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Global Health Econ Sustain Decolonization of health care

staple foods within several communities. Moreover, the likely to gradually diminish with vaccination programs,
forced labor of men from these communities has altered and access to free retroviral and anti-tuberculosis therapy
population dynamics, often exposing women and children proving highly effective in reducing deaths from infectious
to famine and disease. diseases, NCDs already account for nearly half of all deaths
The situation was not helped by the UK’s decision to (Kraef et al., 2020) and much morbidity across East Africa.
reduce its support for developing countries in the wake We facilitated a program on NCDs to combine medical
of its own financial challenges following the COVID-19 education, clinical research, and service development
pandemic (Cameron-Chileshe, 2021), with Africa bearing and extended this initiative to multiple sites. African and
the brunt of these cuts. Having already lost many people to European hospitals and universities have worked in tandem
the AIDS epidemic a generation earlier, this reduction in to exchange knowledge within an equitable partnership
support has threatened the gradual recovery evident across to provide and sustain evidence-based clinical practices.
much of the continent. However, Rishi Sunak, who was The rapid changes in the patterns of disease in Africa
responsible for this decision as Chancellor, had announced have implications for the training and responsibilities
that he would host a UK/Africa investment summit of all health-care workers across the continent. There is
conference in April 2024 as Prime Minister (The Africa a huge need to develop and staff screening programs for
Report 2024). This announcement could conceivably the detection and treatment of hypertension and diabetes,
presage a return to previous levels of support for Africa. The which requires investment in teaching and training in
reduction in the provision of UK government-sponsored these areas. Likewise, there is increasing recognition of
expert medical staff to former colonies, intended to aid in the importance of auto-immune disorders (Krauth et al.,
education and staffing, has left several initiatives incomplete 2022) and musculoskeletal disease (MSK) (Kuo et al.,
and greatly diminished the value of their legacy. Despite 2023) across all age groups (Walsh et al., 2022) in East
acknowledging the atrocities perpetrated in Africa, the UK Africa, although the present provision of rheumatological
government has been intransigent in not apologizing (as services remains woefully behind that available for the
Germany did). Such an attitude may indicate a reluctance rest of the continent (Mody et al., 2023). Evidence exists
to engage in decolonization efforts in the health sector. that an increasing burden of systemic complications of
Given the UK’s political intransigence, how can we begin these chronic disorders is recognized (Said et al., 2023),
to redress the global imbalance within health-care access and that mental health issues are becoming a bigger issue
and delivery? Such a task requires collaboration across among younger Africans (Elinisa et al., 2020). Together,
many organizations. The British Medical Association must these chronic disorders carry a growing clinical, economic,
reassess its policies and priorities from a decolonizing and societal burden for East Africa (Mmbaga et al., 2023).
perspective (Akinnawonu, 2023), while the British Perhaps the previous poor emphasis on NCDs is another
Broadcasting Company needs to change its focus away from legacy of the former colonial administrators?
UK-centric to a more global interest in health care (Looi,
2023). A fundamental change in approach is required in 4. Strategies to address clinical challenges
the relationship between the Global North and Africa, as Much rhetoric has been expressed over the principles
the present mechanisms of support risk potentiating the of decolonizing medicine, yet fewer discussions have
tendency to maintain the present power base in “colonizer addressed the practical aspects of achieving this goal at
countries” (Rasheed, 2023). a clinical level. Following the recognition that clinical
learning resources inadequately represent individuals with
3. Clinical service challenges and changes darker skin tones (Abduelmula et al., 2022), we have been
A recent British Medical Journal (BMJ) editorial part of a collaborative to develop medical educational videos
encouraged us all to be “‘brave, hopeful, and essential”’ in featuring African doctors examining African patients with
decolonizing health (Abbasi, 2023, p. 383), and we would Swahili commentary, accompanied by a photo library
like to share our experiences in that endeavor. Over the illustrating disorders present in patients with dark skin.
past 5 years, Tanzanian and UK physicians have worked These resources will soon be freely accessible to all African
together to design, develop, and deliver clinical services clinicians. The Tanzanian medical curriculum has been
for Tanzanian patients with non-communicable diseases expanded to incorporate the increasing burden of NCDs for
(NCDs). We agree that “efforts must begin with medical all staff, consolidated in a series of open-access PowerPoint
education and training” (Naidu, 2023, p. 383), as our presentations. Clinical services have been established with
Tanzanian medical curriculum previously focused largely ongoing input from self-funding UK clinicians during
on infectious disorders. With tropical diseases like malaria sabbaticals and study leave. These clinicians continue to
(Datoo et al., 2023), and even leishmaniasis (King, 2023), facilitate online seminars and case discussions and provide

Volume 2 Issue 2 (2024) 3 https://doi.org/10.36922/ghes.2299