Medicine and public health at the end of empire (original) (raw)

Resisting the Imperial Order and Building an Alternative Future in Medicine and Public Health

Monthly Review, 2015

Although medicine and public health have played important roles in the growth and maintenance of the capitalist system, conditions during the twenty-first century have changed to such an extent that a vision of a world without an imperial order has become part of an imaginable future. 1 Throughout the world, diverse struggles against the logic of capital and privatization illustrate the challenges of popular mobilization. In addition to these struggles, groups in several countries have moved to create alternative models of public health and health services. These efforts-especially in Latin America-have moved beyond the historical patterns fostered by capitalism and imperialism. (We have chosen not to address the Cuban case here, which is in many ways exceptional, and on which a great deal of previous work exists. 2) All the struggles that we describe remain in a process of dialectic change and have continued to transform toward more favorable or less favorable conditions. However, the accounts show a common resistance to the logic of capital and a common goal of public health systems grounded in solidarity, not profitability. Protagonists of struggles in Latin America have experienced the direct impacts of political and economic imperialism imposed by the United States over the course of nearly two centuries. Policies that fortified U.S. dominance throughout the Americas originated formally with the Monroe Doctrine in 1823. Subsequently, U.S. economic and political elites succeeded in imposing a neocolonial environment, in which multinational corporations based in the United States could extract raw materials and open up new markets for the entire Western

The Coloniality of Global Health

Africa Is A Country, 2023

Full recognition of the neocolonial structure of international economic and global health relations demands much more radical political alternatives.

Security, Disease, Commerce Ideologies of Postcolonial Global Health

Social studies of science, 2002

Public health in the United States and Western Europe has long been allied with national security and international commerce. During the 1990s, American virologists and public health experts capitalized on this historical association, arguing that 'emerging diseases' presented a threat to American political and economic interests. This paper investigates these arguments, which I call the 'emerging diseases worldview', and compares it to colonial-era ideologies of medicine and public health. Three points of comparison are emphasized: the mapping of space and relative importance of territoriality; the increasing emphasis on information and commodity exchange networks; and the transition from metaphors of conversion and a 'civilizing mission', to integration and international development. Although colonial and postcolonial ideologies of global health remain deeply intertwined, significant differences are becoming apparent.

Imperial or postcolonial governance? Dissecting the genealogy of a global public health strategy

Social Science & Medicine, 2008

During the last decades of the twentieth century it became increasingly apparent that the interrelationship between globalisation and health is extremely complex. This complexity is highlighted in debates surrounding the re-emergence of infectious diseases, where it is recognised that the processes of globalisation have combined to create the conditions where once localised, microbial hazards have come to pose a threat to many western nations. By contrast, in an emerging literature relating to the epidemic of non-communicable diseases, and reflected in the WHO 'Global strategy on diet, physical activity and health', it is the so-called 'western lifestyle' that has been cast as the main threat to a population's health. This paper explores critically global responses to this development. Building on our interest in questions of governance and the ethical management of the healthy body, we examine, whether the global strategy, in seeking to contain the influence of a 'western lifestyle', also promotes contemporary 'western-inspired' approaches to public health practices. The paper indicates that a partial reading of the WHO strategy suggests that certain countries, especially those outside the West, are being captured or 'enframed' by the integrative ambitions of a western 'imperial' vision of global health. However, when interpreted critically through a post-colonial lens, we argue that 'integration' is more complex, and that the subtle and dynamic relations of power that exist between countries of the West/non-West, are exposed.

Entrenched Colonial Influences and the Dislocation of Healthcare in Africa

Journal of Black and African Arts and Civilization , 2011

This paper argues that Africa's colonial experience which mediated contact with Western medicine brought about a confrontation of values in the sphere of health, and that this offers some explanation for why the outlook of practitioners and, indeed, the practice of health care in Africa remains riddled with subtle colonial trappings. It attempts an analytic and systematic examination of this state of affairs and seeks a critical exploration of where, how and why contemporary medicine in Africa remains largely immune to her endogenous cosmological systems. Since colonialism was also the wheel through which Western medicine gained entry into America, the paper probes why American practitioners were able to incorporate a Western theoretical framework about disease while at the same time maintaining their cultural uniqueness. Ultimately, it suggests feasible ways to amend and address the African situation.

Global Social Medicine for an Equitable and Just Future

Health and human rights, 2023

The papers in this special section work together to move toward a global social medicine for the 22nd century. They envision a global social medicine that confronts and moves beyond the traditionally colonial, xenophobic, heteronormative, patriarchal, gender-binary-bound, capitalist, and racist histories of the fields of global health and human rights. They seek to instantiate a global social medicine that centers knowledge and experiences from the Global South and works toward social justice and health equity at scale. In this special section, the authors are particularly interested in understanding, challenging, and expanding our perspectives and enactments of the right to health. Unlike neoliberal perspectives on health that often limit their explanatory capacity to how individuals behave in the world, the papers here move beyond the focus on lifestyles and on the phantasmagoria of a sovereign subject with supposedly free agency. Instead, authors work toward critical consciousness that accounts for structural processes-with their inequities and disruptions, as well as their effects on individuals-and how this consciousness can open new horizons for collective transformation and social emancipation in health. These papers build on a long history of theorizing and critiquing coloniality and racism. The seminal works of Frantz Fanon (in the Antilles and beyond), W. E. B. Du Bois (in the United States), and Aníbal Quijano (in Latin America), to name only a few in the Antilles and beyond, theorize systemic racism and its intersections with colonialism. 1 These and other thinkers lay the groundwork for critical applications to diverse fields. In particular, these contributions are the foundation of key critiques of racism, colonialism, and neocolonialism in science and biomedicine, elucidating how these structural processes impact individual and collective health. 2 Such forces condemn some human groups not only to exclusion but to pure and hard "extinction." 3 This critical work on colonialism and racism has also shaped the framework of critical interculturality in health, which recognizes the weight of the coloniality of knowledge from Global North and Eurocentric perspectives and stresses the need for epistemology from the Global South and from social movements around the world. 4 Critical interculturality imagines a science that is critical and emancipatory