Finding the balance between academic productivity and impact: evaluation of the Botswana - University of Pennsylvania partnership over a 5-year timeframe

INTRODUCTION: There is consensus that global health needs a new power and incentive structure and academia must benefit society more directly. However, there are few metrics to help academic global health partnerships enact these changes.This study evaluates the impact of the Botswana - University of Pennsylvania Partnership (BUP) between July 2018 and June 2023, through the lenses of academic productivity, global health decolonisation and social accountability. METHODS: The data were organised based on BUP's five strategic goals. Alignment with Botswana's burden of disease was calculated through the ratio between the percentage of BUP's funding or activities devoted to 22 Sustainable Development Goals (SDGs) targets and the percentage of total disability-adjusted life years (DALYs) for the same targets. RESULTS: BUP employed 67 full-time personnel, hosted 263 international personnel and raised US$22.6 million.BUP supported service delivery in public facilities across multiple specialties and trained hundreds of local health workers and 81 local investigators.Research output was 28 publications/year, 30% featuring a local investigator as first/last author.80% of grant funding went to research. Funding and activities were distributed primarily to Gaborone (75% and 69%) and hospitals (60% and 57%). Funding and activities were less for other geographic areas (25% and 31%) and health system levels (40% and 43%).BUP's DALYs alignment was strong for 7/22 SDG targets (ratio ≥80%), intermediate for 7/22 (ratio 40-79%) and weak for 8/22 (ratio