There may be perfectly good reasons why developing countries choose to restrain their ambitions in basic research (financial and infrastructural reasons, mainly) and why they may simply work to adapt imported knowledge (although we are typically talking about information here - materials in books and journals, rather than knowledge delivered by a human being).
However, there is a constant need for health systems and health services research in developioing countries - and this really should be done locally, and written up for publication locally.
Of course there is scope to publish health services/systems research internationally as well. And when such publication is in open access journals, it becomes accessible in developing countries as well. In this way, open access can enable the full circle of knowledge sharing to take place, allowing people to "import" their own knowledge from international sources.
HIFA profile: Chris Zielinski: As a Visiting Fellow in the Centre for Global Health, Chris leads the Partnerships in Health Information (Phi) programme at the University of Winchester. Formerly an NGO, Phi supports knowledge development and brokers healthcare information exchanges of all kinds. Chris has held senior positions in publishing and knowledge management with WHO in Brazzaville, Geneva, Cairo and New Delhi, with FAO in Rome, ILO in Geneva, and UNIDO in Vienna. Chris also spent three years in London as Chief Executive of the Authors Licensing and Collecting Society. He was the founder of the ExtraMED project (Third World biomedical journals on CD-ROM), and managed the Gates Foundation-supported Health Information Resource Centres project. He served on WHO’s Ethical Review Committee, and was an originator of the African Health Observatory. Chris has been a director of the World Association of Medical Editors, UK Copyright Licensing Agency, Educational Recording Agency, and International Association of Audiovisual Writers and Directors. He has served on the boards of several NGOs and ethics groupings (information and computer ethics and bioethics). UK-based, he is also building houses in Zambia. chris AT chriszielinski.com
His publications are at www.ResearchGate.net and https://winchester.academia.edu/ChrisZielinski/ and his blogs are http://ziggytheblue.wordrpress.com and https://www.tumblr.com/blog/ziggytheblue