I have been writing about power imbalance in global health.
Every aspect of global health is dominated by individuals, institutions and funders in HICs. Global health is neither global nor diverse. https://www.forbes.com/sites/madhukarpai/2020/03/08/global-health-needs-to-be-global--diverse/#28936f0c7659
The 2020 Global Health 50/50 report shows that privileged older men from elite institutions in the global north call the shots in global health. Global health needs to be global and diverse.https://www.forbes.com/sites/madhukarpai/2020/03/08/global-health-needs-to-be-global--diverse/#28936f0c7659
Whatever the outcome, it is critical to use this moment to reflect on the structural issues that make tuberculosis problematic. Otherwise, nothing will change.
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.
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.
Our own bibliometric analysis shows that America dominates TB research (despite the low incidence). USA is also the biggest funder of TB researcher and R&D. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199706
Background Tuberculosis (TB) research is a key component of the End TB Strategy. To track research output, we conducted a bibliometric analysis of TB research from the past decade. Methods The Web of...https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199706
Geneva, Washington DC, London, Seattle, NYC
UNAIDS, UN, MSF, Women Deliver, USAID, Planned Parenthood, London School, IWHC, etc.
Time for high-burden countries to lead the tuberculosis research agenda https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002544
In a Guest Editorial, Madhukar Pai discusses the need for high-burden burden, middle-income countries to take a leading role in tuberculosis research.https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002544
-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
My piece on burnout in global health digs deeper: https://www.forbes.com/sites/madhukarpai/2020/07/20/burnout-a-silent-crisis-in-global-health/#3242a49d4df8
Global health is about big saves and big goals. But in the race to save lives, the field of global health tends to ignore burnout. Burnout was a concern before the Covid-19 pandemic, and might get...https://www.forbes.com/sites/madhukarpai/2020/07/20/burnout-a-silent-crisis-in-global-health/#3242a49d4df8
Here are some recent articles on this:
This op-ed examines the action and structural changes needed at senior leadership level, drawing on experiences of racism from working at the headquarters of two white-dominated development organiz...https://www.devex.com/news/opinion-we-must-translate-anti-racism-statements-into-action-97591
Antiracist language is one way to explicitly consider ethnicity and racism within our institutions, both during the pandemic and beyond Millions of people have been deeply moved by the Black [...]M...https://blogs.bmj.com/bmj/2020/07/03/nisreen-alwan-lets-equalise-our-antiracist-language/
Like many of you, I’ve been thinking a lot about power and privilege lately. Only that hasn’t taken the shape you might expect. You see, I don’t have as much interest in or energy for rehashing all...https://globalhealth.org/letter-from-loyce-real-talk-on-racism-in-the-global-health-sector/
Women comprise 70% of health workers around the world. And yet a new report shows that 70% of health organizations are currently headed by men, and that the women working in these organizations earn...https://www.project-syndicate.org/commentary/gender-parity-improves-global-health-by-tedros-adhanom-ghebreyesus-and-senait-fisseha-2019-03?barrier=accesspaylog
Funding in the development sector continues to fail women: too little is changing too slowly, because women do not have an equal role in decision-making, write Dr. Roopa Dhatt and Rachel Firth in...https://www.devex.com/news/opinion-challenging-international-development-to-get-out-of-its-comfort-zone-on-gender-equality-96687
While activism involves external efforts to bring about systemic change in society, intravism involves internal efforts to change organizational structures, this op-ed explains.https://www.devex.com/news/opinion-on-equity-in-the-international-development-sector-we-need-more-intravists-97404
@StephKimou @romainmurphy & @communityheal10 https://medium.com/aidreimagined/video-how-to-be-anti-racist-in-aid-a6eaebc54d3e
The words we use in NGOs and aid agencies draw imaginary lines between ‘us’ and ‘them,’ stifling our imagination.https://www.opendemocracy.net/en/transformation/its-time-to-put-an-end-to-supremacy-language-in-international-development/
by @arnabmajumdar_ https://www.thenewhumanitarian.org/opinion/first-person/2020/08/18/MSF-Amsterdam-aid-institutional-racism
- 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 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.