The World Health Summit, a pivotal global event convened in Berlin from October 15 to 17 amidst the backdrop of devastating wars, brought together key figures in the realm of international health. Attendees included the director-general of the World Health Organisation (WHO), diplomats, policymakers, and leaders from organisations such as Unicef, UNFPA, the World Bank, the World Medical Organisation, USAID, and the European Commission, as well as representatives from the G-7 and G-20 health and development partnerships. This annual summit, a fixture in Berlin since 2009, centred its discussions around the theme “A Defining Year for Global Health Action”. The deliberations were not only informative and inspiring but also refreshingly candid, striking a chord with those who shared similar experiences.
This candidness played a pivotal role in addressing the summit’s overarching focus on global health equity.
The summit’s agenda featured a diverse array of panels addressing crucial themes. These included topics such as human-centred health coverage, the development of effective financing models for healthcare through public-private partnerships, initiatives to close the gender equality gap through a women’s health agenda, and the unveiling of the Equity 30 Alliance. This alliance aims to empower women and girls by creating self-care opportunities. Other focal points encompassed fostering health systems in conflict-affected regions, understanding the dynamics of race in global public health, innovations in mental healthcare to bridge the treatment gap, advancements in new technologies and digital healthcare, pandemic preparedness, region-specific insights for global health policy (including the Asia-Pacific perspective), academic-community collaborations, the role of national health institutions in connecting research with evidence-based public policies, and pathways for global cooperation.
The discussion on global health equity, particularly regarding race and partnerships involving academia, has proven to be challenging yet essential. Loyce Pace, the United States assistant secretary for global public affairs in the department of health and human services, acknowledges the difficulty of conversations around race but underscores their necessity. Amidst the positive stories of success during the COVID-19 pandemic, Pace issues a caution against rewriting history, citing a longstanding pattern where innovations accessible in wealthier nations are not extended to poorer ones—a trend evident even in recent pandemic responses. This echoes a historical exploitation of natural and human resources in less affluent nations by their wealthier counterparts, perpetuated through centuries of colonialism. Pace, emphasising the absence of a race-neutral world in her experience, urges the articulation of unspoken truths, including the continuation of colonial practices within Western academia. This includes the erasure of work done by women, racial minorities, and individuals from the Global South, especially those with relatively less power—a sentiment echoed by academic colleagues who have faced similar challenges.
In my own journey, an example is a panel I organised in my area of expertise, featuring national and international experts—all women, with women of colour in the majority. Not only were they regional experts but also thematic authorities, focusing on a topic specifically related to women’s experiences. These panellists had provided testimony on high-level foreign affairs committees, served as diplomats, coined terminology, and made significant contributions to teaching, writing, research, and policy engagements. A senior female colleague astutely observed that the senior white male director of the international policy unit had singularly named himself as the faculty expert in the event description. This inquiry was reiterated by a co-panellist, prompting the question, “So, gender, race, and power don’t matter in universities?” I received nearly a dozen screenshots revealing that even presentations by tenure-stream women of colour faculty and external experts had similarly credited only him as the expert.
Attempting to find a diplomatic resolution, I presented various explanations, such as highlighting that another centre had acknowledged me as the faculty expert for a policy talk. In my efforts, I commended him to the audience and shared his verbal and written appreciation of my expertise and contributions. Despite my attempts, the response was a sceptical “How convenient”. The underlying sentiment pointed out the apparent imbalance: he retained the position of the expert, while I, in the event of any issues, would bear the consequences.
When I served as the faculty adviser for a policy research project, the issue resurfaced, regardless of its accuracy. In one instance, only two white women mentoring similar projects received public and, in one case, extensive recognition for their work and leadership. Interestingly, the government’s own project description acknowledged our work as advisers, with no apparent discrimination based on rank, race, or citizenship. Throughout the process, from liaising with policymakers to over a semester’s worth of collaboration with the student team, involving teaching, guiding research, sharing readings, conducting meetings, and coaching for presentations, the disparity in recognition became evident.
Addressing the broader context, animals, including organisational ones, exhibit various behaviours driven by different motives: foxes with cunning and bugs with a tendency to bite. While I exercised discretion in specific matters for the sake of my institutions, colleagues, and friends, the larger issue at hand involves hierarchical and exploitative practices within academia. The appropriation or erasure of the uncompensated, extensive work of certain employees, juxtaposed with the highlighting of others, is not only dehumanising but also takes on a different resonance for individuals with diverse histories, proving to be quite traumatizing. This aligns with the summit’s discussion on stress and trauma inflicted on vulnerable individuals and communities due to extractive practices, a discussion that intersects with issues of gender, race, citizenship, and community-academia partnerships. It’s worth noting that, at a time when the latest inclusivity index ranks the United States 118th in racial inclusion, these concerns gain heightened significance. Regrettably, conflation arises when a few influential white individuals, focusing on the Global South, engage in such practices and receive vigorous promotion from their institutions. The unethical response involves using institutional platforms to perpetuate bullying, intimidation, and threats. On the contrary, the ethical response—especially considering that these exploitative acts are not isolated incidents—is to engage in self-reflection and implement necessary course corrections.
Concluding the summit, the final day appropriately zeroed in on leadership, featuring sessions that delved into effective leaders for health systems. The overarching aim was to enhance the quality of life and well-being of populations.
WHO, quoting a youth leader, emphasised the fundamental connection between the health of all people and the achievement of peace and security, underscoring the pivotal role of good leadership. In the context of democracy, acknowledging disagreement is inherent, recognising that not everyone can lead on every issue. Essential to global institutions is the necessity for leaders who refrain from erasing or devaluing the labour and humanity of their less powerful institutional colleagues, irrespective of identities. This extends to local community experts and international partners, emphasising the need for leaders whose commitment to ethics goes beyond being a mere word on their professional profiles.