Self-Determination in Global Health Practices – Voices from the Global South

Despite the commendable progress made in addressing global health challenges and threats such as child mortality, HIV/AIDS, and Tuberculosis, many global health organizations still exhibit a Global North supremacy attitude, evidenced by their choice of leaders and executors of global health initiatives in low- and middle-income countries (LMICs). While efforts by the Global North to support global health practice in LMICs have led to economic development and advancement in locally led research, current global health practices tend to focus solely on intervention outcomes, often neglecting important systemic factors such as intellectual property ownership, sustainability, diversification of leadership roles, and national capacity development. This has resulted in the implementation of practices and systems informed by high-income countries (HICs) to the detriment of knowledge systems in LMICs, as they are deprived of the opportunity to generate local solutions for local problems. From their unique position as international global health fellows located in different African countries and receiving graduate education from a HIC institution, the authors of this viewpoint article assess how HIC institutions can better support LMICs. The authors propose several strategies for achieving equitable global health practices; 1) allocating funding to improve academic and research infrastructures in LMICs; 2) encouraging effective partnerships and collaborations with Global South scientists who have lived experiences in LMICs; 3) reviewing the trade-related aspects of intellectual property Rights (TRIPS) agreement; and 4) achieving equity in global health funding and education resources.

尽管在应对儿童死亡率、艾滋病毒/艾滋病和结核病等全球健康挑战和威胁方面取得了值得称赞的进展，但许多全球卫生组织仍然表现出全球北方至上的态度，这从它们在中低收入国家（LMICs）选择全球卫生倡议的领导者和执行者就可以看出。虽然全球北方支持中低收入国家全球卫生实践的努力促进了当地的经济发展以及本土主导研究的进步，但当前的全球卫生实践往往只关注干预结果，常常忽视知识产权归属、可持续性、领导角色多元化和国家能力发展等重要的系统性因素。这导致了高收入国家（HICs）所主导的实践和体系得以实施，而损害了中低收入国家的知识体系，因为它们被剥夺了为本地问题制定本地解决方案的机会。作为身处不同非洲国家并在一个高收入国家机构接受研究生教育的国际全球卫生研究员，本文观点文章的作者评估了高收入国家机构如何能够更好地支持中低收入国家。作者提出了实现公平的全球卫生实践的若干策略：1）拨款改善中低收入国家的学术和研究基础设施；2）鼓励与有在中低收入国家生活经历的全球南方科学家建立有效的伙伴关系和合作；3）审查《与贸易有关的知识产权协定》（TRIPS）；4）实现全球卫生资金和教育资源的公平分配。