The role of structural racism as a determinant of health informs our views
Joel G. Breman, MD, DTPH, FIDSA, FASTMH, President
Julie Jacobson, MD, DTM&H, President-Elect
Chandy John, MD, MS, FASTMH, Immediate Past-President
Karen A. Goraleski, CEO
The recent killing of Mr. George Floyd by a Minneapolis police officer is an outrage to public decency. The same can be said of recent highly publicized attacks on other Black Americans by police and self-styled guardians of the peace.
The American Society of Tropical Medicine and Hygiene (ASTMH) is composed of scientists and public health practitioners committed to reducing health disparities in vulnerable communities and low-income countries. Society members focus mainly on tropical infectious diseases and the disparities they cause in global health.
“As President and on behalf of the ASTMH Board, our statement of inclusivity and respect is a stance of solidarity to ensure that all members and persons where we live and work are treated with respect, dignity and inclusiveness. We also acknowledge that the world of tropical medicine and global health has its own troubled history with inclusiveness that includes scientists in the global North influencing clinical and research programs based on their own agenda.” – Joel G. Breman, MD, DTPH, FIDSA, FASTMH
The recent events in the United States are intolerable anywhere, particularly in a country considered to be the bastion of democracy and a global leader in human rights. We deplore the structural racism that is at the root of these problems.
Violence is not the solution. While recognizing that not all police officers and departments are racist or otherwise deficient, we see the immediate need for specific actions to begin addressing the systemic flaws at the root cause of negative outcomes.
First, a fundamental principle of successful global public health programs relies on an inclusive consultative process for community engagement. Similarly, recruitment and training in all police departments must ensure the presence of persons of color at all levels, including at the highest echelons of authority and responsibility. Communities must be involved in officer recruitment and in defining actions to maintain peace that aligns with local values and conditions.
Second, we must address the fact that structural racism is a root cause of health, educational and economic disparities. Many acute and chronic health conditions predominate in communities of color. For example, there is an urgent need for providing affordable, effective health insurance for disenfranchised populations.
This deeply painful moment can help reinforce our efforts at ASTMH to create a more equitable approach to global health research. In our evolution as a scientific society, we have made a conscious commitment to increase the inclusion of leaders from Africa, Asia, Latin America and the Caribbean, and listen to them about the direction of the Society. We highly encourage that symposia at our Annual Meeting include experts from low-income countries, and when that is not possible we require an explanation. We have increased travel awards to trainees from low-income countries to allow them to participate in the meeting and take advantage of valuable networking opportunities. We also want trainees from these countries to have equal access to research funding awarded by the Society. Individually and as a community, we will continue to do the work to model and support the transformation of global health training/mentoring programs through enhancements in training in ethics, responsible conduct and cultural competency.
Still, there is much more we need to do.
Structural racism is embedded in a wide range of challenges. A healthy, educated population leads to an economically productive society. The evidence is incontrovertible that until we address the structural racism that led to the current “fed-uprising” across the U.S. and the world, the right to health and well-being will continue to be denied.