Coloniality and Global Health

A cursory review of the history of medical experimentation shows a  throughline between the dehumanization of the colonial past that has  shifted and morphed to the ostensibly postcolonial present. The  instrumentalization of Black and other presumptively “useful bodies”  endures in global health. Medical neocolonialism relies on the  subtraction of the agency of subordinated communities and peoples, where  their agency is removed in the service of the interests of others  through both indirect and direct modalities. Global health law and its  institutions sustain the problematic reality of lackadaisical domestic  enforcement with a weak international regulatory and monitoring regime  on clinical and medical experimentation. International law regulating  bioethics does so primarily through legally non-binding instruments with  only one regional treaty specifying the scope and content of what is  legally prohibited. Further, the primary sources of the World Health  Organization are conspicuously silent on repairing and redressing  historical and ongoing injustices in health relating to medical  experimentation and other forms of subjugation. Moreover, even where  international legal and regulatory frameworks exist on paper for study  participants, the de facto policy of treating Black, Indigenous, and  other peoples as expendable requires more robust measures to counteract  the persistent nature of anti-Blackness and other practices of  dehumanization. Returning to articulated visions of decolonization,  anti-subordination, reparative, distributive and health justice, and  building on this radical imagination in theory and practice, is  essential for positive transformation in global health.