U-M’s expertise is only as valuable as our willingness to learn
By Akbar K. Waljee, MD, MS
Leslie D. Yamada and Tachi Yamada M.D. Director, University of Michigan Center for Global Health Equity
I came to the United States at 17 from Kenya with a straightforward ambition: to become a physician. What I didn’t anticipate was how much of my education, clinical training, and otherwise would happen far from any classroom, in clinics and communities, and in conversations that challenged nearly everything I thought I knew about who holds expertise and where knowledge actually lives.
Years later, as I lead the University of Michigan Center for Global Health Equity (CGHE), I still hold onto that lesson. And increasingly, I think it belongs not just to global health researchers, but to every researcher at this university who works with communities, here or anywhere.
The question is not “how do we bring Michigan’s expertise to the world?” It’s a harder, more interesting one: what happens when we treat the people we work with not as the subjects of our research, but as co-creators of it?
Consistently, the answer is: our work is more impactful.
At CGHE, we are trying to be intentional about what this looks like in practice: building a pipeline of scholars trained to work across disciplines and geographies, to see local and global innovation as interconnected, and to develop equitable technologies designed for real-world conditions. This work is necessarily adaptive—anchored in shared principles, but shaped through reciprocal learning with the partners we work alongside.
Akbar K. Waljee, MD, MS, AGAF
Leslie D. Yamada and Tachi Yamada M.D. Director of the University of Michigan Center for Global Health Equity, Lyle C. Roll Endowed Professor at Michigan Medicine, and Assistant Dean for Global Health Research.
The model we inherited, and why it isn’t working
Across many research disciplines, universities have long operated under a similar assumption: expertise flows outward from institutions like ours toward communities, regions, or countries with fewer resources. We design the study. We set the research agenda. We implement, publish, and move on. The communities involved receive the findings. Sometimes.
That model has produced advances. But it has also generated consistent failures. Interventions designed without the people who will use them get rejected, ignored, or quietly abandoned. Technologies built for well-resourced environments don’t transfer. The questions that get answered are rarely the ones that matter to the people living the problem.
This isn’t a problem unique to global health or international research. It shows up in education research where teachers weren’t in the room. In environmental science, local ecological knowledge was treated as anecdotal. In urban planning research, where residents were surveyed but never consulted. In agricultural science, where farmers were the test sites, not the partners.
The problem isn’t the expertise. It’s the assumption about where it lives.
Constraint as a research laboratory
Here is what I have learned from working across health systems on multiple continents: necessity isn’t just the mother of invention. It’s often the mother of better invention.
When you design something for conditions of constraint (limited infrastructure, limited resources, limited margin for failure, and where delay has real consequences), you are forced to create something genuinely robust. A diagnostic tool designed to function in a clinic with intermittent electricity and minimal training time performs better in constrained settings worldwide, including under-resourced communities in Michigan. A community engagement model proven in a refugee settlement may hold more keys to reaching marginalized populations in American cities than anything developed in a controlled research environment.
The same principle applies well beyond health. Engineering solutions designed for low-infrastructure environments often outperform their expensive counterparts under real-world stress. Pedagogical approaches developed for overcrowded classrooms with limited materials have changed how we think about learning in all classrooms. Climate adaptation strategies developed by communities with the most direct exposure to environmental change often yield insights that top-down modelers miss entirely.
This is the central argument for why equitable partnership should change how institutions like ours define rigor, relevance, and impact. When we work alongside communities and colleagues who have been solving hard problems under constraint for decades, we gain knowledge we couldn’t have generated on our own.
What genuine partnership actually requires
Equitable partnership is not a posture or a values statement. It is a set of concrete choices: who sets the research agenda, whose questions get prioritized, who holds the data, who is named on the publications, and what capacity remains in the community when the grant period ends. It also requires asking who is funded to lead, whose timelines govern the work, and whose institution is strengthened when the partnership is over.
In our center’s work, we have tried to build those choices into the structure of collaboration from the start, rather than as an add-on to the research design. That means co-developing research questions with local partners, not delivering them. It means investing in training and infrastructure that outlasts the project. It means being willing to ask questions our partners identify as urgent, even when they aren’t the questions we came in expecting to answer.
The result is not just more equitable research, but research that can be evaluated by whether it actually improves outcomes. It is more durable research: work that communities actually use, systems that don’t collapse when external funding ends, findings that reflect the real complexity of the problems we’re studying.
These principles translate across disciplines. The researcher who embeds with a community for a year before designing a study. The engineer who prototypes with end-users in under-resourced settings rather than testing there after the fact. The social scientist who treats local knowledge-keepers as methodological collaborators rather than just informants. The same orientation, differently expressed, consistently produces better outcomes.
The local-global connection
One of the false distinctions in research is the idea that working “globally” is categorically different from working at home. It is not. The forces that create the conditions researchers study: poverty, structural exclusion, infrastructure gaps, and communities excluded from the systems designed to serve them. These forces play out across settings that differ in history, scale, and consequence. Yet, all share the same patterns: exclusion, underinvestment, and unequal access to care and opportunity.
Approaches developed in one context routinely apply in the other — if researchers are positioned to recognize them. But that transfer doesn’t happen automatically. It requires reciprocal relationships. It requires trust.
Michigan researchers working globally are not doing separate work from Michigan researchers working locally. They are building the same thing: a body of knowledge grounded in real-world conditions, generated in genuine partnership with the people most impacted by those conditions.
Michigan’s distinctive opportunity
The University of Michigan is not a single lab or a single discipline. It is an institution-wide ecosystem — with the scale, interdisciplinary depth, and relationships to build partnerships in ways few institutions can.
For an institution like Michigan, humility is not a retreat from excellence. It is a condition of it.
There is a version of Michigan that exports expertise. There is another that builds with partners who have spent decades developing solutions we haven’t thought to look for, in conditions we haven’t had to solve. The second version produces better science, stronger relationships, and a more durable impact. It is also the version consistent with what this institution has always claimed to stand for.
The question is not whether others should look to Michigan, but whether institutions like ours are willing to be changed by the knowledge, priorities, and leadership of the people with whom we work.
The question worth sitting with
I left Kenya believing that the knowledge I needed was somewhere ahead of me, in medical school, in research, in institutions like this one. What I’ve learned in the decades since is that much of what I was searching for was already around me, in the communities and colleagues I had been quietly taught not to see as sources of knowledge.
That relearning is the work. Not alongside the research. As the foundation of it.
The researchers featured alongside this piece are doing exactly that across disciplines and contexts. They are not arriving with solutions. They are doing the harder, more generative work of asking: what can we learn from our partners? And what would it mean, for them and for us, if we built our research on the honest answer to that question?