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Colonialism, which involves the systemic domination of lands, markets, peoples, assets, cultures or political institutions to exploit, misappropriate and extract wealth and resources, affects health in many ways. In recent years, interest has grown in the decolonization of global health with a focus on correcting power imbalances between high-income and low-income countries and on challenging ideas and values of some wealthy countries that shape the practice of global health. We argue that decolonization of global health must also address the relationship between global health actors and contemporary forms of colonialism, in particular the current forms of corporate and financialized colonialism that operate through globalized systems of wealth extraction and profiteering. We present a three-part agenda for action that can be taken to decolonize global health. The first part relates to the power asymmetries that exist between global health actors from high-income and historically privileged countries and their counterparts in low-income and marginalized settings. The second part concerns the colonization of the structures and systems of global health governance itself. The third part addresses how colonialism occurs through the global health system. Addressing all forms of colonialism calls for a political and economic anticolonialism as well as social decolonization aimed at ensuring greater national, racial, cultural and knowledge diversity within the structures of global health. Le colonialisme, qui implique la domination systemique de terres, de marches, de peuples, de ressources, de cultures ou d'institutions politiques dans le but d'exploiter, de detourner et d'extraire des richesses et des ressources, affecte la sante de nombreuses manieres. Ces dernieres annees, la decolonisation de la sante mondiale a suscite un interet croissant, l'accent etant mis sur la correction des desequilibres de pouvoir entre les pays a revenu eleve et les pays a faible revenu, ainsi que sur la remise en question des idees et des valeurs de certains pays riches qui faponnent la pratique de la sante mondiale. Nous soutenons que la decolonisation de la sante mondiale doit egalement aborder la relation entre les acteurs de la sante mondiale et les formes contemporaines de colonialisme, en particulier les formes actuelles de colonialisme d'entreprise et de colonialisme financiarise qui operent par des systemes mondialises detraction de richesses et de profits. Nous presentons un programme d'action en trois parties destine a decoloniser la sante mondiale. La premiere partie porte sur les asymetries de pouvoir existant entre les acteurs de la sante mondiale des pays a hauts revenus et historiquement privilegies et leurs homologues des pays a faibles revenus et marginalises. La deuxieme partie concerne la colonisation des structures et des systemes de la gouvernance mondiale de la sante elle-meme. La troisieme partie traite de la maniere dont le colonialisme se manifeste a travers le systeme de sante mondial. La lutte contre toutes les formes de colonialisme necessite un anticolonialisme politique et economique ainsi qu'une decolonisation sociale visant a garantir une plus grande diversite nationale, raciale, culturelle et des connaissances au sein des structures de la sante mondiale. El colonialismo, que implica la dominacion sistemica de tierras, mercados, pueblos, bienes, culturas o instituciones politicas para explotar, apropiarse indebidamente y extraer riqueza y recursos, afecta a la salud de muchas maneras. En los ultimos anos ha crecido el interes por descolonizar la salud mundial, en particular para corregir los desequilibrios de poder entre los paises de ingresos altos y los de ingresos bajos, y para cuestionar las ideas y los valores de algunos paises ricos que influyen en la practica de la salud mundial. Sostenemos que la descolonizacion de la salud mundial tambien debe abordar la relacion entre los actores de la salud mundial y las formas contemporaneas de colonialismo, en especial las formas actuales de colonialismo corporativo y financiarizado que operan a traves de sistemas globalizados de extraccion de riqueza y especulacion. Presentamos un programa de accion dividido en tres partes para descolonizar la salud mundial. La primera parte se refiere a las asimetrias de poder que existen entre los actores de la salud mundial procedentes de paises de ingresos altos e historicamente privilegiados y sus homologos de entornos de ingresos bajos y marginados. La segunda parte se refiere a la colonizacion de las estructuras y sistemas de la propia gobernanza de la salud mundial. La tercera parte aborda como se produce el colonialismo a traves del sistema sanitario mundial. Abordar todas las formas de colonialismo exige un anticolonialismo politico y economico, asi como una descolonizacion social destinada a garantizar una mayor diversidad nacional, racial, cultural y de conocimientos dentro de las estructuras de la salud mundial. [phrase omitted], Introduction Medicine and public health have always been shaped by social and political values, (1) as evident in efforts to redress social inequities in health, struggles to realize health as [...]

Background: As a measure to slow down the transmission of Coronavirus disease (COVID-19), governments around the world placed their countries under various stringent lockdown measures. Uganda is one of the countries that had a strict lockdown in Africa. This qualitative study explored the social and economic impacts of the COVID-19 lockdown in both an urban (Kampala) and rural (Wakiso) setting in Central Uganda. Methods: The study used focus group discussions (FGDs), household interviews, and key informant interviews (KIIs). 14 FGDs were conducted among several stakeholders including community health workers, health professionals, and members of the community. 40 household interviews were conducted among low, middle, and high-income households, while 31 KIIs were held among policy makers, non-governmental organisations, and the private sector. Data were analysed thematically in NVivo 2020 (QSR International). Results: Findings from the study are presented under six themes: family disruption; abuse of children's rights; disruption in education; food insecurity; impact on livelihoods; and violation of human rights. The study found that the COVID-19 lockdown led to family breakups, loss of family housing, as well as increased both caring responsibilities and gender-based violence especially towards females. Children's welfare suffered through increased child labour, sexual exploitation, and early marriages. The extended closure of schools led to delayed educational milestones, poor adaptation to home-based learning, and increased school drop-out rates. Increased food insecurity led to changes in feeding patterns and reduced food varieties. Livelihoods were negatively affected hence people depleted their savings and capital. Unlawful detention and beating by law enforcement officers increased during the lockdown. Conclusion: Future pandemic planning needs to consider the consequences of lockdown on the social and economic wellbeing of communities hence put in place appropriate mitigation measures during and after the outbreak. [ABSTRACT FROM AUTHOR]

COVID-19 presented countries with unprecedented health policy challenges. For low-income countries in particular, policymakers had to contend with both the direct threats posed by COVID-19 as well as the social, educational, and economic harms associated with lockdown and other infection prevention and control measures. We present a holistic and contextualised case study of the direct and indirect impacts of COVID-19 on women and children, with some assessment of their uneven distribution across socio-economic, age and gender groups. We used different types of primary and secondary data from multiple sources to produce a holistic descriptive analysis. Primary data included: qualitative data obtained from 28 in-depth interviews of key informants, six focus group discussions; and 40 household interviews. We also extracted data from government reports and announcements, the District Health Information Software version 2 (DHIS2), newspaper articles and social media, as well as from published research articles. Our findings show that the direct and indirect adverse impacts of COVID-19 were compounded by many years of severe political economic challenges, and consequent deterioration of the healthcare system. The indirect effects of the pandemic had the most severe impacts on the poorest segment of society and widened age and gender inequalities. The pandemic and its accompanying infection prevention and control measures negatively affected health service delivery and uptake. The management of COVID-19 presented enormous challenges to policymakers and public health specialists. These included managing the greatest tension between direct and indirect harms; short-term and long-term effects; and the unequal distribution of harms across different segments of society., Competing Interests: Conflicts of interest SN was one of the health experts working on the ground who called for the lockdowns as he had first-hand information on the healthcare preparedness to face such a new novel coronavirus.

Recent debates on decolonizing global health have spurred interest in addressing the power asymmetries and knowledge hierarchies that sustain colonial ideas and relationships in global health research. This paper applies three intersecting dimensions of colonialism (colonialism within global health; colonisation of global health; and colonialism through global health) to develop a broader and more structural understanding of the policies and actions needed to decolonise global health research. It argues that existing guidelines and checklists designed to make global health research more equitable do not adequately address the underlying power asymmetries and biases that prevail across the global health research ecosystem. Beyond encouraging fairer partnerships within individual research projects, this paper calls for more emphasis on shifting the balance of decision-making power, redistributing resources, and holding research funders and other power-holders accountable to the places and peoples involved in and impacted by global health research., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kumar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)