Rethinking partnership paradigms in global health
“We need a renewed vision for global health as well as a renewed vision of ourselves in it.”1
In the global advance towards 2030, there is a sense of urgency to evaluate if partnerships in global health at home and abroad are sufficient in their present form to reach the United Nation’s Sustainable Development Goals (SDGs). The SDGs require an integrated and horizontal approach to achieve universal health care, equity and an end to poverty by 2030. By their design, one goal is dependent or related to another. It is therefore impossible to address health without considering its determinants, including the impact of connections between people, animals and their ecosystems. The complexity of the SDGs and the current state of the planet requires a paradigm shift in the way we work together. Silos, one directional knowledge flow, North-South or top-down approaches are no longer “fit for purpose” in partnerships and need to be reviewed in light of the values of compassion, equity, inclusion and respect.
The global COVID-19 pandemic has enabled us an opportunity to review and explore the current state of partnerships and to investigate new possibilities for cooperation at all levels. It has demonstrated both the failures and promise of partnerships in advancing a more inclusive, adaptive, and creative kind of global governance for equitable futures. The global pandemic has unmasked and perpetuated inequities of disease transmission, access to health care and vaccination distribution in countries and among countries. In addition, COVID-19 has exacerbated existing health challenges due to climate change events (droughts, wildfires, migration, floods, food insecurity) hampering the pandemic response. Globally the health community has learned how ill-prepared we were for a pandemic from the highest levels of surveillance and preparedness to the facilities of a nurses’ station in a rural outpost. While at the same time, we have witnessed the role that systemic racism, the history of colonialization and injustice have played in intensifying poor health outcomes. We have seen how women around the world have shouldered a heavier burden from the pandemic, highlighting the continued need for the inclusion of gender-based approaches.
The 27th annual Canadian Conference for Global Health calls for a shift in partnership paradigms in global health in order to achieve the complex and integrated social, health and environmental goals set out in the SDGs. While there are many paradigms for partnership, CCGH 2021 will provide a platform to highlight different partnership models at local, national and international levels and understand how they contribute to equitable and sustainable outcomes. Specifically, how have partnerships demonstrated tangible improvements to health and how they have facilitated the spread of social, health and environmental improvements? How do partnerships impact the lives of those that work within them and how do they benefit other organizations or communities outside of the partnership?
With a global focus on equity, compassion and social justice as part of new partnership paradigms, we need to understand how these values are practiced and measured and how they impact health. Current initiatives, like Tri-angular Cooperation provide guidance on combining partners from across sectors (academia, civil society, private sector, private philanthropy and international organisations) to work together with nations and communities to develop innovative and creative ways to address health challenges. Overcoming the implicit racism and neocolonialism in longstanding North/South aid relationships requires both a culture shift and a system shift in how northern and southern NGOs see themselves and how they relate to one another. New partnership paradigms explored at the conference should address both the technical and moral challenges in global health so that we can “look forward to a value-based approach to global health that aims to do things with people, rather than to people.” 2
This call for a shift in partnerships for global health will be explored across three pressing and interrelated issues facing our world in 2021: power and privilege, pandemic resilience, and planetary health.
Conference streams (subthemes)
Accounting for power and privilege to improve equity in partnerships
Equitable partnerships (global, local, local-global) must be built on a foundation of respect, mutual reciprocity, and humility. We recognise that power imbalances, which include systemic racism and historical and present-day colonialization, continue to pose barriers to partnerships and to achieving our global goals. Rethinking partnership paradigms must include a reckoning with the impact of power and privilege on how we work together. Conference proceedings will examine the following questions: How equity and inclusiveness in partnerships have been operationalized and measured? How does the legacy of systemic racism impact research, development and donor partnerships? How is power shared with affected populations in partnerships for improved health? How can these discussions occur in a way that communicates compassion and healing?
Lessons learnt from the global pandemic towards more resilient systems
Over one year into the pandemic, it is important to review what has been learned from the Covid-19 pandemic and how we might translate those lessons into more equitable partnerships and more resilient systems. For example, what has been the role of science, politics and the media in reaction to the pandemic including misinformation management? What COVID-19 responses have broken down silos in health infrastructure (in Canada or abroad)? Have there been new partnerships or innovations borne out of the response that have improved global health and strengthened health systems? Conference proceedings will elaborate on the strategies and partnerships that are needed to contribute to preparedness, mitigation, resilience and recovery for current and future emergencies.
Planetary health and opportunities for new partnerships
As described in the Rockefeller Foundation - Lancet Commission 3, planetary health refers to “the health of human civilisation and the state of the natural systems on which it depends.” Events in 2020 and 2021 have demonstrated clearly that one nation’s health is not independent of another’s. Addressing the complex challenges facing our world today requires new partnerships to ensure that environment, veterinary and human health are connected. Climate change continues to bring new and dramatic health challenges in terms of non-communicable diseases, infectious diseases, nutrition and civil unrest and migration. CCGH 2021 will explore how to address planetary health through multisectoral partnerships and approaches. Conference proceedings will explore what we can learn from indigenous communities about traditional approaches that combine the elements and dynamics of land, animal and human together.
1) Cislaghi B, Bukuluki P, Chowdhury M, et al. Global health is political; can it also be compassionate? J Glob Health. 2019;9(2):020306. doi:10.7189/jogh.09.020306
3) Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health. Lancet 2015; published online July 16. http://dx.doi.org/10.1016/S0140-6736(15)60901-1.