Growing research in global surgery with an eye towards equity

Background Global surgery research is often generated through collaborative partnerships between researchers from both low‐ and middle‐income countries (LMICs) and high‐income countries (HICs). Inequitable engagement of LMIC collaborators can limit the impact of the research. Methods This article describes evidence of inequities in the conduct of global surgery research and outlines reasons why the inequities in this research field may be more acute than in other global health research disciplines. The paper goes on to describe activities for building a collaborative research portfolio in rural Rwanda. Results Inequities in global surgery research collaborations can be attributed to: a limited number and experience of researchers working in this field; time constraints on both HIC and LMIC global surgery researchers; and surgical journal policies. Approaches to build a robust, collaborative research portfolio in Rwanda include leading research trainings focused on global surgery projects, embedding surgical fellows in Rwanda to provide bidirectional research training and outlining all research products, ensuring that all who are engaged have opportunities to grow in capacities, including leading research, and that collaborators share opportunities equitably. Of the 22 published or planned papers, half are led by Rwandan researchers, and the research now has independent research funding. Conclusion It is unacceptable to gather data from an LMIC without meaningful engagement in all aspects of the research and sharing opportunities with local collaborators. The strategies outlined here can help research teams build global surgery research portfolios that optimize the potential for equitable engagement. Power dynamics in the field of global surgery research lead to inequitable opportunities for researchers in low‐ and middle‐income countries. This paper describes the authors' own experiences in Rwanda, and outlines strategies to develop a strong global surgery research portfolio and fair partnerships. Probity is key