Epistemic injustice in academic global health

Himani Bhakuni,Seye Abimbola

doi:10.1016/s2214-109x(21)00301-6

Abstract

This Viewpoint calls attention to the pervasive wrongs related to knowledge production, use, and circulation in global health, many of which are taken for granted. We argue that common practices in academic global health (eg, authorship practices, research partnerships, academic writing, editorial practices, sensemaking practices, and the choice of audience or research framing, questions, and methods) are peppered with epistemic wrongs that lead to or exacerbate epistemic injustice. We describe two forms of epistemic wrongs, credibility deficit and interpretive marginalisation, which stem from structural exclusion of marginalised producers and recipients of knowledge. We then illustrate these forms of epistemic wrongs using examples of common practices in academic global health, and show how these wrongs are linked to the pose (or positionality) and the gaze (or audience) of producers of knowledge. The epistemic injustice framework shown in this Viewpoint can help to surface, detect, communicate, make sense of, avoid, and potentially undo unfair knowledge practices in global health that are inflicted upon people in their capacity as knowers, and as producers and recipients of knowledge, owing to structural prejudices in the processes involved in knowledge production, use, and circulation in global health.

Highlights

Some social groups find that academic global health is geared towards their interests, whereas others find less priority is placed on what they know, how they see the world, or what is of pronounced consequence to them
There have been increasing calls for greater, deeper, and ethical community engagement,[2] for disseminating locally relevant research and knowledge to their appropriate end users,[3] for moving away from top–down approaches to research and interventions,[4] and for doing research that equitably meets the needs of people in low-income and middle-income countries (LMICs)[5] and, more broadly, the needs of marginalised people everywhere, including in highincome countries (HICs)
It is well known that structural and persistent epistemic exclusion exists in academic global health, and that knowers, and producers and recipients of knowledge, from marginalised groups in HICs and LMICs suffer distinct epistemic wrongs

Summary

Epistemic injustice in academic global health

This Viewpoint calls attention to the pervasive wrongs related to knowledge production, use, and circulation in global health, many of which are taken for granted. We describe two forms of epistemic wrongs, credibility deficit and interpretive marginalisation, which stem from structural exclusion of marginalised producers and recipients of knowledge. We illustrate these forms of epistemic wrongs using examples of common practices in academic global health, and show how these wrongs are linked to the pose (or positionality) and the gaze (or audience) of producers of knowledge. The epistemic injustice framework shown in this Viewpoint can help to surface, detect, communicate, make sense of, avoid, and potentially undo unfair knowledge practices in global health that are inflicted upon people in their capacity as knowers, and as producers and recipients of knowledge, owing to structural prejudices in the processes involved in knowledge production, use, and circulation in global health

Introduction

Knowledge practices in global health as epistemic injustice

Interpretive injustice

Interpretive marginalisation

Conclusion