Bridging the north/south divide

Simon Linacre outlines the changing dynamics of pharmaceutical research between Global North and Global South and the implications for scholarly communications

Having spent more than 20 years in scholarly communications, I can’t help thinking about what has changed over the years… and what hasn’t. Having spent much of my early career waiting by a fax machine for the last copyright form to be sent through to complete an issue, I can confirm that continuous publication processes are much more efficient. However, after seeing so many false dawns for academic articles over two decades, I can also confirm that the pdf still does the job for most researchers.

Another aspect of academic research that stubbornly persists is the dominance of Global North research over that of the Global South. With so many systems and research cultures set against Global South researchers – the English language, university rankings, legacy  journal rankings and Western research paradigms to name just a few – it is perhaps no surprise that research from Global South countries struggles to make itself heard over more established competition. But could that all be about to change?

North and South

A recent study by Dr Briony Fane at Digital Science explores the fragmentation of the global pharmaceutical research landscape, with a focus on the divide between the Global North and Global South. The study maps aspects of the landscape in this area exploring differences in pharmaceutical research practices from different perspectives, including funding and collaboration, pharmaceutical research and its association with the SDGs, as well as the impact of the cost of medicines developed by pharma and their accessibility in distinct geographic regions.

To add some context to the study, Global North and Global South are defined by the Royal Geographical Society as: “The concept of a gap between the Global North and the Global South in terms of development and wealth”. In areas such as the United Nations Sustainable Development Goals (SDGs), this gap is particularly important, with the Goals aiming to effectively bridge the divide by 2030 as many of the environmental problems they are concerned with impact on Global South countries to a much greater degree.

This ‘fragmentation’ is the focus of a new campaign from Digital Science, which aims to highlight these sorts of divides. With regard to pharmaceutical research specifically, Dr Fane found in her study that there is a significant divide in pharmaceutical research between the Global North and Global South. This divide is evident in the following areas:

• Funding: The Global North accounts for the vast majority of pharmaceutical research funding. In 2020, the top 10 pharmaceutical companies in the Global North spent over $170 billion on research and development, while the top 10 pharmaceutical companies in the Global South spent just over $4 billion

• Research areas: Pharmaceutical research in the Global North is largely focused on diseases that are common in high-income countries, such as cancer and heart disease. In contrast, pharmaceutical research in the Global South is more focused on diseases that are common in low- and middle-income countries, such as malaria and tuberculosis

• Accessibility to medicines: The high cost of medicines is a major barrier to access in the Global South. In 2020, only 55% of the population in low- and middle-income countries had access to essential medicines, sometimes delivery to Global South countries is delayed, and often there are also accessibility issues regarding how to get to where the vaccines need to be administered by a healthcare professional

• Collaboration: The Global North also dominates in terms of pharmaceutical research collaboration. In 2021, there were over 100,000 international collaborations in pharmaceutical research, but only 10% of these collaborations involved researchers from the Global South.

A way forward

From a scholarly communications perspective, what is most frustrating is that this state of affairs seems to have persisted despite the clear benefits for Global North academics of more focused research on - and collaboration with - academics based in the Global South. Increased collaboration is one of the key recommendations from the study, along with increased funding  for pharma research by governments and other agencies in the Global North, and capacity building from Global South countries through investment in the pharmaceutical sector. 

But there is some room for optimism. Firstly, studies of this kind are beneficial in that they provide insights into this important topic, while showing the problems run much deeper into government policy and funding. Secondly, there is evidence in the data of a growing commitment on behalf of the pharmaceutical industry to increasing access to medicines, as well as improving collaboration between Global North and Global South researchers. This later point is critical if this global divide is going to be closed.

And finally, other reports have shown that collaboration is also improving between academia and industry, so long the Holy Grail of government policy the world over. If these collaborations continue, then there is genuine hope that the grand challenges faced by society may be met quicker as a result of clear focus on improved outcomes for the Global South.

Next steps

So, bridging the divide in pharmaceutical research between the Global North and Global South is evidently a complex challenge, but it is one that must be addressed to achieve global health equity. But what role does scholarly communications play in this? Efforts towards coordinated change in the industry have not always turned out as hoped. It was thought, perhaps naively, that moving towards Open Access (OA) would dramatically open up both publishing opportunities and access for Global South authors. However, the growth of Gold OA models can prevent many of those authors from submitting articles due to their inability to pay APCs.

For Global South authors to further close the divide they face in areas like pharmaceutical research then a paradigm shift has to happen, where research that does the most good is the most valued. This will take a major change in research culture, particularly in the Global North, as well as changes in policy making, funding decisions and attitudes to the purpose of academic research. 

For scholarly communication, perhaps the role they can play in this is to embrace the new opportunities presented by advances in AI for things like translation, lay summaries and impact analysis. As these enhancements become quicker and easier to overlay onto research, the societal value of research could be released, especially from Global South authors whose work has the potential to have the biggest impact. By working together – like pharma and academia seem to be doing – a more equitable and sustainable research landscape that benefits everyone might just be within reach.

Simon Linacre is Head of Content, Brand & Press at Digital Science