Centres for Exchange

Project Overview

Centres for Exchange (CfE) is a global learning initiative funded by the Wellcome Trust that explores how health and climate research systems can become more equitable, inclusive, and responsive to the communities most affected by health and climate challenges. The programme brings together researchers, practitioners, and community organisations to experiment with approaches to equitable knowledge exchange, where community expertise meaningfully shapes research questions, processes, and outcomes.

The initiative emerged from growing recognition that while community engagement is widely promoted in health research, the structures of knowledge production often continue to privilege institutional expertise over lived experience. Centres for Exchange seeks to address this challenge by supporting place-based collaborations that bring researchers and community actors into long-term relationships of shared inquiry and learning.

The programme is unfolding across multiple phases:

Phase 1 (2023-2024): An initial global landscaping and design phase explored existing practices of community-engaged research and knowledge exchange across several regions.

Phase 2 (2025-2027) The current second phase supports eight organisations across India, Kenya, and South Africa to experiment with and strengthen community-driven approaches to knowledge exchange within their own research ecosystems.

Together, these efforts aim to generate practical learning about how research institutions, funders, and community organisations can work differently to build more equitable and accountable research systems.

Our Role

During the programme's first phase (2022-2024), Pivot led a global landscaping and co-design process, examining how community engagement and knowledge exchange are currently practiced across diverse research contexts. Working with partners Eh!woza, Fiocruz, Praxis, Restless Development, and Vocal, we gathered diverse perspectives through case studies, convenings, and facilitated co-design processes, and brought them together to craft a vision for change. This work shaped the conceptual foundations, guiding principles, and strategic investment approach for the Wellcome Centres for Exchange programme.

Following this phase, Pivot also supported an interim ecosystem mapping process to identify organisations already advancing aligned approaches to community-engaged research. This work informed the selection of organisations invited to participate in the current phase of the programme.

In Phase 2 (2024-2027), Pivot Collective leads the programme's Learning and Evidencing partnership, working closely with Wellcome and a multidisciplinary team that includes Southern Hemisphere and the Health Equity Action Lab at the George Institute for Global Health. We work with funded organisations to co-develop learning agendas, facilitate reflection and adaptation through workshops and dialogue spaces, and steward cross-project learning across regions.

Our team also leads the programme's knowledge sharing work, including designing and maintaining the Centres for Exchange website and curating learning outputs such as blogs, reflections, and synthesis pieces. Alongside this, we work with Wellcome to translate emerging evidence into strategic learning that can inform future funding decisions and contribute to broader transformation in the global health research ecosystem.

What We're Learning

Learning from Centres for Exchange continues to surface important tensions and possibilities in community-engaged health research.

Early work in the programme highlighted a central challenge: while community engagement is widely recognised as essential, it is often practiced in ways that leave existing research hierarchies intact. The issue is rarely a lack of participatory methods, but rather limited institutional recognition, resourcing, and support for community leadership within research systems.

In response, the first phase of Centres for Exchange focused on designing a different kind of infrastructure for knowledge exchange. Working with partners across the Global South, the programme developed a model based on place-based knowledge communities: locally rooted collaborations that bring together community organisations, researchers, practitioners, and activists to shape research agendas, exchange diverse forms of knowledge, and build long-term relationships of trust and care. These communities aim to centre the priorities and capabilities of those most affected by health challenges, supporting more reciprocal and context-responsive forms of research collaboration.

As Phase 2 projects unfold across India, Kenya, and South Africa, learning is revealing how equitable knowledge exchange is shaped through process rather than predefined methods. Across projects, partners are finding that shared meaning does not automatically emerge through participation. Concepts that seem familiar in research, from community engagement to vulnerability, often carry different meanings in different contexts. Through co-design and dialogue, teams are working to surface these differences and reshape research questions and approaches in ways that reflect lived experience and local priorities.

At the same time, partners are exploring how power is embedded in research processes themselves. Decisions about who defines research questions, when participation begins, and how much time is available for reflection all influence whose knowledge carries authority. As projects experiment with approaches that move participation earlier in the research cycle, they are also navigating tensions with institutional structures such as funding timelines and research governance. These experiences reinforce that shifting power in knowledge exchange is ongoing, relational, and negotiated through everyday research practice.

Across the programme, learning is therefore being approached not as a fixed set of indicators but as a collective and evolving process stewarded by the organisations and communities involved. The Centres for Exchange website offers a space to follow this journey, sharing reflections, resources, and insights as learning develops across the network.