Genetics for all: Tri-directional research engagement as an equitable framework for international partnerships

Over the past 5 years, human genetics and genomics research has placed a greater emphasis on increasing diversity among research participants and study researchers as a means of expanding the reach of human genetics and the knowledge accrued by it. Within this context, international collaborations between investigators in well-resourced research-funded countries (RFCs) and those in research-underfunded countries (RUCs) have flourished, with the goal of recruiting more geographically diverse participant pools. Past harms to communities engaged in genetics research have underscored the importance of bi-directional relational engagements, in which researchers and communities work together to ensure ethical research practices and participant involvement. Successful collaborations in the global genomics space, however, are often dependent upon RUC stakeholder investigators and physicians, whose needs are frequently either excluded from existing models of bi-directional community engagement or conflated with that of the study community. Here, we advocate for building more equitable international partnerships through the empowerment of RUC stakeholder investigators-a tri-directional engagement model-that includes supporting, building, and validating the efforts of RUC investigators through training, access, and authorship. We highlight existing initiatives that serve as exemplars in this effort and offer a framework for the broader genetics community to support equitable models of international research partnerships while being mindful of practical challenges. The core concepts embodied augment ongoing efforts to diversify the field of human genetics and complement the long-term goal of genetics for all.