What Do Global Health Practitioners Think about Decolonizing Global Health?

Abstract

The growing awareness of colonialism's role in global health partnerships between HICs and LMICs and the associated calls for decolonization in global health has led to discussion for a paradigm shift that would lead to new ways of engagement and partnerships, as well as an acknowledgement that colonialism, racism, sexism, and capitalism contribute to inequity. While there is general agreement among those involved in global health partnerships that the current system needs to be made more equitable, suggestions for how to address the issue of decolonization vary greatly, and moving from rhetoric to reform is complicated. Based on a comprehensive (but not exhaustive) review of the literature, there are several recurring themes that should be addressed in order for the inequities in the current system to be changed. The degree to which decolonization of global health will be successful depends on how the global health community in both the HICs and LMICs move forward to discuss these issues. Specifically, as part of a paradigm shift, attention needs to be paid to creating a more equal and equitable representation of researchers in LMICs in decision-making, leadership roles, authorship, and funding allocations. There needs to be agreement in defining basic principles of best practices for global partnership, including a universal definition of 'decolonization of global health'; the extent to which current policies allow the perpetuation of power imbalance between HICs and LMICs; a set of principles, best practices, and models for equitable sharing of funds and institutional costs among partners; a mechanism to monitor progress prospectively the equitable sharing of credits (e.g., leadership, authorship), including a set of principles, best practices, and models; and, a mechanism to monitor progress prospectively the extent to which decolonialization will contribute to strengthening institutional capacity in the LMIC institutions.

Decolonizing Global Health Research: Perspectives from US and International Global Health Trainees

“…However, our analysis was limited by our small sample size (more than half of the cells had an n < 5), which was not sufficient to produce reliable estimates on the basis of gender (See Supplemental Materials Table S3). [17,18], and decolonizing global health is at present a contested concept [14]. Our respondents' definitions of the concept and their attitudes toward it reflect the significant differences present in the literature around decolonizing global health.…”

“…First, our findings suggest the need for the global health community to develop clarity around exactly what decolonizing global health means. Recent studies involving global health leaders have revealed both agreement and disagreement about the precise meaning of decolonizing global health [ 17 18 ], and decolonizing global health is at present a contested concept [ 14 ]. Our respondents’ definitions of the concept and their attitudes toward it reflect the significant differences present in the literature around decolonizing global health.…”

Decolonizing the decolonization movement in global health: A perspective from global surgery

“…Unfortunately, the movement to decolonize global health may have developed into an echo chamber of rhetoric, roadmaps, and buzzwords that upholds the very power dynamics it claims to dismantle (Khan et al, 2021). This explains why there is so much contention within the movement about what decolonization ought to look like (Chaudhuri et al, 2021;Mogaka et al, 2021;Finkel et al, 2022). Moreover, this is why we ought to take a step back and a closer look at the reality of the work as it exists today.…”

Health, sustainability and transformation: a new narrative for global health

“…Originating in tropical medicine and later in international health, it has colonial baggage that needs to be acknowledged and dealt with. Calls for ‘decolonising global health’ have been voiced 2. At the same time, old structures prevail and are reproduced 2.…”

“…Calls for ‘decolonising global health’ have been voiced 2. At the same time, old structures prevail and are reproduced 2. This is troublesome since the colonial narrative lingers on and thereby hampers the potential for global health to contribute to addressing the challenges it is fit for.…”