Working together seems like a good idea-especially when working toward a noble goal. In the hopes of more efficiently and quickly reaching their aims, many humanitarian and development organizations (HDOs)-including nongovernmental organizations, such as the International Committee of the Red Cross (ICRC) and Doctors Without Borders (MSF), and international organizations such as the United Nations International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO)-have frequently sought partnerships with academia in recent years. These partnerships aim to use academic research and scientific expertise to address problems, through technology, that HDOs encounter "in the field"-generally in low-income or crisis-affected settings. There are hundreds of examples, covering diverse topics: from digital health software, to drone cargo delivery, to the development of new biomedical hardware (1-3).An International Committee of the Red Cross mobile surgical team performs a skin-graft on a patient with a severe burn. In poor, war-torn countries, well-equipped medical facilities are often unavailable or damaged, so ICRC surgical teams work in basic care facilities or in vacant buildings. Appropriate technologies are essential, but medical equipment is typically not designed for harsh environments. Developing new technologies adapted to such environments is essential to save more lives-collaborations with research institutes can help. Image credit: International Committee of the Red Cross/Jacob Zocherman.

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Increasing numbers of collaborations between the humanitarian and academic sector should have led to a significant increase in the amount of quality technology reaching the field and having a scaled impact. It has not. Following on from research with key stakeholders in these collaborations, we lay out the key reasons why there is often such a disconnect between high-level strategic intentions, and practical implementation. These are broken down into misunderstandings over: resources; deployment strategies; and roles and responsibilities. Through articulating such pitfalls, it is hoped that this commentary can contribute to smoother collaborations and greater impact.

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