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Four Lessons to Reverse Inequity in the Global Health Workforce

An eight-month-old boy is examined by a doctor in Dar es Salaam, Tanzania. Credit: Kristin Palitza/IPS

An eight-month-old boy is examined by a doctor in Dar es Salaam, Tanzania. Credit: Kristin Palitza/IPS

ABUJA, Dec 16 2019 (IPS) - Recently, Madhukar Pai, the Director of McGill University Global Health Program wrote about the inequity in global health research. He observed that researches are skewed in favor of the global north. We agree that this inequity exists. However, we also have found that global fellowships such as the Atlantic Fellowship, of which we are both Senior Fellows, are platforms to reverse this inequity, foster international partnerships and amplify voices of development practitioners from the global south. 

Shubha Nagesh is a medical doctor by training and thereafter specialised in Global Health from Karolinska Instituet, Sweden as an Erasmus Mundus Fellow. She presently works with children with developmental disabilities in the foothills of the Indian Himalayas.

Ifeanyi Nsofor is a Nigerian medical doctor and a graduate of the Liverpool School of Tropical Medicine. He is a Senior New Voices Fellow at the Aspen Institute and 2006 Ford Foundation International Fellow. Ifeanyi is a leading advocate for universal health coverage in Nigeria.

The world must realise that fostering a global village requires that different geographical locations do not attempt to solve problems alone. There must be a sense of community in all efforts to improve health

The Atlantic fellowship is funded by the Atlantic Institute and connects the seven Atlantic fellows programmes spread across six countries. The goal of the Atlantic Institute is to advance fairer, healthier societies. Fellows have diverse backgrounds and are united by their commitment to a more inclusive world.

As Senior Fellows of the Atlantic Fellowship for Health Equity at George Washington University, both authors have benefitted from an enriching fellowship year. This experience has led to convenings in the U.S., Rwanda and other locations and have been great learning opportunities to understand the local health systems and the benefits of international collaborations.

The mid-year convening at the University of Global Health Equity in Rwanda, allowed both authors to witness firsthand the partnership between the government of Rwanda and Partners in Health, which has led to significant improvements in mental health through the Mario Pagenel Fellowship in Global Mental Health Delivery. In previous opinion pieces, Shubha wrote about her Rwanda experience and Ifeanyi did the same.

From our combined experiences of benefiting Erasmus Mundus Fellowship, Ford Foundation International Fellowship, Aspen New Voices Fellowship and Atlantic Fellowship, there are four lessons that the global health community can learn to gradually reverse the inequity in global health workforce.


First, talent is universal, but opportunities are not. Opportunities for development experts from the global south are limited, especially those that demand leadership positions. Fellowships help create platforms for development experts from different countries to interact, get to know each other and learn about the capacities that everyone brings to the table.

For instance, the 2019 Atlantic Fellows for Health Equity at George Washington University comprises of 18 Fellows from 7 countries – Ghana, Malawi, Nigeria, US, Philippines, India and Iraq. Over a period of one year, the Fellows exchanged ideas and supported each in pushing for health equity in their different countries.


Second, prioritise women in global health workforce appointments because women face more inequities than men. Out of the 18 Fellows mentioned above, 15 are females. This was intentional on the part of the organizers in order to ensure that the gap between men and women will gradually be reduced. While women form the bulk of the health workforce, . key decision makers in the health sector are usually men. The recent appointment of Winnie Byanyima as the Executive Director of UNAIDS, after serving a successful 6-year tenure as the Executive Director of Oxfam, should be replicated across more global health agencies.


Third, Fellowships can amplify global south voices on the global stage. This is the core aim of the Aspen Institute’s New Voices Fellowship. It has trained more than 100 senior fellows from many countries from the global south.

These fellows have written more than 1,000 opinion pieces published on different platforms and have been interviewed on radio, TV and other platforms sharing their ideas. Ifeanyi is a Senior New Voices Fellow and has within the past 2 years written and published 33 opinion pieces on platforms such as DevexThe HillScientific AmericanBiomed CentralAll AfricaInter Press News Service etc.

Therefore, this opinion piece is another case of amplifying voices of Indian and Nigerian development experts on the global stage.


Fourth, collaborations are for life and reduce inequities. The agenda of most fellowships is to nurture collaboration and not competition. Collaboration beats competition, every single time. Mentorships created within the boundaries of Fellowships can be transformed to collaborations that could prove beneficial for a long time.


The world must realise that fostering a global village requires that different geographical locations do not attempt to solve problems alone. There must be a sense of community in all efforts to improve health. This African proverb captures our thoughts succinctly; “If you want to go quickly, go alone. If you want to go far, go together.”

To be sure, Fellowships will not stamp out the global health workforce inequity overnight. However, fellowship should be used as platforms to systematically work to reverse the inequities articulated by Madhui Pai.

As Senior Fellows for health equity at the Atlantic Institute, we will collaboratively continue to advance fairer, healthier and more inclusive societies.


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