Coloniality, Elite Networks and Intersectionality: Key Concepts in Understanding Biomedical Power and Equity in Health Policy Processes; Comment on “Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process”

Document Type : Commentary


1 Health Policy and Systems, Sambodhi Research and communications, Noida, India

2 School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

3 School of Public Policy and Global Affairs, University of British Columbia, Vancouver, BC, Canada

4 Independent Researcher, New Delhi, India

5 Global Studies Ambedkar University, Delhi, India


To understand the role of power in health policy processes in low- and middle-income country (LMIC) contexts, it is necessary to engage with global and local power structures and their historical contexts. In this commentary, we outline three dimensions that shape a dominant power in health policy processes — the biomedical power. We propose that understanding the linkages between medical power and colonialism; the close connection of public health, medicine and elite networks; and the intersectionalities that shape the powers of medical professionals can offer the means to examine the biomedical hegemony in health policy processes. Additionally we suggest that a more nuanced understanding of the interaction of local powers with global funding can offer some entry points to achieving more equitable and interdisciplinary health policy processes in LMICs.


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