Category Archives: Research

On becoming a decolonial scholar

I have observed some early, tentative steps of young academics to become world-class decolonial scholars in global health. This is a rich and rewarding area of endeavour that has real potential to launch a career without the baggage of narrow disciplinary boundaries, rigid methodological commitments, or premature demands for epistemic closure. When approached carefully, decolonial scholarship allows emerging researchers to engage critically with power, history, and knowledge while retaining considerable flexibility in analytic approach. What follows is offered as practical guidance for those who wish to navigate this space with confidence and coherence.

Decolonising global health has become a central ethical orientation for contemporary scholarship in the field. For early-career researchers, the challenge is not whether to adopt a decolonial stance, but how to do so convincingly within existing academic norms. You do not want a piece buried in the Malawi Medical Journal when global recognition can be found in The Lancet, PLOS, or BMJ. This brief guide offers practical advice on positioning oneself as a decolonising scholar, drawing on common techniques that are widely recognised as markers of both epistemic and moral alignment.

A successful decolonial paper begins with the scholar rather than the question. Reflexive positioning statements have become an essential opening move, allowing authors to locate themselves within global hierarchies of power, privilege, and complicity. Personal proximity to marginalisation is an asset. These declarations are most effective when they are candid yet indeterminate, signalling awareness without constraining interpretation. Once positionality has been established, subsequent analytic choices are more readily received as ethically grounded rather than methodologically contingent.

Research problems should then be framed in historical or structural terms rather than as empirical hypotheses. Questions that invite falsification risk reintroducing evaluative standards associated with dominant epistemic traditions linked to globalised practice. By contrast, concepts such as colonial residue, epistemic silencing, or inherited injustice resist closure and encourage moral elaboration. Where findings introduce ambiguity or contradiction, this can be interpreted not as analytic weakness but as evidence of the complexity produced by colonial histories themselves.

Within this framing, epistemic injustice can be treated as an outcome rather than a proposition requiring demonstration. The presence of asymmetry—between disciplines, regions, or forms of expertise—may be taken as sufficient indication of harm. Distinguishing between the unjust exclusion of valid insight and the justified rejection of erroneous claims is rarely necessary and may inadvertently reinscribe colonial distinctions between knowledge and belief. Moral recognition, once granted, does much of the epistemic work.

Lived experience occupies a privileged place in this literature and should be elevated accordingly. Personal and communal narratives can be used generously as data, though care should be taken to avoid subjecting them to processes such as validation, triangulation, or comparative assessment. Such techniques imply the possibility of error, which sits uneasily with commitments to epistemic plurality. Where accounts conflict, the tension may be presented as evidence of multiple ways of knowing rather than as a problem requiring resolution.

Ontological language offers particular flexibility. Early declaration of commitment to multiple ontologies allows scholars to accommodate divergent claims without adjudication. Later, when universal commitments are invoked—such as equity, justice, or health for all—these can be treated as ethical aspirations rather than propositions dependent on a shared reality. The absence of an explicit bridge between ontological plurality and universal goals rarely attracts critical scrutiny.

Power should be rendered visible throughout the paper, though preferably without becoming too specific. Abstractions such as “Western science”, “biomedicine”, or “the Global North” serve as effective explanatory devices while minimising the risk of implicating proximate institutions, funding structures, or professional incentives. Authorship practices, by contrast, provide a concrete and manageable site for decolonial intervention, often with greater symbolic return than methodological reform.

Papers should conclude with a call for transformation that exceeds immediate implementation. Appeals to reimagining, unsettling, or dismantling signal seriousness of intent, while the absence of operational detail preserves the moral horizon of the work. Evaluation frameworks, metrics, and timelines may be deferred as future tasks, once the appropriate epistemic shift has been achieved.

Finally, dissemination matters. Publishing in high-impact international journals ensures that critiques of epistemic dominance reach those best positioned to recognise them. Should access be restricted by paywalls, a brief acknowledgement of the irony is sufficient to demonstrate reflexive awareness.

In this way, decolonising global health can be practised as a scholarly orientation that aligns ethical seriousness with professional viability. The goal is not to resolve uncertainty or to determine what works, but to occupy the correct stance toward history and power. When that stance is convincingly performed, the work will speak for itself.

Parsing the NIH Reform Debate

I was recently alerted to Martin Kulldorff’s Blueprint for NIH Reform — a document that’s stirred some intense reactions among my colleagues. A few view it as a needed critique of systemic inefficiencies. Most regard it as an ideological Trojan horse—an attack on science dressed as reform. So where does the truth lie?

The short answer is: it’s complicated—and the messenger matters.

Kulldorff, once a Harvard professor and biostatistician, became a polarising figure during the COVID-19 pandemic for promoting ideas widely dismissed by the mainstream scientific community, including opposition to lockdowns, masking, and even some aspects of vaccination policy. He was also a co-author of the controversial Great Barrington Declaration, which called for herd immunity through natural infection — a strategy many experts considered unscientific and dangerous at the time.

This background understandably colors how his recent proposals are received.

But here’s the nuance: the Blueprint itself raises a number of ideas that aren’t inherently fringe. Calls for reforming NIH grant structures, enhancing academic freedom, incentivising open science, and streamlining peer review are echoed by many researchers across disciplines — including those with no ties to politicised public health debates. Frustrations with bureaucratic inefficiencies and perverse incentives in scientific funding are real and shared.

Where it becomes tricky is in the framing. Kulldorff doesn’t just argue for reform — he implies that current structures are suppressing truth, and that controversial views (like his own during the pandemic) have been silenced not because they lack merit, but because of groupthink or institutional bias. That framing, for many, crosses the line from constructive critique into undermining the scientific process itself.

There’s also a risk that pushing for more “openness” in what research gets funded — while laudable in theory — could result in resources being diverted to low-evidence, high-noise pursuits. Or, as one colleague aptly put it, “sending the ferret down an empty warren.” Science thrives on curiosity, but it also requires discipline and evidence-based filters.

Venue choice also matters. If this proposal were intended as a serious intervention into science policy, it might have been published in a mainstream medical or policy journal where it could be openly debated across the full spectrum of scientific opinion. Instead, it was published in the Journal of the Academy of Public Health — a platform co-founded and edited by Kulldorff himself, with close ties to politically conservative and contrarian public health figures. That choice raises questions about whether the article is seeking reform through consensus, or carving out space for alternative narratives that have struggled to find support in mainstream science.

So how should we engage with this?

  • Acknowledge the valid points: There is room — and need — for reform in how science is funded, reviewed, and communicated.

  • Be vigilant about context: Not all calls for reform are neutral. Motivations and affiliations matter, especially when public trust is on the line.

  • Defend the integrity of science: We can advocate for better systems without abandoning the core principles of evidence, rigor, and accountability — including fair peer review and a balance of risk and reward.

In the end, this is not a binary question of “pro-science” vs “anti-science.” It’s about how science evolves, who gets to shape that evolution, and what values we prioritise along the way — openness, yes, but always in service of evidence and public good.


This is an independent submission, edited by D.D. Reidpath.

A dark, dystopian government data center filled with towering servers and flickering computer screens. Dust-covered books and old research papers sit abandoned, while glowing terminals display files. A lone researcher, illuminated by the cold blue light of a monitor, desperately tries to recover lost data from a corrupted drive. The atmosphere is eerie, with dim overhead lights and an air of secrecy, symbolizing the slow decay of knowledge in a forgotten digital vault.

The Purge

The Trump administration has started one of the most significant assaults on human knowledge in centuries. Well-collected, curated and communicated data are facts—an evidence base. When facts contradict a political narrative, they are dangerous. The US government has realised the danger and begun The Purge. The government will now establish new “facts” to replace old facts. Purge-and-replace is part of the process of state capture. Evidence represents dissent, and the government must crush dissent. Reality is altered.

Until a week ago, successive US governments had invested in a data, evidence-based policy enterprise with generous global access. It was a resource for the world that supported research and evidence-based decision-making. And, unless the information was classified or subject to privacy laws (e.g., HIPAA for health data), anyone could look at everything from labor and criminal justice statistics to environmental and health data.

Going, going … !

Starting late last week, government websites began to disappear; among them, the USAID website vanished without a trace. All the development evidence USAID published has disappeared. If you try to reach the website today (2 Feb, 2025), you will get a message from your internet provider informing you the site does not exist. Perhaps you have the wrong address…or maybe it was never really there. (Queue spooky music.)

Individual pages on government websites are also disappearing. The Centers for Disease Control and Prevention (CDC) webpage, for example, providing evidence-based contraceptive guidelines has vanished. A week ago, the guidelines helped people exercise their reproductive choice using the best available evidence. But facts are dangerous. The idea of personal autonomy in reproduction runs counter to the authoritarian narrative of the current US administration. CDC is being scrubbed clean.

Data are also disappearing. The Youth Risk Behavior Surveillance System (YRBSS) is a longitudinal survey of adolescent health risks coordinated by the CDC. If I search the CDC website for “YRBSS”, I get links. If I follow the links: “The page you’re looking for was not found”. This loss of data is a tragedy. A quick look at PubMed reveals the kind of research that has used YRBSS data: everything from adolescent mental health to smoking. Without those data, no one today could do the same kind of research that was done before. Trends in adolescent health are lost and we will not know about any emerging health risk factors. It is hard to know precisely why the YRBSS has disappeared. However, in keeping with the religiously conservative nature of the current US government, maybe it is adolescent sex that is too dangerous for people to know about.

The US government is not content with just removing facts. They also want CDC scientists to rewrite their research to adopt a single, approved, authoritarian view of the world. Their research must conform to the Trump government’s ideology. An approach which is oddly reminiscent of Stalin’s insistence that Soviet researchers adopt the dead-end genetic science of Trofim Lysenko.

The CDC has instructed its scientists to retract or pause the publication of any research manuscript being considered by any medical or scientific journal, not merely its own internal periodicals…. The move aims to ensure that no “forbidden terms” appear in the work. The policy includes manuscripts that are in the revision stages at a journal (but not officially accepted) and those already accepted for publication but not yet live.

It hasn’t happened yet, but I have to wonder what will happen when the US Government targets PubMed and PubMed Central—exceptional scientific resources provided free of charge to the world by the National Library of Medicine (NLM)? NLM could be directed to purge from the database all abstracted data on every journal article that contains ideas that do not support the government’s worldview: gender, transgender, climate change, vaccines, air pollution (from fossil fuels)…. Commercial providers could still abstract those articles, but the damage would be enormous.

The vaccine denier, Robert F. Kennedy, junior, is currently being confirmed as Secretary of Health. He believes the widely debunked, fraudulent claim that vaccines cause autism. What happens when he decides that the National Library of Medicine should selectively purge evidence debunking the vaccine-autism link? Will that mean vaccines cause autism in the US (a “US-fact”) but not in the rest of the world (a “fact-fact”)? Researchers in universities and institutions that can afford subscription services can avoid such excesses, but that will not be the case for many Global South researchers who rely on PubMed for their research, nor will it be the case for the general public, who also have free access to PubMed.

I have focused on health because it is the domain I know the best. There is, however, almost no factual resource of the US government that will be safe from the purge. Facts that endanger a Trump administration political narrative must not be allowed to exist.

The US government is a climate-denying administration that has again pulled out of the Paris Climate Accord. It has already targeted climate change research. Justice, labour, and population statistics that do not conform to the US government’s socially conservative, racist and xenophobic views about the world will also be in danger. Trade data that don’t support Trump’s political narrative of a “golden age” will need to be adjusted.

One of the great tragedies is that, now that the US government has shown itself to be institutionally disinterested in (or actively opposed to) facts, it has endangered the value of its entire evidence-based policy enterprise. If you visit a US government website in a year, will you trust the content? You shouldn’t. Instead, you should ask yourself what political interest influenced the information. Researchers, policymakers, journalists—everyone— will need to parse US government websites like they parse information from any other authoritarian regime. Sadly, research coming out of US universities will also require extra scrutiny. Where we trusted the voices before, now we would need to ask, has US government policy biased it, what is the nature of the bias, and can we manage the bias?

Sometimes, it will be easier to ignore US research altogether because verification carries a cost.

There are small glimmers of hope. Archive.org (the Wayback Machine) has historical snapshots of US government websites, including some data snapshots, such as the YRBSS. These snapshot are BTP (befor the purge). Unfortunately, the archive is not as easy to navigate as the World Wide Web nor as easy to navigate as dedicated government websites. The value of the archived information also relies on the snapshot being taken at the right time to capture the latest BTP information. The CDC contraceptive-use guidelines purged a few days ago, are available on archive.org from a snapshot taken on 25 December, 2024. Assuming the CDC made no BTP updates since the last snapshot, the information is up to date…for now. Of course contraceptive guidelines evolve with new data and new technology and they will be out of date in the coming years.

If we are to survive the worst damage of The Purge, other government and non-government institutions worldwide will have to step into the breach. Historical data may need to be reconstructed and curated from sources such as archive.org. The Pubmed and Pubmed Central databases should be copied before the US government corrupts them. Where US data are still available, copy them. Outside the US, we will need to put in place prospective mechanisms to collect valuable global data that we can no longer trust from US sources.

…going…

We cannot assume that the facts from US government sources will remain uncorrupted tomorrow because they are uncorrupted today. The preservation of the truth will require resources and investment.

… GONE!

Welcome to The Purge

A Christmas Story

In the last year of the reign of Biden, there was a ruler in Judea named Benyamin. He was a man of great cunning and greater cruelty.

In those days, Judea, though powerful, was a vassal state. Its strength was created through alliances with distant empires. It wielded its might with a fierce arm and harboured a deep hatred for its neighbors. Benyamin, fearing the loss of his power, sought to destroy the Philistines on that small strip of land called Gaza, and claim it for himself.

For over four hundred and forty days and nights, he commanded his armies to bomb their towns and villages, reducing them to rubble. The Philistines were corralled, trapped within walls and wire, with no escape. Benyamin promised them safety in Rafah and bombed the people there. He offered refuge in Jabalia, and bombed the people there.

In Gaza, there was no safety and there was no food.

Even as leaders wept for the Philistines, they sold weapons to Benyamin and lent him money to prosecute his war. Thus, the world watched in silence as the Philistines endured great suffering. Their cries rose up to heaven, seemingly unanswered.

And so it came to pass, in the last days of the last year of Biden, there was a humble Philistine named Yusouf born of the family of Dawoud. Before the war, Yusouf had been a mechanic. He worked hard each day fixing tires and carburetors, changing break-pads and exhaust systems. And at the end of each day, he would return home to his young wife, Mariam. The same Mariam, you may have heard of her, who was known for her inexhaustable cheerfulness.

That was before the war. Now Mariam was gaunt and tired, and heavy with child.

On the night of the winter solstice, in a dream, a messenger came to Yusouf. “Be not afraid, Yusouf”, the messenger said. “Be not afraid for yourself, for the wife you love so very much, or for your son—who will change the world. What will be, will be and was always meant to be”. Yusouf was troubled by this dream, and found himself torn between wonder, happiness, and fear. Mariam asked him why he looked troubled, but he said nothing and kept his own counsel.

The following night the same messenger visited Mariam in her dreams. Mariam was neither afraid nor troubled. The next morning she had a smile on her face that Yusouf had not seen for so long he had almost forgotten it. “It is time, Yusouf”, she said. “We have to go to the hospital in Beit Lahiya.”

Yusouf was troubled. Long ago he had learned to trust Mariam, but his motorbike had no fuel and it was a long walk. Too far for Mariam, and they were bombing Beit Lahiya. He remembered the words of the messenger in his dreams and he went from neighbour to neighbour. A teaspoon of fuel here, half a cup there. No one demanded payment. If they had any fuel, no one refused him. Having little, they shared what they had. It was the small act of kindness that binds communities. Yusouf wept for their generosity.

When he had gathered enough fuel, he had Mariam climb on the bike. Shadiah, the old sweet seller who had not made a sweet in over a year and could barely remember the smell of honey or rosewater, helped her onto the back.

Yusouf rode carefully. He weaved slowly around potholes and navigated bumps. In spite of his care, he could feel Mariam tense and grip him tighter. And then the motorbike stopped. A last gasping jerk and silence. The fuel was spent.

The late afternoon air was cooling as he helped Mariam walk towards the hospital. When they arrived at the gate, a porter stopped, them. “They’re evacuating the hospital. You can’t go in”, the porter told them. Yusouf begged. “My wife, she is going to give birth,” he told the porter—who could plainly see this for himself. The porter looked at Mariam and took pity. “You can’t go in, but there is a small community clinic around the corner. It was bombed recently, but some of it, a room or two, is still standing. I’ll send a midwife.”

Yusouf gently guided Mariam to the clinic. He found an old mattress on a broken gurney and a blanket. He lay it on the floor and settled Mariam.

If there had been a midwife—if she had ever arrived… if she had ever got the porter’s message—she would have been eager to retell the story of the birth. Sharing a coffee, with a date-filled siwa, she would have painted the picture. Mariam’s face was one of grace. Yusouf anxiously held her hand. The baby came quickly, with a minimum of fuss, as if Mariam was having her fifth and not her first.

Yusouf quickly scooped up the baby as it began to vocalise it’s unhappiness with the shock of a cold Gaza night. He cut the cord crudely but effectively with his pocket knife. And it was only as he was passing the the baby to Mariam that he looked confused. He did not have the son he was promised, he had a daughter. The moment was so fleeting that quantum physicists would have struggled to measure the breadth of time, and Yusouf smiled at the messenger’s joke.

Because there was no midwife to witness this moment, we need to account for the witnesses who were present. There was a mangy dog with a limp looking for warmth. He watched patiently and, once the birth was completed, he found a place at Mariam’s feet. There were three rats that crawled out of the rubble looking for scraps. They gave a hopeful sniff of the night air and sat respectfully and companionably on a broken chair. As soon as the moment passed, they disappeared into the crevices afforded by broken brick and torn concrete. Finally, there was an unremarkable cat. In comfortable fellowship, they all watch the moment of birth knowing that, tomorrow or the next day, they were mortal enemies, but tonight there was peace.

“Nasrin”, Yousuf whispered in Mariam’s ear as he kissed her forehead. “We’ll call her Nasrin.” The wild rose that grows and conquers impossible places.

There was a photo journalist called Weissman, who heard from the porter that was a very pregnant woman at the clinic. “She’s about to pop”, the porter said. Weissman hurried to the bombed out clinic so that he could bear witness to this miracle in the midst of war.

He missed the birth. And when he arrived, he did not announce his presence. It seemed rude. An intrusion on a very private moment. It did not, however, stop him from taking photos for AAP.

He later shared those images with the world. Yusouf lay on the gurney mattress, propped against a half destroyed wall. Mariam was lying against him, exhausted, eyes closed, covered in a dirty blanket. The baby Nasrin was feeding quietly, just the top of her head with a shock of improbably thick dark hair peeking out. Yousuf stared through the broken roof at the stars in heaven. The blackness of a world without electricity made resplendent. He looked up with wonderment and contentment on his face. He was blessed, he thought. No. They were blessed. The messenger was right.

As Weissman picked his way in the dark towards the hospital gate, where he had last seen the porter, he shared the same hope that he had seen on Yusouf’s face. New life can change things.

The night sky lit up, brightening his path to the hospital. He turned back and was awed by a red flare descending slowly over the remains of the clinic as if announcing a new beginning to the world. A chance for something different was born here today.

The explosion shook the ground and Weissman fell. Cement and brick dust from where the clinic had stood rose sharply in to the air. An avalanche of dust raced towards him.