On Repositioning Global Health As A Meaningful Discipline

On Repositioning Global Health as a Meaningful Discipline: The Need for a Paradigm Shift in the Understanding of Power and Knowledge Systems.

By Luchuo Engelbert Bain, MD, PhD.

The future of impactful global health demands an intentional and deep understanding of its meaning and essence, and how these relate to core ideals such as equity and solidarity. A deliberate shift from colonial practices to inclusive, equity-driven, and respectful frameworks are highly needed. Addressing systemic inequities in knowledge production, power dynamics, and funding practices is critical. The central question remains: how?

𝗧𝗲𝗻 𝗔𝗰𝘁𝗶𝗼𝗻 𝗣𝗼𝗶𝗻𝘁𝘀 𝗳𝗼𝗿 𝗣𝗮𝗿𝗮𝗱𝗶𝗴𝗺 𝗦𝗵𝗶𝗳𝘁𝘀 𝗶𝗻 𝗚𝗹𝗼𝗯𝗮𝗹 𝗛𝗲𝗮𝗹𝘁𝗵

1. Decentralize Power Structures: Shift decision-making to local and regional levels to empower marginalized voices.
2. Ensure transparent, needs-based resource allocation, prioritizing Global South institutions.
3. Adopt approaches that address overlapping axes of oppression, such as gender, race, and socio-economic status.
4. Address epistemic injustices by valuing diverse knowledge systems and redefining what constitutes evidence.
5. Center communities in the design and implementation of health interventions.
6. Move beyond paternalistic models to collaborative and justice-focused global health.
7. Build frameworks for authentic allyship within organizations to combat systemic inequities.
8. Use innovative tools to address inequities while ensuring ethical considerations and accessibility.
9. Establish mechanisms to hold global health actors accountable for equitable practices.
10. Integrate foresight methodologies to anticipate future challenges and opportunities in global health.

Global health, an inherently political discipline, has not systematically nor optimally embraced the political – diplomatic dimensions as a discipline.

𝗧𝗵𝗲 𝗺𝗲𝗻𝘁𝗼𝗿𝘀𝗵𝗶𝗽 𝗼𝗳 𝘁𝗵𝗲 𝗻𝗲𝘅𝘁 𝗴𝗲𝗻𝗲𝗿𝗮𝘁𝗶𝗼𝗻 𝗼𝗳 𝗴𝗹𝗼𝗯𝗮𝗹 𝗵𝗲𝗮𝗹𝘁𝗵 𝗹𝗲𝗮𝗱𝗲𝗿𝘀 𝗿𝗲𝗾𝘂𝗶𝗿𝗲𝘀 𝗮 𝗰𝗼𝗺𝗽𝗹𝗲𝘁𝗲 𝗼𝘃𝗲𝗿𝗵𝗮𝘂𝗹 𝘁𝗼 𝗮𝘃𝗼𝗶𝗱 𝗿𝗲𝗽𝗲𝗮𝘁𝗶𝗻𝗴 𝗰𝗼𝘀𝘁𝗹𝘆 𝗺𝗶𝘀𝘁𝗮𝗸𝗲𝘀 𝗿𝗼𝗼𝘁𝗲𝗱 𝗶𝗻 𝗶𝗿𝗿𝗮𝘁𝗶𝗼𝗻𝗮𝗹 𝗶𝗴𝗻𝗼𝗿𝗮𝗻𝗰𝗲 𝗼𝗳 𝗰𝗿𝗶𝘁𝗶𝗰𝗮𝗹 𝗶𝘀𝘀𝘂𝗲𝘀 (𝗱𝗶𝗽𝗹𝗼𝗺𝗮𝘁𝗶𝗰 – 𝗽𝗼𝗹𝗶𝘁𝗶𝗰𝗮𝗹 𝗶𝗻𝘁𝗿𝗶𝗰𝗮𝗰𝗶𝗲𝘀).

With the “elite capture” of the movement, foundational and disruptive actions appear inevitable for the  decolonization of global health movement to survive its “recolonization”.

This transformation demands intentional effort, courage, and sustained commitment to reimagine global health as a field rooted in justice, equity, and authentic collaboration.