Reactions to Global Health League Table
What have UK universities said about the UK Report Card?
UAEM Barts and Medsin Barts invited professors, researchers and staff at Queen Mary's University of London (QMUL) to share their impressions and thoughts on the Global Health League Table (GHLT). Who dared to show up? What did they say? Were they happy with the grade that QMUL received (19th out of 25)?
The GHRLT was designed with the goal of fostering student-staff collaboration to improve relevant university policies. At Barts and The London, the medical school belonging to Queen Mary’s University of London (QMUL), UAEM Barts and Medsin Barts set out to open this dialogue with a panel discussion. QMUL was ranked only 19th out of 25, and the criticisms of the GHRLT were harsher than expected.
Although several speakers had been invited, only Jonathan Meldrum (co-author of the league table) and Professor Allyson Pollock (Director of Global Public Health Unit and Professor of Public Health Research and Policy) spoke. Some of the other invited speakers did not wish to say something publicly on behalf of the university. The debate that resulted illuminated some causes behind the problems experienced.
Professor Allyson Pollock conveyed serious concern about the methodology and consequences of the league table. She pointed out that ‘global health research’ was a very broad term, and that the methods used to construct the GHRLT – mainly based on PubMed – omitted a vast majority of QMUL’s global health research contribution beyond work published in PubMed; the biggest health gains in history, she argued, had after all not come from biomedical research, but from addressing social determinants such as sanitation, clean water, and nutrition. She also argued that the main problems with access to medicines were not patents sought by universities, but again wider social determinants. League tables may have unintentional harmful consequences, such as being used as a tool for allocating governmental funding away from low-scoring universities.
In defense of the league table, Meldrum pointed out that using PubMed was not meant to capture all available research, but was used to take a snapshot of the output of the universities. He pointed out that other universities probably have a comparable proportion of research in non-PubMed fields. He also argued that the methodology of the league table did include many studies that looked at social determinants and did not just focus on drugs and innovation. And while access to medicines may be influenced more by other factors than by universities’ patent-seeking behaviours, it is still a significant problem, and one that universities are in a place to change easily. Meldrum pointed out that UAEM have been campaigning in the UK for ten years, and has seen minimal change. The league table is therefore a high profile tool to catalyse change at a faster pace.
Intended to be an event of staff-student collaboration, there was only one staff member in the audience, a researcher in Global Health. He said that league table could rather alienate global health researchers and relevant staff, encouraging ‘teaching for the test’, where universities would focus more on the metrics that would benefit their league table position, rather than giving them the freedom to work in areas that may have the most benefit in global health.
Overall, the attitude from university staff welcomed socially responsible licensing policies, but suggested that the current metrics used are in their view flawed if it is to be labelled as a league table for ‘global health research’. The difficulties faced by Barts students trying to change QM policy calls attention to problems that students in other universities might face in the future in their own efforts. Perhaps the global health research league table’s controversy is actually its strength; after all, we are talking about it.