Addressing the global health crisis: epidemiologists attempt to bring back harmony with the BRIDGE guidelines

Addressing the global health crisis: epidemiologists attempt to bring back harmony with the BRIDGE guidelines
9 February, 2022

Blog series ‘Equitable partnerships: Lessons from practitioners’

Sandra Alba and Susan F. Rumisha

Bora kujenga daraja kuliko ukuta
[Translation from Swahili: Better build bridges than walls]

The famous African proverb is used and known across the continent in various languages. According to Maua Kikari, a Swahili language scholar from the University of Dar es Salaam, Tanzania, the proverb is traditionally invoked to manage disagreements – ranging from simple misunderstandings to outright conflicts – between individuals or communities. The proverb aims to build harmony into relationships by encouraging dialogue between parties to establish common ground. 

The global health sector has certainly been going through crisis lately: the Black Lives Matter protests have reignited calls to decolonise global health and colonial legacies are seen for what they are. Researchers around the globe are claiming their right to lead and manage research conducted in their countries, and questioning whether the field can survive its decolonisation.  

As global health epidemiologists, we welcome these developments. Equitable partnerships are key to ensuring high quality, impactful research with long term benefits for local communities. But with many years of experience in global health, we are also aware of the challenges to achieve anything we can call “equitable”. 

To provide practical support to those involved in global health epidemiological research, we recently developed the BRIDGE guidelines. Much like the African proverb, the guidelines encourage dialogue between parties, to bridge differences and ensure that no-one is shut off, intentionally or unintentionally. Below are some examples of how the BRIDGE guidelines attempt to support researchers at various stages of a study: 

Bridging academia and practice
Involving end-users of research is one way to increase the impact of research on local communities, because it ensures that studies answer the right questions for public health practice. Depending on the context, end-users may be policymakers, service providers, communities, etc. To ensure that studies provide useful information to end-users, a dialogue between the researchers and the end-users should occur. A number of tried and tested stakeholder engagement methods can facilitate this. 

Bridging disciplines
Global health research questions are often multi-layered and thus best studied with a mix of disciplines. The mix of quantitative (epidemiology, statistics, etc.) and qualitative research (sociology, anthropology, etc.) is especially challenging as researchers need to understand and compromise on different world views. Dialogue between researchers can be achieved with regular pre-planned moments of reflection during study design and analysis.  

Bridging the power gap
Global health research partnerships typically involve researchers from diverse backgrounds. This can lead to power imbalances, as some people may be more or less advantaged with respect to access to resources, technology, expertise, etc. Those with more power can and may take all the scientific credit for research instead of others who put in all the legwork. Fair agreements at the outset of a partnership are one way to promote dialogue between researchers and avoid such situations.  

In short, dialogue is key to move towards equitable partnerships. Through dialogue, the various stakeholders in global health can establish common ground. Through dialogue, we can conduct high quality studies with an impact where it is needed the most: in the local communities and local research systems. Through dialogue, we may be able to bring back harmony to global health.  

As Black Panther’s T’Challa recently said when he invoked the famous African proverb, “In times of crisis the wise build bridges while the foolish build barriersWe must find a way to look after one another as if we were one single tribe.” We hope that the BRIDGE guidelines and checklists can offer a step forward in that direction for global health epidemiology – and beyond.  

Author bios

Sandra Alba is an epidemiologist based at KIT Royal Tropical Institute in the Netherlands. She has over 15 years of experience the application of statistical and epidemiological methods to monitor and evaluate global health interventions.

You can reach Sandra on Twitter @san_dra_al_ba

Susan Rumisha is a Tanzanian researcher and statistician currently working with the Malaria Atlas Project at the Telethon Kids Institute in Western Australia. She has over 15 years of experience in the application of geo-statistical methods to generate evidence for decision making and support infectious disease control programs globally.


The BRIDGE guidelines were developed thanks to funding from the KIT Knowledge Investment Fund.

Photo credit

Photo by Ikunda Rumisha (2019): Bridge connecting villages of Sembeti and Samanga in Marangu, Moshi, Kilimanjaro, Tanzania. The bridge proverb may or may not have been used at some point in time to quell disputes between Sambeti and Samanga villagers.  

About the ‘Equitable Partnerships: Lessons from Practitioners’ Blog Series 

At UKCDR, we know that research for development needs equitable partnerships. We also know that there are still lessons to learn as we move equitability in collaborative research from principles to practice, which will be explored in upcoming UKCDR and ESSENCE guidance. In the leadup to these guidelines, we’re excited to share our new blog series, ‘Equitable Partnerships: Lessons from Practitioners’. Each week, we’ll hear from International Development practitioners as they share their insights on the topic, providing best practice and learning examples informed by their experience in the field.

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