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Madhukar Pai: The reality of global health academia in many places

Madhukar Pai/X

Oct 30, 2024, 10:18

Madhukar Pai: The reality of global health academia in many places

Madhukar Pai, Inaugural Chair of the Department of Global and Public Health at McGill University, shared a post on LinkedIn about a recent paper with him as the first authur published in The Lancet.

“On precarity of academics in Global Health and ‘soft money culture’ as a rarely discussed determinant of inequities.

This is the reality of global health academia in many places:

1. Universities see global health as a ‘revenue stream’ and expect huge overheads

2. Because universities see global health as an income-generating project, they charge high tuition fees for global health degrees, even for LMIC applicants

3. Faculty positions are mostly soft-money funded and precarious:

This means faculty have to keep writing grants to raise a huge chunk of their salary, year after year.

Tenure, even if it exists, can mean little when faculty members get little security from their institutions

4. Tenure/promotion criteria are mostly about individual accomplishments (e.g. number of first or senior-authored publications, number of grants held as PI, prizes, citations):

Allyship and partnership-building work is rarely recognised or rewarded by promotions committees.

These institutional pressures and precarity force academics to prioritise their own career advancement, even when many Global North scholars genuinely want to walk the path of allyship.

The results can be seen in how grants often go to Global North institutions, even when the research is entirely done in LMICs; also seen in authorship inequities: first and senior authors are often from HICs; Global health awards, prizes often go to HIC individuals and orgs.

So, without institutions (funders, universities) changing their policies and incentive structures, it is unlikely that individuals alone can advance equity.”

Alvaro Carrascal shared this post, adding:

“There cannot be a more accurate statement.

‘Universities see global health as a ‘revenue stream’ and expect huge overheads’. ”

“Shifting power in global health will require leadership by the Global South and allyship by the Global North”

Authors: Madhukar Pai, Shashika Bandara, Catherine Kyobutungi.

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Madhukar Pai: The reality of global health academia in many places