The Harvard Center for African Studies interviewed Dr. Eugene Richardson, Assistant Professor of Global Health and Social Medicine and Assistant Professor of Medicine at Harvard Medical School to learn more about his upcoming book, Epidemic Illusions: On the Coloniality of Global Public Health.
1. What inspired you to write Epidemic Illusions: On the Coloniality of Global Public Health?
Coloniality can be described as the matrix of power relations that persistently manifests transnationally and intersubjectively despite a former colony’s achievement of nationhood. As a conceptual apparatus, “coloniality” attempts to capture the racial, political economic, social, epistemological, linguistic, and gendered hierarchical orders imposed by European colonialism. These hierarchical orders transcended “decolonization” and continue to oppress in accordance with the needs of pan-capital (i.e., economic and cultural/symbolic) accumulation. Examples of these orders include institutionalized racism, religious discrimination, economic exploitation, purposeful underdevelopment, control of gender and sexuality, and dominion over subjectivity and knowledge.
My ideas on the coloniality of global public health come from engagements as a privilege-exerciser (white upper-middle-class male settler-colonist) in the Global South and its spigots in the Global North. I define spigot as a municipal area (e.g., London, New York, Beijing, Geneva, etc.) where illicit financial incentives from the Global South are funneled.
Through the various guises of physician, anthropologist, researcher, consultant, intern, student, I have struggled to understand the causes of epidemics, while aiming to care for groups of people affected by them. Nonetheless, the biggest epidemic I have encountered, and the one I struggle most with in the book, is an epidemic of illusions. It is an epidemic propagated by the coloniality of knowledge production. What are the mechanisms in public health science, epidemiology in particular, that enable groups to sanction one account of disease causation over another, that is, to achieve monopolies on truth? How do such groups achieve the authoritative status to set public health agendas? In addition, how do their views become reified as common sense, such that other perspectives are marginalized? By engaging with theories of symbolic violence and the coloniality of power, I probe the elusiveness of the ways of parsing health phenomena that hold a lock on the imaginations of the public, decision-makers, planners, students, and scientists.
2. If you could change one thing about our understanding of the legacy of colonialism in global public health today, what would it be?
I would echo Boaventura de Sousa Santos’s claim that global social injustice is by and large epistemological injustice, and that there can be no global social justice without addressing symbolic violence. (Symbolic violence can be thought of as “the capacity to impose the means for comprehending and adapting to the social world by representing the economic and political world in disguised, taken-for-granted forms.”)
I would, therefore, hope that public health ‘scientists’ begin to understand that coloniality greatly shapes the methods they use and the knowledge they produce, with the truth value of the categories they employ being a contingent process. By tracing human rights failings to the impoverished discursive infrastructure of objectivist epidemiology, we can transform global health by transforming its representations.
3. What developments, if any, are being made to reduce global health inequities caused by colonialism?
Not many. Kwame Nkrumah already taught us—over 50 years ago—that Aid is merely “a revolving credit, paid by the neo-colonial master, passing through the neo-colonial State and returning to the neo-colonial master in the form of increased profits.” Legacies of colonialism have yet to be repaired—hence we have joined others in advocating for reparations. I currently chair the Lancet Commission on Reparations and Redistributive Justice, which will be issuing a report next year. We then hope to ally with grass-roots movements to support a variety of reparations claims worldwide.
4. Recently, you traveled to the Africa CDC in Addis Ababa, Ethiopia, to support the COVID-19 response there. Please share more about this.
I am helping their surveillance team set up national COVID-19 antibody surveys for African Union member states to better understand SARS-CoV-2 transmission on the continent. I was vexed by the fact that the Africa CDC had plenty of monetary resources but, were unable to procure adequate supplies of tests and personal protective equipment (PPE) due to being outbid by countries in the Global North. It was yet another reminder that coloniality exists not only in knowledge production, but in the continued dominance/distortion of economies in the Global South.
5. Can you share what is next for you? On research, writing, or work?
I’ll be heading to Sierra Leone soon to work on COVID-19 seroprevalence studies there. I’m also trying to raise money to start a Center on Social and Ecological justice at Harvard Medical School, with a particular focus on antiracism and climate change.
Eugene Richardson, MD, PhD, is an Assistant Professor of Global Heath and Social Medicine at Harvard Medical School and an Associate Physician in the Division of Infectious Diseases at Brigham and Women’s Hospital. He received his MD from Cornell University Medical College and his PhD in Anthropology from Stanford University. He completed his residency in Internal Medicine and fellowship in Infectious Diseases and Geographic Medicine at Stanford University Medical Center.