (the Democratic Republic of the)
  4. Warwick Clinical Trials Unit, Warwick Medical School, Coventry, West Midlands, UK

  Correspondence to: Dr Michelle Nyah Joseph; Michelle_Joseph@hms.harvard.edu

  We want to congratulate Phan et al. on their thoughtful analysis of our article “Conference equity in global health: a systematic review of factors impacting LMIC representation at global health conferences” (1). Phan et al. are addressing inequities in global health conferences. This is evidenced by their inspiring work with transitioning the Global Women’s Research Conference (GLOW) from a physical to an online event. It is clear from Phan et al. recount that the transition helped increase access and equity to a major global health conference. We agree with the authors that such a strategy can help address many of the barriers we identified in our systematic review.

  Prior to 2019, some global health events offered an online component; however, none of the major global health conferences hel...

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  Lotta Velin1,2, Ulrick Sidney Kanmounye1,3, Michelle Nyah Joseph1,4

  1. Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
  2. WHO Collaborating Center for Surgery and Public Health, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
  3. Department of Neurosurgery, University of Kinshasa Faculty of Medicine, Kinshasa, Congo (the Democratic Republic of the)
  4. Warwick Clinical Trials Unit, Warwick Medical School, Coventry, West Midlands, UK

  Correspondence to: Dr Michelle Nyah Joseph; Michelle_Joseph@hms.harvard.edu

  We want to congratulate Phan et al. on their thoughtful analysis of our article “Conference equity in global health: a systematic review of factors impacting LMIC representation at global health conferences” (1). Phan et al. are addressing inequities in global health conferences. This is evidenced by their inspiring work with transitioning the Global Women’s Research Conference (GLOW) from a physical to an online event. It is clear from Phan et al. recount that the transition helped increase access and equity to a major global health conference. We agree with the authors that such a strategy can help address many of the barriers we identified in our systematic review.

  Prior to 2019, some global health events offered an online component; however, none of the major global health conferences held fully virtual events. The Covid-19 pandemic has accelerated this shift online, and at the same time, created a window of opportunity for us to address systemic inequities in the global health field. Now is the time to reflect on failures, and to develop and implement solutions that end these disparities. In our systematic review (2), we define conference equity as: the attainment of an equitable level of attendee active engagement, influence and access to a conference regardless of country of origin, location, available funds or affiliation, through the mitigation of known barriers and enhancement of efficacious facilitators. We highlighted visa issues and conference locations, primarily in high-income countries, as two barriers to conference equity. Although, Phan et al. have shown that these barriers can be overcome with online conferences, the issue of conference equity by definition, is far greater than these two barriers. Fully virtual events alone create a new set of challenges, and will not suffice to achieve conference equity.

  Over a year into the pandemic, we have data to suggest online conferences are not the great equalizer of global health conferences. Limited access due to time zone differences and cost are the obvious inherent obstacles that perpetuate the inequities we witness. The financial burden of global health conference attendance has been shifted from travel, conference registration, and accommodation to the cost of internet broadband. According to the United Nations Broadband Commission, over a billion people live in countries that fail to meet the “1 for 2” recommendation, that is, 1 gigabyte should cost no more than 2% of the average monthly income to allow efficient internet use (3). Zoom (San José, California, USA), the most widely used video conferencing platform, uses 810MB-2.4GB per hour for group meetings (4). Hence a two-day 8-hour conference could cost in excess of 26.0-76.8% of the average monthly income (total broadband consumption 13.0GB-38.4GB).

  Beyond financial barriers and attendee demographics, prioritization must be given to developing metrics in active conference engagement. The global health community need to ensure equity when setting conference agendas and avoid global north dominance. A conscious decision to diversify panels and provide support for low- and middle-income country researchers in presenting is an initial step.

  Global health conferences are currently undergoing a major transformation, such change lends itself to research opportunities that we hope will be further explored. We thank Phan et al. for their prior communication with our team, and seizing the opportunity to propose tangible solutions. We hope online conference organizers assess their current equity status; acting upon the findings may lead to the attainment of conference equity.

  1. Phan T, Lightly K, Weeks A. Conference equity in global health: are online conferences a solution? BMJ Glob Health [Internet]. 2021 Feb 25; Available from: https://gh.bmj.com/content/6/1/e003455.responses#conference-equity-in-gl...
  2. Velin L, Lartigue J-W, Johnson SA, Zorigtbaatar A, Kanmounye US, Truche P, et al. Conference equity in global health: a systematic review of factors impacting LMIC representation at global health conferences. BMJ Glob Health. 2021 Jan 1;6(1):e003455.
  3. Alliance for Affordable Internet. 2020 Affordability Report [Internet]. 2020. Available from: https://a4ai.org/affordability-report/report/2020/
  4. Hannula L. How Much Data Does Zoom Use? [Internet]. WhistleOut. 2020 [cited 2021 Mar 15]. Available from: https://www.whistleout.com/Internet/Guides/zoom-video-call-data-use#:~:t....

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  Conflict of Interest:
  None declared.

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• Published on: 28 February 2021

  Conference equity in global health: are online conferences a solution?

  • Thuan Phan, Postgraduate student Department of Women’s and Children’s Health, University of Liverpool, UK
  • Other Contributors:
    • Kate Lightly, Clinical Research Fellow
    • Andrew Weeks, Professor of International Maternal Health

  We congratulate the authors on their systematic review of conference equity in global health (1) and agree that this is a key step towards decolonising global health research. Their review identifies barriers and facilitators impacting attendance from low-and-middle-income countries (LMICs). The authors have identified many solutions to improve the equity of conferences but did not mention online conferences. These have rapidly become the norm during the COVID-19 pandemic and could offer a feasible solution. (2)

  The global pandemic forced the Global Women’s Research Society (GLOW) society conference to go online for the first time and it had dramatic impacts on the reach of the conference. We have run the annual UK-based GLOW conferences in global reproductive, maternal and new-born health since 2012, with a typical attendance of 70-140. In 2020, however, the pandemic forced us to pivot to an online conference. We fundraised £25,700 to provide the online platform and recordings, allowing free attendance for anyone from around the world. As a result, over 1300 people from 70 countries registered, with up to 1076 live views at one time. This works out at just £20 per registrant. During 2 days of the conference, there were a total of 3347 views, with 546 of those from LMICs. Additionally, there have been nearly 500 views of the videos on the YouTube channel since the September conference. We estimate costs of over £1,000,000 if all registrants and presenters had attend...

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  We congratulate the authors on their systematic review of conference equity in global health (1) and agree that this is a key step towards decolonising global health research. Their review identifies barriers and facilitators impacting attendance from low-and-middle-income countries (LMICs). The authors have identified many solutions to improve the equity of conferences but did not mention online conferences. These have rapidly become the norm during the COVID-19 pandemic and could offer a feasible solution. (2)

  The global pandemic forced the Global Women’s Research Society (GLOW) society conference to go online for the first time and it had dramatic impacts on the reach of the conference. We have run the annual UK-based GLOW conferences in global reproductive, maternal and new-born health since 2012, with a typical attendance of 70-140. In 2020, however, the pandemic forced us to pivot to an online conference. We fundraised £25,700 to provide the online platform and recordings, allowing free attendance for anyone from around the world. As a result, over 1300 people from 70 countries registered, with up to 1076 live views at one time. This works out at just £20 per registrant. During 2 days of the conference, there were a total of 3347 views, with 546 of those from LMICs. Additionally, there have been nearly 500 views of the videos on the YouTube channel since the September conference. We estimate costs of over £1,000,000 if all registrants and presenters had attended in person. This works out at nearly £800 per person, or more if attendance is lower. Further details will be reported in a separate publication.

  Feedback from 226 attendees clearly demonstrated that the online format overcame several barriers presented in this review. 83% rated the conference as very good or outstanding. Attendees’ feedback highlighted the benefits of no visa, travel and subsistence costs. It is likely that political barriers and unconscious bias inhibiting attendance and engagement may have also been reduced.

  Nevertheless, there are several ongoing concerns with the virtual format. These include poor internet access and unstable connections, technological challenges, co-ordination across time zones and underdeveloped conference platforms and tools. Additionally, virtual conferences cannot offer the same networking opportunities, informal feedback and opportunities for focused attention for the entire event. (3)

  We believe that online conferences or hybrid events offer one solution to reducing conference inequity. This requires purposeful action from conference organisers and funders to increase accessibility to those in LMICs. Further comprehensive evaluation of the impact of the virtual format, aimed at exploring whether this format reduces conference inequity, is required.

  1. Velin L, Lartigue J-W, Johnson SA, et al. Conference equity in global health: a systematic review of factors impacting LMIC representation at global health conferences. BMJ Global Health 2021;6(1):e003455. doi: 10.1136/bmjgh-2020-003455
  2. Sarabipour S. Virtual conferences raise standards for accessibility and interactions. Elife 2020;9 doi: 10.7554/eLife.62668 [published Online First: 2020/11/05]
  3. Falk MT, Hagsten E. When international academic conferences go virtual. Scientometrics 2020:1-18. doi: 10.1007/s11192-020-03754-5 [published Online First: 2020/11/25]

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  Conflict of Interest:
  None declared.

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