Introduction: Reframing Global Health through Decolonization
Decolonizing global health is more than a slogan—it is a framework for dismantling power imbalances, redistributing decision-making, and legitimizing non-Western knowledge in global health practice. A comprehensive scoping review of 91 articles (newer than 2020) identifies three core pillars: redefining the field, enabling agency for the global south, and transforming education and governance to foster pluralistic knowledge. This article distills the review’s findings into accessible definitions, key concepts, and practical actions for researchers, policymakers, funders, and practitioners.
PART I: What does decolonizing global health mean?
Foundational definitions converge on removing supremacy in global health practice and recognizing the right of all communities to contribute on their own terms. Notably, some scholars emphasize liberating knowledge systems from Western paradigms and validating Indigenous and local knowledge. The review highlights three recurrent themes:
- Power asymmetries between the global north and south shape priorities, funding, and whose voices drive the agenda.
- Colonial legacies and neocolonial practices such as parachute research and unequal data ownership that mirror historic domination.
- Epistemic injustice—the marginalization of non-Western knowledge, languages, and research outputs in publication and policy arenas.
Together, these themes show that decolonization requires more than rhetoric; it demands a structural shift in who defines questions, who funds, and whose knowledge counts.
PART II: Can decolonizing global health be acted on? Proposed actions
The scoping review outlines five action domains, acknowledging that some may lack robust implementation research but remain vital conceptual contributions:
1) Overhaul power structures
Authors argue for radical redistribution of funding away from HICs, dismantling vertical, top-down relations, and replacing them with horizontal, locally led partnerships. This shift aims to deter perpetuated inequality and ensure that research serves local development and autonomy rather than external interests.
2) Establish agency and self-determination for the global south
Empowering LMICs to lead agendas, set priorities, publish locally, and own data is central. Genuine inclusion means not only relinquishing seat at the table for HIC actors but inviting LMIC scholars to occupy leadership roles, decision-making positions, and influential journals.
3) Epistemic reformation and pluralism
A decolonized approach promotes multiple ways of knowing—moving beyond Western biomedical paradigms to embrace Indigenous knowledge and alternative epistemologies. This involves creating space for diverse ontologies, reforming curricula, and challenging universalist claims about “the” best way to understand health.
4) Education reform
Curricula must confront colonial legacies, improve access for LMIC scholars, and include critical theory on colonialism’s impacts. Remote learning and global south-led programs can broaden participation and diversify expertise in global health.
5) Inclusivity, solidarity, and allyship
Decolonization is a collective project. Allies from the global north should cede influence, honor LMIC leadership, and cultivate sustainable partnerships grounded in equity, mutual respect, and shared goals for social justice.
PART III: Who is contributing to these discussions?
Scholars note a surge in decolonizing global health literature after 2020, with strong links to the COVID-19 era and the George Floyd/BLM movements. The discourse has been criticized for underrepresenting LMIC voices; calls to empower global south scholars, authors, and institutions are recurrent. Geographically, first-author leadership remains concentrated in the global north, with LMIC authors comprising a smaller share of leadership despite the movement’s aims. This points to both progress and ongoing gaps in representation that must be addressed to realize true decolonization.
Conclusion: A roadmap for equitable global health
Decolonizing global health is an ongoing, multi-faceted project. It requires audacious changes to funding, governance, knowledge production, and education, along with a commitment to inclusivity and allyship. By centering LMIC leadership, embracing epistemic pluralism, and reforming educational and research practices, the global health community can move toward a more just and effective system that prioritizes health equity over prestige.
