Structural disparities in India’s health research ecosystem and their consequences for health equity
摘要
Equity in health research is more than an ideal; it is essential to ensure that research addresses real-world needs. In India, however, deep and long-standing disparities affect how research is shaped: who is studied, who gets to lead, and which health concerns are prioritised. These exclusions are rarely captured through conventional academic research alone. To address this gap, a narrative approach was adopted, allowing for the inclusion of grey literature and underdocumented sources essential for examining structural research inequities that are often underrepresented in academic databases. Drawing from a real-world case of a measles outbreak in Mumbai’s Govandi slum, the review highlights the dangers of research neglect in marginalised communities. It also examines the challenges faced by researchers from underserved regions, institutions, and communities who often lack access to funding, infrastructure, and leadership opportunities. These dual exclusions of participants and researchers stem from structural biases that influence which communities are studied and whose voices are heard. The review is grounded in an equity-informed perspective and draws on purposively selected academic, institutional, and grey literature published between 2000 and 2025. Sources were identified through targeted searches and selected based on their relevance to health research disparities, representational gaps, and policy implications in the Indian context.The review concludes with actionable solutions to democratise research, including decentralised funding, equity-sensitive ethics review, inclusive research leadership, and a national equity-monitoring framework. To serve all populations, Indian health research must not only expand its evidence base, but also diversify the experiences and expertise it includes.