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

Pilla et al. Globalization and Health (2026) 22:28 https://doi.org/10.1186/s12992-026-01192-1 Globalization and Health Open Access RESEARCH Addressing global health equity through Global Collaborative Evidence Networks: a narrative literature review of governance models, power and participation Bianca Pilla1*, Kylie Porritt1 and Zoe Jordan1 Abstract Background Global 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. Methods A 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. Results The 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. *Correspondence: Bianca Pilla Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creati vecommons.org/licenses/by-nc-nd/4.0/. Pilla et al. Globalization and Health (2026) 22:28 Page 2 of 16 Conclusion Global 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. Keywords Global health equity, Global Collaborative Evidence Networks, Network typologies, Network theory, Governance, Equity, Diversity and inclusion Background Global health equity (GHE) faces unprecedented challenges in an era marked by multifaceted and interrelated global crises. Various intersecting global challenges— including climate crises, environmental disasters, escalating cybercrime, political conflict and polarisation, mass migration, global inflation, debt crises, and pandemics—are straining efforts to advance global health equity and achieve healthcare objectives at local, national, and international levels. This unprecedented “polycrisis” significantly threatens the attainment of the United Nations Sustainable Development Goals (UN SDGs) and the overall well-being of people worldwide [1, 2]. This pressure crucible has exposed structural and systemic weaknesses in the global evidence ecosystem on various fronts, including global inequities in public health capacities [3]. GHE is a fundamental, yet evolving concept rooted in social justice, human rights, and the fair distribution of health resources across diverse populations [4, 5]. It is an approach based on values and rights that reflects a desire to reduce disadvantage, discrimination, and marginalisation [6]. Achieving GHE requires a robust evidence ecosystem that facilitates the co-production, translation, and dissemination of knowledge across institutional, national, and disciplinary boundaries [7, 8]. Global Collaborative Evidence Networks (GCENs) have emerged as key mechanisms in this effort, fostering interdisciplinary research dissemination, knowledge sharing and translation [9], particularly in low-resource settings [10, 11]. However, despite their potential, GCENs face significant challenges related to equitable governance, inclusivity, power asymmetries, and sustainability [12, 13]. Moreover, there is a dearth of research on how they can function more effectively and efficiently, specifically, how equity, diversity, and inclusion are understood and measured. Clear guidance on how GCENs should be structured, managed or governed to advance GHE is lacking. Yet, how GCENs are governed will have significant implications for their ability to help reduce global health disparities and ‘leave no one behind’ [7, 14]. As an emerging network typology, limited research has focused on conceptualising GCENs within network research. Before guidance on governing equitable, diverse and inclusive GCENs to advance GHE is developed, we first need to explore the t (...truncated)