One Size Does Not Fit All: How High-Income Countries (HIC)-Created Standards Limit Global Majority Wellness and Achievement of the Sustainable Development Goals (SDGs)

Abstract

Disproportionate differences in power, resources, and decision making power allotted to high-income countries (HIC) have created an imbalanced structure that hinders participation of low-to-middle income countries (LMIC) in shaping Global Health (GH) agendas. Thus, global standards and protocols in GH and Public Health (PH) are created by HIC and modeled after their own contexts, resulting in far-reaching and often detrimental consequences on the global majority. Failing to account for the vast cultural, resource, infrastructural, and governance differences across diverse settings, these standards and protocols may not translate effectively to LMICs. Similarly, PH measures, demonstrated by global responses to the COVID-19 pandemic, are ineffective or impractical in regions where overcrowding, inadequate sanitation, and resource constraints render these interventions untenable. With the mission of empowering people in LMICs with the resources to be creators of change in their own communities, the Nuvance Health GH Program has partner sites in twelve countries as well as domestic sites within the United States. Our areas of focus include medical education, clinical research, infrastructure development, and academic scholarship, with a commitment to fostering mutually beneficial collaborations and addressing the systemic imbalances prevalent in GH initiatives. LMICs are most greatly impacted by the challenges the SDGs aim to address, and yet have limited say in global standards impacting their communities. Standards that cater specifically to LMIC contexts in GH are directly necessary for advancing SDGs related to health, education, economic growth, innovation, reduced inequalities, peace, justice, and partnerships.