From short-term engagements to meaningful and equitable global health partnerships

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The struggle for global health equity is complex, often fueled by a desire for quick solutions.Though global health should be a broad, 'big-tent' endeavor, quite often it gets simplified to the immediacy of clinical medicine.Short-term global engagements in global health (STEGH), like medical missions and student trips, embody this impulse.These, like many other aspects of global health, have roots in the late 19 th century as a largely neocolonial pursuit of "international medicine" [1].These may also be driven by availability of opportunities and push towards broader marketization of global experiences-not just by the need of the respondents, but also by the supply of these opportunities [2].While these activities may come from altruistic intentions, that of 'hoping to help', they often create more problems than they solve [3].STEGHs may inherently be hampered by lack of context, thereby neglecting the unique needs and cultural nuances of communities, leading to interventions that are irrelevant, disruptive, or even harmful [4].Despite overwhelming evidence that clinical care contributes to ~10% of the health of a community, emphasis on a predominantly biomedical model of health and healing ignores socio-cultural and sprititual perspectives that can predispose a rejection of health services by communities [5].Imagine delivering a week-long diabetes management workshop in a community struggling with malaria-the mismatch is clear.This mismatch in disease-based approaches, or when the socio-cultural factors are not considered, can lead to lasting mistrust of health care systems, as has been seen in the rejection of vaccination or emergent Ebola care [6,7].The drivers for engaging in STEGHs are often determined in far away places rather by local communities [8].The 'need' is made manifest through a 'partnership' with a local entity, such as an NGO or an academic partner-a setting for an unequal relationship between a donor and recipient.These partnerships create a revolving door of well-meaning strangers; building trust and rapport takes time-an investment these fleeting interactions fail to make.Sustainability is another casualty; these programs often lack long-term funding and end when the grant or funding has been spent.Short-lived programs lead to disrupted healthcare systems and dependency on external aid, fostering a "band-aid" approach to complex issues rather than sustained systemic change.For example, it may lead health sector actors to prioritize perverse incentives rather than develop much needed sturctures for universal health coverage [9].This is not a critique of global health partnerships but rather a call for partnerships that are meaningful and ethical, forming the foundation of all global health initiatives.It's time to move beyond the illusion of progress and focus on building sustainable solutions alongside local communities.The Advocacy for Global Health Partnerships (AGHP), with its secretariat at the Uganda National Academy of Sciences, has been bringing together people

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