The trouble with inequalities in global health partnerships

In this essay, I offer a philosophical–ethical analysis of inequalities in global health partnerships. Using literature from medical anthropology and the health sciences as a basis, I begin by distinguishing two categories of concern. First, I identify the inequalities between partners, such as between research institutions in the United States and African countries, which can include resource, epistemic, and power inequalities, and, second, I highlight associated concerns such as the lack of acknowledgement of inequalities. I then focus on what might be ethically wrong with these inequalities, emphasizing that there can be significant instrumental and noninstrumental harms associated with them. By underscoring what may be ethically troubling about inequalities in global health partnerships, this essay provides preliminary guidance on how to create more equal and more equitable relationships between partners in the field of global health.