Sep 2026· Journal of Clinical Epidemiology· pp.
112528
· 0 citations
Medicine
Abstract
Objective
To develop guiding principles and governance options for the Evidence Synthesis Infrastructure Collaborative (ESIC) to ensure its effectiveness, legitimacy, and sustainability.
STUDY
Design
AND
Setting
ESIC was established with Wellcome Trust funding to strengthen global evidence synthesis infrastructure and foster collaboration among researchers, funders, policymakers, and citizens. The ESIC Governance Planning Group (GPG) was tasked with designing a governance framework (during a six-month consultative phase) despite uncertainty about ESIC's future structure and functions. The GPG adopted a broad interpretation of 'governance', focusing on principles, potential functions, and high-level models rather than prescriptive structures. GPG activities included weekly meetings, online surveys, iterative drafting, external consultations, and an environmental scan of governance models in global non-profit organisations. Insights were synthesised through four stage reports and discussions during a face-to-face meeting at the end of the consultative phase.
Results
The GPG formulated guiding principles emphasising equity, transparency, agility, and subsidiarity. A four-quadrant framework was developed to classify ESIC functions: Connector (advocacy and partnerships), Participatory Platforms (inclusive engagement), Core Infrastructure (standards and tools), and Engine Rooms (regional technical support). Four governance models were assessed: federated, membership-based, flexible partnership, and rotational leadership. Two options were finally recommended: (1) a centralised shared-support body delivering Connector functions and coordinating other quadrants, or (2) a smaller network body with limited Connector roles. Both options were associated with modest costs vis-à-vis ESIC's projected budget.
Conclusion
Robust ESIC governance is critical to address inequities in the global evidence ecosystem. The GPG recommends phased implementation of a central support body alongside decentralised structures, guided by subsidiarity and inclusivity.
PLAIN LANGUAGE SUMMARY
The Governance Planning Group (GPG) developed principles and governance options for the Evidence Synthesis Infrastructure Collaborative (ESIC). For this, the GPG first considered the potential functions and roles of ESIC, and then developed broad governance principles. These emphasized equity, transparency, agility, and subsidiarity. A four-quadrant framework was developed to classify ESIC functions as Connector (for advocacy and partnerships), Participatory Platforms (for inclusive engagement), Core Infrastructure (for standards and tools), and Engine Rooms (for regional technical support). Four governance models were explored, and finally two options were recommended viz. (1) a centralised shared support body delivering Connector functions and coordinating other quadrants, or (2) a smaller network body with limited Connector roles. Both options were associated with modest costs.
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