Table 1.

Qualitative Responses.

QUESTION	HIC	LMICS
Why are power relationships in the collaboration not balanced?	Funding equals power Priorities are dictated by European and US funding agencies. There is an unequal involvement between partners that creates an imbalance at the very start. LMIC partners may be too polite to challenge HIC partners. HIC partners do most of the work and ask for (tacit) approval from LMIC partners. The same people usually older white men are in control of the global health research agenda in most US universities. Putting HIC Institutional gain as a priority. Power imbalances sometimes unavoidable and not part of decolonization.	Financial interest is the power. The funders usually have their own agenda. Greater value attached to skill sets of Global North partners, and little value attached to skill sets of Global South partners, unless educated in the Global North. Researchers based in the Global North have more resources and better connections to funders LMIC researchers seen as somehow inferior. Budgets not shared and PIs are condescending and not transparent.
What aspects of the partnerships could be changed to make things more equitable at the individual level?	Increased access to resources and representation in leadership. Have LMIC partners interact (and be accountable) directly to funders. Shared leadership, faculty appointments for local leaders in countries of partnership. Co-PIs/co-authorship on all research and financial reimbursement/salary for local country program leaders/supervisors/educators, be at par with HICs.	Decisions to be made together by both parties at the planning phase of a study. Allow equal control over financial resources. Ensure research is context relevant. Increased funding to local organizations by international donors. improved capacity building and educational opportunities for local professionals. Provide equal opportunities to partners—share budgets, share authorships, include those with less opportunities in projects of those with more resources. Building trust and respect.
What aspects of partnerships could be changed to make/to ensure equity at institutional level?	Greater awareness of behaviors and language that reinforce colonial attitudes and practices. Equal engagement of partners. Mutual respect. Relationship building. Practice humility. Better communication.	Decision making should be inclusive and funds equitably distributed. Explicit discussion about roles and authorship Equitable access to information and to discussions with funders. More engagement on budget decision making and allocation Targeted hand-holding for publications. Expectations set at the beginning of a relationship.
What aspects of the partnerships could be changed to make things more equitable at the funder level?	Funders must be willing to have LMIC partner be the lead recipient and take full ownership. More career development awards for in country investigators. Seek to fund directly in low-income countries. Funders must give a consistent message about whether or not these issues are significant to them. Support Global South partners to lead research; don’t just ask them to add to the research.	Funds should be shared equally and planning should be done together. -Allow Global South partners to include agenda-setting decisions. -Funders should provide more access to all researchers in a team, not only the one based in a Global North institution. -Funders should give equal opportunities for all organizations to compete for funds and also empower organizations from LMICs. Directly funding each institutional partner instead of having a ‘lead’ institution and a subcontract to a second institution. More consultations with LMICs.