Background Calls to decolonise global health have highlighted the continued existence of colonial structures in research into diseases of public health importance, particularly in low- and middle-income countries (LMICs). A key step towards restructuring the system is equitable leadership in global health partnerships whereby researchers in LMICs are given the opportunity to successfully secure grant funding to lead and drive their own research based on locally defined priorities.

Methods In February 2022, the Tuberculosis (TB) Centre of the London School of Hygiene and Tropical Medicine (LSHTM) hosted a virtual multi-stakeholder workshop aimed at bringing together funders and early- and mid-career researchers (EMCRs) to identify funder initiatives that have worked to improve equitable leadership, to better understand barriers faced by EMCRs, and collectively brainstorm approaches to overcome these barriers. The workshop transcript was analysed using a deductive thematic approach to identify key emerging themes.

Results The workshop was attended by 140 diverse participants representing funders, research institutions, and researchers from Africa, Europe, Asia, and South America. 83 participants self-identified as early- or mid-career researcher, and 19 as senior scientists, with varied areas of interest including communicable and non-communicable diseases and neglected tropical diseases. Major barriers identified were lack of individual and institutional level support, and flawed funding structures for EMCRs in LMIC settings. Strategies on how equitable leadership can be further facilitated included institutional reforms for funders to facilitate equity, diversity, and inclusion in their partners through consultative engagement, and reshaping how research priorities are defined. Other strategies identified included diversified funding streams for research institutions, promoting south-south partnerships, and dedicated funding for capacity building of EMCRs.

Conclusion Advances to overcome funding barriers in global health speak directly to its decolonisation. Complex changes in practice, which are intentional and require uncomfortable shifts, are urgently required.

Funding: Wellcome Trust Institutional Strategic Support Fund.