Redefining Global Health in the 21st Century, Chapter 2: A New Epistemology for Global Health — Embracing Complexity and the "Both/And" Approach
Episode Description
Ben Plumley speaks with Dr. mike Reid and Eric Goosby about their new book Redefining Global Health in the 21st Century, focusing on epistemology—how global health defines knowledge, evidence, and success. They argue global health has overprioritized biomedical metrics and donor-driven targets, often sidelining local knowledge, community co-design, and broader measures like sustainability, equity, and trust. Using examples from HIV/TB programming, maternal health, differentiated service delivery, and integration vs vertical programs, they discuss how humility and partnership shape effective, resilient responses and how “measurement is rarely neutral.” The conversation addresses threats to key populations under current political decisions, the need for epistemic justice and a preferential option for the poor, failures in academic authorship equity, and how shifts in US leadership and the climate crisis may reshape global health governance. They also stress better explaining global health’s value to taxpayers.
00:00 Local Wisdom vs Evidence
00:55 Meet the Authors
01:45 Epistemology and Priorities
05:09 Epistemic Humility
08:51 PEPFAR Lessons on Partnership
10:39 Measurement Is Not Neutral
13:18 Motivation and Co-Design
21:09 Integration vs Vertical Programs
25:05 Equity and Key Populations
32:06 Politics and Funding Dilemmas
34:31 Moral Case for Care
36:09 Domestic Front Lines
36:56 Beyond Us Versus Them
40:10 Epistemology and Donor Power
44:15 Inclusive Leadership Priorities
47:37 Vacuum After US Retreat
51:09 Climate as Next Crisis
55:34 Decolonizing Academic Incentives
57:55 Preferential Option for Poor
01:00:27 Selling Global Health at Home
01:04:36 Three Arguments for Taxpayers
01:06:56 Closing Reflections and Next Episode
Learn more about the book:
https://bit.ly/redefining-global-health
More from UCSF Institute for Global Health Sciences:
https://globalhealthsciences.ucsf.edu
Check Out mike Reid’s Substack:
https://substack.com/@reimaginingglobalhealth
Check Out Ben’s Substack:
https://substack.com/@benplumley1
Join the Conversation!
What would it take for global health to avoid decline? Share your thoughts in the comments!
Subscribe & Stay Updated:
Listen on Spotify, Apple Podcasts, or your favorite podcast platform.
Watch on YouTube & subscribe for more in-depth global health — and look out for a dedicated sub channel for Redefining Global Health in the 21st Century under A Shot in the Arm’s YouTube home.
Redefining Global Health in the 21st Century: The Podcast (Playlist on Youtube)
https://youtube.com/playlist?list=PLW7yagTEtywqvW9_bs6heRikREgwS9sE9&si=TuNEdwcA9Z-VKLH
A Shot in the Arm Podcast Youtube (Main Channel)
