• Ethics

In a feature article in the Journal of Medical Ethics entitled ‘Where is knowledge from the global South? An account of epistemic justice for a global bioethics’,1 Pratt and de Vries give a highly persuasive account of global injustices within global bioethics especially health ethics against the global South that every bioethicist needs to read and to reflect on. The opening three sentences of the abstract of this account capture the ethical essence of the whole article.

The silencing of the epistemologies, theories, principles, values, concepts and experiences of the global South, constitutes a particularly egregious epistemic injustice in bioethics. Our shared responsibility to rectify that injustice should be at the top of the ethics agenda. That it is not, or only is in part, is deeply problematic, and endangers the credibility of the entire field.1

It is quite significant that both authors of this article are scholars of the global North with research interest in the global South; so where are the scholars of the global South, the putative conceptualisers and creators of global South knowledge who should be complaining about the injustice in question? The answer to this question is part and parcel of the question itself that has been so boldly raised by Pratt and de Vries. They go on to describe in some detail the general conditions and requirements of epistemic justice for global health ethics and bioethics including even a consideration of putative objections to their theory which they attempt to answer. Their article is a paradigm of scholarship done under the rigours and guiding canons of the global North’s peer-review system. It is a system with a great pretence to objectivity, impartiality and fairness, whereas in fact it is not completely immune to the practice of subtle censorship, intimidation, bullying and unfairness.2

In this comment, I have limited myself to suggesting some of the root causes of the problem of epistemic injustice as identified by Pratt and deVries. I have also limited myself to the continent of Africa rather than the global South in general which may raise complex problems of delimitation. In doing this, I am not aiming at impersonal objectivity or an account devoid of all emotions but rather at true authentic subjectivity, inasmuch as my perspective on the problem, based on my own experiences, sensibilities and point of view, can only be appreciated intersubjectively.

The root causes of the problem of epistemic injustice in global health ethics and bioethics, as identified and highlighted by Pratt and deVries, as far as the African continent is concerned, are traceable to the colonial heritage, predatory exploitation, educational hegemony, religious proselytisation and the attempt of the global North to impose a global monoculture through scientific myths and pretentious philanthropy. The situation needs to be remedied by changing the dominant paradigm on which our world has operated for centuries, through decolonisation,3 4 self-reliance, rejection of all forms of colonial hegemony and unjustified dependency, rejection of double standards and embracing of a new world order based on diversity, solidarity, acceptance of difference and mutual respect.

The hegemonic colonial stranglehold of the global North on the African continent is well exemplified in the ongoing twin events that are shaping indelibly the contemporary history of the world—the COVID-19 epidemic and the war in Ukraine. These two events have impacted the continent of Africa as well as peoples of African descent all over the world in fundamentally troubling ways implying and occasioning a jolt in consciousness.

The war in Ukraine, pitting Russia against the North Atlantic Treaty Organization is, for all intents and purposes, the third world war (WWIII) and this may not be evident simply because nuclear weapons have not yet been used as many people unconsciously expect for any WWIII. The war has reawakened especially Euro-Americans to doing what they know best how to do as far back in their history as one may want to investigate—warring. The war involves all the superpowers of the world who are mobilising all resources they can to ensure that the emerging, postwar, new world order would be under their power and control. In that situation, as in the first (1914–1918) and second (1939–1945) world wars, Africa and Africans are victims, mercilessly exploited and manipulated by both sides of the conflict, each in its own rational self-interest. The war has confirmed that Africa, Africans, people of African descent and black people all over the world, for some unfathomable reason, are victims of deep-seated racial discrimination, persecution and exceptionalism. In Ukraine, during this war, we have witnessed African students, fleeing for safety like other human beings, discriminated against and denied war refugee entry into some European countries, in preference for even cats and dogs.

Regarding COVID-19, it has clearly highlighted the fact that there is no part of world, including the African continent itself, where Africans are treated with equity vis-à-vis other human beings. The experimental vaccines produced in the global North against the pandemic were hoarded,5 by the most powerful and richest countries of the global North and some sent to Africa only when they were close to expiry. Meanwhile, various plant-based remedies discovered by some African healers against the virus were ridiculed and sidelined by global North international agencies and even by the WHO whose close relationship with for-profit health research organisations6 has significantly eroded traditional medical ethics in the global North itself.7

Scholars in Africa, as researchers, knowledge producers or users, labour under the constraints of the colonial education they have received and global North funding which puts them in a conceptual straight-jacket, but without which it is difficult, almost impossible, to do any meaningful research. In the interest of job or career, let alone international recognition, therefore, they are often constrained to sweep ethics to the upper chamber of empty platitudes and bold pretentiousness. They have remained on the global landscape basically as medical sample and data collectors for global North agencies. This partly explains why African scholars/researchers are mostly silent over the glaring epistemic injustice pointed out by Pratt and deVries and why they are likely to pretend unawareness in cases where any colleagues had been bold enough to raise the alarm. (Since the mid-1990s my own work in Bioethics has been largely focused on this problem). It is not easy to jeopardise a lucrative career or opportunities by undue radicalism.

It is to be hoped that this discussion would occasion a mutation that puts African elites before their responsibilities to their communities and continent and leads to greater epistemic justice, moral equality and equity, not only in global bioethics and health ethics but in all other domains and activities where the dominant global North and the global South are bound to work together for the good of human beings anywhere and everywhere on planet Earth. For while it is good to talk, all good talk is empty and useless, unless it results in effective action.