Global health and the elite capture of decolonization: On reformism and the possibilities of alternate paths

Abstract

Global Health is experiencing a moment of reckoning over the field’s legacy and current structuring in a world facing multiple, intersecting challenges to health. While “decolonization” has emerged as the dominant frame to imagine change in the field, what the concept refers to and entails has become increasingly unclear. Despite warnings, the concept is now being used by elite Global North institutions and organization to imagine their reformation. In this article, I attempt to provide clarity to the issue of conceptualizing change in Global Health. By first outlining a brief history of decolonial thought and then exploring the current state of the decolonizing global health literature, I show a profound disjuncture between popularized calls for decolonization in Global Health and other theorizations of the term. I then argue that the diluting of “decolonization” into a depoliticized vision of reforming the inherently colonial and capitalistic institutions and organizations of Global Health is an example of “elite capture”—the coopting and reconfiguration of radical, liberatory theories and concepts then used by elites for their own gain. Showing how this elite capture has facilitated harm within the field and beyond, I conclude by calling for resistance to elite capture in all its forms.

Assembling a global health image: Ethical and pragmatic tensions through the lenses of photographers

“…In such restricting settings, briefs become powerful carriers of stereotypes and normativity that participate in the re-production, amendment and proliferation of stereotypes. As such, positive imagery such as ‘empowered subjects’, which is currently promoted as a heuristic solution to prior abusive tropes [ 18 ], can be effectively staged or enacted for the purpose of taking a positive representational photo, risks becoming, nearly literally, an elite global health capture [ 11 ] informed by mainstream marketing principles. This indicates that ‘empowered subjects’ could be emerging as yet another potentially dehumanising visual trope to depict people and their life-worlds that stems from the cultural logic of white saviours as enables of power and providers of care.…”

Missing in action: a scoping review of gender as the overlooked component in decolonial discourses

“…Both within global health and among allied movements, we must ensure that the voices of the oppressed shape our agendas, approaches and actions. In short, we must ensure that decolonising movements are not themselves colonised 74 or sanitised.…”

Decoloniality in global health research: ten tasks for early career researchers

“…Focusing discussions about decolonising global health on leaders and decision-makers risks disenfranchising the large community of early career researchers (ECRs). Without grassroots change, decolonisation risks being ‘performative’1 or co-opted by elites 2. In this Commentary, we propose ten practical tasks to advance decoloniality.…”

“…Without grassroots change, decolonisation risks being 'performative' 1 or co-opted by elites. 2 In this Commentary, we propose ten practical tasks to advance decoloniality. We focus on the field of global health but consider these principles indispensable across all disciplines engaged in international, collaborative research.…”