Letters to the Global Health community from African students and young professionals (part 1)

By guest contributors Zahra A Fazal (Ms), Prince Adu (Ms, PhD) and Nicemode Charles (MPH) on behalf of the African Diaspora Public Health working group

For nearly a decade, the global health community has committed to decolonizing its field, particularly addressing power imbalances fraught in Global North-South partnerships. Yet, as recent graduates from the African continent who trained in North America, the view from within is much different.

Take the example of global health conferences. As graduate students training in fields from epidemiology to health policy, we have often been the only Africans in the room despite a sea of posters with data from studies conducted on our beloved continent. Discussions on disease burdens, emerging infections, and planetary health in Africa are frequently led by Western researchers, sidelining the very voices closest to these realities. When representation is absent, global health discourse inevitably falls into a cycle of Western perspectives on African health, despite the deeply local nature of these issues. This absence of African students, trainees and professionals at these gatherings undermines the ideals of decolonization and collaboration. Conference organizers should address the unique barriers faced by Global South researchers such as passport privilege and limited travel grants by working with funding bodies to prioritize financial support for Global South participants.

The publication landscape is another dimension where promises for decolonization fall short. The ongoing culture overwhelmingly favors English as the language for academic discourse, publication fees are prohibitive for Global South student authors, and power imbalances in collaborations frequently pigeonhole Global South researchers as secondary authors. While some journals offer waivers and special calls to amplify Global South authorship, structural inequities persist. Decolonization must go beyond visibility—it must dismantle the systemic barriers that prevent African researchers from leading and disseminating their own work, including recognizing the value of publishing in local languages when data is collected in them.

These dynamics extend to laboratories and research teams, where those studying African health challenges are rarely leaders from the community being studied. Instead, researchers from the Global South are often positioned as junior partners, with limited access to funding or decision-making power. How much is community-led research really, truly, community led? How is the current training of graduate students preparing them to put down their scientist hat and lean into their constant learner role where the community members are not ‘subjects’ rather ‘experts’ of the research question and data collected. This further begs the question that if the experts of the data are the community, why do we not see this reflected in accolades whether that be by granting bodies, journal articles or the room make-up of a global health conference. These structural imbalances reinforce outdated hierarchies, making it difficult for genuinely equitable partnerships to flourish.

Finally, this colonial erasure in global health persists in how we teach foundational public health discoveries and methodologies. One of the authors recalls a highly recommended course at Stanford, The History of Epidemiology, taken by both Master’s and PhD students. While the course was exceptionally well taught, it rarely acknowledged the colonial legacy of tropical medicine, which in many ways shaped global health as we know it today. Similarly, the long-standing contributions of Global South scholars, epidemiologists, and public health leaders—both historical and contemporary—were largely overlooked. As a result, one of the authors decided to dig into the contributions of African epidemiologists for their student-led project of this course. As the saying goes, “Until the lion learns how to write, every story will glorify the hunter”, the same held true during this exercise.The author found that contributions from the Global South were either co-opted such as in the case of Dr. Jean-Jacques Muyembe, a Congolese microbiologist, who first identified the Ebola Virus but had his discovery credited to Western institutions until recently. And worse – contributions of African individuals were left undocumented such as the Washa women of Cape Verde, who pioneered early contact tracing during a yellow fever outbreak but were never acknowledged in official epidemiological records. Such narratives are often absent from curricula that continue to highlight Western figures and bodies as the primary architects of this field.

The term “decolonizing” has become but a term, rather than an active commitment. As African students expected to be empowered through the mishmash of our Global South lived experiences and Global North training to lead the field’s evolution, we are inheriting a system that at best – will weight us down in our isolation of being the only other African in the room – or at worse teach us that the only way to keep afloat in global health is to reinforce the very inequities we seek to dismantle. The path forward lies in structural solutions: expanding PhD opportunities for Global South students that prioritizes their leadership training, ensuring that journals have a dedicated granting mechanism to waive all publication costs for African scholars, and global health donors restructuring their funding criteria to require an African principal investigator for studies based on our continent. Investing in these measures will shift power dynamics, enabling African researchers to take the lead in defining and addressing their own health priorities.

In a forthcoming letter, members of our group will explore what it means to truly flip these power imbalances—not just by pushing for inclusion in existing structures, but by building African-led initiatives from within.

About the authors:

Zahra Fazal is from Morogoro, Tanzania, and has a Msc. in Epidemiology and Clinical research from Stanford School of Medicine and a Bsc. in Global health from the University of British Columbia (UBC). She was a Knight-Hennessey and Karen McKellin International Leader of Tomorrow scholar. Zahra has led mixed-methods research on health inequities amongst under-served populations within Sub-Saharan Africa, Canada and the United States. She is the founder for the African Diaspora Public health working group and in her free time enjoys rock climbing, gardening, crocheting and being outdoors.

Prince Adu Ph.D. is an Assistant Professor at Ohio University Heritage College of Osteopathic Medicine, Dublin, OH. His research focuses on the structural determinants of health, using both quantitative and qualitative approaches to examine how systemic inequities shape disease patterns-particularly among minority and under-served populations. With expertise in health equity, epidemiology, and policy development, his work spans multiple global contexts, including Canada, the United States, Ecuador, Ghana, Mozambique, Zimbabwe, and South Africa. When he is not working, Prince enjoys cooking, listening to music and playing football (soccer).

Nicemode Charles is from Morogoro, Tanzania and is pursuing her MPH at the Johns Hopkins Bloomberg School of Public Health and has a Bsc in Biochemistry and Economics from Agnes Scott College. Nicemode is passionate about improving access to innovative therapies for patients in underserved communities using multidisciplinary evidence-based methodologies while incorporating the lived experiences of patients. In her free type she enjoys cooking, dancing and exploring new cities.

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