Medical Dominance in Global Health Institutions as an Obstacle to Equity and Effectiveness; Comment on “Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process”

Document Type : Commentary


1 Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA

2 Institute for Global Health, University College London, London, UK

3 Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA

4 College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia


Medical professionals exercised structural and productive power in the Global Fund’s Country Coordinating Mechanism (CCM) in Nigeria, directly impacting the selection of approaches to HIV/AIDS care, as described in a case study by Lassa and colleagues. This research contributes to a robust scholarship on how biomedical power inhibits a holistic understanding of health and prevents the adoption of solutions that are socially grounded, multidisciplinary, and co-created with communities. We highlight Lassa and colleagues’ findings demonstrating the ‘long arm’ of global health institutions in country-level health policy choices, and reflect on how medical dominance within global institutions serves as a tool of control in ways that pervert incentives and undermine equity and effectiveness. We call for increased research and advocacy to surface these conduits of power and begin to loosen their hold in the global health policy agenda.


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  • Receive Date: 07 October 2022
  • Revise Date: 02 December 2022
  • Accept Date: 04 December 2022
  • First Publish Date: 06 December 2022