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Global health, as defined since the turn of this century, endeavors to address global inequity in health outcomes. In the wake of the domestic and global social justice movement, this mission has heightened. Many of the organizations shaping global health policy, research, and services have inextricable roots in colonization. As these organizations seek to address global health disparities and renounce their colonial origins, it is important to understand how their practices have evolved to achieve true change.
A new article in Preventive Medicine by CUNY SPH Distinguished Professor Luisa N. Borrell and Delivette Castor, Assistant Professor at Columbia University, Department of Medicine, summarizes the evolution of terminology defining the theory and practice of health in the global south and how the definition evolved to include language on health equity and social justice.
Drs. Borrell and Castor studied the websites of 25 national, multilateral, philanthropic, non-governmental global health organizations to understand their history, places of critical operations, budget, organizational structure, leadership, mission, policies, and representation of the global south. They found that although the organizations may have inclusive and equitable language on their websites, organizational structures and bureaucratic processes persisted unchanged.
“Within this global health framework of equity, the non-convergence of language purporting global health equity with static praxis is damaging on many levels,” says Borrell. “The disconnect between the language they adopt and the ways in which they operate is akin to cognitive dissonance within and between individuals.”
Borrell says this dissonance perpetuates inequity across global health organizations and impedes decolonization by and in the institutions that promote global health, undermining the achievement of current goals across the global health system.
To truly decolonize global health, researchers must measure and study changes in how organizations operationalize their goals, structures, policies, and administrative processes to address equity and social justice across all sectors of the global health system.
