Decolonising Global Health: What Does It Mean For Asia?

Summary

The panel discussion centered on the theme of what decolonizing global health means for Asia. Organized by SingHealth Duke-NUS Global Health Institute and featuring esteemed panelists from various Asian institutions, the webinar explored the complexities of the 'decolonizing global health' term. The session emphasized collaborative action among Asian institutions to redefine global health education and research, challenging Western hegemony, and incorporating Asian contexts and histories. The panelists shared personal insights and called for structural changes, such as creating inclusive partnerships and re-envisioning leadership roles to address power imbalances in global health initiatives. The event culminated with a call to action for participants to reflect and act on these issues in their capacities.

Highlights

• Panelists called for collaborative actions to decolonize global health in Asia. 🌐
• The discussion emphasized the need for structural changes in global health education and research. 🏛️
• Panelists shared personal journeys and perspectives on how to achieve equity in global health. 🚀
• There was a focus on the importance of Asian leadership and representation in global health. 🌟
• The event closed with a challenge for participants to take action towards decolonizing global health. 💪

Key Takeaways

• Decolonizing global health involves addressing power asymmetries and racial biases inherent in global health initiatives. 🌍
• Asian institutions should take a collaborative approach to reshape global health education, emphasizing local contexts. 🎓
• Redefining research agendas to include voices from the Global South is crucial for fair representation. 🗣️
• Fostering partnerships in global health should prioritize equity and mutual respect. 🤝
• Role models from Asia need to be highlighted to inspire future leaders in global health. 👩‍⚕️

Overview

In an engaging panel organized by SingHealth Duke-NUS Global Health Institute, experts converged to discuss the urgent need to decolonize global health in an Asian context. The session was an eye-opener, emphasizing the deconstruction of western-centric dominance in global health practices. With panelists hailing from esteemed institutions like Mahidol University, Aga Khan University, and others, the discussion delved into the nuances of what decolonizing global health means for Asia. The dialogue highlighted that Asia must not just follow but also lead and innovate in creating an equitable global health landscape.

Throughout the discourse, significant emphasis was placed on adapting global health education curricula to incorporate local Asian histories and traditions. Panelists underscored the importance of developing research agendas that are inclusive and representative of Asian contexts. By redefining educational approaches and emphasizing the importance of local knowledge, the panelists believe that Asia can contribute to and reshape the global health narrative substantially.

Concluding the event, the panelists issued a rallying cry for action, urging participants to take proactive steps toward decolonizing global health. Reflective practices were encouraged, asking professionals to challenge themselves and step out of comfort zones. It was made clear that achieving decolonization in global health is a collaborative effort demanding participation from all sectors, ensuring that future global health policies are inclusive and equitable.

Chapters

• 00:00 - 01:00: Introduction and Welcome The chapter "Introduction and Welcome" serves as the opening of a discussion event focused on the theme of 'decolonizing global health' with a particular emphasis on its implications for Asia. It begins by noting the current time and date in Singapore, establishing the context and setting. The speaker extends greetings to all participants, including panelists, audience members, and organizers, expressing gratitude for their presence. Despite some panelists not being in full health, their participation is appreciated, and there is a hopeful tone that their ailments are temporary. The introduction sets a positive and inclusive tone for the upcoming discussion.
• 01:00 - 37:00: Opening Remarks by Panelists The chapter features opening remarks by panelists at a webinar co-organized by the Singh Health Duke and US Global Health Institute in Singapore, along with five other institutions. Amina Mahmoud, the Deputy Director of the institute, extends a welcome on behalf of these collaborators. The co-organizers include the Planetary and Global Health Program of St Luke's Medical Center College of Medicine in the Philippines, the James P. Grant School of Public Health at Brock University in Bangladesh, and the Li Ka Shing Faculty of Medicine at the University of Hong Kong.
• 37:00 - 57:00: Panel Discussion on Decolonizing Global Health The chapter titled 'Panel Discussion on Decolonizing Global Health' focuses on a webinar organized by the Institute for Global Health and Development at Aarahan University in Pakistan and the ASEAN Institute for Health Development at Mahidol University in Thailand. The discussion features five esteemed panelists representing these institutions. The primary aim is to grow the presence of global health institutions across Asia and the global stage. This webinar marks one of the first collaborative initiatives between these organizations.
• 57:00 - 95:00: Audience Q&A and Final Thoughts The chapter titled 'Audience Q&A and Final Thoughts' begins with an emphasis on continued collaborations and concrete examples of initiatives discussed during the session. The speaker expresses a desire to extend conversations about these topics with other institutions in the region. The focus then shifts to the main topic of the day, which is decolonizing global health. This is described as a complex and multifaceted issue that has generated global discussions and literature. However, the chapter aims to narrow the focus and address how this subject relates to specific contexts or regions.

Decolonising Global Health: What Does It Mean For Asia? Transcription

• 00:00 - 00:30 get started because my watch says it's 2 p.m in singapore on monday 24th january 2022. uh hello and welcome to everyone our panelists our audience our organizers great to have you all here with us to in this discussion on decolonizing global health what does it mean for asia i do hope you're all well and safe i know some of our panelists are not 100 and i thank you especially for being with us today but um hopefully you know it's a passing thing um i'd like to welcome everyone on
• 00:30 - 01:00 behalf of the singh health duke and us global health institute here in singapore i'm amina mahmoud deputy director of the institute and i also extend this welcome on behalf of our collaborators who also co-organizers of this webinar and these are the five other institutions the planetary and global health program of st luke's medical center college of medicine in the philippines the james p grant school of public health at brock university in bangladesh the leak and xing faculty of medicine at the university of hong kong
• 01:00 - 01:30 the institute for global health and development at aarahan university in pakistan and the asean institute for health development at mahidol university in thailand and these institutions are represented by our five esteem panelists today as a group we've been talking about this uh topic for a while and we really want to talk about how to grow uh the presence of global health institutions across asia and even the global stage this webinar is one of our first joint initiatives and i look forward to our
• 01:30 - 02:00 continued collaborations as well as some concrete uh examples of initiatives and i also look forward to extending these conversations with many other institutions in the region so turning to the topic of today we are here to kind of unpack this very complex and multifaceted topic of decolonizing global health i'm sure a lot of you have been reading discussions and papers around this topic and their global you know conversations but today we'll try to focus the conversation on how this is particularly
• 02:00 - 02:30 relevant to and kind of plays out in asia i'd like to first set the stage by citing some statistics and these come from the global health 50 50 report which came out in 2020 it was aptly kind of called power privilege and priorities so this report notes that 85 percent of global organizations who are active in health and health policy are headquartered in europe and north america it also cites that 80 percent of global health leaders are nationals of high-income countries and 92 percent
• 02:30 - 03:00 obtain their degrees in high-income countries so kind of the question in front of us today is what role can asia play in changing some of these statistics and maybe this can be at the individual level at the institutional level at national regional global levels we hope to offer some insights during this webinar and kind of just have a conversation around this in terms of the structure of the webinar i will introduce each of our five panelists as i ask them to give short opening remarks which are really centered around what this term
• 03:00 - 03:30 decolonizing global health means for them and their institution we follow their remarks by a panel discussion where we kind of further probe into key topics like how does one restructure education curriculum and institutions to be more reflective of realities on the ground how do we enable research to incorporate local voices and be contextually relevant or maybe even how to redress political constraints that impinge on health structures and outcomes so once we've kind of talked amongst
• 03:30 - 04:00 ourselves we'll then turn turn to questions and answers from the audience some of you have already sent in some questions and answers and we'll certainly try to address those but we also welcome other questions to be posted in the question and answer box and you also have the option of voting on those that you really like so that's kind of how we're going to set it up so i think i'll just jump into and thank you again for the audience uh panelists to be with us and i'll jump into introducing our first panelist and that is dr renzo guinto he is the
• 04:00 - 04:30 associate professor of the practice of global public health and the inaugural director of the planetary and global health program of the saint luke's medical center college of medicine in the philippines he is concurrently also the chief planetary health scientist and that might be a new term and co-founder of the newly established sunway center for planetary health in kuala lumpur in malaysia he's a member of the national panel of technical experts of climate change commission of the philippines and a convener of planetary health
• 04:30 - 05:00 philippines a community of filipino planetary health advocates scholars and practitioners he is an obama foundation asia pacific leader and aspen institute new voices fellow he's a member of several international groups and has served as a consultant for various organizations including the world health organization the world bank he sits on many editorial boards of prestigious journals and then renzo obtained his doctor of public health from harvard university and the doctor of medicine from the university of the philippines in manila
• 05:00 - 05:30 in 2020 he was included by tatler magazine in its gen t list of 400 leaders of tomorrow who are shaping asia's future so we're delighted to have him with us today and renzo over to you wow thank you very much amina for that very generous introduction but more importantly i feel very thrilled even if i'm still recovering from kovid to be part of this important conversation you know and you mentioned amina that uh you know we've been seeing in social media
• 05:30 - 06:00 and in journal articles a lot of a lot has already been said about decolonizing global health but maybe one important question that we should be uh asking and i guess this first webinar will try to answer that is what do asians think about decolonizing global health and what we can do to help decolonize global health this is this is not a new conversation we've been having this for several years several years now but undoubtedly the kovid 19 but pandemic
• 06:00 - 06:30 somehow you know gave it a a boost you know we're talking about booster so you know kovite 19 boosted or gave a boost to this conversation around decolonizing global health i actually started to engage with this discourse um in 2018 you know it just started with a tweet i saw some exchanges about it and that's the first time i used the hashtag they called the nice global help and since then i've been um you know caught in
• 06:30 - 07:00 this exciting and also difficult uh terrain of global health scholars and practitioners asking very difficult questions about the future of our field and our sector but um and and of course you know over the past year or two we've seen a lot of as mentioned papers but also activities and events you know actually a lot of these decolonizing global health conferences started in institutions based in the global north particularly north america and europe
• 07:00 - 07:30 and then last year we've also seen a big conference of colleagues in africa and in 2022 this is actually the first event i think as far as i'm aware of uh of asians talking about this subject and i hope that this will not be the last so of course you know uh the colonization the coloniality uh the colonial the colonized people might be wondering what does it really mean right this term and if you look at the literature there are many ways it has
• 07:30 - 08:00 been defined or interpreted some will describe it as you know challenging western superiority and hegemony or a reversal of colonial legacies and even a return to indigenous practices and belief systems some describe the colonization as this recognition that there are you know pluralistic knowledge systems it's not just the knowledge system that we learn
• 08:00 - 08:30 for example in schools and it's important that we discuss this as leaders of educational institutions in asia our is our education you know the one that we are teaching in a region still very western and how we can decolonize it um and you mentioned amina a while ago that the colonization or the colonizing you know happens at the institutional level but also it happens at a personal level and you know i see my journey as a young emerging global health and
• 08:30 - 09:00 planetary health scholar and practitioner to be an act of the colonization in in some way you know i finished uh in the united states uh in 2019 and right away immediately i decided to come back and be part of this journey in southeast asia in particular uh as we speak uh i was privileged to be part of establishing two global health planetary health research centers one in the philippines and one in malaysia so moving forward you know what are the
• 09:00 - 09:30 key challenges and and questions and issues that that we need to uh you know confront and and consider you know education certainly will need to be re-examined and i guess that's why we are all uh bringing together uh educational leaders you know from asia of course the practice of global health as well we know that um there are still a lot of uh you know asymmetrical relationships in global health research in global health implementation projects
• 09:30 - 10:00 but i think it's also very important to acknowledge that asia is a very different place you know unlike for example the continent of africa asia is not very much reliant uh on uh global health aid for instance uh except perhaps for india and you know other neighboring countries but many countries in asia are also you know rising stars you know they're now funding global health research you know they're now using the global health
• 10:00 - 10:30 diplomatic tools to influence global health policy and so i think i'll stop there i'm pretty sure there's so much to discuss but i think we need to decolonize at the individual level at the level of our institutions and perhaps as a region as well thank you thanks lorenzo you bring up many points which we will be getting into later so certainly i won't you know go into them now but the one thing i really appreciate is you're bringing the strongly personal element to your even opening remarks and that's also
• 10:30 - 11:00 something i would like us to discuss further but i'll now turn to our next panelist who is dr sabina rashid she's the dean and professor at the brock school of public health um she's a medical anthropologist by training she has over 25 years of work experience in bangladesh her areas of research and teaching interests and experience are ethnographic and qualitative research with a focus on urban populations adolescents and marginalized groups she's particularly interested in examining the impact of structural inequalities and and inequities and
• 11:00 - 11:30 intersectional factors that affect the ability of these populations to realize their health and rights she founded the center of excellence for gender sexual and reproductive health and rights and co-founded the center for urban equity and health in 2013. both of which focus on research capacity building with the focus on influencing program designs and policies in the country very practical programs sabine has also been integral in the founding growth of the international master of public health program at the school so
• 11:30 - 12:00 with that sabina thank you amina and it's a pleasure to be here i think these conversations and the webinar is timely it's never too late to raise some fundamental issues and in the backdrop of covet 19 some of these discussions for me at least are greatly magnified now we just wrapped up an international conference on covet 19 and responses public health responses bringing in speakers from 18 countries
• 12:00 - 12:30 and it made me reflect again because this is an ongoing journey at least for me to go on renzo's comments on personal but professionally what does it mean globally so renzo talked about the national and the regional i want to kind of move from the top to the bottom and go back to amina your comments around power privilege and i would add equity because really what are the drivers a lot of this it's sort of the spaces where power and
• 12:30 - 13:00 resources are concentrated it's about privilege that we have assumptions around privilege by class by race by geographies by location but an additional value and recognition of where you're located where your position that gives you greater voice and i think we need to really remember that because often we become differential or socialized to accept assumptions of knowledge secondly i think when we're going to go into the conversation later on is how do we re-envision or continue
• 13:00 - 13:30 strategies to reshape and rethink our own organizations schools institutions national region but also global because it's all interconnected one does not operate without the other one does not influence without the other and we are all part of this larger ecosystem i mean just to quote mother carpal i mean bola and even onu kumar they keep talking about how do we move forward to shifting actively to becoming i mean these are very very
• 13:30 - 14:00 strong terms but i think they're needed and people are speaking about it to a space which is anti-super mist anti-oppressionist and anti-racist and i would even add anti-elitists because even our approaches tend to be from an elitist perspective whether you do curricula or research secondly i want to throw some key key drivers is how do we place value on knowledge so what kind of knowledge is valued it's been unidirectional whether we want to admit it or not how do we make it
• 14:00 - 14:30 bi-directional secondly how do we move away from labels the local the global which means there's geogra geographic geo geographic geographic spaces that are considered knowledgeable and there's geographic spaces that need capacity and there's an absence of knowledge which means in the covert times if you look at vietnam or cyrilli senegal that performed so well in tackling covet was sort of silenced or there was like
• 14:30 - 15:00 little in the media news about learning from them so we adopt approaches we assume certain kinds of geographic locations are our knowledge base and we value that second my final point is we'll get into this later is funding and resources which are very much influenced whether it's philanthropist whether it's even national kind of knowledge what are our goal standards that we are socialized and immediately accept without questioning or even if we do question
• 15:00 - 15:30 the structural or the systemic barriers make it difficult does that mean nothing can be done of course we're doing a lot at the school but i'll come to that later in the next round of questions finally i do think webinars like this but also our continued work in our various spaces and fields as we are on boards and different memberships but also in our own teaching is how do we pay attention to new voices and priorities that are not always counted but are counter narratives to
• 15:30 - 16:00 the accepted discourses that are out there on curriculum and research because that means we have a responsibility but even at whatever we define as global national local in this field from different disciplines allows that space for diversity and inclusion of what we consider knowledge so finally we need to really unpack valuing valuing of curriculum valuing of research what are gold standards
• 16:00 - 16:30 and really look at uh the different space that we have when we address this thank you very much thanks thanks for those remarks abina and again as you pointed out we will be getting into some of these topics for me the strong message that you know came out you know going beyond whether it's education research was really this issue of rethinking you know everything maybe we have to just uh i was gonna you know the word paradigm shift was going on my head but i think it's even more than that i think it's a full revolution we need we need
• 16:30 - 17:00 revolution we thinking to be able to really move beyond it others will be stuck in the same cycles but leaving that for our further discussion i'll now turn to our next panelist who is dr vivian lin she's the executive associate dean and professor of public health practice at the leak and shing faculty of medicine university of hong kong she has more than 40 years of experience in public health with a variety of leading roles in policy and program development health services planning research and teaching and senior administration in complex
• 17:00 - 17:30 organizations in previous roles vivian was chair of public health from 2000 to 2013 at la trobe university in melbourne before working with who as director of health systems in the western pacific regional office for from 2013 to 2018. there she led in on achieving global priorities of universal health coverage and sustainable development goals and other cross-cutting priority issues she continues to be involved with who is
• 17:30 - 18:00 a member of the technical advisory group on universal health coverage in the western pacific region as well as supporting several global projects including urban governance for health and well-being she is the author of several leading textbooks and has served on multiple editorial boards for leading journals including his health policy editor for social science and medicine and she is presently involved in two landsat commissions on gender and global health and on korea 19. so vivian thank you over to you thank you so much amina and it's a great
• 18:00 - 18:30 pleasure to be part of this conversation and i think it would be the start of a conversation really across the region in in many ways now um worked at the who i'm ever mindful of the privileging of knowledge and voices from the global north it comes in subtle ways it's like when you hit people with unconscious bias
• 18:30 - 19:00 you know it when you see it but for me the decolonizing conversation i'm not interested in replacing with different colors even though that does seem to be part of it because i think as with everything else we need to understand structure we need to understand agency and we need to understand context
• 19:00 - 19:30 and so when we think about institutional change these are the elements that we need to focus on now perhaps just to drill down on a couple comments that have been flagged by the others when we look at our global health institutions they are path dependent because they reflect this complex history the institutions that we know today reflect a particular world order that
• 19:30 - 20:00 emerged after the second world war the knowledge base for so much of global health reflects that dominant anglo-american research funding and publication channels the workforce is also educated in anglo-american institutions as well as of other colonial powers and significantly the financing of these institutions reflects the wealth that have been
• 20:00 - 20:30 created from the period of 19th century imperialism as this present-day global capitalism so i think we need to understand these structural factors as we think about change rather than just say move over let me take charge because the institutions reinforce practices but i think we also need to be reflective about the motivation for people who do global health and
• 20:30 - 21:00 people who are part of the decolonizing conversation and this is complex and i think we all need to be reflective how much of it is geopolitics how much of this ideology about modernization however old-fashioned that might be how much of it is about this elusive notion of democracy however it is uh translated in different countries how much of individual leaders come from
• 21:00 - 21:30 a sense of the white man's burden or they've got the final solution in terms of one side's all that can fix the world's problems or whether they're the white knight coming on the horseback um or move over it's my time so i think these are really complex individual factors that are often at play but when i think about asia i also think that there are some very distinctive things about asia the pre-colonial
• 21:30 - 22:00 social and economic institutions were strong as largely commercial societies very pluralist in terms of religion and philosophy the post-colonial health systems while we see a dominance of western medicine we do have embedded traditional cultural beliefs and practices that are part of it and strong um
• 22:00 - 22:30 so and at present day when we think about the institutions asians are at the margins i would say for a whole range of reasons one of which is linguistic diversity another maybe a more inward focus on nation building and national identity and countries in asia are not big donors nor are they the retreating global powers so i think these shape asia in many
• 22:30 - 23:00 different ways so i think when we talk about decolonizing what are we really talking about is it to turn away from worshiping the us in the uk is it to understand our own history and culture our own practices better to really appreciate our own health and social innovations is it to strengthen our regional institutions for shared learning and comparative analysis i leave those questions and i say what
• 23:00 - 23:30 is our vision of global health with an asian twist and i hope that we can have conversations around that thank you thanks for those remarks vivian i love it you go straight for the jugular you know let's talk about the structural underpinning let's talk about history let's talk about politics so i look forward to getting into those details uh but certainly let's not leave any stone unturned and look inwards as well
• 23:30 - 24:00 as outwards so with that i'll introduce our next panelist who is dr zainab samad she's the professor and chair of the department of medicine at the aggakhan university she also serves as director of the citric health data science center and the associate faculty of the institute of global health and development at arakhan university she graduated from aahan university's medical college in the year 2000 and subsequently completed a residency in internal medicine and fellowship in cardiology both at duke
• 24:00 - 24:30 university medical center in the u.s she served on their faculty for many years her clinical and research efforts are focused on understanding the epidemiology and outcomes of heart disease her mentorship and educational efforts have been recognized with international awards and she serves on several editorial boards of prestigious journals she coaches the agar khan university pakistan initiative think tag for non-communicable diseases an important part of her professional vision is to improve cardiovascular health in pakistan through gender inclusive capacity building efforts that
• 24:30 - 25:00 fully leverage available data resources and global connections over to you zenna thank you very much and i i'd say vivian is a hard act to follow there um but you know you asked us is first of all it's so awesome to be actually be on the same forum with all of you um and you asked us each panelist to kind of think about this term deconstructing you know decolonization and what it means to the institutions that we work at
• 25:00 - 25:30 so i think you know for us to deconstruct decolonization it's probably first important unpack what global health is in the present day you know global health has evolved as a discipline in a scope and practice no longer tropical medicine practiced by institutions in high income countries that are former colonizer is no longer understanding of problems or disease that might pose a threat to a high income country through stakeholders operating in low-income countries you know the world has largely improved in its condition over the last few hundred
• 25:30 - 26:00 years there's less conflict conflict is improvement in health indices and economic indicators and the world is more connected um and is residents more affair of each other's problems science has evolved with the clear shift to global um highlighting the need for diversity and research subjects you know i serve as the uh the director of the citric health data science center and our ability to contribute to that data conversation is a reflection of that
• 26:00 - 26:30 science wants more diverse research investigators and inclusion of diverse discovery and implementation narratives that's the shift that we're seeing and that that that is being where we're being surrounded by at this point so we've all come to realize that indeed many of the present day challenges such as kobe 19 and climate change are shared and required shared solutions there's just no way getting out of it it's just one one earth that we're all on um the impact of these challenges on human health and well-being
• 26:30 - 27:00 are unequal though and across the world driven mainly by power and resource asymmetries in our previous uh speakers have touched on this it's so fundamental to addressing these large challenges that fall very well in the remake of global health in this day and age is tackling these power asymmetries you know decolonizing global health is about addressing these power asymmetries and leveling the playing field across the whole process of the global health agenda from from you know it starts from
• 27:00 - 27:30 who sets the agenda for what is important what needs to be looked at who allocates the resources who implements who does the research who takes action when all is done and dusted who narrates the story who gets to tell that story and for whom who consumes the story who consumes the research and finally how are the learnings and discovery brought to benefit everyone on earth what does this mean to my institution you know look i am actually a graduate of the afghan university i
• 27:30 - 28:00 went to med school here went off to the us and then came back uh a similar story to renzo's um but i would say that the institution um in its practice is a global health institution it operates over three continents has six campuses and teaching sites and very much inherent to its mission is being responsive to the identified needs of the communities the regions it serves so understanding local needs and leading in addressing those local needs is very
• 28:00 - 28:30 much what it has been doing for the last several years of its existence another very important focus of the university is promoting access and equity by addressing the particular needs of the disadvantaged promoting welfare and advancement of women that's a very key articulated uh goal in its mission the institute of global health and development which i'm associated with with was established in 2019 and is a major initiative of the university to champion large-scale
• 28:30 - 29:00 interdisciplinary research and capitalize on all of the campuses and the faculty available to us it is focusing currently on climate change food security the linkages between agriculture human nutrition across the life course and then social and structural determinants of health including gender equality women empowerment education healthcare seeking behaviors all of these challenges that are very local but also very global in their importance and so
• 29:00 - 29:30 when i think about the fundamental nature of decolonizing global health or addressing power asymmetries and in inequities um and leading on those local problems i think it's almost mission aligned for us i think this conversation that we're having today as far as institutions uh across uh asia in terms of how heterogeneous they are and what they're addressing is really important um how can we network together better um
• 29:30 - 30:00 vivian pointed out that institutions have been mostly especially asian societies have been inward looking more towards nation building how can those learnings be cross-translated um we've had some uh economic miracles happen over the last 30 40 years right we've have some rising stars across asia um but the conversation has to really be centered and equity how can you how can you translate learning share learnings but also be very sensitive
• 30:00 - 30:30 this idea of decolonizing because we don't also don't want a new set of neo-colonizers renzo pointed out a very nice blog that i actually read last night if people have a chance they should go and check it out it's actually on the duke's website for resources on global decolonizing global health so so i you know i really i think um i'm glad that this conversation is happening it continues to continue to happen for us to make any dent in this space thank you
• 30:30 - 31:00 thanks then i'll be out so again you point out you know that whole range of conversations that need to take place um but what i really liked on in your remarks is that focus on let's bring this conversation to asia what can we and that's something i think we as a group have certainly you know started talking about what can we do together how can we you know promote these conversations and and you know about decolonizing global health but even going beyond that but really that will naturally you know feedback kind of have a feedback into
• 31:00 - 31:30 decolonizing is how can we now not be looking each one individually associated with a western or you know european uh north american or european uh institution but amongst ourselves what learnings can we have how can we network so really looking forward to not only this conversation today but like going forward our work together so with that i'll turn to our uh next speaker uh which is associate professor dr puti teja vadhana who he is a
• 31:30 - 32:00 diplomat with the thai board of family practice in the thai border preventive medicine public health track he serves as the director of the asean institute for health development at mahidol university and last year he was appointed as executive director asean university network for health promotion he is executive editor of the journal of public health and development and the honorary assistant editor of asia pacific journal of health management pudet has over 20 years experience in the fields of primary health care health management and health professional
• 32:00 - 32:30 education he's passionate about building his in is his institute to be a leading academic institute in the asean region in global health and health policy and the development in primary care sorry in global health and health policy and development in primary care recently his institute has become the secretariat for the mahidol university global health which aims to achieve health equity at national regional and global levels he works closely with the national and international partners such as ministry of public health ilo and educational institutions in asia so put
• 32:30 - 33:00 it over to you thank you emina it is very privileged for me to join this initiative webinar and good afternoon all panelists and participants to answer the question that emina said for us about what we mean by decorating global health
• 33:00 - 33:30 i think global health is becoming an increasingly political professional and academic field and global health problems as all of us know are getting more complex with rapid changes in the disease epidemiology and health determinants including the geopolitical competition of each country and as you can see from a space of being sabina or and cynam
• 33:30 - 34:00 that those problems for one country cannot alone solve those problems and we have connected problem between local and global and global health requires cooperation from all sectors at all levels in the global community to come together to solve global health problems and i agree and support all of us to join hand in hand together to make
• 34:00 - 34:30 our our voice become one so that otherwise will be stronger and for the colonization of global health i think it would require firstly the principle of health equity and we need to bring this principle to be implemented or apply in all missions for example training education opportunities research and resources
• 34:30 - 35:00 secondly i think we need to balance between localization regeneration and globalization or the terminology that we may know about pro qualization that we need to transfer of global health technology and knowledge to meet the solution to find the solution to meet the needs of local context and
• 35:00 - 35:30 in a in another way those in the local level also have some local wisdom that can spread to the world as dean sabina and sanap thought about the innovation from a country like vietnam or silicon for example last but not least i think for the decolonization of global health we need to clearly understand about key elements of localization
• 35:30 - 36:00 for example equitable partnerships it doesn't mean equal return but it should be focused on equity for example collaborative leadership capacity strengthening risk management effective financing and monitoring and evaluation and i think it will be important that we have to note that
• 36:00 - 36:30 each country needs maybe we need to put it at a second and we need to put the common need for global hill security as the first priority thank you very much and i think we can talk more during the next question thank you thank you for those remarks and yes i think that your emphasis on working together the importance of working together obviously in today's kobe age that's so obvious you know that we
• 36:30 - 37:00 really need to do that um but i also kind of appreciated your emphasis on local context so yes we need to work together but we also need to remain rooted in our own communities in our own context and see the value of you know how to bring that for forward so uh thank you all for your opening remarks and uh we already kind of talked a lot a lot of topics um but maybe in our panel discussion what i want to start with is at the highest level so you know we are all kind of coming from the public
• 37:00 - 37:30 health uh space but can we operate alone so really my question to you is can this agenda for decolonizing global health be separated from that broader political agenda that has to address political and economic structures and these are international regional local or certainly i would love it if anyone wants to address the issue of how do we work with our own local elites and power structures and how do you bring that element into that
• 37:30 - 38:00 international context of decolonizing so um i don't have any particular speaker who wants to be brave enough to start this conversation but if anyone wants to just jump in or raise your hand and start renzo is there okay let me start the ball rolling wow you know just listening to uh my colleagues you know our colleagues was was very uh you know inspiring and you know i also mentioned in our you know private chat it gave me a lot of goosebumps uh and i
• 38:00 - 38:30 think to answer your question amina uh well the quick answer is yes right we cannot be disconnected from you know the broader this discourse around achieving social justice addressing you know the political forces that shape our societies in fact you know a colleague of mine sent me a private message you know why are there no historians and political scientists in your panel and i said oh it's just the first webinar you know wait for it right we're just really
• 38:30 - 39:00 you know launching this conversation in asia and i think you know for example the remarks of vivian about the uniqueness of asia is is enough a reason for us to have these very difficult conversations so you know we need to really uh understand the decolonization of global health from a multi-lens perspective we cannot um be disconnected from the bigger discourses you know we for example you know if you look at the colonizing global health literature it's always uh and
• 39:00 - 39:30 when i refer to literature i'm referring to the more recent literature it's always connected to for example the you know issues around racism you know in in the united states structural racism you know with what happened to you know george floyd etc but racism exists in asia we just don't talk about it right and and and so you know we need to start looking at some of these issues that happen in our own backyard uh and that
• 39:30 - 40:00 also requires you know cooperating and collaborating with our neighbors you know food it i really appreciate your call for greater collaboration and you know we tend to collaborate more with our western colleagues but not so much with our neighbors and so i'm really thrilled that we have this mini group and we hope to expand this uh by including more voices from asia i'll stop there for now great thanks does anyone else want to jump in yeah i was going to come in um thank you
• 40:00 - 40:30 always uh interesting um for me it's learning and listening and trying to understand some of this so um of course there are the structural factors that i alluded to everyone has alluded to and vivian laid out so so well for all of us to think about but i am also very very lucky i mean i the school of public health was founded by our late founder fasan abid who actually is one of the leaders along with mohammed eunice who got the nobel
• 40:30 - 41:00 prize for setting up innovations innovations in public health ors model micro credit model if you look at you know the uh are bringing down immunization our family planning success stories which have been featured in landscape for a long a long time ago around what made bangladesh different in south asia despite the challenges so i think it's sort of this this sort of intersecting factors but we're not paralyzed by inaction because of the intersecting factors because that may take a stronger longer journey so i'm
• 41:00 - 41:30 just going to quickly break it down so one is within the school the history of the school when it was established in 2004 was we've always had sort of this community-based experiential learning along with the theoretical understandings which meant a lot of immersion for our students in slums and urban rural areas and villages which means it flips the idea of what teaching and learning is about secondly in 2016 one of my sort of collaborating colleagues mikhail islam
• 41:30 - 42:00 brought in how do we indigenize the introduction to public health where we bring in as vivian referred to our local cultural history practices bodies of knowledge to understand the body and we introduce solutions thinking students spend time in the slum they come up with solutions talking to communities and programs then we also have professor malabika sharkar who you know amina is our associate dean my partner in crime as i call her who's been running an implementation science course which is very much about
• 42:00 - 42:30 learning and implementers bringing practitioners together with students to learn about real lived realities on the ground on service delivery so it can be done has been done in bangladesh since the seventies by abid and yunus the founder of brac but also eunice i'm not saying it's perfect but things can move forward if there's a commitment to a certain kind of philosophy what that does is you take practical steps and envision a curriculum
• 42:30 - 43:00 which also kind of is embedded in context which takes into community public health priorities of public health as we see it in our own country context which is relevant to share in terms of best practices to institutions all over the world because there are disproportionately affected latinos african-americans in many different countries migrants in singapore et cetera et cetera so there's a lot of knowledge and learning that we can do from each other if we recognize that knowledge is a multi-kind of directional
• 43:00 - 43:30 process finally i think one big learning is that we need to also expand this sort of the global public health space we work in which means being courageous and having strong leadership having integrity and sometimes it means being sidelined being cut out of conversations being dropped out of boards because you mention uncomfortable truths and that means how much are we at least i can speak for myself i can't speak for
• 43:30 - 44:00 others how much am i willing to be co-opted to be part of a network how much am i meant to speak out and vocalize uncomfortable truths that coexist with very very authentic good practices as we say and work that's going on so if that's why it's an ongoing process i know at the school we've turned away funders and partners that have systemic uneq unequalities in their structures of partnerships
• 44:00 - 44:30 whether it's assumed authorship is led by someone data's owned by another group so i think it's about you know strong kinds of leaderships from a dean or an associate dean or my colleagues i have very you know a lot two of my professors um our associate dean is an implementer who worked in practice for 30 years and then and then she's also a professor for many years another one is professor khalsa afsana and i'll stop now but who led the brac health program throughout the country and she's a professor as well so practice implementers academic thinking
• 44:30 - 45:00 comes together so you can kind of do step-by-step change and starting learning from mistakes starting again but continuing and having supports you have to work as a team it's not something i'm doing we're doing together but also the global level what do we say global regional we have certain responsibilities if we're in certain positions to voice certain aspects of what is doesn't sit right or comfortably with us
• 45:00 - 45:30 in these spaces and i think that's just one thing there's a lot of other things we know we can voice and write right out to write about these uh issues which many many uh academic scholars and practitioners are writing about thanks abhinav those are very powerful examples of the examples that you give from bangladesh you know not only brac but as you mentioned grameen are really something that yes uh worldwide i acknowledge but they need to multiply you know so we have these very powerful examples from bangladesh but i
• 45:30 - 46:00 think we need they need to be further acknowledged and they need to multiply and we need to like see how we can do that from all our institutions you know as we are situated in asia because certainly you know as you mentioned we can you know there are ways to do that um i don't know if anyone has a specific comment to say on this but we you could do that and also maybe bridge to the the focus you know sabine already brings it up but really what one of the topics i really wanted to focus is on education so how can we reimagine how can we
• 46:00 - 46:30 redesign our educational systems so that they exactly incorporate all these topics you know issues that we've talked about how can they be recognized internationally you know in a way that gives the same levels of prestige and acknowledgement for their students so what are the some of the practical things that maybe you've already done or you are thinking of doing or maybe you've wanted to do but have faced constraints in doing
• 46:30 - 47:00 so did anyone want to think about their own institutions or maybe institutions you know about that have taken this challenge on i add a quick point given we're waiting for this i'll keep it short i think one of the challenges renzo was talking is about the personal it's a personal journey it's also critical reflection where we need to take off some of the veils because we're so embedded in systems socialized to
• 47:00 - 47:30 particularly think in particular ways to unlearn some of that recognize and appreciate some of our own local success and bodies of knowledge along with the challenges and some of the constraints are also resistance from uh maybe other actors or stakeholders but even within a university or other universities like during uh covert 19 we set up a public health platform to reach out to other universities and trying to explain why it is so important particularly in the
• 47:30 - 48:00 covet pandemic to look at our research look at curricula in different ways which is practice oriented which actually can meet some of the gaps actually train capable competent competent leaders i mean we have students globally because it's from all over the world from many you know different contexts basically from lmic countries all over the world but i think it's important to recognize it's sort of this messy space we inhabit and it's to keep taking the steps forward and and and
• 48:00 - 48:30 ensuring that you know curriculum does change content does reflect that i mean uh gaffard many deans and others and including ourselves on the ground in bangladesh are you know we're constantly reflective about how do we improve on the curricula and it is it is it's tough and it takes time but it should be done and can be done that's that's what i was going to say yeah thank you i see your hand up thank you i mean actually the hand was up for the last question but i think i can try and weave in the the next
• 48:30 - 49:00 question you put up to us uh you know i was um reflecting on what you asked about how um this the how health is really completely interconnected with um politics with um economies i think generally we work as silos health professionals separately politicians separately the economics separately but they're so interconnected boils down to the common man and that that common man's everyday life
• 49:00 - 49:30 um and i think um and and you would have traditionally thought these people won't come together we we talk about intersectoral multi-sectoral commissions platforms people come and talk and then there's no action but i'd say that you know one of the silver linings of kobe was that it showed it can actually happen you know the countries where um where the handling of this pandemic was done superbly and i would say i would put pakistan almost in that in
• 49:30 - 50:00 that league is where that uh coalescence happened where politicians scientists health professionals economists sat down and said how do we take care of this um they were agile they were fast um you know politicians forefront of messaging the economist understanding what this was gonna mean for the economy and for the common man rolling out the creating packages that was where they were gonna actually um uh
• 50:00 - 50:30 socially and fiscally protect the the the population uh and then uh really health professionals getting the complete backup from academic institutions from the government are rolling out the measures necessary to tackle the pandemic and so i think it's possible at the this is this this um this this is this is now been shown and so how do we continue to do that in our future conversations
• 50:30 - 51:00 something that curriculums can be designed around you creates case studies the the the work that sadina talked about that's a case study that needs to be shared this kind of the learnings we've had during this pandemic these are also case studies how do we share them and i think finally articulating you see right now people are thinking they're putting our editorials around this very specific topic of you know decolonizing global health what does it mean for asia what
• 51:00 - 51:30 does it mean for the rest of the world actually articulating all those thoughts in you know developing a curriculum sensitizing people to that issue i think that's that's where uh that that's that's the stage where we are right now um and and making sure that the conversation doesn't leave these other important components out of the picture whether it is social scientists politicians economists uh all health professionals and researchers so that's that's what i would say um to
• 51:30 - 52:00 that question thanks putit i see your hand up know yes thank you emilia i totally agree with um being sabina and what sign up just said in terms of decolonizing the curriculum and education at maiden university now we try to promote global health at the one of important track of our phd study and what we
• 52:00 - 52:30 discussed with our colleagues that we don't want we do not want to copy the text from western to be taught for our students but we think what we can make our curriculum attractive and interesting is we used there was interactive learning through action that we need to build up the case study for example like we are
• 52:30 - 53:00 forming one of the study unit called digital health we we do not want like you know our student or staff just read the book and teach students but we want something real in the system so our colleagues from the faculty of ict went to the local health services and invite doctors and nurses as well as public health officers who were in the local to come to do the research
• 53:00 - 53:30 with us to build up the uh visualization for digital health to inform the corporation of uh corporate vaccine vaccination for example and also we collaborate with music public health uh about another study unit on primary health for example and i think networking is really important to make this happen so that our student can learn from the real
• 53:30 - 54:00 practice and this can i think include competency of our students and yes we need them to meet the competency of the global health and also the local health issue that will impact to the global health thank you thank you putin thank you for this very practical kind of examples you've given so that's great to know and i think certainly as we continue our discussions
• 54:00 - 54:30 beyond this that student exchanges amongst our young universities at our institutions and you know others in asia also is something we really should focus on because again that's tends to be that you know from an asian university going back out to the western universities and that back and forth but i think the richness and this we are only six amongst a whole lot of other very strong institutions in asia you know so i think that strength needs to be really acknowledged and acted upon but vivian i saw your hand up
• 54:30 - 55:00 i want to uh in a sense compliment some what it's been saying i think this question about education is so important because education is how we socialize people the values the attitudes the practices that continue with people for life and certainly i think strengthening the the practice based education across the regions doing placements
• 55:00 - 55:30 um sharing you know lectures with each other are some very very practical ways forward but i also want to just raise this concern which i'm sure many of us on this this webinar experience which is that the global kind of imperatives that education institutions are often working under may actually go against some of the purposes i mean when you think about institutions
• 55:30 - 56:00 chasing global rankings when you think about the league tables you know when you think about education ministries wanting to support that the research funding agencies in asian countries taking the same kind of framework as those in the high income
• 56:00 - 56:30 countries journal impact factors citations all these kinds of standard metrics go against in fact what we are talking about so there is a challenge of how do we carve out something which can also stand up which is rigorous and which will reshape and i think in many of our educational institutions you know we go after the
• 56:30 - 57:00 accreditation by the american institutions so we fall into a certain kind of a curriculum structure now there may be nothing wrong with that curriculum structure in the broad but how do we think about the specific content of learning history our own histories learning much more about our own literature cultural perspectives and practices you know i'm reminded of a couple of
• 57:00 - 57:30 recent books wing soon's global medicine that looks at the development of indigenous models but also taking from western models in the way the chinese diasporic influences have actually been important in the development of institutions in the 20th century on both the mainland and taiwan um so these are the kind of histories we need to know much more about rather than
• 57:30 - 58:00 just learning about the greeks and the romans and you know their cow and all those people are important but they're not the only ones and similarly in terms of the research on innovation on the development of local solution and to have that integrated with you know practice so i think there's a lot that we need to be doing in the way that we shape our educational institutions big agenda thank you thanks vivian lorenzo i saw your hand up
• 58:00 - 58:30 and then maybe we'll go to a slightly different topic sure very quickly just to reinforce everything that has already been said one i think we need to re-examine the content of our global health public health education in our respective institutions and i came up just now with a 3v letter v alliteration maybe you can add more we need to re-examine the vision of global health that we're teaching our students right is it um a homogenous or a universalist uh
• 58:30 - 59:00 vision that is coming from one corner of the world that is not inclusive of other people's uh aspirations we need to examine the vocabulary of global health sabina was mentioning a while ago that global for always pertains to expertise and local uh has this connotation that it always requires capacity we need to change uh that language and narrative and also values and you know vivian was already mentioning about indigenous you know
• 59:00 - 59:30 knowledge systems etc you know is there a room for confusion and islamic and other asian traditions to contribute to the uh enrichment of the global health discourse i would love to see a global health book that has a chapter on global health ethics that acknowledges these asian philosophies and traditions number two on the how i think digital is giving us a window of opportunity you know to be able to bring students from different
• 59:30 - 60:00 parts of the world inside a single classroom or rather class zoom and i recall you know last early this early last year i actually co-organized a class with the university of global health equity in rwanda i noticed that uh professor agnes vinoguajo is in the audience and we brought rwandan students and filipina students to learn with each other and from each other about climate change and human health we should be doing more of that in the age of zoom and finally i think in terms of you know
• 60:00 - 60:30 another how is i think it's important that we role model role modeling you know and and to show to our asian students that they can make a difference you know i always tell my students in saint luke's you are world class you can contribute to the world while at the same time you can be also responsive to the needs of the country and they need to see more people who look like them as role models you know and you know i'm reminded in the united states they have this habit of writing biographies about
• 60:30 - 61:00 public health experts who are or white men who help the poor world right uh we need more faces uh from asia and voices from asia uh to be role models for our asian students so i like the examples that sabine just mentioned a while ago from bangladesh we should start a collection of asian global health leaders that will be emulated by our next generation of asian global health leaders i'll stop there
• 61:00 - 61:30 i can see then i want to say something yeah i just want to continue in the same vein at renzo and um uh maybe vivian earlier pointed out to here's the thing you see when you're creating curriculum there not only should be diversity of content but the curriculum creators need to be diverse as well right we constantly put uh we we we put this we put up the western institution to this all the time how diverse is your global health faculty but yes here we are sitting as global
• 61:30 - 62:00 health institutions we should also have a diverse faculty more asian voices reflected within the faculty whether it is through visiting faculty status or actual faculty so i think we we should be putting um the same ideas and principles that we put up uh uh for the colonizers we should be actually embracing them as well as institutions uh working towards more equitable global health practice absolutely and maybe i can use that kind
• 62:00 - 62:30 of mind frame to link to the other question that you know obviously some of the things people have said links to it but is the question of research you know so this often comes up what kind of research who sets the research agenda where's the funding for research coming who are the authors on research papers you know how does that all kind of set up because as academics that you know your research and your publications becomes like you know your whole uh career and your uh voice in the public space and you know things like that so how do we
• 62:30 - 63:00 link uh in a way from this educational conversation how do we change changing the curriculum but how do we also change what is valued in research and for me that's really thinking going back to our communities how do we make sure that their voices are part of it uh and not just uh kind of cherry-picked you know and and then kind of utilize for someone else's uh agenda so i don't know if anyone wants to kind of start this conversation
• 63:00 - 63:30 thank you very much i think there's been comments anyways earlier by the the experts on the panel but you know invariably this is this is something that as i again say it's sort of these parallel worlds we have to live in or live simultaneously which is one is usually when people in power represent uh only those with social dominance or resource dominance or a geographical dominance in terms of if we're going to pit north versus south with you know
• 63:30 - 64:00 there's there's a lot of uh blurring there as well but but really it's about dominance which means that research can inevitably overlook the the the needs and priorities of the most marginalized groups because even allocation of budgets or funding if you see the global politics of a budget allocation around health issues in the health sector is often defined in different ways which are not necessarily always relevant to the needs of priorities within a country
• 64:00 - 64:30 so that's one two i mean some have started writing about this and you'd already mentioned amina in your statistics is that why is authorship primarily led by many sitting in in in northern institutions when a lot of the evidence and data is coming from uh those countries that are not uh in the north so lmic or other countries and how does one go about changing this you know so there is that kind of bigger structural research issues and i think
• 64:30 - 65:00 it's about first of all challenge this whole system and i think vivian refer to this as the whole saviors and beneficiaries which we tend to suffer from in our siloed in our academic worlds but very much so in terms of north and the unidirectional kind of knowledge that is brought to us for us to learn right so i think there's a couple of things going on here which is how do we ensure a different form of of research because i feel also within public health there's a dominance of
• 65:00 - 65:30 predominance of a biomedical epi biostatistics approach which is critical which is important which is relevant but social sciences anthropology are as critical or important to understand the whys and how the pandemic unfolded to tailor and customize policies and programs why people still refuse to wear mars what kind of impacts has uh you know certain kinds of uh covet had or what kind of health services have been neglected and this is
• 65:30 - 66:00 where we need to also re-engage and reinforce certain kinds of disciplines right and work across sectors so research by nature has to be embedded in the contextual realities one two this has been said many times so it's not like i'm saying anything that's new or rocket science but it needs to be said over and over again at the school most of our our senior professors the senior management are very very clear about data ownership and data autonomy
• 66:00 - 66:30 we have a whole data management system and an irb process which means that there are systems in place so that colleagues cannot be exploited and become data collectors for others in the country but also other multi-country consortium research partnerships and i think that is sort of an uncomfortable pushing because it is uncomfortable in that space when you're the only one or there's two or three but when and i've also worked with many partners
• 66:30 - 67:00 who are want to meaningfully engage in equitable ways and are open to and push for data on ownership and autonomy and writing spaces for individuals that also means investing in our own capacity we also need to recognize we need to invest in these capacities and research because you can screen but if you don't back it up with investments and the ability to deliver which many are delivering then we're also kind of going around in circles right and i also want to say i think one thing
• 67:00 - 67:30 that should underline research tools conceptual frameworks and this has been alluded to referred to by everyone is the co-creation co-designing of even research what's important not just tools development which is a given but how do we have community-led data kind of uh gathering going on which is already taking place in our school by many many of our professors and teams but also there are certain principles that should outline research ethics and ethos
• 67:30 - 68:00 final point is what vivian also referred to and others is publications and research i'm a part of a srhm platform one of the conversations we had was we had many practitioners send in their writings but it's based on practice and implementation and doesn't follow the standard outline of an abstract and a methodology with how many you interviewed blah blah blah blah and we really had to sit and discuss this because many of us come from this part of the world and said this is
• 68:00 - 68:30 actually really relevant very important valuable knowledge so even journals have to create that space and we have to push editors in many parts of the world to create the space for subsidies for waivers it's so expensive to publish two and a half thousand dollars so automatically resources and systems and even funding is set up in a way that privileges certain voices and continues to reproduce inequality so i think it's very important to continue to engage
• 68:30 - 69:00 these conversations ask the richard hortons ask the aminbola who writes about this ask the you know all these editors who talk about privileged power and equity what are they doing in their own journals and systems to create those spaces thank you thanks uh excellent points that i love the last one is like let's hold people responsible also so we need to address the structural issues but it has to start with you know each one of us taking an individual position on it
• 69:00 - 69:30 but renzo i see your hand up yeah very quickly uh well maybe we need to find the asian richard hortons who will actually you know reform or even transform uh global health academic publishing uh very quick comments regarding method of research you know it's funny because i sit in one uh editorial board now and we actually got a question do you accept uh unconventional ways of presenting data rooted in indigenous knowledge systems and i think many well all journals in
• 69:30 - 70:00 the world are still unready for it you know just a quick story you know my doctoral dissertation is actually half written and half in film and that written version has you know until today has only been read by three people that's my doctoral committee but my film has been viewed by tens of thousands of people around the world and is making an impact in policy discussion so you know we need to start exploring new ways of presenting data information and findings
• 70:00 - 70:30 regarding finances sure we need to keep on pressing global health research funders to give more money and give them to low and middle income country based institutions and not to project proponents or principal investigators uh based in the global north but also i think especially in the emerging economies of asia we should be pushing our own governments to increase their funding their domestic funding for research you know it takes two to tango we you know we demand for money from
• 70:30 - 71:00 outside but we also have to make sure especially the ones that are capable of financing research to do the same and finally regarding journals you know i already mentioned about my you know interesting experiences being part of an editorial board you know what we're seeing now is that there's still very limited number of peer reviewers and members of editorial boards from low and middle income countries from the global south and journals tend to privilege you know the who's who of global nor of
• 71:00 - 71:30 global north and global health who tend to be from the west you know uh in terms of publishing and we are actually working hard to refashion you know uh journals and the academic publishing uh system because if we want more voices to be in the print version then we need to make sure the ones that are governing those platforms are also diverse and inclusive i'll stop there thanks then up i see your hand yeah i mean i was gonna say you know it
• 71:30 - 72:00 starts with um being sensitized to this issue you see um uh partners in low-income countries need to be able to negotiate right we all we all know it's always a negotiation like renzo pointed out takes two to tango if one partner is not there it's not gonna happen so it is a negotiation and you are actually at equal footing because it requires two places to do whatever project that needs to be done and so you know coming from this from like a woman's perspective that you know
• 72:00 - 72:30 women are known to be just bad negotiators that sensitivity happened first and then second understanding that happens uh and and that can uh that that could that is unconscious then reminding yourself uh putting in perhaps a checklist that this is a negotiation negotiate all these points authorship funding allocation of resources setting the agenda co-design like sabina pointed out co-create so these are all points that
• 72:30 - 73:00 need to be negotiated but i feel like the income partners need to be reminded sensitized first and then actually intentionally remind themselves to do that through almost a checklist approach thanks so that actually leads to a kind of side question i had is how does one ensure equity in partnerships when the resources might be very different so the resources might be coming from one side and the know-how and the
• 73:00 - 73:30 local knowledge is coming from the others but you know my question was how do we enjoy it but you've already kind of answered that to some extent but we can think about that also in terms of what are the leadership roles that our asian researchers and practitioners should consciously focus on to uh you know make sure that we're going along this agenda and i saw put its hand up first and then sabina thank you emina i would like to respond to your question about how to enable equity in partnerships
• 73:30 - 74:00 i think if we can clearly define the laws and responsibilities of the stakeholder and balancing between giving and taking i think this can make us work together well and effectively and i think we should understand and compensate for inequalities to enable our partners to fully participate and benefit from the
• 74:00 - 74:30 collaboration of partnerships and yes we need effective communication we need the co-decide or appropriate project and we need to estimate the share objective and mutual benefits we need to understand the similarities and differences of equality and equity that may be different and i think mutual understanding and respect for different
• 74:30 - 75:00 we may be different in culture different in norm including religious cultural and societal boundaries need to be clearly understand and the concept of fairness respect and honesty last but not least i think we should hold the concept of no one left behind and this view make us the equity in partnership thank you now i think it's also about
• 75:00 - 75:30 a willingness to take risks i do think that yes i'm going to sign up point and put its point which is also it's very very relevant but we have been placed in positions we've just said no because the way the partnership the approach the resources did not have any meaningful engagement at any point beat the research beat the resource allocation beat even the expectations but that also has taken time and it's a
• 75:30 - 76:00 risk because we're entirely self-financed all my colleagues at the school 296 of us raise our own funding we raise our own finances from grants and from teaching so i think somewhere sometimes you just have to say no i'm not going to be part of this and and and that is a scary uh space to be in but it's also quite liberating because sometimes it's not worth it because what you end up doing is just reproducing the same things now if it's
• 76:00 - 76:30 i'll and i'll be honest if it's a lot of funding you've been brought to the table i think some of it's what zainab was talking about it's about negotiating and navigating spaces by talking to each other we've been pretty lucky because most of our partners been working with us for a long time so they they understand brac they understand even the way we operate and there's a willingness to exchange and learn but in cases where there isn't we've actually managed to work together because partnerships also evolve as we learn right you create space you bought heads and then you fi and then you try and
• 76:30 - 77:00 understand in other spaces to be honest in a few times in my life and i've been 18 years of the school nine years as dean i've said no it's been a few times i've just had to say no our associate deans had to say no some of our professors it's rare but it does happen and you have to take that risk because otherwise where do you take that step forward right thank you absolutely um i'm aware of the time so uh we could keep kind of
• 77:00 - 77:30 on this topic but i do want to get to some of the questions uh that we have in the audience i don't think we can some of them are quite specific so i don't think we'd be able to get into those uh i did want to just briefly touch it i think this um touches on kind of not the exact question that the audience has given but the general frame of what do we do to ensure that you know and i think it also reflects to all of your personal journeys what do we do to ensure that leaders of public health from asia or
• 77:30 - 78:00 from other you know kind of um south uh countries who've been trained in the west who've had some kind of background and training how do we retain them how do we grow and how do we well retain the ones who've had it and how do we grow that pool to make sure that we then have that critical mass that we can achieve these things that we're talking about in research and education
• 78:00 - 78:30 sorry it's just that you know i remember when i uh you know as we have a senior management we have our associate dean professor malavika there's me and we talked about how do we create systems or incentives and i remember professor malabika and professor massoud drew up sort of a performance bonus a performance sorry e-t-o-r of how do we create incentives because the reality is people want to leave often because children opportunities there's a
• 78:30 - 79:00 brain train they're giving off offers after a couple of years of just doing really amazing work at the school how do we hang on to them and i think it's removing the hierarchies because even if we're in universities in bangladesh we tend to be hierarchical there's a sense of deference age mail etc etc and it's about creating systems and policies that say your mid-level colleagues uh you know assistant uh professors lecturers should have first authorship how do we
• 79:00 - 79:30 encourage that space how do we encourage spaces for for women you know we have a larger group of women in our school 60 or 70 percent our women 30 are men how do we create a space for women that are sort of uh you know child-friendly policies they come in later flexible hours they have children they have to take care of households how do we create a space where we are forced to nominate and build capacity by sending them to conferences and seminars and not hog the limelight as professors where there's a tendency it's me again and then it's me
• 79:30 - 80:00 again and then it's me again so how do we create those spaces and having a checklist of criteria where we create also for smaller grants asking some of our mid-level faculty or or researchers to be pis or co-pis in grants so i think there needs to be that set up for sustainability because at the end of the day one we don't know everything whether you're at the top or at the middle or at the bottom two what i can speak from the school i today
• 80:00 - 80:30 i'm a dean and the jsp grant school of public health has done well if i can modestly say that we've done well but it's because of the efforts of everybody at the school all the professors the mid-level the faculty and the researchers so if we don't create that space many people leave jobs not because of the money because they lose motivation they don't see a career path or they don't feel like they're being heard and i think i'm not saying we're perfect but i think it is important to reflect and
• 80:30 - 81:00 take stock recently uh you know there was again a reflection on how do we revise our tur for performance how do we recognize the changes within now what happened with covid and how do we kind of increase engagement and ownership so it's a continual process within an organization irrespective of the university because some where we're semi-autonomous and sometimes it's also saying to the university i'm sorry this is our system because we need to raise funds and this is what we need to motivate ourselves and our colleagues if that kind of helps
• 81:00 - 81:30 finally i just want to add because we're wrapping up i think for decolonizing global health i would argue that we only think about a socially just model in curriculum in research as we engage in conversations thank you very much thanks renzo i see your hand very quickly because i think because i'm the most junior in in our team um and and you know just finished my studies uh three years ago returned to the country to help you know strengthen the philippine and
• 81:30 - 82:00 southeast asian public health system um i can share some of the lessons that i've learned so far uh over the years i think one is really role modeling is very important it's just so thrilling to see you know people like you you are who are doing great things for your respective countries and societies and you feel the same way i want to be like them too secondly of course what sabine was also saying we need to make sure that there's an enabling environment for people to return to or or for them to stay in uh and that's not just financial
• 82:00 - 82:30 it's also our systems of rewards and incentives and promotion you know research money do they have access to them um etc and of course i think finally it's very important that you find your allies and your colleagues who are also on the same both and both and it becomes a shared journey of learning together you know that the colonizing global health movement kind of kind of exploded because of the digital generation of young scholars and
• 82:30 - 83:00 practitioners who have been become vocal about these issues on social media and so we now have a virtual community of young people emerging leaders who are facing the same challenges but are not daunted by these challenges we are really uh committed uh to succeed in quote unquote decolonizing uh global health so so yeah those are just some of my uh inputs thanks great thanks for that and actually i'll kind of
• 83:00 - 83:30 leverage what you just said and what sabina you were talking about to address one of very directly one of the questions uh from our audience where they you know you had earlier mentioned that sometimes when you take on certain stance you risk being sidelined or not heard so the audience is asking because i like the personal element of it they're saying do you have any recommendations of you know how to deal with that how you broach this topic in the workplace to you know either deal with big side light or make sure you're not sidelined you know so at a very personal level uh
• 83:30 - 84:00 do you have any words of advice uh i think what renzo referred to as creating allies both in your own institution or having allies helps even within global committees or research consortiums creating that space being strategic i think you need to be strategic and think through it doesn't mean calculating it means being smart about pushing through what should work that you think at a practical ethical level should be there and allies building kind of a good
• 84:00 - 84:30 argument of why this would actually benefit institutions or schools or boards or committees for me as i said i've been lucky uh with with with our associate dean professor malabica we're often on the same wavelength we always put the school first but when i'm talking about uncomfortable truths in other spaces uh you have to kind of find those spaces where you speak in a way that you can actually talk about how this brings about better
• 84:30 - 85:00 longer-term benefits and engagement and having this uh this sort of diverse approaches sometimes you're just a troublemaker or labeled as problematic you have to also be strong in your beliefs and not shy away from those conversations if it means that much to you then you need to be able to walk away yeah i think yeah you have to be brave um so i'm just saying we have only five minutes left so maybe i will just ask
• 85:00 - 85:30 each of you to give a one minute closing but maybe we can center it around a question that has come up that i think would you know depending on your answer could approach a lot of these things is how do we make these global health institutions accountable and you know even who are they accountable to so in your closing remarks if you can just you know think about that uh response also so let's go maybe in reverse order so put it do we want to start with you
• 85:30 - 86:00 thank you amita i think i would like to close with there was that i started joining hand-in-hand will be very important if we have the platform like this literally i think this will create the collaboration and finding like-minded people come together and i think we have the same goal it doesn't matter that we
• 86:00 - 86:30 may have different way but if we reach the similar goal i think how our work will be successful thank you very much great thanks uh then it was uh what was my audience vivian um look i think when we talk about global institutions we need to look at both the different types of institutions as well as the different
• 86:30 - 87:00 approaches to to accountability it's a very important question we have to recognize that we have a number of very large private philanthropies that pump more money into global health than in fact the public sector institutions and they're not accountable because they're private it comes out of you know and they do distort so i think that's one conversation that has to be had i think then we have the multilaterals
• 87:00 - 87:30 and the bilaterals now the bilaterals are really a creature of their own governments so there's questions about what processes you instigate in terms of the multilateral i think we do have had an evolving framework around civil society engagement research institution monitoring a lot of that can be strengthened much more although some of the member states fight against that because they ultimately wish to be in control
• 87:30 - 88:00 then there's an evolving conversation around the framework convention on global health now as a concept as opposed to some of perhaps the details that's been put out there maybe there's more conversation that needs to be had so a few things to go forward with thank you thank you stand up yeah thanks amina i think uh for accountability uh i believe there are at least three things one is articulating the issue like really clearly spelling
• 88:00 - 88:30 it out for everybody and you know the written word is very powerful so writing about it public conversations that's the public conversation whether it's twitter whether it's blogs whether it's you know editorials in the landsat or other journals that actually allow for global health spaces um shared global health spaces i must say the second is having forums like this where you can have an open conversation about this you know uh that that also generates
• 88:30 - 89:00 accountability within the the institutions engaged in this process and the third is i would say from an asia perspective you know vivian pointed out one the legacy is inward looking perhaps what we really need to be doing is expand the inward looking to all of asia really engage all the global health institutions in the conversation something that i know that um that all of us are engaged and renzo and you in particular are leading uh and i
• 89:00 - 89:30 and i wish to see more on that front in the next uh several years great thanks sabina the accountability as everyone pointed out as a very complex complicated messy space because of vested interest right i mean if you look at public health what are the commercial determinants of health beyond the structural and social uh what about vaccine inequities who controls patents but also where the multiple hats of being um funders so i think it's it's a messy space does that mean we do nothing of
• 89:30 - 90:00 course we do this exact webinar or conferences uh writings uh bringing it up in your own meetings in your own spaces be it regional global local whatever you may state is a good space for sharing these critical uh aspects of who's accountable for what right because it's very multi-layered two i think how much can we do we need to recognize our limitations i will stay [Music] a leader of the third world network
• 90:00 - 90:30 movement she's challenging the trips agreement that still exists that allows for countries not to be able to develop vaccine technologies which is completely unfair and there's a lack of response from the global bodies right so i think what is our role in education and research and we kind of try and create that space for accountability two by sharing counter or i would say alternative or competing curriculum and research that is also gold standards which we're doing already creates a space for scrutiny reflection but also accountability of what's
• 90:30 - 91:00 missing in other spaces so there's also this kind of other way of looking at accountability by bringing to the forefront what we're already doing and saying how this makes sense in our context and is very much aligned in public health in asia because that's also diverse context that's what i would say in terms of these spaces that we inhabit thank you thanks renzo can you hear me i think my internet went unstable you know very quickly i think what we always
• 91:00 - 91:30 forget is that the sibling of accountability is reflexivity and we need to have reflective practice both from the side of the one ho to be held to account but also from the side of the one holding the other to account so among these organizations that we need to hold to account they need to start this reflexive exercise and i just want to update everybody that a lot of the global health organizations now they're having difficult conversations internally about their hiring practices
• 91:30 - 92:00 about their decision making uh last year i was in a workshop of the big five in geneva global fund uh gavi etc they're looking they're coming up with the colonizing global health uh policies uh doctors without borders as well i hope wh o will also initiate that internal reflective exercise but also i think from our side who are trying to challenge these institutions and push for the decolonization of global health we need to always reflect what are our
• 92:00 - 92:30 motives what are our interests what are our visions for the future of global health because what we don't want to do and this is what zainab was referring to a while ago the article that i wrote what we don't want to do is in our pursuit of the colonizing in challenging the colonizer we ended up being neocolonizers ourselves because it's our agenda that has uh been uh you know the past triumphs i'll stop there thanks thank you and we're already out of time
• 92:30 - 93:00 and i'm not going to try to summarize what we all talked about that's way too much but i just do want to mention uh a couple of points that you know really strong was so strong is our willingness to take risk and and i want everyone to like uh take this at a very personal level our willingness in each of us to take our risk whatever that means and you know however it works out for us our willingness to look at hierarchies and maybe you know kind of reimagine the world so i'm you know thinking in a different way our willingness to um
• 93:00 - 93:30 really look at it at a system and structural level and saying how that needs to change and our willingness to take on the elites and privileges of ourselves and our own countries because as we talk about yes the west should do this and we should be this it's it's within each and every one of our countries we have the same hierarchies and same privileges and same kind of attitude so i think that really needs to be tackled head-on and we are all part of that so you know how do we overcome
• 93:30 - 94:00 our own backgrounds and make sure that we are as renzo was saying we are not you know assuming just another that same hat that someone that we're trying to knock off someone else's head um so what i will end with is one a challenge for everyone in the audience and of course our panelists too is in the next three months think about making sure that you do something where you have challenged yourself you've stepped out of your comfort zone and you've done something whatever it can be tiny tiny that has helped this part of decolonizing global
• 94:00 - 94:30 health and if you feel inspired write to us about it we will actually try to write up this um conversation and kind of put it into our you know more formal um view that we then circulate back not only to all the audience uh but you know hopefully maybe wider than that um and it will be it's been taped so we'll also have that available so with that i will say thank you all to the audience thank you all to the panelists it was great thank you all to the sdga organizers as
• 94:30 - 95:00 usual our team is just fabulous and does all the heavy lifting and uh hope to we'll have these conversations again bye-bye