She drew the distinction between these concepts and equality. Equity goes beyond equality of opportunity, recognising that certain groups are inherently disadvantaged so cannot take advantage of opportunities to the same degree as others. Extra measures are required to achieve ‘true’ equality in opportunity.
The African context
Dr Kyobutungi argued that locally led research needs to be strengthened. Africa is not publishing its fair share of papers and, compared with other regions, it has proportionately far fewer numbers of PhDs and health researchers.
The lack of local leaders is contributing to a translation gap, with African populations typically slow to benefit from interventions and research not always generating answers to questions of importance to Africa.
She pointed out multiple structural inequities in African research, relating to factors such as language, geography and institutional strength. Where research funding is directed is also skewed, with diseases such as HIV/AIDS and malaria gaining the lion’s share of support and mental health research just 1%.
Furthermore, African countries are not reaching the African Union target of committing 1% to health research. The regional average is 0.45%, with individual countries committing between 0.01% and 0.85%.
Global imbalances
This lack of national investment leaves the country at the mercy of donors. Dr Kyobutungi pointed out that international funders direct their support to institutions primarily in their own countries. African researchers are often the junior partners in research collaborations, their main role being data collection. They typically end up as middle rather than lead authors on scientific publications.
Analyses have also demonstrated that global health leadership is dominated by those from the northern hemisphere. Key voices from Africa are not being heard and are not having the chance to inform decision-making.
The need for change
In conclusion, Dr Kyobutungi argued that equity, fairness and justice need to be baked into funding processes. Equity both within and between countries needs to be considered. Equity in health outcomes should be a key driver of research, and research activities should focus on the information needs of decision-makers at all levels.
She acknowledged that change would be difficult. However, the best way to predict the future, she concluded, is to create it.