Anti-Colonialism in Global Health Grant Applications: A Single-Site, Participant-Observation-Based Assessment

Background/Rationale: Anti-colonialism in global health aims to eliminate colonial power imbalances inherent in Western scholar-driven work. Central to anti-colonial global health are more equitable grant application processes, particularly within NIH’s Fogarty International Center (FIC), a global arm of the largest public biomedical research funder. Hypothesis or Research Question: How do NIH grant application processes drive/impede efforts to conduct anti-colonial global health research? Study Design/Methods: While interning at a nonprofit focused on one South Asian country, I employed participant-observation approach working on two NIH grant applications. Participant-observation included participating in literature reviews, application writing, team meetings, and reflections, and observing team structure and meeting flow. Nonprofit identity, application contents, and country of study are anonymized to protect confidentiality. Results: All meetings were conducted in English. The team defined application success as being awarded NIH funding. Team leaders demonstrated familiarity with NIH, either through receipt of prior funding, or past selection committee membership. I observed team leaders leverage these experiences to highlight factors believed to increase our likelihood for success. Team leaders focused on curating the application team before finalizing grant content, and sought team members satisfying two forms of expertise: subject-matter and geospatial-context. Observing individual roles and contributions, I determined that subject-matter expertise was typically filled by widely-cited scholars affiliated with US-based institutions with previous NIH funding; geospatial-context expertise was typically filled by scholars from the country of study, familiar with on-the-ground realities. Conclusions/Future Plans: Based on this single-site participant-observation study, NIH FIC grant processes simultaneously drive and impede anti-colonial efforts in funding applications. Prioritizing geospatial-context expertise serves as an anti-colonial force by strengthening cultural competence and increasing LMIC-based-scholar representation. Observed barriers to even broader LMIC-based-scholar representation include language and use of prior NIH funding receipt and publication count as proxies for subject-matter expertise.