The Unseen Challenge in Scientific Collaboration
In the ambitious endeavor to solve the world's most pressing health problems, researchers from high-income countries (HICs) and low- and middle-income countries (LMICs) are forming essential research partnerships. These collaborations bring together diverse expertise, resources, and cultural perspectives to tackle diseases and health disparities affecting global populations. Yet, behind the promising scientific breakthroughs lies a complex ethical landscape that often goes unseen—the question of who receives credit as an author on resulting publications 1 .
The allocation of authorship is far from merely an academic formality. In the world of research, authorship credit carries profound academic, social, and financial implications, directly impacting hiring decisions, tenure, promotions, and future research funding 1 7 . Unfortunately, studies reveal that unethical authorship practices occur in upwards of 10% of cases, with approximately 36.4% of researchers in Nigeria reporting authorship disagreements 1 2 . When credit isn't distributed fairly, it doesn't just harm individual researchers—it undermines the very spirit of global cooperation and perpetuates historical power imbalances in the scientific community.
Through examination of bioethics literature and authorship guidance documents, scholars have identified four critical areas where global health research partnerships frequently encounter authorship dilemmas 1 .
The ICMJE recommendations, followed by most reputable health science journals, require authors to participate in drafting or critically revising the manuscript for important intellectual content 1 4 . This seemingly straightforward criterion creates systematic disadvantages for researchers from non-English speaking backgrounds.
While ICMJE guidelines state that the criteria should not be used to disqualify colleagues by denying them the opportunity to contribute to writing, the practical challenges remain significant 1 4 . Professional translation services are costly and time-consuming, creating a barrier that often leads to the exclusion of valuable local researchers from authorship roles.
Beyond determining who qualifies as an author lies the complicated question of author sequence. The ICMJE offers no specific guidance on author order, leaving research teams to develop their own approaches 1 . This vacuum creates space for power dynamics to influence decisions, potentially undervaluing crucial contributions from LMIC researchers.
Context-specific knowledge and technical tasks essential to research success—such as local participant recruitment, navigating community relationships, and understanding cultural nuances—often receive insufficient recognition in authorship order discussions 1 . These contributions, frequently provided by LMIC researchers, may be undervalued compared to more traditional academic inputs typically provided by HIC partners.
There is a perceived editorial bias in favor of prominent researchers from Western institutions, creating what some term "prestige authorship" 1 . This occurs when well-known HIC researchers are added to manuscripts primarily to increase the likelihood of publication, regardless of their actual contribution to the work.
This practice is particularly problematic when it displaces LMIC researchers who made substantive contributions or when it pressures LMIC researchers to include HIC colleagues as "guest authors" in hopes of improving publication chances 1 . Such practices distort true contributions and reinforce dependency dynamics rather than fostering genuine partnership.
Diverse cultural practices and expectations regarding authorship can create significant conflict in international research collaborations 1 . Different research traditions may have contrasting understandings of what types of contributions merit authorship, how credit should be allocated, and whether seniority should outweigh actual contribution.
In some contexts, senior researchers traditionally expect authorship on all publications from their department, regardless of direct involvement—a practice known as "gift authorship" 3 8 . Meanwhile, the contributions of junior researchers, laboratory staff, or data managers might be overlooked despite their essential roles—a form of "ghost authorship" 3 9 . When these different cultural expectations collide in global partnerships without open discussion, misunderstandings and ethical breaches often follow.
To understand how these ethical challenges manifest in actual research, let's examine a hypothetical but representative study based on real-world scenarios described in the literature 1 .
The PARTAKE (Partnership for Research on Tropical Disease and Knowledge Equity) study was a multi-year investigation into the genetic factors influencing malaria susceptibility in three West African countries. The collaboration included:
Geneticists, biostatisticians, and manuscript developers from a European university
Local principal investigators, community engagement specialists, field coordinators, and data collectors from African research institutions
Joint development by HIC and LMIC researchers
Led by HIC researchers with LMIC input on local feasibility
Secured in both HIC and LMIC institutions
Managed primarily by LMIC team with HIC technical support
Conducted mainly at HIC institution due to equipment requirements
Jointly conducted with HIC biostatisticians and LMIC researchers
Primarily led by HIC team due to language requirements
As the study concluded, the partnership faced critical decisions about authorship. The data revealed significant contribution misalignment, with LMIC researchers providing the majority of context-specific expertise and implementation work, while HIC researchers dominated the analysis and writing phases.
Despite this imbalance, the initial authorship plan proposed by the HIC team listed their members disproportionately in first and senior author positions. After negotiation, the team implemented a contributorship model that explicitly acknowledged each member's input, leading to more equitable authorship distribution. This approach helped recognize intellectual contributions beyond writing, such as cultural adaptation and community engagement.
Thankfully, the global research community has developed practical tools to address these ethical challenges.
| Tool/Solution | Function | Application in Global Health Research |
|---|---|---|
| ICMJE Guidelines | Defines authorship criteria | Provides standardized framework for determining who qualifies as an author 4 |
| Contributorship Model | Specifies each author's contributions | Increases transparency and recognizes diverse inputs beyond writing 4 |
| Authorship Agreements | Outlines expected contributions and authorship order at project start | Prevents conflicts by establishing expectations early 3 |
| AuthorAID | Provides writing support and mentorship for researchers in developing countries | Addresses language barriers without excluding contributors 1 |
| CRediT Taxonomy | Standardized list of 14 contributor roles | Offers precise vocabulary for describing contributions 3 |
| Research4Life | Provides free or low-cost access to scientific literature | Reduces information access disparities 1 |
The complex authorship challenges in global health research partnerships demand thoughtful solutions. Based on current research, several approaches show promise:
There is a critical need for empirical research on authorship norms and practices specifically in GHR settings to better understand the current landscape and identify effective interventions 1 .
The development of field-specific standards that address the unique contextual factors in global health research could provide more relevant guidance than one-size-fits-all approaches 1 .
Perhaps most importantly, researchers from both HICs and LMICs must commit to early, open conversations about authorship expectations, contribution recognition, and power dynamics—ideally before the research even begins 3 .
By acknowledging these challenges directly and implementing practical tools like contributorship models and written agreements, global health research partnerships can become more equitable, transparent, and truly collaborative.
As global health challenges grow increasingly complex, our ability to conduct ethical research partnerships becomes not just a matter of individual credit, but a prerequisite for generating the trustworthy, contextually relevant knowledge needed to improve health worldwide. The future of global health research depends not only on what we discover, but on how fairly we acknowledge those who make the discoveries possible.