I respect the Board's independent investigation and look forward to the findings.

Whatever the outcome, it is critical to use this moment to reflect on the structural issues that make tuberculosis problematic. Otherwise, nothing will change.
Second, although TB did kill millions in Europe and North America, the disease today mostly affects Black, Indigenous and People of Color (BIPOC) people in low and middle-income countries. In Canada, it primarily affects Indigenous communities where the incidence is 300X higher.
Although TB mostly affects BIPOC folks, the agenda today is still set by agencies and individuals in high-income countries, and mostly led by White folks from privileged backgrounds. I am aware that I am privileged, working on TB in a Center located in Canada.
Who controls TB funding & who has influence?

USAID, Global Fund, BMGF, Unitaid, DFID, Global Affairs Canada, etc (all led by White folks in HICs)

Yes, TB affected countries do spend money, but donors have a huge influence on the global agenda.
Where are major TB agencies headquartered & who leads them?

WHO, Stop TB, USAID, Global Fund, FIND, Aeras/IAVI, TB Alliance, Unitaid, Union, KNCV, BMGF,

All are based in HICs, all led by white folks.
Where are big decisions made about TB?

Geneva, Washington DC, London, Seattle, NYC
So, this is why TB, like all of global health, is structurally problematic. Even well-intentioned people cannot overcome this deep power imbalance.
So, at some level, it is not surprising that TB has been included in a long and growing list of agencies which have structural racism and lack of diversity:

UNAIDS, UN, MSF, Women Deliver, USAID, Planned Parenthood, London School, IWHC, etc.
I had written: The world cannot depend on a few wealthy countries with very low TB incidence to support all the research that is required to tackle TB. High-burden, middle-income countries with high TB rates must step up.
What we see in TB, we see in every global health organization & international aid agency.

-BIPOC folks are not in leadership roles
-Decisions are made far away from where the problems are
-Funding is tightly controlled by groups in HICs
-HIC researchers dominate
Since global health leadership is dominated by White men from HICs, it cannot be easy for women and BIPOC. Concerns about sexual harassment, racism, White supremacy and abuse of power have been raised in many settings.

Here are some recent articles on this:
Each of us approaches the above issues through our own lens:
- Some of us are advocating for women in global health
- Some of us are advocating for LMIC representation
- Others focus on racism against BIPOC
- Others point our White supremacy
- Some focus on improving diversity
- Some of us are focused on "decolonizing global health"
- Some focus on neoliberalism
- Some on the White gaze

They are all connected and result in the inequities we see.

We are trying to touch/fix different parts of the same elephant.
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