LAUSR

### Summary box Trickle-down economics holds that the way to lift the poor out of poverty is to support wealth creation in those who are already rich.1 The underlying assumption is that as the wealth of the rich grows, they will purchase more goods and services, creating opportunities for the less well-off to benefit. The theory is in direct contrast to one that actively redistributes wealth. The analogy in science is that the way to improve science in the less developed parts of the world (the Global South) is to concentrate the intellectual gravitas, the resources and the opportunities into the Global North. The concentration will produce the best science which will trickle methods, theories, and insights down to the Global South. Ten years ago, Nigel Crisp observed, with respect to the healthcare workforce that ‘the global health system is characterised by an import–export business in which rich countries export the ideology of Western scientific medicine and aid predicated on this ideology to poor countries. In return, …