The Colonial Legacy of Power, Profit, and Prejudice in Global Health Governance
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Abstract
This article examines how colonial legacies continue to structure global health financing and governance, perpetuating systemic inequities between the Global North and South, particularly African countries. Historical analysis reveals that colonial health systems were strategically designed to protect European interests while exploiting indigenous populations and establishing racially segregated frameworks whose structural biases persist in contemporary institutions. International financial architecture, particularly through bodies such as the International Monetary Fund (IMF) and World Bank, reinforces these asymmetries through governance mechanisms that privilege wealthy nations in decision-making and resource allocation. The COVID-19 pandemic exposed these entrenched disparities, as vaccine nationalism and disparate fiscal capacities widened the existing health gaps. Emerging digital health technologies now risk establishing new extractive relationships, as health data harvested from vulnerable populations flows to high-income countries without adequate benefit-sharing frameworks, a pattern identified as data colonialism. Addressing these interconnected challenges requires decolonising global health governance through fundamental reforms that redistribute power, ensure data sovereignty, and centre historically marginalised voices in shaping health priorities and financing mechanisms.
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