Rigorous public health research in the Global South, especially in conflict-affected contexts, depends on trust, reciprocity, local leadership, and culturally grounded evidence, Rasha Bayoumi and colleagues explain
Public health research in fragile and conflict-affected settings is never just about evidence; it is also about power, trust, access, language, and who decide what counts as knowledge. Science diplomacy matters most, not as a slogan about international collaboration, but as the practical work of negotiating how knowledge is produced, whose expertise is recognized, and how evidence becomes credible and usable in unequal contexts. Taken together, the perspectives below show how three Global South researchers practise science diplomacy through adaptation, capacity-building, and redistributing authority in knowledge production.
Bayoumi
My research sits at the intersection of psychology, public health, and global health equity. Across work on fertility, mental health, and quality of life, I have been guided by one question: how can research be rigorous, culturally grounded, and ethically equitable in settings where standard Global North models often fail to capture lived reality? In public health, science diplomacy is not only about cross-border collaboration, but also about negotiating whose expertise counts, how problems are framed, which methods are valid, and whether research relationships strengthen local capacity or reproduce dependency.(1,2)
A major strand of my work focused on reproductive health in Sudan, where infertility is social and psychological as well as biomedical. My research examined clinical indicators alongside lived experiences of stigma, uncertainty, and distress. Across this work, science diplomacy meant negotiating global reproductive health frameworks and local realities: showing that fertility experiences in Sudan could only be understood in context,(3) testing whether tools developed elsewhere were meaningful in Sudanese settings,(4) and showing that implementing a fertility quality-of-life tool required cultural and ethical negotiation, not simple technical adaptation.(1) My wider fertility research challenged dominant assumptions by identifying overlooked determinants of fertility problems, including genital tuberculosis, HIV and FGM/C, and by highlighting the long-term effects of Type III FGM, helping reframe infertility research in ways more relevant to Global South realities and to practice, policy and global guidelines (WHO).(5,6,7)
My second major focus has been mental health in conflict settings, where chronic violence and instability often lead to urgent use of models developed elsewhere, even though technical effectiveness alone is not enough. In research assessing locally engaged and adapted mental-health intervention in Gaza, we showed that contextual adaptation contributed directly to its success.(8) Here, science diplomacy meant moving beyond one-directional transfer toward co-produced intervention design grounded in local culture, community realities, and lived experience. Through collaboration with the Palestine Trauma Center, this approach extended beyond publication to capacity-building through training, and co-authorship.(9) I took a similar approach in Pakistan, where mentoring early-career researchers supported a community trauma project later integrated into the mental health support system. These experiences reinforced that science diplomacy in public health must include building conditions for others to generate, interpret, and use evidence beyond specific projects.
This perspective was shaped by earlier work with World Health Organization on trauma and gender-based violence, and collaborations across UAE, Sudan, Gaza, Pakistan, and DRC. Across these settings, the lesson has been consistent: science has diplomatic value when it enables equitable problem-solving, strengthens local capacity, and translates evidence into services, training, and policy. My later work on science diplomacy and neocolonialism grew directly from these field realities and from the need to name the power imbalances that still structure too much of global public health research.(2)
Dajani
Rigorous public health research in the Global South, particularly in conflict- affected settings, must be grounded in trust, reciprocity, and local leadership.
Often, policy makers, international NGOs, governments, and UN agencies operate within colonial narratives that frame communities as helpless victims in need of rescue, unintentionally striping people of agency and dignity, despite intentions to help. If we are serious about equitable public health, we must move beyond this narrative.
One powerful shift is to recognize that people living through conflict are not merely victims; they are adaptive problem-solvers navigating complex environments. When scientists study octopuses or other species, their behaviours are described as sophisticated adaptations to challenging conditions. Yet when humans survive war, displacement, and scarcity, the dominant discourse often reduces their resilience to trauma narratives. Reframing survival as adaptation is liberating and more accurate.(10,11)
My research identifies intergenerational epigenetic signatures of trauma among refugee populations. We found 14 epigenetic modifications transmitted from grandmother to granddaughter, the first evidence of this in humans. Rather than signaling vulnerability, these may reflect inherited adaptive capacity, or “my grandmother’s wisdom,” with implications for interventions, policy, and impact measurement.(12,13)
This perspective reshapes how we design solutions. Grassroots, locally organized initiatives such as “We Love Reading“ tend to be holistic, practical, and sustainable because communities themselves own them. Ownership ensures solutions are low-cost, realistic, and responsive to lived realities. Instead of imposing externally designed programs that serve institutional agendas, we should cultivate the belief that communities can generate their own solutions, not only for current challenges but future ones. This decentralized approach fosters resilience, dignity, and long-term transformation.(14,15)
Rayes
A persistent challenge in public health research is not simply a lack of data, but lack of epistemic inclusion. Too often, knowledge about Global South communities, particularly those affected by conflict and displacement, is produced without meaningful participation from those being studied. This creates what scholars have described as epistemic injustice; situations in which those being studied are excluded from how problems are identified, research questions are framed, and how findings are interpreted or applied.(16)
My work in humanitarian health, during and after the Syrian crisis, demonstrated the importance of shifting this dynamic. I met many Syrians displaced to Turkey, Lebanon, Jordan, Europe, and USA who redirected their careers toward public health response, often stepping into roles they had little formal preparation, to serve their communities. Their expertise, grounded in lived experience, challenged a humanitarian system long burdened with assumptions about needs on the ground and shaped by the priorities of international donors and organizations.
A key part of this work is questioning positionality and power in designing future interventions for communities affected by crisis. It requires redistributing authority in knowledge production such that those most affected help define the questions, interpret the evidence, and shape the solutions. Key examples include initiatives I have led with the Syria Public Health Network and the Syrian Global Mental Health Alliance (SyGMA), both dedicated to supporting the next generation of Syrian public health and mental health professionals, respectively, an approach that warrants replication across contexts. Our experiences underscore a broader lesson for science diplomacy: equitable research is only possible when communities most affected by crises, and those who understand local needs linguistically, culturally, and spiritually, help define questions and shape solutions.
Conclusion
These collective efforts reflect a broader lesson for science diplomacy: equitable research requires more than international collaboration or listing authors on a paper. It is about capacity- building and co-knowledge production. With these strategies in mind, power can be handed to those best placed to advocate for their right to health.