In this article, I conduct a philosophical ethical analysis of inequalities in global health partnerships. Using literature in medical anthropology and the health sciences as a basis, I begin by distinguishing two categories of concern. First, I identify the inequalities between partners, e.g. between research institutions in the US and African countries, which can include resource, epistemic and power inequalities, and, second, I highlight associated concerns such as a lack of acknowledgement of inequalities. Once I have parsed out these two categories, I focus on what might be ethically wrong with them, emphasizing that there can be significant instrumental and non-instrumental harms associated with them. By underscoring what may be ethically troubling about inequalities in global health partnerships, this paper provides a preliminary basis for guidance on how to create more equal and more equitable relationships between partners in the field of global health.