Offline: The myth of “decolonising global health”

Abstract

The Lancet's inaugural issue was published on Oct 5, 1823. In his opening editorial, Thomas Wakley, our founding Editor, described the journal's intended audience: London's physicians and surgeons; country practitioners; medical students; and, rather ambitiously, “every individual in these realms”. Wakley also hoped to reach a fifth category of readers—“Colonial Practitioners”. The Lancet was born as a product of colonialism and, at least in part, as an instrument to support and advance British imperial objectives. This history is important to recall because of the growing movement to decolonise medicine and global health—a project, according to Eugene Richardson's definition in Epidemic Illusions (2020), to “reject the notion that social inquiry can produce objective, value-neutral, and univocal understanding”. The legacy of colonialism still casts a humbling shadow over The Lancet today. I remember a meeting in Delhi several years ago between editors and the authors of a series of papers on India's health system. As we began to discuss the suggestions of peer reviewers, one author halted the proceedings. He said that he was not willing to engage with criticisms from western critics invited by a journal complicit over many centuries in oppressing his country and his people. The truth about decolonising global health worth spreadingWith any myth about decolonising global health (as Richard Horton1 describes it), always question intent, dissent, lament, and discontent. Then, remember the wise words of Frederick Douglass, “power concedes nothing without a demand, it never has and it never will”.2 Full-Text PDF Decolonising global health: a Philippine perspectiveWe read Richard Horton's Offline1 with interest. We agree that “Medicine and global health continue to be entangled with colonial attitudes, structures, and practices.”1 That is, in systems of power. Horton concludes that “Decolonisation must mean much more.” We present perspectives from the Philippines. Full-Text PDF Capitalism, not racismRichard Horton1 correctly states that, in efforts to construct a fairer world, “we need to undertake a more realistic and rigorous analysis of where power lies”. However, Horton's Comment does not exhibit the required rigorous analysis. Citing the dubious work of Cheikh Anta Diop and Martin Bernal as authoritative commentary is precisely the type of shallow gesture that he correctly criticises as inadequate. Contrary to what Horton and Kehinde Andrews describe, the primary logic underpinning the western world order is not “that Black and Brown life is worth less”. Full-Text PDF