Unequal Voices: Authorship Disparities in Disaster and Humanitarian Response Research, 2014-2022

Disparities in authorship representation between high-income country (HIC) and low- and middle-income country (LMIC) collaborators are well documented across many global health fields. Yet the extent of these inequities in disaster and humanitarian response (DHR) research is not well understood. DHR research is often conducted in LMIC settings and shaped by complex operational, ethical, and contextual dynamics, making equitable collaboration essential. We assessed local authorship and key authorship representation in DHR publications over time.

We conducted a cross-sectional analysis of DHR-related publications identified through the Global Emergency Medicine Literature Review (GEMLR) from 2014–2022. Primary outcomes were: (1) local authorship representation, defined as inclusion of at least one author affiliated with an institution within each study country; and (2) key-position authorship representation, defined as first and/or last authors holding an affiliation in at least one study country. Univariable and year-adjusted log-binomial models were used to assess factors associated with authorship representation.

Among 846 screened publications, 562 met inclusion criteria. Although 84% of publications were conducted in LMIC settings, only 31% of first authors and 28% of last authors were LMIC-affiliated. Overall, 34% of publications lacked a local author from at least one study country, and 55% lacked any local representation in key authorship positions. Inclusion of local authors increased modestly over time, but there was no improvement in local first/last authorship representation. Research conducted in low-income countries, across multiple study sites, and complex emergency settings was significantly more likely to lack local or key-position authors.

Pronounced authorship inequities in DHR research highlight a critical and ongoing failure to equitably recognize and elevate local expertise, even as crises disproportionately affect LMIC populations. These disparities undermine the relevance, ethical foundations, and effectiveness of humanitarian research. Transformative change will require deliberate shifts in power, including LMIC-led study design, authorship leadership, and control over research agendas. Without such commitments, DHR scholarship will continue to reproduce the global hierarchies it aims to challenge.