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Few articles advocating decolonisation offer actionable strategies within most early career researchers’ (ECRs) sphere of influence.
ECRs are uniquely positioned to drive change.
Educating ourselves and others, advocacy, critical allyship, advancing beneficiaries’ agendas, strengthening capacity, equitable partnership, diversifying paradigms, upholding ethics, ensuring recognition and pursuing epistemic justice are ten tasks within our reach.
Introduction
Although decolonising global health is increasingly advocated, recommendations usually focus on systemic failures at high levels. Focusing discussions about decolonising global health on leaders and decision-makers risks disenfranchising the large community of early career researchers (ECRs). Without grassroots change, decolonisation risks being ‘performative’1 or co-opted by elites.2 In this Commentary, we propose ten practical tasks to advance decoloniality. We focus on the field of global health but consider these principles indispensable across all disciplines engaged in international, collaborative research.
If decolonisation shifts power from colonisers to the colonised, decoloniality entails ‘undoing, unlearning, redoing, and relearning,’ to rid society, culture, education, and institutions of colonial remnants.3 The concept of coloniality as a continuing ‘invisible power matrix’ stemming from historical coloniality4 moves the focus away from top-down concerns with the past to bottom-up changes to current practice.
Despite the heterogeneity of academic career paths, being an ECR is rarely characterised as a position of power.5 ECRs must learn and develop amid uncertainty, insecurity and transition. However, being neither students nor established academics can afford more autonomy, with potential to influence subsequent generations. A diverse, interdisciplinary group, ECRs have the flexibility to move between departments and institutions, encountering and transmitting alternative perspectives. ECRs work closely with data collectors and research partners, providing daily opportunities to critically evaluate standard practice and explore alternatives. Many will ultimately work outside research, disseminating decolonial practice to charitable, healthcare, governmental and other sectors. In this Commentary, we refer to World Bank country categories, while acknowledging the limitations of such classification and other attempts to meaningfully group heterogeneous regions, peoples, and cultures. As global health ECRs from and working in low, middle and high-income countries (HICs), we propose 10 foci for action. While some tasks are more clearly the responsibility of HIC-based ECRs, we recognise the importance of being led by ECRs based in low and middle-income countries (LMICs).
1. Educate ourselves and others
Systemic racism is acknowledged infrequently in research training. Concerns that ECRs’ work constitutes ‘white saviourism’ can invoke ‘white fragility’, the dissonance of which can provoke ‘white silencing’.6 Students have urged diversified reading, active dialogue, listening to lived experience, engaging with collaborative teaching methods, feeling empowered to question and challenging epistemic injustice.3 However, educating ourselves in isolation can be difficult to prioritise. Regular learning, reflective practice and action planning can be fostered by supportive peer groups, such as book circles.6
2. Advocate for reform
While politics and policymaking may be beyond most ECRs’ direct reach, advocacy must be one of our core roles. Online and traditional media, institutional channels and collective organisation are powerful routes to influence. ECRs must develop skills of speaking up and championing continued capacity strengthening in LMICs, to combat increasingly inward-looking agendas in HICs.
3. Be critical allies
As global health leaders of the future, ECRs must reflect on our roles in perpetuating systems of oppression.7 Many ECRs’ relative educational and financial privileges mean that guilt (which can provoke paralysis, avoidance or denial) must be transformed into critical allyship.7 This requires learning from and working on equal terms with historically marginalised groups, building insight among privileged peers, and mobilising collective action.
Critical allyship is a continued, evolving practice requiring long-term commitment. The skill of ‘stepping back’, to centre colleagues with local expertise and lived experience,8 is overlooked—or actively discouraged—by traditional training. ECRs must demand or establish psychologically safe spaces for frank discussion, to encourage self-awareness and address missteps.
4. Advance beneficiaries’ agendas
Stakeholders and beneficiaries must be central to identifying problems, generating research questions, determining strategies and responding to findings. Novel interventions must be acceptable to stakeholders, align with and not undermine existing locally led services and responses. Feasibility studies, process evaluations and implementation science methods are important means of ensuring that local priorities inform large-scale research studies. ECRs can enhance sustainability by prioritising evaluation of cost and scalability.
5. Strengthen capacity
Employing local staff to perform research tasks enhances the validity of findings, strengthens local capacity and benefits the economy. ECRs must budget for overhead costs at local higher education institutions and engage proactively with local transparency, accountability, financial scrutiny and audit processes. Situating data ownership and decision-making within local higher education institutions and opening access to local communities are priorities—but may conflict with HIC institution and funder regulations.
Initiating and participating in international networks enable ECRs to share resources and opportunities with LMIC peers. Digital innovations can reduce inequities between regions by facilitating collaborative learning and mentorship. However, artificial intelligence may exacerbate inequity, if algorithms are informed by unrepresentative data or technologies are unequally shared. ECRs must appreciate digital divisions via intersectional axes of privilege and consider unintended consequences in contexts where innovations are not widely available.
Holding conferences in LMICs makes learning and networking accessible to the broadest range of stakeholders and benefits the local economy. When organising events, ECRs must understand the national visa system, endorse delegates’ applications and work with our institutions to lobby for streamlined conference visas.9 To maximise accessibility, speaker invitations and acceptances must be issued far in advance, with events scheduled at the most affordable times of year.
6. Forge equitable partnerships
Challenging coloniality may be particularly difficult in global health because of its roots in medicine, which is inherently hierarchical. ECRs are well placed to promote team cohesion and psychological safety, which mediate the relationship between perceived hierarchy and effectiveness.10 However, best practice guidance for collaborative global health research is sorely needed, to address inconsistencies in overseas staff pay, working conditions, insurance, training, supervision, and mentorship.
ECRs should apply for grant funding in equitable partnership with principal/coinvestigators from the country being studied and propose to do so when this is not currently offered. We must recognise and value cultural differences in working style, values, communication, team collaboration and writing.11 Safe and supportive conversations with supervisors can foster these skills and build more inclusive working cultures.
7. Appreciate diverse paradigms
ECRs are well placed to access a range of transdisciplinary training and incorporate qualitative and mixed methods into our proposals, to illuminate synergistic and syndemic interactions. Indeed, the research practice of examining phenomena in isolation may disincline many academics from engaging with ‘messy’ subjects like decoloniality.
The dominant positivist paradigm presumes an underlying objective truth that can be discovered by rigorous methods. Purely biomedical understandings of health and disease neglect psychological, social and cultural aspects, which may be better understood by interpretivist explorations of diverse lived realities.12
8. Uphold ethical standards
Making research decisions with local academics familiar with the context is critical to ethical practice. ECRs must consult local communities on how our research can have lasting positive impacts. We must offer poststudy access to knowledge, techniques and technologies generated by research demonstrating local benefits.
ECRs must anticipate and mitigate for unintended consequences. Disproportionately high reimbursements for participation, attending training or delivering interventions can adversely impact recruitment by local programmes.13 Excessive compensation may detriment prospective participants’ ability to decline to take part.
In each context, ECRs should consider culturally adapting information sheets and consent forms, working closely with local communities. We should develop contextually appropriate alternatives to written consent, to optimise accessibility.
9. Ensure recognition
ECRs must transparently outline authorship plans at the outset of studies and revisit them regularly. We should create opportunities for LMIC colleagues to meet criteria for joint, coauthorship and last authorship and offer LMIC student projects, including secondary data analysis. Supporting local research staff to participate in analysis and writing up can enhance the career benefits of working on global health studies.
The time, training, technology and confidence to peer-review articles is a privilege. ECRs with more experience can jointly review articles with less experienced colleagues, including those facing intersectional barriers, affording insights into review and publication processes.
ECRs should budget for open-access article processing or prioritise journals offering waivers for LMIC authors, to ensure that research is accessible to all. Disseminating summaries using non-scientific terms and translating journal abstracts into local and other relevant languages widens access to findings. However, we must also challenge prevailing exploitative models of publication, explore alternative approaches, and advocate for change.
10. Pursue epistemic justice and repair
Intrinsic to decolonial global health research is not only avoiding epistemic injustice14 but also pursuing epistemic justice.15 Through educating ourselves and engaging with decoloniality, we will all identify mistakes by ourselves and our teams. Each is an opportunity to reflect, learn and change for the better, while some failures may yet be amenable to repair. Work which has not been adequately shared can be disseminated in accessible formats and local languages. Communities can be consulted on previous practice and set the agenda for the future. If global health is to become meaningfully decolonial, we must all reckon with our previous injustices and commit to working with knowers to produce, use, and disseminate knowledge with commensurate dignity and respect.15
Conclusion
Being an ECR is highly competitive. Feeling disempowered can perpetuate dichotomies, such as perceiving all as either oppressors or oppressed. We may feel in constant competition, even with less privileged peers. However, we are uniquely positioned to engage with transdisciplinary perspectives, drive change, challenge power imbalances and advocate for decoloniality. With this Commentary, we seek to initiate candid, compassionate conversations with early career and more senior colleagues, to build an international decolonial network, representing the diversity in global health.
Data availability statement
There are no data in this work.
Ethics statements
Patient consent for publication
Acknowledgments
We thank the Circle U European University Alliance for hosting the 2022 and 2023 ‘Rethinking Global Health’ Summer Schools at which many of us first met. We thank King’s College London’s Circle U group for awarding us a Seed Fund grant to host a hybrid in-person/online meeting to develop our ideas. We thank Dr Juliana Onwumere, Dr Rebekah Lee, Dr Renzo Guinto, Dr Frode Forland, Dr María Cristina Quevedo-Gómez, Dr Sohail Jannesari and Dr Reima Ana Maglajlic for speaking at the event, which is available to watch, open-access, at: https://www.youtube.com/watch?v=uiUCeM58T_c&feature=youtu.be
Footnotes
Twitter @RoxanneKeynejad, @Njie111, @NepalChirp
Correction notice The published version misspelled co-author’s name as Hiwot Hailu Abera. The correct name should be Hiwot Abera.
Contributors RCK: led the development of this article, led the drafting and interpretation, submission, and approved the final version. OD: led the initiation of this group and initial drafting of this article. Contributed to the acquisition, interpretation, drafting and approval of the final version. RI, FE, HN, SG, TBA, PZ, M-CM, AS: contributed to the acquisition, interpretation, drafting and approval of the final version. HOL, FG, HA, HHAm, SBA, AM: contributed to the acquisition, interpretation and critical review of the manuscript including approval of the final version. PG: supervised the acquisition, interpretation and critical review of the manuscript, including approval of the final version.
Funding The authors received funding from DAM Foundation, NIHR (Clinical Lectureship), Fonds de la recherche scientifique, King’s College London (Circle U. Seed Fund Grant).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.