How to identify epistemic injustice in global health research funding practices: a decolonial guide

Abstract

Epistemic injustice is a growing area of study for researchers and practitioners working in the field of global health. Theoretical development and empirical research on epistemic injustice are crucial for providing more nuanced understandings of the mechanisms and structures leading to the exclusion of local and marginalised groups in research and other knowledge practices. Explicit analysis of the potential role of epistemic injustice in policies and practices is currently limited with the absence of methodological starting points. This paper aims to fill this gap in the literature by providing a guide for individuals involved in the design and review of funding schemes wishing to conduct epistemic injustice analysis of their processes using a decolonial lens. Placing contemporary concerns in a wider historical, political and social context and building from the intertwined issues of coloniality of power, coloniality of knowledge and coloniality of being that systematically exclude non-Western epistemic groups, this practice paper presents a three-step decolonial approach for understanding the role and impact of epistemic injustices in global health research funding. It starts with an understanding of how power operates in setting the aim of a call for research proposals. Then, the influence of pose and gaze in the review process is analysed to highlight the presence of epistemological colonisation before discussing methods to address the current funding asymmetries by supporting new ways of being and doing focused on knowledge plurality. Expanding research on how epistemic wrongs manifest in global health funding practices will generate key insights needed to address underlying drivers of inequities within global health project conception and delivery.

Funders: The missing link in equitable global health research?

“…The current power asymmetries influence control of resources and knowledge generation and prioritisation [4]. Global health research funding primarily comes from HICs and may not correlate with the burden of disease [9].…”

“…The topic of global health research differentially benefits populations of the global North [4,19]. Examples of such inequities include the trickle-down science of adopting technology from HICs to LMICs, often with limited consideration for the contextual needs of LMICs [20].…”

“…Researchers and journals within the global health community have been increasingly vocal regarding these inequities contributing to the discourse about what is wrong with global health [2,3]. The epistemic injustices in global health research funding are shaped by deeply entrenched unequal power dynamics, rooted in a colonial history that has to date consistently applied an outsider gaze to local problems and needs [4]. For their part, funders and donors, though they have diverse platforms for expressing their voice, often in ways that go unchallenged, are not engaged in this discourse, nor is there any evidence of their reflection on their responsibility, accountability and positionality in global health research and the injustices that perpetuate in this space.…”

“…There have been calls for example for urgent review of the current funding mechanisms in the UK research environment specifically in global health research collaborations with lowand middle-income countries (LMICs) [7]. The need to align the positionality and gaze of global health funding models has been described, providing recommendations for how to address the power imbalances which inhibit epistemic diversity [4]. This approach calls for greater division of power between North and South actors which will require active engagement on both sides.…”

Transforming global health education during the COVID-19 era: perspectives from a transnational collective of global health students and recent graduates

“… 2–4 23 25 64–68 As Libola Hirsch makes clear: we will not ‘achieve structural change while seeking progressive reform and working through channels that were set up within structures that uphold White supremacy’. 16 Ideas and recommendations concerning how to change GH, 23 68 or what the components of a different GHE 25 69 70 could look like exist and have been widely circulated. In this time of urgency, the transformation of education within classrooms needs to be supplemented by leveraging the agency of students and educators to create autonomous collectives and organise beyond classrooms.…”