International Working Group for Health Systems Strengthening

The idea of health systems is at a crucial impasse. While access to biomedicine is improving worldwide, contradictions abound. Top-quality hospitals and dispensaries are being built across the global south by corporations and pharmaceutical companies, creating access but turning patients into consumers. Low-income nation-states such as Ethiopia are creating corps of community healthcare workers, but these groups of women remain unpaid or underpaid while their work is bound up with the interests of authoritarian, violent governments. As the biomedicine that is deeply linked to health systems becomes more accepted and a larger part of life in localities across the global south, scholars, practitioners, and activists are beginning to point out the harms of this trend, and are beginning to call for “decolonization” and the reclamation of non-Western medical knowledge and practices. Across the global north and global south alike, the expansion of health systems–or the growth of institutions, organizations, and networks to expand biomedical care–correlates with the expansion of certain kinds of power. With this, critical questions must be asked. What actually is a “health system?” Is the idea of a health system something that is intrinsically linked to state power, capitalist expansion, and Western knowledge hegemony, or can it be detached from these larger systems? Are these tradeoffs with violent systems and abusive power structures inherently necessary to expand health access around the world? What would a decolonized–that is, anti-colonial, anti-racist, and anti-capitalistic–health system look like? What would a truly global health system be, and how do we get to it? 

This working group seeks to understand these questions and more through a program designed around “the salon.” Instead of working towards a specific scholarly output or following a specific syllabus, this group will go where it is led by the collective decision making of its members. Weekly topics and readings will be determined by the conversations had at the previous meetings. The progression of themes discussed and theoretical predicaments worked through will be decided by the group iteratively as the weeks and months progress. As coherent ideas and findings form through this process, writing and other projects will be determined by group consensus. Ultimately, this group seeks to redefine the idea of the “health system” to then parse what the concept could possibly be. Exploring cutting-edge scholarship from philosophy, sociology, anthropology, Black Studies, political theory, and critical theory as well as first-hand accounts of health systems and their issues from around the world, we will explore the boundaries of health institutions and networks, then use the small pockets of radical and revolutionary health projects to imagine the future of what health system could be.