📢🤝 Three calls to action: public accountability, intersectional solidarity, global health equity seen as a pragmatic necessity.
In the face of funding cuts and the rollback of rights (p. 3), the authors refuse to adapt in silence. They invite everyone to consider what they can do at their level, "first as a citizen" (p. 4). The text defines three concepts: public accountability, intersectional solidarity, and global health equity (p. 4-5). It provides concrete examples of engagement: making visible the human costs of funding decisions, translating results into forms accessible to the public, co-creating reports with civil society, linking grassroots organisations to decision-makers (p. 4). It finally calls for examining one's own position of power and privilege, and mobilising under the leadership of vulnerable populations (p. 4-5). It is a text of reflection and a call to action, not a practical guide: it offers neither tools nor methods.
✍️ Under fire, unyielding: tripling down on public accountability and intersectional solidarity for global health equity. - Global Health Promotion, vol. 33, no. 2, pp. 3-6 — section "Editorial" (p. 3)
Muriel Mac-Seing (Department of Social and Preventive Medicine, School of Public Health, University of Montreal; Public Health Research Centre), Charity Oga-Omenka (University of Waterloo; McGill International TB Centre; Institute of Human Virology Nigeria), Joanne Liu (University of Montreal; School of Population and Global Health and Pandemic and Emergency Readiness Lab, McGill University)
"
1️⃣ SUMMARY
Three racialised Canadian women sign this text: two early-career researchers born in sub-Saharan Africa, and an experienced humanitarian (p. 4). They describe global health as "under fire": conflicts, a rollback of women's rights, sexual and gender minorities, and migrant rights, attacks on academic freedom (p. 3). This is compounded by the closure of USAID in July 2025, after the elimination of over 80% of its programmes, and cuts to PEPFAR and support for the Global Fund. According to a modelling study, these cuts could cause millions of avoidable deaths by 2030 (p. 3, ref. 3).
Refusing to "adapt in silence", the authors call on researchers, practitioners, and humanitarians, "but first" as citizens. They make three calls: to revitalise public accountability, embody intersectional solidarity, and recognise global health equity as a pragmatic necessity (p. 4-5). They conclude that we must refuse to normalise catastrophe and make research an instrument of justice, to move from vision to action (p. 5).
2️⃣ WHAT TO REMEMBER
1️⃣ Revitalising public accountability (call from the authors, p. 4). Observation: when donor countries reduce funding for global health while maintaining or increasing their military budgets, and when proven interventions remain inaccessible due to a lack of political will rather than a lack of technical capacity, it is « a profound failure of public accountability ». Definition: active participation of the public (communities, civil society organisations, universities, including interdisciplinary and intersectoral health professionals) to uncover inequities and injustices supported by evidence and propose alternatives to the failures of leadership, governance, and democratic processes in global health (ref. 5)
2️⃣ Embodying intersectional solidarity (call from the authors, p. 4-5) : genuinely committing to eliminate « all forms of power asymmetries within a coalition », forging authentic partnerships, shifting power and rethinking the design and implementation of initiatives (ref. 7) ; collaborating with the most vulnerable communities and their representative organisations ; reflecting on one’s own position of power and privilege (ref. 8). An equitable partnership is not a benevolent cooperation from a position of privilege, but a shared struggle with the communities. The authors recognise that, as researchers from the North, they hold structural advantages over their colleagues from the South. It is a long and intergenerational process (p. 5)
3️⃣ Equity in global health, a pragmatic necessity and not a utopia (call from the authors, p. 5). They invoke COVID-19, emerging zoonoses, the One Health approach (One Health) and climate change. The framework of social determinants reminds us, according to them, that health inequities are produced by political choices (ref. 11). Health inequities are neither natural nor inevitable: they result from political choices regarding the distribution of resources and power, governance structures, and "the lives we value, or not" (ref. 11). The authors call for a decolonial approach and the rejection of the "white saviour industrial complex" (ref. 12).
They conclude that we must refuse to normalise catastrophe and retreat into "safe and fundable" projects, make research an instrument of justice rather than a mere documentation of suffering, and move from vision to action. Not because individual action will reverse global trends, but because collective resistance can preserve the possibility of a fairer future (p. 5)
3️⃣ TO ACT
1️⃣ Make visible the human costs of funding decisions (action explicitly requested by the document, p. 4). Examples given by the authors: translate results into accessible public forms, co-create reports with civil society and community partners, connect grassroots organisations to decision-makers, speak truth to power (speaking truth to power)" and "monitor these decisions to prevent them from getting lost in bureaucratic silence or in publications serving careers" (p. 4)
2️⃣ Examine one's own position of power and privilege (action explicitly requested by the document, p. 4-5): listen to populations in vulnerable situations, qualified as experts of their own realities, and mobilise under their leadership, for example in research, evidence-based political advocacy or knowledge mobilisation, the development of initiatives” to the list (research, development of initiatives, evidence-based advocacy, knowledge mobilisation).
3️⃣ Forge strategic partnerships with diverse civil society organisations, whether close to or not to its positions, in the North as well as the South (action explicitly requested by the document, p. 4), and engage in coalitions by building trust through consistent action over time (p. 4-5).
The document does not cite any existing tools and does not propose a method. Its calls primarily target global health and North-South relations (p. 4-5).
Suggestion Practices in Health: these calls can be transposed at the scale of a territory, for example to document and make public the local effects of social health inequalities with the people concerned. This transposition is not proposed by the document.
4️⃣ 3 PRACTICAL QUESTIONS
1️⃣ Who is concerned by public accountability? The public in the broad sense: communities, civil society organisations, universities, including interdisciplinary and intersectoral health professionals. The authors call for to go beyond passive observation and simple documentation by mobilising the capacity to produce and translate knowledge to influence policies » (ref. 5).
2️⃣ What does it mean to "redefine the alliance" (allyship)? To move from "the study of the oppressed" to examining how researchers, professionals, and privileged citizens perpetuate systems of inequity themselves (p. 5, ref. 8). Writing and publishing on equity is not enough (p. 5).
3️⃣ What systemic change pathways does the text report? According to five regional reports: decentralise power to countries and regions, sustainably finance beyond volatile aid (regional funds, global transaction mechanisms), extend priorities beyond pandemics to primary health care and global health equity (p. 5, ref. 13).
5️⃣ TO GO FURTHER
External resource — Emoto S., Ferguson L., Baezconde-Garbanati L., Hu H., Samari G., Gruskin S. "Promoting More Equitable Global Health Research, Education, and Community Partnerships: The Efforts of One US-Based Academic Institution", Annals of Global Health, 2025, vol. 91, no. 1, art. 31 (11 June 2025, open access, in English). Eight principles of equitable partnership adopted by a university (shared governance, reciprocity, information sharing, accountability…), each broken down into concrete components.
https://annalsofglobalhealth.org/articles/10.5334/aogh.4772
6️⃣ #️⃣ HASHTAGS
#healthpractices #GlobalHealth #HealthEquity #Intersectionality #Advocacy #SocialDeterminants #InternationalSolidarity #HealthPromotion
To go further, order a research or literature review
This article : An editorial production based on
the experience enhanced by artificial intelligence - The English version of the site is an automatic translation: the French version is authoritative - Click on the image 