T.L. Rabin is associate professor of medicine and director, Office of Global Health, Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut; ORCID: https://orcid.org/0000-0002-4829-9051 .
H. Mayanja-Kizza is professor of medicine, Department of Internal Medicine, Makerere School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; ORCID: https://orcid.org/0000-0002-9297-6208 .
Acad Med. 2021 Jun 1;96(6):795-797. doi: 10.1097/ACM.0000000000003911.
Global health and its predecessors, tropical medicine and international health, have historically been driven by the agendas of institutions in high-income countries (HICs), with power dynamics that have disadvantaged partner institutions in low- and middle-income countries (LMICs). Since the 2000s, however, the academic global health community has been moving toward a focus on health equity and reexamining the dynamics of global health education (GHE) partnerships. Whereas GHE partnerships have largely focused on providing opportunities for learners from HIC institutions, LMIC institutions are now seeking more equitable experiences for their trainees. Additionally, lessons from the COVID-19 pandemic underscore already important lessons about the value of bidirectional educational exchange, as regions gain new insights from one another regarding strategies to impact health outcomes. Interruptions in experiential GHE programs due to COVID-19-related travel restrictions provide an opportunity to reflect on existing GHE systems, to consider the opportunities and dynamics of these partnerships, and to redesign these systems for the equitable benefit of the various partners. In this commentary, the authors offer recommendations for beginning this process of change, with an emphasis on restructuring GHE relationships and addressing supremacist attitudes at both the systemic and individual levels.
全球健康及其前身热带医学和国际卫生，历史上一直受到高收入国家（HIC）机构议程的推动，其权力动态使中低收入国家（LMIC）的伙伴机构处于不利地位。然而，自 21 世纪以来，全球健康学术界一直致力于关注健康公平，并重新审视全球健康教育（GHE）伙伴关系的动态。尽管 GHE 伙伴关系主要侧重于为来自 HIC 机构的学习者提供机会，但 LMIC 机构现在正在为其学员寻求更公平的体验。此外，COVID-19 大流行的经验教训强调了教育交流双向性的重要性，因为各地区从彼此的策略中获得了有关影响健康结果的新见解。由于 COVID-19 相关旅行限制而中断的体验式 GHE 项目提供了一个反思现有 GHE 系统的机会，思考这些伙伴关系的机会和动态，并为各种合作伙伴的公平利益重新设计这些系统。在这篇评论中，作者提出了开始这一变革过程的建议，重点是调整 GHE 关系，并解决系统和个人层面上的至上主义态度。
