Africans have authored just 3% of COVID-19 research papers, despite the fact that 17% of the world's population lives in Africa, reveal two analyses, published in the online journal BMJ Global Health.
One in five COVID-19 papers listed no African authors, while two thirds of authors weren't from Africa, one analysis of 10 leading medical and global health journals shows.
Historically, African authors have been underrepresented in published research on disease affecting Africa, so the study authors wanted to know if this was also true of COVID-19.
In the first analysis, the study authors looked for African authors publishing research and comment on COVID-19 in Africa in the top five general medical and top five global health journals between 1 January and 30 September 2020.
A total of 2196 articles on COVID-19, with 9222 authors listed across them, were included in their analysis.
In all, just 94 articles (4.3%) contained content related to Africa or a specific African country; 292 (3.2%) of the authors were affiliated to an African organisation.
The average number of authors per article was 4.2, overall, with an average of 0.13 (3.1%) of these authors being African.
In articles with African content, 619 authors were listed. But only a third (210; 34%) of these authors reported an affiliation to an African organisation. There were an average of 6.6 authors on each article about Africa, 2.2 of whom were African.
Authors from other parts of the world made up two thirds (66%) of authors on African papers, but Africans comprised just 3% of authors on non-African papers.
One in five (19) African COVID-19 papers listed no African authors. Some 39 (41.5%) of these articles had an African first author, while 18 (19%) had an African last author.
African authors occupied both of these prime authorship positions in 13 articles (14%), compared with 60 (3%) instances of Africans occupying prime authorship positions for content that wasn't about Africa.
While 1.3 billion people--17% of the world's population--live in Africa, less than 4% of articles related to COVID-19 and published in the top 10 medical journals are relevant to the continent, say the study authors.
It is perhaps unsurprising that high income countries have produced most COVID-19 research, given their resources, but they are nevertheless overrepresented in research about Africa, add the study authors.
"Health policy is not only informed by original research; sensible, contextually appropriate guidelines, opinions and commentary are also essential to improving the functioning of healthcare systems. This is especially true during times of surge, when original research can be challenging to produce in low resource settings, like those in Africa," note the study authors.
Of the 94 articles related to COVID-19 in Africa, almost three quarters were opinion-based, compared with just over half for those not related to Africa. Nearly 90% of the opinion-based articles related to Africa listed authors from elsewhere, while only 2.4% of opinion-based articles unrelated to Africa listed African authors.
"Results from the 10 journals included in this analysis--which have a disproportionately strong influence on healthcare worldwide-- suggest that African representation in African COVID-19 literature is insufficient," conclude the study authors.
This is particularly the case for opinion-based articles that aim to offer advice on system response and clinical care, they highlight.
"These findings add to the evidence of coloniality in global health research and decision-making," they point out.
"The time has come that authoritative journals need to turn to authors and ask where local representation is on papers describing health systems in regions that are not their own--else the inequity and coloniality highlighted in this review are perpetuated," they insist.
A second analysis echoes the findings of the first, and emphasises the important and unique contribution African researchers can make to health issues affecting the continent.
In this analysis the authors mined research databases looking for authors reporting single or multiple affiliations to organisations located in an African country between November 2019 and August 2020.
They found that 42 African countries produced 1130 documents, representing 3% of the global share of COVID-19 publications during this period.
Almost two thirds (65%) of articles by Africans on COVID-19 were from just three countries: South Africa, Egypt, and Nigeria.
It's important for Africans to publish research on COVID-19 in Africa because this helps to create locally relevant knowledge to address the pandemic, note the study authors.
"African research groups are in an excellent position to intensify and sustain intracontinental collaboration to more accurately describe what goes on in Africa as the pandemic evolves," they write.
"Despite the unusual circumstances, such as inadequate research funds and lower capacity, African scientists have made valuable contributions to the science of COVID-19," they emphasise.
"Based on our findings, we posit that African governments should increase research resource allocations needed to build trust for academic institutions that will rapidly catalyse the contribution of African-led research in infectious diseases," they conclude.
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External peer review? Yes
Evidence type: Observational
Subjects: African researchers
Journal
BMJ Global Health