Is the Coronavirus Response Reflective of Global Health’s Colonial Legacy?

After studying Biomedical Sciences I wanted to understand the social determinants of health and disease, so I decided to study an MSc in Global Health (GH) and Development. I do love my Masters. It has taught me to be critical of health in the context of Foreign Policy, forcing me to understand my privilege and responsibilities in the field, and to challenge my own preconceptions as a White self-identifying woman from Britain, Italy and France. This is largely because of the colonial legacy of Development studies that I have been exposed to in my course, and the historic failures of GH — these have made me question the sincerity and legitimacy of Western foreign policy efforts to combat health crises. 

Global Health is an extension of Tropical Medicine, which became popular during Colonialism; settlers used indigenous people to develop personal treatments against infectious diseases, leading to purposeful and calculated termination of vulnerable populations. The field does have its successes; the creation of bodies such as the World Health Organisation (WHO) after WWII, has allowed a focus on health issues which transcend national barriers and prevented major epidemics. An example is the eradication of Smallpox and certain strains of Polio. Yet, the Foreign Policy rationale for aid remains, thus promoting a form of neo-colonialism. Developed countries and international institutions strategically offer aid which aligns with national security and economic interests and less-so to fulfill the end goal of improving health.
 
These are exemplified by Structural Adjustment Programs, loans provided by the World Bank and International Monetary Fund since the 1990s, which have been criticised heavily for their conditionalities. These SAPs implemented ‘free market’ policies, such as privatisation and reduction of trade barriers, with the aim to boost the economy, alleviate poverty and ensure repayment. The market-focus led to austerity measures being put in place and the collapse of health systems and welfare. The White Saviour Complex deeply shapes foreign policy responses to GH, in the search for quick fixes and validation. In addition to a countries’ resources and political stability, or lack thereof, fashion also determines why specific countries or diseases get more attention than others, which inherently leads to foreign policy failures.

The New Coronavirus (COVID-19) epidemic is a really good example of this. What I have been baffled by is the clear disconnect between the hysteria created in the press blaming China for having created a possible global pandemic, and the lack of urgent international help in Wuhan. In fact, the WHO’s appeal for $600 million has only been responded to by 20% of countries. Whether this is due to a lack of national vested interest in donating or a tumultuous past with China’s lack of transparency during epidemics, it is representative of a real underestimation of the epidemic, which may result in rapid spread to other countries. The absence of international support has been enhanced by blatant discrimination towards the Chinese population as seen in the racialised press coverage - for example the demonisation of Chinese food practices on mainstream news.

Finally, there is a need to think of the ethics of foreign aid which is delivered for humanitarian, associative and reparative reasons. These seem to be incompatible with trade deals which promote the rise of obesity and cancers in the Global South, and the TRIPS agreement, limiting the access to pharmaceuticals for the sake of the economic benefit to the North. Until these hypocrisies are resolved, foreign policy responses will continue to lack credibility and the White Saviour Complex will remain.

As a student, I appreciate that it is easy to be critical of GH when exposed to its failures everyday, and that it is fundamental to understand that the realities in practice are incredibly bureaucratic and complex. Yet, I hope that in my future as a GH professional, I am able to remind myself of these controversies and avoid similar misconceptions and mistakes.

Martha Bowler is a WIFP Interview Contributor with a backgroud in Biomedical Sciences and Global Health.