A Parallel Perspective
Coloniality of Global Public Health
Just as Dr. McCool explains the deep colonial roots of global health, in “An ironic guide to colonialism in global health,” published in The Lancet, Simukai Chigudu discusses the unique views of Eugene Richardson in his book Epidemic Illusions: On the Coloniality of Global Public Health. Richardson argues that the current approach to global health promotes and reinforces “coloniality,” which he describes as the preservation of hierarchical orders (racial, ethnic, socioeconomic, etc.) imposed by former European colonial powers that have transcended decolonization. In his view, global health is approached very conservatively, where those in the field seek to explain disease strictly through a biomedical approach and refuse to acknowledge the heavy influence of socioeconomic factors, such as poverty, corruption, and social marginalization, on the manifestation and spread of disease. By failing to address these broader issues, the citizens of developing countries cannot rise up the social ladder. This reinforces a system in which they remain poor and the Western elite leading global health endeavors maintains their positions of power, a relationship with strong colonial imagery that ultimately fails to truly benefit the local populations being served.
Economic Exploitation
In fact, some of the socioeconomic issues that Richardson believes are not appropriately addressed by present-day global health efforts were a direct result of colonial rule. In her presentation, Dr. McCool describes how economic exploitation by colonial powers led to inescapable poverty among locals. As poverty is highly associated with poor health outcomes and is still a major issue in formerly colonized countries, Richardson’s argument that we must change our approach to global public health by addressing socioecomic problems is very reasonable.
Decolonizing Global Health
Richardson rightfully argues that to decolonize global health, we must accept and understand how colonialism has influenced the practice of medicine and actively work to undo the imbalanced power dynamics that exist. Global health endeavors must include input from citizens of formerly colonized countries. Without their perspectives, involvement, and leadership, the coloniality of global health cannot be broken and the populations served cannot truly benefit from global health efforts.