Global Health Education in the Time of COVID-19: An Opportunity to Restructure Relationships and Address Supremacy

Abstract

Global health and its predecessors, tropical medicine and international health, have historically been driven by the agendas of institutions in high-income countries (HICs), with power dynamics that have disadvantaged partner institutions in low- and middle-income countries (LMICs). Since the 2000s, however, the academic global health community has been moving toward a focus on health equity and reexamining the dynamics of global health education (GHE) partnerships. Whereas GHE partnerships have largely focused on providing opportunities for learners from HIC institutions, LMIC institutions are now seeking more equitable experiences for their trainees. Additionally, lessons from the COVID-19 pandemic underscore already important lessons about the value of bidirectional educational exchange, as regions gain new insights from one another regarding strategies to impact health outcomes. Interruptions in experiential GHE programs due to COVID-19-related travel restrictions provide an opportunity to reflect on existing GHE systems, to consider the opportunities and dynamics of these partnerships, and to redesign these systems for the equitable benefit of the various partners. In this commentary, the authors offer recommendations for beginning this process of change, with an emphasis on restructuring GHE relationships and addressing supremacist attitudes at both the systemic and individual levels.

Remote online global health education among U.S. medical students during COVID-19 and beyond

“…As educational initiatives transitioned to online learning during the COVID-19 pandemic, other evaluations of these educational efforts have also highlighted the positive components of virtual learning and corroborated our findings that both students and faculty appreciate the accessibility and increased opportunity for global collaborations of remote global health education [ 38 , 39 ]. In particular, in making the field of global health more equitable and engaging with global colleagues, both our course and others in remote global health demonstrated clear advantages of integrating global perspectives and restructuring equitable partnerships in global health by removing the barrier of travel that in-person learning presents [ 39 – 41 ].…”

Global Health Partnerships During the COVID-19 Pandemic: Perspectives and Insights from International Partners

“…Furthermore, GH education now has the opportunity to restructure its relationship and address supremacy at a systemic level. 17 A foundation of mutual respect and open communication must be further cultivated during the postpandemic era, and the tendency for unilateral decision-making that was experienced within GHPs during COVID-19 must be avoided. Future research and discussions should focus on how to optimize communication and establish mutual, equitable exchanges within GHPs.…”

Capacity building in low- and middle-income countries

“…Many groups have taken this time to restructure relationships within their partnerships and address supremacy. 61 Some groups focused on this even prior to the pandemic; one nonprofi t organization dedicated to critical care training, NICST, has been working to fl atten the hierarchy between highand limited-resource settings by encouraging social interaction and bidirectional knowledge sharing and supporting local expertise. 9 The principle of equality remains at the forefront of efforts moving forward and requires the attention and action of all those involved in the creation of new education programs.…”