The issues we care most about – like drug-resistant infections, vaccines and planetary health – tackle health burdens that are inherently international, even though much of the research we fund is led by teams based in the UK.
This creates a challenge for public engagement. Our goal is to involve the public in Wellcome’s work – not just because it’s the right thing to do, but because it helps us achieve our mission of improving health. But who should we involve? Where are the people we need to engage?
Why we need to think globally
There is a case for focusing on the UK. It is where our biggest public engagement assets are – the institutions and the researchers we support. And it’s also where we’ve invested the most in infrastructure – the artistic and academic institutions that live and breathe public engagement, as well as the local knowledge that makes it work.
But the brightest minds are scattered across the globe – many of them outside academia – and if we want the best ideas, we must include them in our work. Also, we can’t hope to understand health inequality – let alone reduce it – if we don’t work with the people it harms the most.
In public engagement, most of our international work is led by and takes place in low- and middle-income countries, an organic development driven by historic decisions.
The burden of disease in these countries is among the highest in the world. Plus, many people living here may have lost trust in research, health services or authority more broadly as a result of corruption, colonialism and conflict. Good engagement can play an important role in addressing these issues. It can empower communities to generate and use evidence to improve health outcomes; improve the trustworthiness of science; and break down traditional structures and research methods that may have done harm in the past.
This is why we continue to make the case for supporting public engagement work globally.
An example of the value this brings to our research programmes is Health in the Backyard run by Oxford University Clinical Research Unit (OUCRU) in Vietnam. The project embeds the knowledge of rural farmers into research about how diseases are spread by animals. It has snowballed over the years and attracted government partners, making it more likely that the research conducted by OUCRU will drive a real change in research, policy and people’s health.
Despite these successes, one of the biggest challenges for our partners, and for us in knowing how best to support them, is the scale of their ‘public’ and the diversity of health issues the programmes are addressing.
OUCRU, for example, sits in a tertiary hospital with 500 beds and a catchment area of 40 million people. How do they choose who to engage? What research do they prioritise when the health issues are so vast and varied? How do they have an impact when wider infrastructure is so poor and communities are wearied by trials and interventions? These are questions many of the programmes grapple with, which we must help them to tackle.
Alongside our Africa and Asia programmes, we run three funding schemes to support a variety of institutions and people, recognising that the diversity of the sector is one of its most valuable assets:
Public Engagement Fund – for projects in the UK and low- or middle-income countries in Sub-Saharan Africa, South Asia, or East Asia and Pacific
Engagement Fellowships – for engagement leaders, with a small number of international applicants invited each year.
Working with others
We’ve funded public engagement for decades, but we know that to inspire far-reaching change we must bring others along with us.
We lead conversations
As a sector, we need to make a stronger case for engagement. At Wellcome, we’re advocating for a more strategic, outcomes-oriented approach across our work and the work we fund; this will make the impact of engagement more visible and build a stronger evidence base for the whole field.
But making the case is not always enough. We also have a role to play in disrupting the system, a system that at times feels hierarchical and set in its ways.
We will continue to lead the debate on the importance of putting people at the heart of global health research, and to challenge the norms of traditional research agendas and approaches.
We bring partners together
Through partnerships, we can achieve a much greater impact for public engagement work worldwide.
With the UK Department for International Development, we’ve co-funded a scheme led by our partners at the African Academy of Sciences to seed-fund engagement work across Africa. This is the start of a long-lasting relationship to foster collaboration and learning in engagement.
It’s also a first step in forming funding coalitions for engagement, making the case for wider investment in this sector and devolving funding decisions away from London.
This recognises the importance of local expertise and Africa-led decision making – something we care deeply about when deciding who we partner with and why.
We form networks
There is a lot of common ground among those doing and supporting engagement across and outside health research, in areas such as public health, development assistance and social mobilisation. To have a bigger impact, we need alignment, coordination and joint working.
Two months ago, we convened 60 people from 15 countries to share learning, make connections, and challenge one another.
This is complemented by our online community of practice for engagement, Mesh, which brings together people from across 141 countries.
We will continue to create opportunities to broaden conversations about engagement around the globe. We’re committed to investing in people and supporting inclusive global leadership in the field. And we will work hard to capture and shout about the impact engagement has on society and human health, and make sure we see a step change in the way engagement is embedded in research culture.