To plan for the Future, we must understand the Past
- Dr. Sharon Rudy
- May 21
- 2 min read
International development has long been shaped by the imposition of Western systems onto Indigenous societies. For centuries, Indigenous communities had a rich, holistic approach to health that was integrated into their social systems.
However, beginning in the 1600s, Western missionaries, and their governments introduced a medical model centered on the diagnosis, treatment and management of disease, specialization of care, and a hierarchy of practitioners with physicians as all-powerful. Social, psychological, and environmental aspects were sidelined. While bringing important scientific advancements, this model often devalued local practices and exploited low-resource settings for research.
This power dynamic persisted, with high-income countries (HICs) driving the global health agenda. Funding remained centralized in HIC institutions, with local organizations in low- and middle-income countries (LMICs) often stereotyped as lacking accountability and competence. Although this era saw many positive contributions, it also solidified existing inequalities and power imbalances.
Shifts Enabling Change
Today, five key factors are reshaping global health and development:
Technology & Globalization
The internet connects us globally, enabling more voices to join the conversation
Pandemics
The AIDS crisis, and more recently COVID - 19, emphasized our shared vulnerabilities and linked global health to security.
Capacity Building
Decades of training have produced a critical mass of skilled, technically competent LMIC professionals and leaders.
Voice for Change
LMIC experts are increasingly visible in media and academic circles, demanding equity, resources, and recognition.
Data Transparency
Analysis of past projects reveals that many failed to produce sustainable change, highlighting the need for new, impactful approaches.
What Does This Mean for Global Health Professionals?
For LMIC Professionals
This moment offers unprecedented leadership opportunities, both locally and globally. With these roles comes the responsibility to challenge historical power dynamics and promote inclusive practices.
For HIC Professionals
Genuine partnership and power-sharing are essential to driving sustainable change. While fewer overseas positions are available, the virtual workspace has created new avenues for collaboration and impact. With so much academic focus on producing global health professionals, watching the system gradually rebalance itself will be fascinating.
As global health professionals, thoughtful engagement with the changing landscape of international development is crucial.
We can choose to be part of the problem or work toward solutions by fostering equitable partnerships and consciously respecting and integrating diverse perspectives.
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