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How to identify epistemic injustice in global health research funding practices: a decolonial guide
  1. Emilie S Koum Besson
  1. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Emilie S Koum Besson; emilie.koum-besson{at}lshtm.ac.uk

Abstract

Epistemic injustice is a growing area of study for researchers and practitioners working in the field of global health. Theoretical development and empirical research on epistemic injustice are crucial for providing more nuanced understandings of the mechanisms and structures leading to the exclusion of local and marginalised groups in research and other knowledge practices. Explicit analysis of the potential role of epistemic injustice in policies and practices is currently limited with the absence of methodological starting points. This paper aims to fill this gap in the literature by providing a guide for individuals involved in the design and review of funding schemes wishing to conduct epistemic injustice analysis of their processes using a decolonial lens. Placing contemporary concerns in a wider historical, political and social context and building from the intertwined issues of coloniality of power, coloniality of knowledge and coloniality of being that systematically exclude non-Western epistemic groups, this practice paper presents a three-step decolonial approach for understanding the role and impact of epistemic injustices in global health research funding. It starts with an understanding of how power operates in setting the aim of a call for research proposals. Then, the influence of pose and gaze in the review process is analysed to highlight the presence of epistemological colonisation before discussing methods to address the current funding asymmetries by supporting new ways of being and doing focused on knowledge plurality. Expanding research on how epistemic wrongs manifest in global health funding practices will generate key insights needed to address underlying drivers of inequities within global health project conception and delivery.

  • public health

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Summary box

  • Global health research funding is affected by unequal power dynamics rooted in global coloniality that manifest in the prioritisation of outsiders’ perspectives over local needs.

  • This practice paper investigates why Global South actors’ research funding applications are less likely to be successful than applications from Global North actors.

  • It outlines a three-step decolonial approach to epistemic injustice analysis of research funding processes and practices.

  • Findings suggest that epistemic wrongs occur when common biases and ethnocentrism are not mitigated during the review process.

  • Global North and Global South funders can address current funding asymmetries by ensuring that pose and gaze are aligned from the design of the call for proposals to the review process.

Introduction

Criticism of donor funding and research grants schemes processes and practices is common among applicants. Complaints are often related to the cost of wasted efforts, and concerns around various forms of biases including einsider bias, personal bias, dominant group bias and bias related to the incentive to do research that please the interests of those dispensing the funds1

While different ways to allocate research-funding are associated with different issues, global health research funding carries additional challenges due to unequal power dynamics related to the coloniality of power, of knowledge and of being (figure 1).2–4 While the studies are designed to address health challenges in the Global South, the financial power including decision-making around delivery remains concentrated in the Global North.5 6

Figure 1

Global coloniality and global health research funding - Source Ndlovu-Gatsheni SJ (2014).

In May 2021, in an open letter, African scientists called for the decolonisation of global health research funding after a US-led malaria initiative favoured partnering with Western institutions over African institutions.7 They argued that funders continue to favour Western institutions by dismissing Global South expertise and undermining local agencies.7 8

While funders deny favouritism, this paper introduces approaches to systematically interrogate the processes and practices that enable and maintain the dominance of Euro-North American-centric ways of doing by presenting some of the unacknowledged barriers between the researchers whose application are being assessed, and the funders and reviewers of their application.4

It aims to guide global health financing actors including member states, United Nations agencies and non-governmental organisations to identify discrimination and coloniality in their work, adopt a decolonial approach, and recognise the critical need to disrupt power asymmetries and promote ownership, participation and equity.5 9 10

The role of research funders in decolonising global health

Given their central position in the processes involved in knowledge production, research funders have an important role to play in driving efforts towards equitable and decolonial research.2 11 12

Epistemological colonialism refers to the way in which the expansion of colonial power enabled the expansion of colonial knowledge, the colonial way of understanding and acting in the world to the detriment of local knowledge systems.13 14

With the overwhelming majority of funding being located in the Global North, organisations that issue calls for proposals can intentionally or unintentionally disadvantage and constrain Global South applicants through research priorities, language, eligibility criteria, due diligence rules and other expectations that can generate ethical and practical research issues.15 16

Several studies have shown that global health research practices are currently geared towards the interests of certain social/epistemic groups over others.11 17–19 This situation translates into less priority being placed on the knowledge and perspectives of certain groups and what is of pronounced interest and consequence to them, in addition to affording less credibility to the knowledge they hold.20–24

Decoloniality is a movement focused on untangling the production of knowledge from a primarily Euro-North American-centric lens by challenging the perceived universality of Western knowledge and practices and the superiority of Western institutions and paradigms of research.4 17 21 25 Applying a decolonial approach to research funding can therefore be defined as a process to acknowledge, understand and address Euro-North American-centric norms and structures inherited from colonialism that continue to act as a barrier to non-Western applicants during calls for proposals.4 17 20 26

Lack of awareness and reflexivity on existing structural inequalities directly impacts resource allocation and ultimately knowledge production.12 15 27 Research funders have reported lower number of successful proposals from Global South applicants despite the burden of global health challenges being situated in the Global South.4 The resulting asymmetries manifest as both higher access to financial resources for applicants based in the Global North and the generation of inadequate, incomplete or not fit-for-purpose evidence to meet the needs of Global South communities.4 16 18 28

There is growing pressure to drive substantive changes in funding practices and ensure that the definition of global health interventions is embedded in the broad social, cultural, economic and political contexts that underpin the issues being addressed.29–31 As an example, in the humanitarian sector, the Inter-Agency Standing Committee’ 2016 Grand Bargain pledged to ‘get more means into the hands of people in need and improve the effectiveness and efficiency of humanitarian action’.29

This paper outlines a decolonial approach to epistemic injustice analysis of research funding processes and practices. The overall aim is to guide practitioners towards greater equity in research funding and partnership and inform the development of transformational processes.

The article is divided in four sections. After defining the key principles of epistemic injustice, the author will show how the design of a research call for proposals can favour foreign/dominant epistemic groups over local groups. Then, the author will discuss the influence of pose and gaze during a review process using the epistemic injustice framework created by Bhakuni and Abimbola.18 Finally, the author will introduce different approaches to address current asymmetries in the research funding architecture.

Understanding the epistemic injustice of colonialism in global health research funding

Epistemology is a branch of philosophy that focuses on the nature, origin and scope of knowledge. It is concerned with the way in which knowledge is defined and validated. The intended receiver of the knowledge produced (ie, gaze or audience) and the standpoint from which knowledge is produced (ie, pose or positionality) directly impact the way it is understood and creates opportunities for epistemic injustices.16 20 32

An epistemic wrong occurs when knowledge produced by a group is misinterpreted or undervalued by others epistemic groups.18 It manifests when (figure 2)18:

  • Foreign/dominant knowledge practices limit the extent to which other epistemic groups have ownership of knowledge production and sensemaking.

  • Foreign/dominant group do not prioritise local audience or the local gaze for the purpose of local learning.

  • Foreign/dominant group produce knowledge to serve the needs of foreign and distant actors or elite epistemic communities.

  • Local/non-dominant group do not prioritise the local gaze, but directs its knowledge production to foreign/dominant groups.

Figure 2

Examples of credibility deficit and interpretive marginalisation in academic global health (Source: Bhakuni and Abimbola18).

Bhakuni and Abimbola argued that common practices in global health research are peppered with intentional or unintentional epistemic wrongs that lead to or exacerbate epistemic injustices—that is, through practices that systematically exclude local and marginalised producers and recipients of knowledge.18

This paper uses Bhakuni and Abimbola’s epistemic injustice framework and the concept of global coloniality centred around the coloniality of power, knowledge and being to develop a three-step approach for investigating the presence of epistemic wrongs inherited from colonialism in global health research funding schemes.5

Step 1: coloniality of power and analysing the aim of a call for research proposal

Practising decoloniality in research funding starts at the definition of the grant objectives. Analysing the aim of knowledge production systems can reveal our expected audience and our positionality and inform why some groups remain mostly represented as bystanders in knowledge production.4 16 19 33

When a call for proposal bears the implicit assumptions that the primary purpose of knowledge production is to be used elsewhere, it highlights an expectation that knowledge produced in the grants to be funded must be a universal one that is easily transferable.16

While public/private funders in Euro-North American settings may not insist that knowledge produced to answer national public health concerns be transferable, generalisable to population outside of the country and publishable in a peer-review journal, those expectations are often maintained as an essential requirement to fund research conducted in the Global South.16

The notion that knowledge that is contextualised is of limited value because it would not have impact in other settings is a common fallacy that stem from Global North institutions distance from the issues being addressed and unchallenged colonial legacies that continue to present non-Western communities as a singular group/context.16 34

The resulting academic literature imply that large or multisite studies are inherently more valuable than small or single sites studies which leads to more support given to knowledge producers and systems that can claim to be universal.16 35 In reality, health systems challenges are complex and require deeply local perspective to be responsive to local systems and realities.36 Consequently, what is ‘robust’ for generating decontextualised, generalisable knowledge may not be ‘robust’ enough for generating contextualised and necessarily local knowledge.16 28

When the objective of a call for proposal is mostly focused on ‘addressing gaps in the literature’ and finding ‘universal truths’, it can clash with Global South researchers’ focus on making sense of and altering the social structures that disadvantage communities in their context. Such a call for proposal therefore ultimately advantages Global North applicants.3 16

Step 2: coloniality of knowledge and acknowledging the influence of gaze and pose during the review process

After submission, a funding committee makes an informed decision on the outcome of proposals using technical reviewers’ feedback on the potential impact of the research findings, the scientific robustness, the feasibility, the value for money and in certain cases, the strength of a research consortium.

These criteria and the associated comments directly influence the committee’s decisions even though they are not completely responsible for the outcome. While these criteria are often considered neutral and universal, the way funders and reviewers define them and the background of the reviewers can have an impact on the review process, especially when funders and reviewers associate Euro-North American-centric ways of doing—including structures, methods, processes and practices—as the only legitimate and scientific ways of producing knowledge and of knowing and understanding the world.3 5 15

The author will use Bhakuni and Abimbola’s framework (figure 1) to present how the extent to which the review process accounts for and mitigates epistemological differences within the review criteria can systematically favour Global North (ie, foreign/dominant) over Global South applicants. Potential lines of analysis are organised in two categories—testimonial injustice and interpretive injustice—drawing on examples from commonly known, discussed and anticipated reviewer comments.18

Testimonial injustice: credibility deficit and excess

Testimonial injustice is defined as the act of prejudicially misrepresenting a knower’s meanings or contribution to knowledge production. It leads to the undervaluation of one’s status (eg, credibility deficit) and the overvaluation of others (eg, credibility excess).18

Global South groups have relatively few interpretive tools in circulation available to be used or recognised as equal to those designed by foreign/dominant groups (Global North) that have a monopoly on both knowledge production and development of interpretive tools.4 18 21 25 26 37 This situation directly impacts the credibility of Global South epistemic groups if reviewers are not familiar with their interpretive tools and physically distant from their context.18 37

The following examples show how testimonial injustice during a reviewing process can discount the credibility of Global South applicants as holders and producers of knowledge while increasing the credibility of Global North applicants.

When the need to produce knowledge is based on what is globally known or not known, rather than on what is locally known or not known, a credibility deficit is imposed on local applicants.

It occurs when Global South applicants are encouraged to justify a study or publication based on a gap in the literature, as if the literature could be considered the sum of all available knowledge.16 It implies a presumption that knowledge on issues about which people have day-to-day experience does not exist because it is not in the literature.38

When the value of a proposal to generate local knowledge is determined using what is known or deemed valuable elsewhere, then local knowledge and needs are side-lined, and credibility deficit is imposed on local knowers.

It occurs when the definition of novel knowledge is applied at the global level rather than the specific context. It seems to imply that local expertise is only valued in comparison to evidence from elsewhere even though knowledge that is relevant in a given context may not be deemed ‘new’ or of value elsewhere.

When the proposal is evaluated based on common practices in foreign/dominant groups context that are perceived as ‘evident’, credibility excess is given to foreign applicants

It occurs when the assumptions used in the review process (eg, budgeting or the structure of research groups) do not match local practices in Global South contexts and are based on common Global North structures and processes.39

Testimonial injustice reduces the success rate of Global South applicants. Lack of acknowledgement of what is often described as an ‘expat bias’ will continue to systematically impact Global South applicants’ success in calls for proposals.40–43

Interpretive injustice: interpretive marginalisation

Interpretive injustice is a form of epistemic injustice that prevents certain groups from being able to efficiently communicate knowledge to other, perhaps more powerful groups.44

An interpretive marginalisation occurs when foreign/dominant groups prejudicially impose or only recognise their interpretive tools as valid, thus preventing other groups from sharing their experience of the world.18 When it manifests, it contributes to the illusion that prejudicial low credibility judgements are epistemically justified.23

In the absence of available legitimised collective interpretive tools, Global North groups often assume that their own approach to knowledge production and sensemaking is universal.18 Consequently, the experiences of Global South groups can be misunderstood because they do not fit concepts known to Global North groups.26

The following examples show how interpretive injustice during a review process can discount the credibility of Global South applicants as holders and producers of knowledge while increasing the credibility of Global North applicants.

When the ability of local applicants to interpret their own reality for their own people is taken away, interpretive marginalisation is imposed on them.

It occurs when decontextualised findings and needs are deemed more desirable in the selection criteria. It demands that Global South applicants’ proposal needs to be aligned with the needs of a Global North audience and signals that only knowledge that claims to be universal is considered valuable.

When foreign/dominant interpretive tools are expected to be used or imposed, it leads to interpretive marginalisation

It occurs when review criteria assume that Global South applicants would/should justify conducting a study in their own setting similarly to how an applicant might justify conducting a study in a foreign setting—for example, by using ‘structured research’ or information available in the literature. In practice, the kind of insight available to Global South applicants, which then influence how they frame and justify their work is inherently different. Local interpretive tools, ways of making sense of reality in data analysis, ways of deciding whether a study is necessary, or an intervention is appropriate are not allowed to flourish, risk remaining marginalised and at worse disappearing.21 23

When a foreign/dominant group places its understanding of local realities above local groups perspective, interpretive marginalisation is imposed on local actors.

Local practices and realities shape the way a project is proposed. The physical proximity or distance of a reviewer can affect the reviewer’s interpretation of what is being proposed.16 28 Global South applicants see the complexities of their setting and are compelled to engage with it given what they know and how they make sense of it.23 25 Whereas Global North applicants see from afar and are prone to simplify complex realities in ways that Global South applicants tend not to.16 26 Global South applicants are more likely to go for methods and approaches that allow them to make sense of the full complexity of their setting, system or reality.17 28

Interpretative marginalisation reduces the success rate of Global South applicants and can lead to epistemic violence and epistemicide (ie, the erasure of marginalised knowledge systems), instead of the stated social transformation when Global South applicants are denied the opportunity to use approaches that challenge Euro-North American-centric research paradigms.5 21

Step 3: coloniality of being and addressing asymmetries in global health research funding

This analysis of calls for proposals and review processes from a decolonial perspective highlighted the ways in which the project definition and the pose and gaze of the reviewers can legitimise the inferiority of Global South applicants and influence their success rate compared with Global North applicants due to entrenched assumptions and expectations in the field.18 20

In reality, despite calls for localisation, stated commitment to ‘decolonise’ research funding and the added logistical constrains created by COVID-19-related restrictions, research funders’ expectations seem to remain strongly centred around Euro-North American-centric processes, structures, practices and norms.21 For example, there is a tension in the way lived experience and contextual understanding is valued relative to training and institutional affiliation. Consequently, applicants from or who trained in the Global North are often implicitly afforded credibility excess due to their proximity to Euro-North American practices.18 27 Meanwhile, one can argue that Global South applicants’ time/efforts ratio during proposal writing is systematically underestimated as it is unclear whether funders take cognizance of the numerous logistical constraints including poor internet connection, unpaid labour, limited electricity, limited access to academic journals and libraries, etc.45 46

As long as commonly used evaluation criteria remain perceived as neutral, their colonial epistemic foundations will continue to legitimise existing inequalities and hinder the evolution of non-Western epistemic groups with the risk of epistemicides.45 47–49

Redefining evaluation criteria towards knowledge equity

Rather than hampering the production of contextualised knowledge, existing inequalities should be used as opportunities to design innovative and equitable processes to reduce funding access gap.45 46 50

To do so, research funders need to move away from unidimensional diversity and equity criteria that are often focused on geography alone (eg, regional funding panels) and instead, systematically account for common biases and ethnocentric tendencies during the proposal review process of international grant schemes.51

Table 1 presents key questions and considerations that highlight how knowledge equity objectives can be attained by adjusting for epistemological colonisation (eg, absence of collectively legitimised tools), power dynamics (eg, dominance and leadership in research partnerships and authorship order), positionality (eg, diaspora vs ‘local’; Global North vs Global South diploma) and logistical barriers (eg, lack of publications vs systematic barriers of access to academic journals through exclusionist fee policies).22 28 35 47 49 51

Table 1

Key questions and considerations to address epistemic injustice in funding reviewing process

For instance, lower access to institutional funding in the Global South might results in lower experience managing large grants. While this is often an important criterion, it can be addressed by providing a grant management training or inviting Global South applicants to include one in the proposal.

Similarly, prioritising lived experience requires research funders to place greater value on—often—unpaid community work experience and balance potential technical skills gap with inviting Global South applicants to include national/regional/international training(s) that would be complementary to their project and their professional development.45 50

Funders should consider asking reviewers to attach a reflexivity statement to their comments to highlight how they accounted for their gaze and positionality when reviewing the applications.52 Further, including local civil society organisations in the definition of the call for proposal and the review process should also be considered to ensure that applications meet the needs of the communities.

Aligning pose and gaze towards local knowers and fostering knowledge plurality

Epistemic injustices are also facilitated by the current disconnect between the pose and gaze of funders, reviewers and local researchers (figure 3).18 As demonstrated by our analysis, in the absence of clear commitments to epistemic diversity (ie, the ability to make sense of the world using diverse forms of knowledge, knowledge creation and dissemination methods), actors’ positionality and interests can influence the outcome of a proposal review.4 19 22 26 37

Figure 3

Aligning pose and gaze in research grant schemes.

To reduce epistemic wrongs, actors’ pose and gaze should be perfectly aligned. When actors from Global North groups or applicants from the Global South legitimise a single knowledge framework, they impose epistemic injustice on other groups while also omitting to consider the possibility that Euro-North American-centric interpretive tools can be rigid, imperfect and inappropriate especially regarding the experiences of those in the Global South.4 16 19 20 26 It also raises questions around the ethics of analysing work conducted in the Global South with a dominant Euro-North American-centric framework rather than prioritising the voices of experts who use local approaches or have lived experience.4 21 26

Supporting the production of the knowledge needed to accurately understand Global South issues, craft appropriate interventions, or design projects that are responsive to Global South applicants’ culture, context and needs, requires research funders and Global South applicants to show clear commitments to the inclusion of diverse perspectives, accounts and ways of thinking and doing through practical transformational change.4 6 21

It starts with being transparent about the grant objectives by clearly defining the preferred epistemic frameworks and the intended audience and receiver of the knowledge to be produced. In practice, research funders should increase opportunities for Global South applicants to develop alternative interpretive tools by allowing them to either adapt Euro-North American-centric tools to their context, use existing but marginalised tools or develop and disseminate novel contextualised methods.

To reach equity goals, funding scheme guidelines and reviewers need to embody and acknowledge past and ongoing asymmetries and promote the coexistence of different research paradigms that reflect local needs rather than outsider’s perspectives4 15 17 20

Conclusion

While proposal definition and reviewing processes may differ across funders, the primary objective of this practice paper was to challenge Euro-North American-centric perspective and provide guidance to address the impact of global coloniality on epistemic diversity. The current research funding architecture is skewed towards Global North applicants. Limited analyses (including of primary data in the form of review reports) are conducted to better understand this phenomenon.

Redressing current asymmetries will require deliberate analysis to identify existing unjust defaults and assumptions. The lack of understanding of the ways in which Euro-North American-centric epistemic domination hinders the success of Global South epistemic groups applications legitimises funding asymmetries and the exclusion of local voices to address local challenges.6 8 10 49

This article presents a decolonial approach to analysing global health research funding processes and practices. This should inform novel perspectives to funding prioritisation that enable funders to move from thinking about how to make international funding more accessible to Global South actors to exploring ideas around the development of appropriate, decentralised and locally led funding mechanisms that increase the success rate of Global South applicants in the future. These reflections should also be taken into consideration by Global South funders.

Data availability statement

No data are available.

Ethics statements

Patient consent for publication

Acknowledgments

First, I want to acknowledge the work of decolonial thinkers, theorists, and activists from the Global South especially the work of professor Sabelo J Ndlovu-Gatsheni which guided this tool. I want to thank Jillian Murray and Jimmy Whitworth at LSHTM who reached out to discuss these issues as well as James Smith and Anne Harmer at Elrha whose interests in research funding equity allowed this work to flourish. Finally, a particular thank to Professor Seye Abimbola for his guidance in writing this guide and for being such a positive role model.

References

Footnotes

  • Handling editor Seye Abimbola

  • Twitter @emilie_skb

  • Contributors ESKB conceptualised, conducted the literature search and wrote this practice paper. ESKB is responsible for the overall content.

  • Funding The author have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.