Iwelunmor, 22, Juliet Iewlunmor, Saint Louis University, Behavioral Science and Health Education, 5/14/2022, “Capitalism, not racism”, https://www.thelancet.com/action/showPdf?pii=S0140-6736%2822%2900830-3 - FT
Richard Horton correctly states that, in efforts to construct a fairer world, “we need to undertake a more realistic and rigorous analysis of where power lies”. However, Horton’s Comment does not exhibit the required rigorous analysis. Citing the dubious work of Cheikh Anta Diop and Martin Bernal as authoritative commentary is precisely the type of shallow gesture that he correctly criticises as inadequate. Contrary to what Horton and Kehinde Andrews describe, the primary logic underpinning the western world order is not “that Black and Brown life is worth less”.¹ The primary logic of the world order is that profit is valued more than human needs. Although racist ideologies can and did acquire considerable autonomy, they developed in large part to justify rampant capitalist exploitation and imperialism.Racist ideologies are more than ideological superstructures, but they can only be understood fully inthe context of the political economy of the world system. I declare no competing interests.. Decolonising global health: a Philippine perspective We read Richard Horton’s Offline1 with interest. We agree that “Medicine and global health continue to be entangled with colonial attitudes, structures, and practices.”1 That is, in systems of power. Horton concludes that “Decolonisation must mean much more.” We present perspectives from the Philippines. First, scientific journals, cooperative trial groups, and subspecialty governing bodies should make active efforts to include voices from low-income regions, which have substantial disparities in medical research. Labelling studies from these nations as global health simply maintains the western gaze.3 These voices need a seat at the table as equal contributors in advancing global health. Second, former (or current) colonial powers must acknowledge and act on past injustices and make amends. It is a little-known fact that the Philippines was a US colony (1898–1946) and that Manila was among the most devastated cities involved in World War 2. Genuine decolonisation of health would entail allocating resources to improve the health of people who are still impacted by the yoke of colonialism. Last, entities of power with genuine interest in decolonising global health should support and enable voices from communities—eg, patients, healthcare workers, and local researchers4 — and recognise that the genealogy of decolonisation includes scholars, such as José Rizal (1861–96), who have long sought to include local and indigenous voices in global academic discourse.5 Efforts should go beyond symbolic acts of inclusion that might only entrench the powers that be. Instead, it is imperative to empower—or pass power to—those they seek to serve. We declare no competing interests.