The wake of the Black Lives Matter movement and the ravages of the COVID-19 crisis lay bare the fault lines in global health. Reflecting on the uncoordinated global response to the pandemic and the exacerbation of inequalities in treatment and supply of essential goods, the international development sector has been primed to reconsider the structural flaws of its systems, rife with entrenched power asymmetries and stalled reform – heritages of its colonial origins, wherein global health was established as a field of research and practice that privileged the voices and goals of the powerful over the populations it purports to aid.

 

In response, the Shifting Power in Global Health: Decolonising Discourses dialogue series was convened as a three-part roundtable discussion on 2 November 2021, 1 March 2022 and 1 May 2022, in partnership with United Nations University – International Institute for Global Health, Wilton Park, and Development Reimagined. The dialogues serve as a contribution to the increasing calls for decolonization in global health by engaging a global cross-sectoral set of actors to identify the problematic rhetoric and approaches and to suggest practical next steps for reimagining the sector.

 

The dialogues involved 65 participants in total, where each roundtable in the series was run as a dual set of dialogues on each day, to facilitate engagement with stakeholders across a broad geography of 5 regions and time zones.

 

Key Takeaways

  • Global health power inequity stems from larger global systemic power differentials between the global North and South
  • Power structures in global health at multiple levels – individual, structural, and systemic – need to be shifted
  • Decolonizing global health will be a socially driven effort, not an academic one
  • Funding methods for global health can improve – or worsen – these decolonization efforts

 

As an opener, the first dialogue mapped out avenues for further discussion by articulating the ideas and visions about what decolonized global health would look like from differing points of view and identifying points of convergence.

As the existing knowledge base in global health –the ideas and principles of “equity”, “justice”, “rights”, “expertise” or “value” – were drawn from Eurocentric conceptions, coloniality perpetuates through the entrenchment of these epistemologies. Separating out coloniality from decolonization and reconsidering the hierarchy in the top-down matrices of knowledge, power and control is the first step toward comprehending the systematic flaws and decolonizing global health. Evidently, purposeful underdevelopment continues today through complex funding flows which had further institutionalized long-existing injustices. To advance from dialogue to action, the dialogue participants identified three imperatives: to call out structural violence and institutional damage; to mainstream a spectrum of epistemologies; and to collapse center-periphery divisions and dynamics.

 

Next, the second dialogue focused on the key themes that emerged from South-South collaboration and set forth the importance of mindsets, principles, partnership and careful use of language in efforts to decolonize global health.

A changed mindset is fundamental for more equitable, inclusive, and accountable partnerships. For genuinely sustainable and equal global development to be achieved, participants posited that the Global North must be prepared to cede power which permitted the exploitative regional and global interactions for centuries, while Global South actors need greater agency to set the decolonizing agenda and embrace a long-term vision for development. In that sense, partnerships should extend beyond the distribution of funding but also to the principles of trust, transparency, and reciprocity. Participants also addressed the synergies among communities, social movements, and academia. Communities are at the very heart of the push to decolonize from below while social movements are well-connected and have been at the forefront of the decolonizing agenda ahead of academia and international agencies. Actively seeking partnerships with – and learning from rather that co-opting – social movements and communities can help the academia in the Global South to dismantle the problematic practices of their Northern counterparts.

 

In closing, the third dialogue situated the core principles of decolonization in the source and power dynamics of funding mechanisms and carried out an inquiry into constructing new power dynamics, centering beneficiaries’ agency for more equitable and sustainable global health finance.

It was posited that through the extended period of colonization and in the current Eurocentric post-colonial world order, local communities have been disempowered, while dependency on imported structures and external resources has continuously been reinforced. Top-down governing institutions established during colonial rule deprived local communities of their sense of agency, while the disconnect from the grassroots accountability of leadership led to failed provision of contextually appropriate and effective services. It was recommended that local leadership and agency established via a bottom-up approach will be key to building adaptive, transparent and accountable health funding models. It also necessitates an inward-looking shift from over-reliance on external donors for financing to harnessing community agency over decision-making, sustainability and ownership/administration of resources. Other funding diversification options discussed included reform of tax and donor funding methods, reparations as a funding option, social impact bonds and blended financing.

 

What comes next?

  • Change in this sector is already in progress with many guiding policies and codes of practice in application globally, but more can be done on implementation.
  • Continuing the conversation and discourse to promote new ideas and spotlight initiatives that work.
  • Involving new and emerging voices in this space to prompt agency and the dismantling of power imbalances

 

In this regard:

Development Reimagined works to build on the decolonisation discourse with further dialogues around systemic change. These dialogues will be focused on more equitable, sustainable financing mechanisms and promoting decolonial collaboration in post-colonial states – at both local and national levels – to challenge existing power structures.

 

United Nations University works on building its unique position as a think tank within the UN ecosystem, applying a decolonial lens to all its work and has launched a programme of work dedicated to Decolonising Global Health, which aims to both continue these dialogues through its convening function and catalyse action through its evidence-to-policy pipeline, with a starting focus on coloniality in knowledge production.

 

Wilton Park works to embed many of the issues and themes that emerged in this series within its global health dialogues, while also engaging directly on how best to support the shift from rhetoric to action.

 

Download each dialogue summary here:

Shifting Power in Global Health: Decolonising Discourses – Dialogue 1

Shifting Power in Global Health: Decolonising Discourses – Dialogue 2

Shifting Power in Global Health: Decolonising Discourses – Dialogue 3

Shifting Power in Global Health: Summary – Available here

 

For further information on this body of work, please contact our team here:

 

Email:

clients@developmentreimagined.com;

osaruomosigho@developmentreimagined.com

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EDMOND BOSILONG

Research Analyst

Edmond is a research analyst who is passionate about sustainable development, innovation, and the environment. Passionate about climate financing, he firmly believe there is a more reliable system to promote equality, growth, and welfare in societies without affecting the ecosystem. Through his skills, knowledge and experienced gained over 7 years, he wants to make an impact in the world of development. Edmond holds a Master’s Degree in Public Policy from Korea Development Institute and a BA Degree (Honors) in Business from University of Derby.

   HANNAH RYDER

    Founder and CEO

Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.

LEAH LYNCH

Deputy Director

Leah Lynch is Deputy Director of Development Reimagined (DR), and head of the China office. Leah has over 10 years of experience in development and has lived in China for over 8 years. Leah has also travelled extensively around Asia and Africa for research. Leah supports the strategic direction of the team across China, with a mission to deliver high quality research on sustainable development and poverty reduction. Leah is also Chair of the Sustainability Forum at the British Chamber of Commerce in China, providing direction on sustainability initiatives for British and Chinese business. Leah has also consulted on various evaluations on UK aid (ICAI) and is a specialist on development cooperation from the UK and China. Leah has also consulted on various UN projects, including providing support to the UN China team during the COVID-19 Pandemic. Prior to DR, Leah was at the United Nations Development Programme (UNDP) China, supporting the UN’s portfolio on communication strategies, China’s South- South Cooperation and the Belt and Road Initiative (BRI). Before UNDP, Leah lived and worked in Kenya developing sustainable water policies for the Kenyan government.

YIKE FU

China-Africa Policy Analyst

Yike Fu is a Policy Analyst and has been responsible for leading numerous areas of work, including on debt analysis in Africa and beyond, and China-Africa trade and investment logistics and analysis. She is the co-author of “African Debt Guide”, in which she challenged the narrative that Africa is in the midst of a new debt crisis by analysing data back to the 1970s and adopting new metrics to present the real story behind the data. She also developed a benchmark to compare the financial distribution of development partners such as the UK, US, Japan, France and China in Africa. Prior to her role at DR she worked at the International Finance Corporation and African Union Representational Mission to the US. She holds a Masters in International Affairs from George Washington University.

JUDITH MWAI

Research Analyst

Judith is a Research and Policy Analyst, where she specialises in Africa-China relations, international development, and diplomacy. During her time at Development Reimagined, Judith has co-authored several articles published in The Diplomat on debt and China-Barbados relations and was quoted by China Daily in a piece on Women Rights in China. Previously, Judith worked as a research analyst for an Advocate and Commissioner and Oats office in Kenya.

OVIGWE EGUEGU

Policy Analyst

Ovigwe specialises in geopolitics with particular reference to Africa in a changing Global Order. He is adept at critically analysing the politics of contemporary development processes and providing insight into the geopolitical interests that influence them. His work includes research, publications, tailored briefings and advising on global and regional trends, and issues at the nexus of geopolitics and development. Ovigwe appears frequently in media around the world such as Al Jazeera, TRT World, SABC, CGTN, BBC Radio, and other platforms.

JING CAI

Policy Analyst

Jing leads China-African health and agriculture cooperation research at Development Reimagined, having managed our FOCAC Policy Analysis and Advocacy project. She is also the co-author of “China-Africa Health Cooperation under FOCAC Umbrella”, in which she analysed China’s commitments around health cooperation since the first FOCAC summit and deepdived into four African countries’ health overview, challenges and cooperation with China as cases studies. Before DR, Jing worked at GIZ Cambodia on M&E of a disability advocacy project. She also worked as a translator with Chinese medical team in Benin.

PATRICK ANAM

Trade Policy Analyst

Patrick is an International Trade Policy and Trade Law Expert with over 5 years of experience. His expertise includes trade law, trade policy analysis and regional integration. He is currently engaged with Development Reimagined as a Senior Trade Analyst and was the lead author of Development Reimagined's recent Report on Africa-China Relations titled "From China-Africa to Africa- China: A Blue Print for a Green and Inclusive Continent-Wide Strategy Towards China." and “Reimaging FOCAC Going Forward.” Patrick has previously consulted for the East African Community, UNECA and for the Kenya Ministry of Trade.

ROSIE FLOWERS

Senior Policy Analyst 

Rosemary is our Senior Policy Analyst. She is a skilled policy analyst and has previously worked as a UK civil servant. She is studying Human Rights at Birkbeck, University of London with a research focus on international law in the context of health crises such as the COVID-19 pandemic.

JADE SCARFE

Project Manager and Africa-China Communication Assistant

Jade is a Project Manager for Development Reimagined’s flagship project Africa Unconstrained, which focuses on financing needs and debt vulnerabilities of African countries. Her research focuses on China-Africa development finance alongside debt vulnerabilities, infrastructure needs and South-South cooperation. She has worked with a breadth of stakeholders from China, Africa and the wider international community, including governments, private sector, NGOs and civil society. Her writing has appeared in a number of publications, including The Africa Report, The China-Africa Project, The Diplomat and more. Jade holds a Master’s in China and Globalisation studies from King’s College London.

ROSIE WIGMORE

Programme Manager

Rosie is the Project Manager of Africa Reimagined (AR) at Development Reimagined (DR) where she supports high-end African brands with entering the Chinese market by operating services such as trademark protection, Chinese market research, Chinese partnership building, and Africa to China logistical support and import/export services. Rosie has worked with DR for over two years now with proven success in helping high-end African brands navigate the Chinese market. She is extremely passionate about her work because more African brands selling in the Chinese marketplace means African countries can export MORE value-added goods, create MORE jobs and foster MORE innovation in African countries.

Rosie is also alumni of the School of International Studies at Peking University in Beijing where she is also an editor at the Peking Africa Think Tank. PATT is led by a diverse group of scholars who specialise in African Studies within the context of Sino-Africa relations.

LAUREN ASHMORE

Consultant

Lauren has lived in six countries from the Americas to Europe and Asia and speaks both French and Spanish proficiently. At Development Reimagined, Lauren’s research focuses on climate action both in the Asia-Pacific and in Africa, and how countries are using tools such as SDGs and Covid-19 action to build a more climate-resilient future. She holds a Masters in International Relations from Leiden University.

ETSEHIWOT KEBRET

Consultant

Etsehiwot holds a Masters’s degree in Development Studies from the London School of Economics. She has diverse experience in humanitarian and development issues by working in both multilateral organizations and international non-governmental organizations. Etsehiwot is currently a consultant focusing on the SDGs and development finance.

DIBEKULU MULU

Economist Consultant

Dibekulu is an economist by training. He holds an MSc in International Development Studies from Palacky University Olomouc, an MSc in Development Economics from the University of Clermont Auvergne, and an MSc in Economics, Finance, and International Integration from the University of Pavia. At Development Reimagined, he works as an Economist consultant. He has strong data analysis skills, with research interests centring around development finance, impact assessment, food security, and agricultural insurance.

OSARU OMOSIGHO

Project Manager

Osaru is a health professional with an MSc in Health Systems Policy and an interest in women’s health and population management. At Development Reimagined, she applies her health sector experience to global health research and collating locally applicable development insights from China.

PIER FERDINANDO CINOTTO

Research Analyst

Ferdinando’s research at Development Reimagined is centred on South-South Cooperation dynamics, specifically on the analysis of Chinese investment and debt flows in Africa and their linkages to African industrialisation. He is currently a Yenching Scholar at Peking University, after having graduated from the University of Cambridge with an MPhil in Development Studies.

DAVID TINASHE NYAGWETA

Research Analyst

David is a Research and data analyst at Development Reimagined. His scholarly focus is mostly on interdisciplinary research in demographic economics and development with interests in migration, economic development and policy, education, health and subjective well-being. He is currently a PhD scholar at Nelson Mandela University from which he also holds B.com Economics and Statistics and M.com respectively.

IVORY KAIRO

Research Analyst Kenya

Ivory is a Kenyan lawyer with experience in policy research and analysis. She also supports the communications team at DR. Ivory speaks English, Swahili and French.

JOY ENE

Research And Data Analyst China 

Joy Ene is a Research and Data Analyst at DR. Joy is passionate about African/global development, poverty eradication and trade policies between underdeveloped and developing countries. She is also a fourth-year student of International Economics and Trade at the  Liaoning University, Shenyang, China. She serves as the President of the Student Union, Liaoning University, International Students chapter.

CHENSI LI

Research Analyst 

Chensi Li is a research analyst. She has previously worked for local NGOs in Nigeria and Cameroon and think-tanks in China.  Her research areas include Sino-African relations, African foreign affairs, public diplomacy, state-building and national governance.

Yixin Yu

Research Analyst 

Yixin is a Junior Research Analyst and her focus areas is on public-private partnership and entrepreneurship. She has over three years of working experience in both private and public sectors in Ethiopia. She was the China Liaison Officer for project ‘Partnership for Investment and Growth in Africa’ at International Trade Centre, where she accumulated rich experience in investment and trade promotion

HANNAH RYDER

Founder and CEO

Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.