Action to protect the independence and integrity of global health research

Correspondence to Katerini T Storeng; katerini.storeng@sum.uio.no Introduction In a recent Viewpoint in the Lancet, some of us shared our experience of censorship in donor-funded evaluation research and warned about a potential trend in which donors and their implementing partners use ethical and methodological arguments to undermine research.1 Reactions to the Viewpoint—and lively debate at the 2018 Global Symposium on Health Systems Research—suggest that similar experiences are common in implementation and policy research commissioned by international donors to study and evaluate large-scale, donor-funded health interventions and programmes, which are primarily implemented in low resource settings. Effects of interference in the research and evaluation process are compounded by more subtle acts of self-censorship and data embellishment that can arise as researchers become embroiled in what was recently called the global health ‘success cartel’.9 Their involvement in a collective drive to demonstrate success can unintentionally ‘instil a fear of failure, stifle risk-taking and innovation, and lead to the fabrication of achievement’.9 For example, research that threatens the position of powerful elites—such as research into high-level corruption—is lacking.10 Meanwhile, selective reporting of ‘unwelcome’ findings can be a way to avoid contractual terminations even though it undermines learning.1 11 12 Moreover, perverse incentives exist across the global health and development sectors to use simplistic indicators of success and bad or fudged data.13–15 Donor agencies exacerbate the problem by distorting research findings to exaggerate their own successes.16–19 Researchers are responsible for conducting research ethically and with integrity. To increase transparency and reduce selective reporting of findings, we recommend establishing a global health evaluation registry, similar to existing clinical trial registries.12 26 Researchers and research institutions Today, universities and research organisations across the world depend heavily on external funding from government departments, private foundations and industry.2. [...]they have an important responsibility to prevent conflicts of interest in research contracts. [...]they could play a fuller role in helping researchers navigate related unforeseen ethical dilemmas that arise in the course of research.