This series is hosted by FACE (the Focus Area for Compassion and Ethics) for sparking discourse and awareness through examination of provocative ethical questions in global health.
Overview
In this Ethics Lunch & Learn, we concluded our four-part series on the Task Force’s core values with discussion of global health equity and social justice. Over the last year, FACE has led an exploration with TFGH programs focused on the concept of ‘decolonization of global health.’ As equity and justice are central to this exploration, we anchored the final L&L on what we have learned together about our fourth value.
During Phase One, FACE facilitated discussions with 14 of the Task Force’s programs; initial learnings and program commitments were presented during the Q2 2024 All Staff Meeting (slides/presentation available on the Intranet or in a condensed report for staff).
Phase Two will engage staff in cross-program workshops throughout 2025 for deeper exploration. These collaborative workshops will support staff in learning together. FACE will then produce a report of actions, challenges, and recommendations derived directly from the experiences and perspectives of Task Force staff.
During this L&L, FACE invited staff to help design Phase 2. Comments, questions, and suggestions will not only be used to guide workshop development, but will apply and exemplify the very participatory tools that are key approaches for moving toward equity and justice.
Introduction and Framing
FACE Project Manager, Amy Richards, provided introductory remarks, describing the centrality of health equity and social justice to the work of the Task Force and in wider field of global health.
Next, Dr. Patrick Lammie, Director of the Neglected Tropical Diseases Support Center (NTD-SC), spoke of the pivotal nature of health equity and social justice in his work at the Task Force and in his career, broadly. He described how this value was central to the founding of The Task Force, which prioritized access to at-risk communities. Nevertheless, Pat shared his hope for renewed organizational commitments to these values to make TFGH an exemplar that stands as a beacon of equity and justice in the global health field, moving forward.
Pat moved on to share several personal reflections. In addition to Dr. Foege’s call to “see the faces,” he called upon staff to “hear the voices.” Whether using the terms decolonization, localization, or equitable partnerships, it is clear that partners in the Global South want and need a seat at the table. They want to have a voice and an active role in decision-making.
He then described how his team is thinking critically about the practical call of health equity and social justice. Notably, NTD-SC – together with their Africa-based partner ARNTD – is now engaged in an equitable partnership co-development process. This process, supported and brokered by FACE, strives for more equity in decision-making, oversight, and management. Pat hopes this work can offer a new model at The Task Force that will help establish updated rules of engagement for all programs with partners in the Global South.
Finally, Pat encouraged staff to be willing to take a step back and share power. All must be willing to be uncomfortable, and to think about the basis and mechanisms of partnership in different ways. He hopes that this type of agreement will allow partnerships to transcend the traditional constraints and dynamics of legalistic language that governs sub-awards and contracts to offer better relationships. These types of efforts will be central to establishing The Task Force as a leader in the field and a role model for its many partners in the global health community.
Recap of Phase One
Next, Dr. Ashley Graham, Director of Research at Ops at FACE, offered a high-level review of findings from Phase One, where health equity and social justice were raised consistently as guideposts for programmatic action. Phase One grew from the question “What is the Task Force doing to decolonize global health?”
During discussion, eight shared commitments that can be grouped into four key domains emerged:
1) equitable and respectful partnerships;
2) centering local needs and priorities;
3) localized leadership and expertise; and
4) culture and communication that is respectful, transparent, and builds trust.
These operational commitments ideally guide the design and implementation of Task Force programs, the way we engage with communities or other partners, and our day-to-day decision making. In other words, our actions and these commitments are underpinned by our values as individuals, as public health practitioners, and as an organization. Sometimes those values are explicit, but even when not, it’s clear how the commitments shared with FACE by Task Force staff reflect an undercurrent or an ambition toward equity and justice.
And an important question moving forward is how this constellation of actions, across all of the people at The Task Force, the programs, the organization, reflect back on our values. In other words, how do we embody our values, and through our work, positively influence the field more broadly?
Ashley invited staff to share further reflections, including the importance of:
- altering meeting locations to be closer to partners and regional audiences,
- listening intently to partners via formal surveying and informal conversation to generate trust and genuine relationship,
- stepping aside and sitting with the discomfort of allowing partners to assume new roles,
- transitioning strategies from country partnership to country ownership for sustainability,
- building representative advisory boards and stakeholder groups to inform project development,
- reframing specific language to display greater respect and understanding for localized context,
- seeking new directors from partner countries, and
- adjusting budgets (both requested and granted) in order to proactively account for operational needs required to enact equity (e.g., funding for partner capacity building, training, visas, travel, and multiple, localized meeting locations with catered topics).
Many of these actions require programs to let go of long-standing roles, but as one staff member recalled, the shift is a positive one: “by kind of doing the work myself, I was missing an opportunity to listen to partners.”
In addition to these many opportunities to reshape our actions in favor of health equity and social justice, a staff member also shared about a recent roundtable facilitated by the Task Force at UNGA, focused on the future of equitable and effective global health partnerships. Gathering multiple key global health organizations and country representatives, this meeting generated commitment towards enhancing the role of partner country leadership, in addition to ensuring they have a seat at the table. Leading this convening placed the Task Force at the forefront of advancing equity and mutual accountability on a global stage.
Moving next to a preview of Phase Two, Ashley described the intention to hold cross-programmatic workshops in 2025 to address not only the who and what of decolonization, and thus enhanced equity and justice, but also the how. This workshop will facilitate continued learning together, and in order to do so, FACE offered the remainder of the L&L to be a listening space, to hear how staff envision workshops that are most feasible, relevant, and valuable.
Reflection
Prior to moving into feedback and planning, FACE’s Lead Program Associate, Lee Wilkers, guided a brief reflective exercise to digest the content shared and prepare participants for a transition to discussion. You can access a recording of this reflection here for individual use. A copy of the image shared during this reflection is also displayed above.
Discussion
Participants then entered break-out rooms to discuss workshop design, including content, format, and outcomes. This information will inform the workshops taking place in 2025, after which The Task Force will disseminate a report both internally and through publication to share what we have learned together.
Closing
In closing, attendees and all TFGH staff were encouraged to complete this survey before the end of 2024 if they have further feedback on the Phase Two workshop development. It was heartening to hear the many ways in which programs already carefully consider how to advance and embody the values of global health equity and social justice, and we can expect only more of these will surface as the conversations continue in 2025.
