Addressing global health equity through Global Collaborative Evidence Networks: a narrative literature review of governance models, power and participation.

backgroundGlobal Health Equity is increasingly threatened by interconnected global crises that expose systemic inequities in health systems, global health governance and evidence infrastructures. Global Collaborative Evidence Networks have emerged as mechanisms for mobilising knowledge, fostering interdisciplinary collaboration, and supporting decision-making across diverse contexts to address Global Health Equity. However, their potential is constrained by persistent challenges related to governance, inclusion, and power asymmetries. This review critically examines the conceptual, structural, and governance dimensions of Global Collaborative Evidence Networks to assess their potential and limitations in advancing Global Health Equity.

methodsA narrative literature review was conducted in July 2024, searching PubMed, Scopus, Web of Science, Embase, CINAHL, and grey literature sources. A thematic analysis of 162 included studies was conducted using Braun and Clarke's reflexive approach to identify themes and sub-themes.

resultsThe review found that while Global Health Equity has emerged as a key normative framework shaped by historical, political, and socio-economic structures, its operationalisation remains fragmented, particularly in global governance and research systems. Global Collaborative Evidence Networks, positioned as vehicles to advance Global Health Equity, demonstrate considerable potential yet often reproduce entrenched power asymmetries. Substantial gaps remain in how equity, diversity, and inclusion are conceptualised and operationalised within these networks. Although many promote shared purpose and trust-based collaboration, participation and influence often concentrated in high-income institutions, reinforcing systemic and resource asymmetries. Key tensions, such as between efficiency and inclusiveness, unity and diversity, and centralisation and decentralisation, shape governance dynamics and impact who benefits from network participation. Despite the proliferation of equity-focused frameworks in global health partnerships, none have been adapted for networks, and accountability mechanisms remain weak. Theoretical perspectives from network typologies and governance modes offer valuable perspectives but require integration with intersectional and decolonial approaches to address persistent power imbalances.

conclusionGlobal Collaborative Evidence Networks are a powerful mechanism for supporting and strengthening evidence-based decision-making to address global health inequities. However, they risk replicating existing inequities without deliberate, equity-centred governance. This review calls for the development of empirically grounded, context-sensitive frameworks to guide the equitable, diverse and inclusive design, evaluation, and governance of Global Collaborative Evidence Networks.