Building Grant Management Systems in Tanzania to Rebalance Research: Experience from Tanzania

Infectious diseases continue to expand in scope and impact globally, with low-and middle-income countries (LMICs) bearing a disproportionate burden while receiving a comparatively small share of global health research investment. This inequity is rooted in longstanding colonial patterns of knowledge production, agenda setting, and financial control. Strengthening research administration capacity within LMIC institutions represents an important pathway toward decolonizing global health by increasing local authority, legitimacy, and ownership of research processes. We describe how the Kibong'oto Infectious Diseases Hospital (KIDH) and the University of Virginia (UVA) engaged in an iterative and reflective partnership to address inequities in research leadership, funding ownership, and administrative control. Following the identification of structural gaps, the partners codeveloped and implemented a strategy to establish and strengthen research administration at KIDH. This approach was guided by principles of rigorous science and a commitment to equitable, decolonial partnerships. It was drawn on five key principles; (1) transforming existing power structures, (2) promoting agency and self-determination in the Global South, (3) advancing epistemic reform and epistemic and ontological pluralism, (4) strengthening education and capacity development and (5) fostering inclusivity, solidarity, and allyship.