Imperialism 2 healthy population
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Gross disparities in access to good quality training, funding opportunities (fellowships, travel grants to attend international conferences, etc.), and publishing opportunities represent potential threats to social justice between researchers. Scientific partnerships in particular, which mobilize researchers from different disciplines, geographical spaces, and cultures, still involve numerous and complex ethical issues.
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Perhaps for being such a vague concept, global health partnerships have so far proved unable to redress the widespread ongoing inequalities. Today, a partnership may refer to a small-scale community-based intervention in a sub-Saharan African country as much as to a transnational structure administering research projects between Northern and African universities. However, the meaning of global health partnerships is far from straightforward. Some authors have posited that “erhaps in response to… postcolonial anxieties, the term ‘partnership’ has emerged as a key word within this new arena or ‘social world’ of global health”. For the purpose of this article, we focus our analysis on sub-Saharan African countries.
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Northern actors encompass what is also generally referred to as “Western actors”, i.e., institutions and individuals representing the USA and Canada, Europe (European Union and European Free Trade Association member states), Australia, and New Zealand, whereas Southern actors represent low- and middle-income countries. In other words, partnership in its current form supposedly rests on the autonomy and independence of each partnering entity. Indeed, embracing the popular social justice discourse that is inherent to ethics, global health aspires to an equal positioning of Northern and Southern actors. Global health conceives of the notion of partnership between North and South as central to the foundations of this academic field. Authentic and transformative partnerships are vital to overcome the one-sided nature of many partnerships that can provide a breeding-ground for inequality. This goes hand in hand with reconceptualizing global health as an academic discipline, mainly through being explicit about past and present inequalities between Northern and Southern universities that this discipline has thus far eluded. Several concrete steps can be undertaken to rethink partnerships. Fortunately, initiatives that shift paternalistic programs to formally incorporate a mutually beneficial design at their inception with equal input from all stakeholders are becoming increasingly prominent, especially initiatives involving young researchers. However, in the name of political correctness, these frustrations are not spoken aloud.
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Conversely, academics from African countries report frustrations at not being consulted when the main conceptual issues of a research project are discussed. African researchers are often unable to lead or contribute substantially to publications for lack of scientific writing skills, for instance. Today, partnerships provide assistance to underfunded African research institutions, but this assistance is often tied with hypotheses about program priorities that Northern funders require from their Southern collaborators. In the 1980s, the creation of a scientific hub of working relationships based on material differences created a context that was bound to create tensions between the alleged “partners”. Historical accounts are helpful in unpacking the genesis of collaborative research between Northerners and Southerners – particularly those coming from the African continent. We also review promising initiatives that may help to rebalance the relationship. In this paper, we reflect on global health partnerships by revisiting the origins of global health and deconstructing the notion of partnership. While the notion of partnership may be used to position the field of global health morally, this politicization may mask persisting inequalities in global health. Indeed, global health aspires to an equal positioning of Northern and Southern actors. Global health conceives the notion of partnership between North and South as central to the foundations of this academic field.