The field of global health is undergoing a transformation, with calls for decolonization becoming increasingly prominent. A recent study published in PLOS Global Public Health by Daniel Krugman from Brown University and Alice Bayingana from the University of Sydney sheds light on the need for institutions in the Global North to practice “ruinous solidarity” in order to truly decolonize global health.
Despite the progress being made in decolonizing global health, institutions from the Global North continue to wield significant power and influence in the field. This is largely due to the “soft money” structure that dominates global health institutions, where funding is dependent on winning grants from donors. This financial dominance further reinforces the ideological power held by Northern institutions in the global health arena.
Krugman and Bayingana’s study focused on a major school of public health in the United States, conducting interviews with 30 faculty members to better understand the ideological and financial structures at play. While most participants expressed support for shifting power to institutions based in the Global South, they also revealed contradictory feelings about how this shift would impact funding for global health programs and research.
The researchers found that the “soft money” systems prevalent in universities, where researchers rely on grants to fund their salaries and research projects, contribute to the perpetuation of the current power dynamics. Faculty members described the constant pressure to secure grants as a distraction from their goal of making a meaningful impact in partner countries and highlighted the negative effects of funding uncertainties on long-term projects.
Despite recognizing the need to shift funding directly to institutions in the Global South, many faculty members expressed anxiety about the potential repercussions on their own livelihoods. Krugman and Bayingana argue that for real transformation to occur in the global health field, Northern researchers and institutions must be willing to accept the possibility of losing significant resources. This concept of “ruinous solidarity” is crucial for dismantling the existing power structures and creating a more equitable global health landscape.
The study underscores the importance of addressing the material systems that perpetuate inequity in global health research, not just symbolic power dynamics. Without meaningful action from elite Northern global health actors to advocate for a restructuring of financial systems, power dynamics will continue to reproduce through the dominance of Northern-grant winning institutions.
In conclusion, the study by Krugman and Bayingana highlights the urgent need for a fundamental shift in the way global health research is funded and conducted. By embracing the concept of “ruinous solidarity” and challenging the status quo, Northern institutions can pave the way for a more equitable and impactful global health landscape.
For more information, the study titled “Soft money, hard power: Mapping the material contingencies of change in global health academic structures” can be accessed in PLOS Global Public Health.
