Shared learning in an interconnected world: innovations to advance global health equity

Abstract

The notion of “reverse innovation”--that some insights from low-income countries might offer transferable lessons for wealthier contexts--is increasingly common in the global health and business strategy literature. Yet the perspectives of researchers and policymakers in settings where these innovations are developed have been largely absent from the discussion to date. In this Commentary, we present examples of programmatic, technological, and research-based innovations from Rwanda, and offer reflections on how the global health community might leverage innovative partnerships for shared learning and improved health outcomes in all countries.

Shared Education and Shared Innovation in the Global Health Setting

“…3 This concept is common in the global health literature when authors describe transferrable lessons from lowincome countries' insights to wealthier nations. 4 In agreement with Cotton et al, 3 the term reverse is patronizing, implying that the natural flow of ideas is unidirectional (from high-to low-income countries), and diminishing the significance of these accomplishments. The authors believe that the flow of knowledge and innovation between nations has always been bidirectional.…”

“…In fact, the global health community has started to acknowledge the potential to build mutual surgical capacity through international partnerships. 4 Many plastic surgery residents and staff participate on international medical missions to perform cleft surgery. In most cases, these itinerant surgeons travel to locations with overwhelming surgical needs permitting relationships that can be formalized into training programs.…”

“…The only barrier that a physician from a low resource setting with Internet access may encounter is the access to a paid-journal-article, which could cost him 2 days of salary. 4 Herein, lays the importance of open access for the dissemination of global health literature. 4 The United States produces almost as much research in citable documents as its closest 5 competitor nations combined (Fig.…”

“…4 Herein, lays the importance of open access for the dissemination of global health literature. 4 The United States produces almost as much research in citable documents as its closest 5 competitor nations combined (Fig. 1).…”

Convergence of Mortality Rates among Patients on Antiretroviral Therapy in South Africa and North America

“…As we have noted elsewhere, when taking average family incomes into account, a monthly round-trip bus fare to refill an ART prescription can pose a similar burden in rural Africa as a monthly business class airplane ticket from Los Angeles to Boston in the US [13]. Sustained reductions in mortality will require investing in approaches to strengthening health systems that support patients in overcoming these obstacles, and that harness the social capital shown to facilitate adherence [14].…”