Histories of Global Health, Medicine & Disease - Lecture Notes

Lecturer: Jeroen Lorist, PhD
Office Hours:
- Monday: 13:15 - 15:00 (Room 3.00)
- Thursday: 09:15 - 11:00 (Room 3.09)
Course Title: Histories of Global Health, Medicine & Disease
Session 1: Tue 9 April 2025

Group Work – Experiential learning
- Running and Malaria Eradication NGO Histories of Global Health, Medicine & Disease

Think critically on Global Health, Medicine and Disease within different contexts and how thinking about health has developed over time.
Learn about the continuities that affect Global Health institutions, knowledge, and practices today (e.g., racism, colonialism).
Take different perspectives on how to study Global Health.
Explore different diseases such as HIV, Polio, and Tuberculosis.
Explore decolonial perspectives on Global Health, Medicine, and Disease.
Explore how we could build better Global Health futures.

Week 1: 9 April - Introduction to Global Health, 11 April - Case Study – Dutch Sexual Health Interventions
Week 2: 16 April - What is Critical Global Health, 18 April - Good Friday – PUBLIC HOLIDAY – No class
Week 3: 23 April – Case Study – Polio behind the Iron Curtain, 25 April – History of bio-medicine
Week 4: 30 April – History of HIV, 2 May – Decolonializing Global Health. First essay due by 23:59 on Sunday, May 4th
Week 5: 6 May – Group presentations, 9 May – How to study Global Health
Week 6: 14 May – Tuberculosis – Guest Lecture, 16 May – No lecture. Second essay due at 23:59 on Sunday, May 18th.
Week 7: 21st May - History of Mental Health, 23rd May – Global Health Futures
Final Exam: To be determined

Continuity of historical processes like racism.
Simplistic single vector focus (only killing the mosquitos).
Exclusion of economic, social, and political contexts and social determinants of health.

“Colonial medicine’s legacy is not only in the infrastructure left behind, but in the ways that disease and health continue to be framed in technical and apolitical terms.”

Authors: Jeremy Greene, Marguerite Thorp Basilico, Heidi Kim, Paul Farmer
Jeremy A. Greene is the William H. Welch Professor of Medicine and the History of Medicine at Johns Hopkins School of Medicine.

Key Quote:

“Critical social history seeks to accomplish three goals:
1. To render the present unfamiliar, and therefore open to social critique.
2. To emphasize the role of continuity between, for example, current global health efforts and former colonial rule.
3. To work to understand the rifts and discontinuities that account for meaningful social change.”

Medicine played a central role in the colonial project, often serving as a justification for imperial expansion.
Colonial health interventions were frequently motivated by economic and military interests rather than humanitarian concerns.
Disease control efforts were often designed to protect European settlers and workers rather than indigenous populations.

Colonial medical policies reinforced racial hierarchies, often prioritizing the health of colonizers over colonized populations.
Indigenous healing systems were often marginalized or dismissed as "unscientific," despite their efficacy.

Many contemporary global health infrastructures were shaped by colonial-era policies, which led to fragmented and under-resourced health systems.
Some postcolonial nations inherited medical institutions that were designed primarily for colonial elites, leading to unequal access to healthcare.

Colonization influenced the spread and management of diseases such as malaria, tuberculosis, and smallpox.
The focus on tropical medicine reflected colonial priorities, often addressing diseases that threatened European administrators rather than those affecting local populations most.

Many inequalities in modern global health can be traced back to colonial histories, with persistent disparities in access to healthcare, medical research priorities, and disease burden.
International health organizations, NGOs, and foreign aid programs sometimes replicate colonial power dynamics, perpetuating dependency rather than fostering self-sufficiency.
Next week’s case study shows how these colonial power dynamics, i.e., historical racialist norms, are invisibly reproduced through knowledge power (Foucault) within Dutch-funded sexual and reproductive health programs.

Postcolonial movements have sought to reclaim indigenous knowledge and decolonize healthcare systems.
Colonized populations did not passively accept colonial medical practices; many resisted, adapted, or integrated aspects of Western medicine into their own healing traditions.
Next week’s case study also shows Dutch-funded colonial power dynamics and knowledge/power (Foucault) are resisted in context in Uganda and Zambia.

Arturo Escobar: A key figure in post-development and post-colonial thought.
Contribution: Radical critique of development as a Western project perpetuating colonial power structures and imposing Eurocentric norms on the Global South.
Landmark book: “Encountering Development: The Making and Unmaking of the Third World” (1995).

Escobar applies Foucault’s concept of discourse to argue that "development" isn't just a set of policies or aid programs—it's a system of knowledge and power that constructed the "Third World" as:
- Poor
- Underdeveloped
- In need of Western intervention
This discourse:
- Frames Western ways of life as the ideal.
- Depicts other cultures as "lagging behind."
- Justifies economic and political control under the guise of helping.
“The problem with development was not that it failed to deliver what it promised, but that it was the wrong promise to begin with.”

Global Health
International Health
Colonial Medicine
Tropical Medicine
Missionary Medicine
Task: Using today’s reading and internet research, develop working definitions that we can use in class. Email them to: h.h.j.lorist@luc.leidenuniv.nl by Thursday 16:00.

Based on the historical lessons learned from the Greene et al. Paper: What would your Western Funded NGO’s strategy be to eradicate Malaria in Ghana?
- What is the name of your NGO?
- Who is the CEO?
- Who takes notes?
- Who presents?