Table 1 A case study of the need to manage tensions between policymakers and researchers in a long-term collaboration

Since the early 1990s, policymakers in the provincial government of the Free State in South Africa have worked closely with researchers on health and health policy-related topics, including the monitoring and evaluation of antiretroviral (ARV) therapy rollouts [21]. The evidence from these studies has exposed major deficiencies in the ARV rollout, and concerns have been raised that if the research findings become too critical, the privileged data access offered to researchers, and the collaboration offered on evaluations, may simply end. This has led to tensions in the relationship between the researchers and the provincial Health Department with both sides being very direct about these concerns. While acknowledging that it is challenging to manage the tensions, both the policymakers and the researchers are committed to learning how to manage this kind of conflict. From the Health Department’s perspective, this is essential in order to evaluate and improve the services delivered by the provincial government. From the researchers’ perspective, this is motivated by “a feeling that you are doing research that is actually relevant and addressing actual needs as opposed to just driving publications” [21].