Locally affiliated authors, particularly women, remain underrepresented in prominent authorship positions in global eye health research conducted in sub-Saharan Africa.
In global eye-health research partnerships in sub-Saharan Africa, locally-affiliated authors are often included, but rarely are offered prominent authorship positions, according to a poster presented at the 2026 Global Ophthalmology Summit, held in Philadelphia August 7-9. Bridging that equity gap will require concerted efforts to include locally-affiliated authors, particularly authors who are women, in prominent first and last authorship positions, the presenters explained
The presenters conducted a cross-sectional analysis of partnership sub-Saharan African eye-health publications between 2003 and 2022. They reviewed 1777 qualifying publications and found 33% featured locally-affiliated authors in the first position and 45% in the last position.1
“We found that 6.2% of publications on eye health in Sub-Saharan Africa had no locally affiliated authors at all,” explained co-author Edinam Y. Hutton-Mensah, MBChB, MGCPS, an ophthalmologist and glaucoma fellow in training at the Komfo Anokye Teaching Hospital in Ghana
The researchers also found that randomized clinical trial studies, high-impact research and when high-income-country-affiliated co-authors are paired with low-income study countries, there is a higher likelihood of the research having either no prominently positioned locally-affiliated or no locally-affiliated authors at all. Journals based in the United States or the United Kingdom seem to have a particularly lower odds of offering locally-affiliated authors in Sub-Saharan Africa prominent representation. Especially those who are women.
…female Sub-Saharan Africa-affiliated first or last authorship was less likely with US or UK journal publishers, low-income study countries, and randomized trials…
“Our study also looked at the gender representation, and we realized that female Sub-Saharan Africa-affiliated first or last authorship was less likely with US or UK journal publishers, low-income study countries, and randomized trials, and more likely with funded studies and high-income co-authors,” Dr Hutton-Mensah explained
No standard criterion for authorship ordering exists, but it is commonly understood that first and last authorship positions indicate positions of authority, with the first author often representing the largest contributor, and the last representing a senior or supervisory role, according to the investigators.
“We found that over time, it didn’t really change too much in the last 20 years. And so something we want to emphasize is the importance of focusing on these collaborations going forward and focusing on equitable contribution,” said co-author Conner Adler, MD, a medical student at Washington University School of Medicine in St. Louis.
The presenters support the inclusion of locally-affiliated authors for the purposes of growing research capacity, improving contextual relevance, and for guidance in staying aligned with local community research priorities. In addition, the American Academy of Ophthalmology has issued a mandate to optimize global collaborations.2
“The AAO has recently shared that we need to have better, more equitable research partnerships in global ophthalmology,” explained lead author Scott K. Herrod, MD, a 4th year Harvard Medical student, MPH student at the Harvard Chan School of Public Health, and Zuckerman fellow at the Center for Public Leadership at the Harvard Kennedy School. “There really aren’t that many studies evaluating how equitable we are. How often are those from Sub-Saharan Africa in first and last authorship positions? How often are they included? And so our study really tried to do a scoping review of where we are at as a field and where there are opportunities for us to continue to grow.”
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References:
- Herrod SK, Hutton-Mensah EY, Alder CJ, et al. Locally-affiliated authorship in global eye health research conducted in Sub-Saharan Africa between 2003 and 2022. Poster presented at: Global Ophthalmology Summit; August 7-9, 2026; Philadelphia. Poster 30.
- Ehrlich JR, Shantha JG, Mathenge C, et al. Research partnerships and guidance in academic global ophthalmology.International Ophthalmology Clinics.2023;63(1):15-24. doi:10.1097/IIO.0000000000000447
