www.thelancet.com/lancetgh Vol 9 October 2021 e1359
Why and for whom are we decolonising global health?
The growing calls to decolonise global health are
welcome but also worrisome. Suggestions for
decolonisation vary greatly, with a common view
to shift power to local ownership but without clear
plans on how to make this suggestion a reality. Many
researchers are calling for global health research to be
led by local leaders in low-income and middle-income
countries (LMICs), with expatriate academics providing
peripheral support rather than the other way around.1
Others call for radical transformation as the only
reasonable response to addressing the complexity of
reforming global health research when many leaders in
global health have built their careers in institutions that
advance and sustain white supremacy.2,3
Global health institutions, researchers, and priorities
are predominantly in high-income countries (HICs),
whereas the bulk of the research work and intervention
programmes are implemented in LMICs. Commendable
gains have been made in addressing global health
issues, such as treatment for people living with HIV, but
wholesome improvement of the health-care system of
LMICs is often minimal or non-existent, highlighting
the priorities of HICs and dependency on donor
programmes. The push to decolonise global health and
the resultant conversations are, unsurprisingly, taking
place primarily among academics based in HICs, and
LMIC participation is limited to researchers who have
built their careers within the current colonial global
health structure. Perhaps there is something to learn
from the process of political decolonisation in countries
like Kenya. Colonial powers, facing the inevitability of
granting independence to colonies, were intentional in
leaving power in the hands of local leaders sympathetic
to the European outlook: western-educated descendants
of paramount chiefs appointed and propped up by the
colonial regime in largely acephalous communities, or
people in LMICs who had converted to Christianity and
had an educationâ€”factors which often were conjoined.
These colonially appointed and backed local leaders were
also the beneficiaries of the Africanisation of the colonial
civil service. In political decolonisation, leaders in LMICs
have sustained the same political and socioeconomic
structures carved by colonial governments, resulting in a
relationship of dependence, neocolonialism, and an everwidening gap between the rich and the poor. Akin to this
transition in political leadership, dominant global health
institutions, through education and leadership positions,
have produced researchers educated to HIC standards
from LMICs who are replete with skills to work within
the current global health system, sustaining their power
structures in the process. The call to diversify global health
leadership, if done within the current structures, runs the
risk of repeating the same decolonising mistakes.
Even if global health research priorities were set
by academics in LMICs, closer examination of the
relationship between global health researchers from
HICs and those from LMICs shows the situation to be
direr: research grants for projects in LMICs are channelled
through researchers and institutions in HICs; researchers
in LMICs have not had the resources at the disposal
of their counterparts in HICs, such as protected time,
grant teams, advanced laboratory infrastructure, and
postgraduate trainees from around the world to work
with. Asking leaders from LMICs to take up positions
within the current structures without acknowledging the
entire systems made to support careers of researchers in
HICs would be but a cosmetic change. True transfer of
power and equitable partnerships will require investing
as much time into rebuilding research infrastructure
from the ground up in LMICs as is done in supporting
individual careers of global health researchers in LMICs.
Similarly, we need to pause and ask whether
ordinary citizens in LMICs, struggling under a system
bearing colonial legacy in multiple spheres of their
lives, are participants in this discourse, and whether
their participation in challenging this system can be
through â€œrational confrontation of points of viewâ€4
journals based in HICs. The ordinary citizen will probably
prioritise comprehensive health careâ€”a stark contrast
to the long history of studying tropical diseases. When
goals of local global health researchers uphold those
of researchers in HICs, will diversifying global health
leadership address the plight of citizens in LMICs? The
fragile health-care system in LMICs is a simple proxy for
equity and justice in global health.
Lastly, decolonising global health cannot be complete
without examining the socioeconomic and political
context. The structure and objectives of research and
collaborations in global health must be decolonised to
address the whole spectrum of health determinants.
e1360 www.thelancet.com/lancetgh Vol 9 October 2021
We declare no competing interests.
Copyright Â© 2021 The Author(s). Published by Elsevier Ltd. This is an Open
Access article under the CC BY-NC-ND 4.0 license.
*Ongâ€™era F Mogaka, Jenell Stewart, Elizabeth Bukusi
Kenya Medical Research Institute, Nairobi 54840-00200, Kenya (OFM, EB);
Department of Global Health (JS, EB) and Department of Medicine, Division of
Allergy and Infectious Diseases (JS), University of Washington, Seattle, WA, USA
1 Costello A, Zumla A. Moving to research partnerships in developing
countries. BMJ 2000; 321: 827â€“29.
2 Hirsch LA. Is it possible to decolonise global health institutions? Lancet
2021; 397: 189â€“90.
3 Abimbola S, Pai M. Will global health survive its decolonisation? Lancet
2020; 396: 1627â€“28.
4 Fanon F. The Wretched of the Earth. London: Penguin Classics, 2001: 31.
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
There is a very low likelihood that you won’t like the paper.
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.Read more
Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.Read more
Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.Read more
Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.Read more
By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.Read more