Organisations and programmes may undertake engagement for a variety of legitimate reasons. What type of engagement is done, how and with whom should always be guided by a clear understanding of its purpose.  Both the Wellcome Trust and the AAPs may have their own range of purposes.  Each AAP operates in its own context but a sample example of ‘The Purposes of Engagement’ for a single AAP, along with potential implications for the who and how, might include:

Programme Engagement
Developing good working relationships with local communities – geographical, professional and political – by providing channels of communication and opportunities for local people/ bodies to engage with and benefit from the programmes, including through education and employment. This might be led by the programme management with involvement of the engagement team. It will mix attention to long term relationships/ impact with awareness of the engagement implications of current research projects. It may seek to develop formal structures, such as community advisory boards or partnership steering groups, to offer oversight and accountability.

Relating to the political and intellectual climate of the host country and its health eco-system and ensuring that the research agenda developed demonstrates sufficient value to local concerns to safeguard its long-term operation. This is likely to involve various forms of political relationship with relevant government organisations and services and also knowledge of and engagement with local currents of academic and professional opinion about health research and service priorities and the value of North/ South research partnerships more generally. It may require a capacity to respond to engagement on these issues initiated by other actors such as NGOs or the media. Again, this is likely to be led by the programme management with involvement of the engagement team but may also provide an opportunity for individual researchers to develop their broader understanding of research management in a developing country context.

Study Engagement
The need for and relevance of engagement should be entirely linked to the nature of the research itself but may fall into any of four categories
1.   Zero - irrelevant to the subject and method of study.  This might apply to laboratory-based work in which all ethical considerations for the collection and use of samples have been addressed by other means
2.   Instrumental – where some form of basic engagement may help address ethical requirements and/or sorting out the practical and logistical arrangements for conducting the research. This would probably be the responsibility of the project leader but could be greatly helped by the involvement of a local engagement team with knowledge of and relationships with the relevant community
3.   Collaborative/ possibly partnership approach to scoping the issues, developing research questions and, possibly, discussing the implications of the results for local health practice.  In this the researcher’s understanding of the context of the research and its application is greatly assisted by channels for engagement with those – either community members, local service staff or specialist patient’s organisations and NGOs – with an interest in the research and detailed local knowledge. The research itself is then carried out by the scientists using their normal methods. The engagement may be initiated by the project researchers, but they may require expert help in structuring and managing the process either from duly experienced social science colleagues, engagement specialists or through working in partnership with community leaders, service deliverers, academics or NGOs. The People’ Science Institute, which organises formal research on engineering challenges raised through its engagement with social groups at a local level, offers an example of this approach.
4.   Advanced - fully participative process in which the agenda is set, the research carried out and its implications discussed with the full participation of local community members, possibly with support from specialised NGOs. This may not be applicable to pure biomedical research but may be relevant to research around public health or service delivery, particularly if this is attempting to identify and meet needs relevant to specific – and often relatively powerless - target groups. Such methods, for example, are often used to develop a gendered understanding of a set of issues.
Other Engagement
More general public engagement, cultural engagement at any of a number of levels or engagement with schools may be used for and contribute to the above purposes, especially at a programme level. They may also have a direct value for other purposes, linked to Wellcome’s overall strategic goals, which AAPs may choose to support.  These might include:

-    Understanding and combatting opposing currents of thought in relation to topics such as homeopathy (UK), climate change and evolution (US), HIV (Gambia), vaccines (widespread)

-    Articulating Wellcome’s overall strategy and the extent to which it engages in the relationship between science and society, as in the focus on ‘people centred science’