Navigating Colonial Love with Seye Abimbola

In this episode of the Global Health Unfiltered Podcast, host Desmond Jumbam speaks with Dr. Seye Abimbola about his book, 'The Foreign Gaze: Essays on Global Health.' They discuss how personal experiences, especially familial influences, shape views on global health. Dr. Abimbola shares his mother's impact on his understanding of health systems and social determinants. They also explore 'colonial love' and its effects on current global health practices, alongside the issue of the 'foreign gaze' in academia, highlighting power dynamics in research and policy. The conversation covers health equity, audience dynamics, local knowledge, and health system history. Dr. Abimbola critiques the colonial legacy in global health, stresses the need for connection within systems, and addresses the role of activism. They examine reactions to US foreign policy and advocate for localized health interventions. The discussion also tackles belief in global health and foreign aid, contemplating the 'America First' concept, the perception of aid, the role of health journals, and calls for a reimagined research approach, underscoring local perspectives and robust discourse in global health.

Download Seye's book: https://www.editions.ird.fr/produit/728/9782709930437/the-foreign-gaze

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To support us, consider becoming a paid subscriber on Patreon or making a one-time donation via PayPal.

Follow us on X (@unfiltered_gh), LinkedIn, Instagram, and TikTok.

Transcript

Desmond Jumbam (00:01)
Hello friends and welcome to season four of the Global Health Unfiltered Podcast, a podcast about the unspoken realities of global health in Africa and the world. I'm your host and I'm glad you joined us today. Today's guest is Dr. Shea Mimbolla, Associate Professor of Health Systems at the University of Sydney and the former editor in chief of BMJ Global Health.

We're very thrilled to have Shere back on the podcast because we had him in season one. And in that particular season, in that particular episode, we spoke about the foreign gaze in global health, which is a concept that Shere has been championing for the past couple of years. And since then, he has continued to think and write on this particular subject. So his recently published book,

The Foreign Gays Essays on Global Health Expand on the Problems and Solutions of the Foreign Gays in Global Health. So we're thrilled to have him back to share additional insights that he has gotten on this topic. So, share, welcome back to Global Health Unfiltered.

Seye Abimbola (01:18)
Thank you very much, Jasmine. It's very nice of you to have me. I'll join you again.

Desmond Jumbam (01:24)
So by the way, congratulations on your book. I've had a chance to go through it. And it's been a delightful read. And there's a lot of great insights, lots of great, just a lot of information in there. So during this episode, we'll be talking about the different ideas that you share in that book. So the first chapter of the book,

You spend a lot of time talking about your mother and the impact that she had on you and the way you see and perceive and even do global health. So perhaps that's a great place to start. Can you tell us a little bit about your mother and how she has impacted the way you view global health?

Seye Abimbola (02:14)
Thank you. Memory is a very tricky thing. Whenever I try to look back, there are some episodes that just jump out in my head. And I'm not sure, I'm always wondering, were there others that I've completely repressed, or what is going on with my memory? So I'm never fully trustful of memory, just to say that first. But what was clear to me growing up was that we were relatively privileged.

Desmond Jumbam (02:44)
Mm-hmm.

Seye Abimbola (02:45)
lived in a smallish town, it's not very small, only by European standards it's a darker city, but by Nigerian standards it's small. There's a sort of sense of it being contained. And we attended a church where most people were of a lower socioeconomic status relative to us. And again, I knew that as a child, that something going on here, and that I was, we were privileged compared to other people.

Desmond Jumbam (02:56)
Mm-hmm.

Seye Abimbola (03:15)
It was also clear to me and to us, because often this is not just me and I have three siblings. it was, and these were things we discussed often and when we gather even now, we still talk about. it's, they were real things for, it was a collective.

Desmond Jumbam (03:33)
Mm-hmm.

Seye Abimbola (03:35)
that the church that we attended had this doctrine of divine healing and that many people will fall sick, die or really suffer. We never just heard of people like children, adults, elderly people. And that when we joined the church, my mother for some reason decided to do something about it.

Desmond Jumbam (03:49)
Mm-hmm.

Seye Abimbola (04:02)
Now was strange enough that she would join such a church because she was a nurse midwife in the biggest hospital in town so everyone knew what she did. And she was undaunted by all of that. I don't know. I'm not, you know, I lost my faith. So I don't believe things anymore. But she was, I believe something really strongly and set out to do lots of things, very organizationally, you know, ambitious things about it. Built a whole...

Desmond Jumbam (04:05)
Hmm.

Mm-hmm.

Seye Abimbola (04:32)
crop of church midwives, you know, with a lot of additional training and mentoring. I would sometimes join in meeting them in sessions with them and observe how all of that played out. And she would often talk about the politics of making things work in church.

Desmond Jumbam (04:52)
Hmm.

Seye Abimbola (04:54)
often with other people, not us, he wasn't discussing these things with us, but we knew everything because we just listened. So we understood how to make, to work a power hierarchy. We understood how to organize people around a common cause. We understood what it took to conceal some things from other people because you didn't want their eyes on it. We also understood

Desmond Jumbam (05:05)
Mm-hmm.

Hmm.

Seye Abimbola (05:21)
very quickly as we started to observe clinical consultations, the role that all the things we now call social determinants of health play in people's lives. And again, wasn't as though that I didn't have the word for those things, but it was clear. I knew why a person died. I knew why those who didn't die did not die. I understood that deeply. Sometimes it's, you know, simple.

Desmond Jumbam (05:31)
Hmm.

Seye Abimbola (05:45)
Poverty is never simple. Sometimes it's simple poverty, Sometimes it's just people having money or access to come and ask for medicines because the church didn't allow you to take medicines. But if you are rich enough and you were confident enough and you could talk to my mom, you likely would get medicines or clinical attention or set up a whole little clinic in your bedroom in our house. And we also knew if you really didn't do that, couldn't do that.

Desmond Jumbam (05:54)
Mm-hmm.

Hmm.

Seye Abimbola (06:15)
And as I said in the book, I often wondered to what extent it was faith at work, faith almost as an excuse for one not being able to do something, being more palatable in a sense than the real reason, which is that I can't, we can't afford it.

Desmond Jumbam (06:29)
Hmm.

Mm-hmm.

Seye Abimbola (06:39)
So anyway, so for me, just from, you know, a years later, I was in medical school. And something that struck me early on in medical school was just how unconnected to all of that that I observed as a child, medical school seemed to be. Something very, pardon my use of language, clinical about it. It was something very sanitized. We're assuming a world.

Desmond Jumbam (07:04)
Mmm.

Seye Abimbola (07:09)
that either did not exist or was not the one I grew up with, which is a world of real people with real problems, needing clinical and other social solutions to their problems. So yeah, so I started to think critically about medical education from early on in my medical school experience. And I finished, I...

Desmond Jumbam (07:31)
Mm-hmm.

Seye Abimbola (07:36)
began to want to do things that still felt connected to that world. But what never left me was what power does to relationships and how poverty and the broader social determinants of health, including gender, especially gender.

Desmond Jumbam (08:00)
Hmm.

Seye Abimbola (08:04)
dogs to people's chances of living a good life.

Desmond Jumbam (08:08)
Mm-hmm.

Seye Abimbola (08:09)
and this notion that I came to appreciate really well that if you find yourself in a situation in which my mother found herself what you had to do even if you do not agree with most of what they believe or what they were doing you can still be of immense use of service to them without questioning what they were doing.

Desmond Jumbam (08:27)
Hmm.

Seye Abimbola (08:35)
Because it's one thing to go there and say, I'm here on a crusade. You shall stop believing what you believe now. And you shall change because you are dying because of it. That's one way of doing it. Another way of doing it is, I'm going to do my best, given the constraints that I'm facing here, to make things as good as it can be. And then set out to do that in a very politically sensitive way. So just that education. was political education. was some sort of clinical education, some sort of apprenticeship.

Desmond Jumbam (08:40)
Hmm.

Mm-hmm.

Mm.

Seye Abimbola (09:03)
that I think in many ways color how I approach global health today.

Desmond Jumbam (09:12)
Mm-hmm. She clearly had a huge impact. Just the opportunity that you had to have those home visits with her. And it obviously went with you to medical school, because you tell the story about when you went on, I think it was an internship or something, where there's a woman who came in with her child, and she was chastised.

By you, is that correct? Yeah.

Seye Abimbola (09:42)
Yeah, yeah, yeah. I was

one of those people. I suddenly thought, I can't remember very well again, memory is a very tricky thing. I can't remember if I said things, but I thought things and I thought them out loud to my friends and colleagues who, some of whom I'm sure said things. But there was a world in which we looked at the women who brought in their children to pediatric emergency.

Desmond Jumbam (09:47)
Right.

Right.

Hmm.

Mm-hmm.

Seye Abimbola (10:09)
and what they were wrong with you.

Desmond Jumbam (10:13)
Hmm.

Seye Abimbola (10:16)
And I'm not sure, I hope things have changed now, but it was quite normal to think and say that out loud. And sometimes it won't at these women.

Desmond Jumbam (10:21)
Mm-hmm.

Seye Abimbola (10:29)
And I remember I often make phone calls to my mother. And a very easy way to track this in terms of memory, you notice in the book, was how available and common mobile phones were. So you knew, so there times when you couldn't call people, you had to go a queue up somewhere. There was a time when you could just pick up the phone and call. So I could sort of track my ability to communicate. And it was a time when mobile phones had become just enough.

years after them. We would talk regularly almost every day and there were many reflections about my clinical experience and in this instance I called her and I sort of gave my diadrive about this woman and this child who had died and I'm not sure where her head was I'm not sure if she had I'm sure she had seen similar things before many of them before.

Desmond Jumbam (11:00)
Mm-hmm.

Seye Abimbola (11:28)
She gave me a very shocking to me, shocking that I hadn't thought about it, but shocking in just the realism of it. That this woman has children at home. This child may die, will likely die. How much of the money, have you wondered how much of the money she has, she wants to put down?

Desmond Jumbam (11:37)
Mm-hmm.

Seye Abimbola (11:56)
for this one who will likely die. What would happen to the ones who will go to school, who will need house to live in, who will need to eat. And it was again, it was a calculation of life and death that I hadn't thought about. And I would be 22 at this time-ish. But it was shocking to me that there's a way in which there's a life that this woman lived that's different from the life I lived.

Desmond Jumbam (12:00)
Mm.

Mm-hmm.

Seye Abimbola (12:26)
And I can't be of use and help and service to her if I can't find a way to imagine myself into that life and see the world through her eyes. And in the book, I referred to something a few times as representative thinking. This ability to almost try and not be yourself. And how important that is, not just in research. I was thinking about it more in terms of research, but also just...

Desmond Jumbam (12:39)
Mm-hmm.

Seye Abimbola (12:54)
in being a human being who is responsible. But that was a moment for me that I keep remembering, just the possibility for the tendency that we have to assess people by the measures of our own lives and not from the prism of the reality of their own lives.

Desmond Jumbam (12:58)
Mm-hmm.

Mm.

Mm. Mm.

Mm-hmm. Mm-hmm.

Seye Abimbola (13:25)
and how we then

proceed to impose and be, quote-unquote, colonial in the process.

Desmond Jumbam (13:32)
Right. So speaking of colonial, in the book you talk a lot about colonial love. I listened to first chapter. What is colonial love?

Seye Abimbola (13:45)
It's a form of abuse. After all is said and done, it's a form of abuse. is, I often try to make myself imagine the different categories of people who would have come to my part of Nigeria.

Desmond Jumbam (14:04)
Hmm.

Seye Abimbola (14:06)
when

I would often imagine that there are people who must be trying to claim the place for the crown, for the British crown. I've invaded the Tistar house. But I'm also always imagining that there were people whose job it is to quote-unquote be kind.

Desmond Jumbam (14:22)
Mm-hmm.

Seye Abimbola (14:34)
to look after people, of the missionaries, know, really large. So this category of people whose job it was to set up clinics, look after children, train people, and change the culture, essentially. And I would often imagine that how they must see themselves, if they were going to be able to proceed to do all that they did.

Desmond Jumbam (14:39)
Mm-hmm.

Seye Abimbola (14:59)
And they must see themselves, of course, first, as superior. In fact, to their own mind, as naturally superior. And second, they must see that whatever else is going on around here must be of limited to no value. If anything at all, negative value, deserving of being completely destroyed.

Desmond Jumbam (15:21)
Mm-hmm.

Seye Abimbola (15:22)
Sometimes I wonder if they believed that. I'm always wondering, you know, I'm always wondering about human action. To what extent do we make ourselves believe things in order to do things that we need to do? To what extent do we lie to ourselves? And I know that as human beings, we have enormous ability to lie to ourselves. Very, very, very.

effectively. So I'm always wondering about those people, what are they trying to do here in this, what were they trying to do in that scenario? And what they did was in the name of love, right? They kind of messed up abusive love. I will look after you. I love you. I want to save your life and the life of your children. I want to civilize you.

Desmond Jumbam (15:47)
Mm-hmm.

Mm-hmm.

Seye Abimbola (16:13)
and go ahead to destroy ways in which people are organized and done health and social life including religion. Again in the name of my love for you which would have also required, which in fact required, completely disregarding what people knew before, what people could do for themselves before, what people should be allowed to determine

how it's done, but because again, you are this person who has come with power and supposed knowledge, you disregard. And when we fast forward it to today, that's us, you know, those missionary people, our global health people. And I always reflect on just how hard it is to say to global health people.

those were your ancestors that you're doing their job. Because again, we are fully convinced that we are doing something great, worthwhile, necessary, saving lives. And it's hard for us, very hard for us to take seriously people who say to us, you're costing a lot of harm.

Desmond Jumbam (17:13)
Mm-hmm.

Mm-hmm.

Seye Abimbola (17:33)
You are destroying things. What you're doing is counterproductive to what may have been your mission, right? If it's truly your mission. And I've noticed as well that many times we know that these people challenging us, we know they are right. Well, we know in terms of levels of knowing, right? But we're also able to convince ourselves that we are the biggest savior. And I see that play out in...

Desmond Jumbam (17:40)
Mm-hmm.

Sure.

Seye Abimbola (18:02)
If someone asks you to apply for a grant and they say show us your impact or show us how you will have impact. You may work for a day or two to figure out how to tell that story of impact. You will likely wish that you weren't asked to tell that story because you know that you don't have to a story that is not true. But once you've told that story, you start to believe it.

Desmond Jumbam (18:29)
Mm.

Seye Abimbola (18:29)
believe it. I've seen it play out in my own head. So I know this is a human problem. You start to believe the story that you've been made to tell and then say tell it one or two or three more times to other people and it becomes your story. But can deep inside your soul you still know that this is not true. So when someone comes and says but this is not true

It lands on a very fragile, vulnerable soil. That what you get back when you say that to a person is a range of emotions, some of which will shock you in the moment. So yes, so there is that sense of colonial law, is which is abusive because it does not respect the supposed beloved.

Desmond Jumbam (19:00)
Hmm. Hmm.

Colonial love. think it's, yeah, you're talking about how it manifested during colonial times. So it continues to manifest itself today. And oftentimes, like you say, the people who do global health, they may not believe it, like, kind of consciously, but subconsciously, it's there.

And so it plays out in the way we are due grants, the way we reach out to different communities, what we believe about what they tell us about themselves, about what works. So in many ways, it still plays out today. And I would love for us to actually, maybe later on in the conversation, apply this thinking to the current reactions to USAID and US policies towards global health.

But before then, I think it would be useful to revisit the concept of the foreign gaze in global health. You begin the second chapter of the book with the quote that the problem of gaze is at the heart of academic global health. Can you remind us what the foreign gaze problem in global health is?

Seye Abimbola (20:37)
I vaguely remember how I described it the first time around, so I wouldn't do it again. I will do another one.

I had to...

I was struggling to say in terms of the foreign gaze when the discussion and the debate about injustice and how global health is done started to focus a lot around the question of authorship.

At that time I realised that this, while important, was in the long term not going to be a useful thing to focus on.

And I knew that in part because in my role as an editor of a journal, I knew at first that regardless of whom the authors are, that you could have country authors and the work is still just as useless. Or just as...

And that it was very easy to game that metric. You just had to stick someone in. And you know, you feel good with yourself. So I'm always interested in how people feel and relate with themselves internally. I'm interested in that. There are things we do that just allow us to feel at peace. But it's false peace because we ought to be able to know.

Desmond Jumbam (22:17)
Mm-hmm.

Seye Abimbola (22:22)
that we just ticked a box that doesn't really mean much. But to the person who has ticked that box, there's a huge emotional experience that is self-fulfilling, in a very self-righteous way. And I was concerned that we may, to the extent that although she was in metric, we may win on that metric. But substantively, nothing has changed in how the field works. So I was looking for something, a concept to express what is...

Desmond Jumbam (22:43)
Mm-hmm.

Seye Abimbola (22:52)
at the heart of what my concern was, which is that very often what matters much more is to whom we are addressing ourselves and the power that they wield on us. And if I was an American academic who has to impress the Gates Foundation or impress the US government,

I would do studies and craft research questions and use methods and make interpretations. While appearing solid and appearing rigorous on the paper is beside the in relation to the reality that it's supposed to be about. And I wanted to find a way to signal that problem.

Desmond Jumbam (23:41)
Mm-hmm.

Seye Abimbola (23:44)
that whilst we want to be fair and equitable and just in how we think about who writes things, and those things are still connected anyway, but the power of the audience as constructed, the power that it wields on our ability to do our work and attend to the things we want to attend to, often goes unacknowledged, has been interpreted over a long time, I think, as neutral.

Desmond Jumbam (23:56)
Mm-hmm.

Seye Abimbola (24:11)
that who funds you, it doesn't matter very much. The journal where you intend to publish it, we all publish in the same international, of and I'm going global journals. Who crafts the research question isn't very important, but the method is important. And getting a rigorous paper is important. And getting it in a big journal is important. So I wanted to say now that there are all these other forces that we don't see.

Desmond Jumbam (24:21)
Mm-hmm.

Mm-hmm.

Seye Abimbola (24:37)
are the most influential and consequential in the ways in which we do the work that we do. So that's that concept. Now it travels, of course. There are many different ways in which it applies. But the place where it came from was how research works and how we as researchers do our work. And the first is that shape the work that we do, that we have been educated and socialized into being oblivious to.

Desmond Jumbam (24:42)
Hmm.

Hmm.

Seye Abimbola (25:06)
in

self-serving ways. It's not as though, again, going back to the self, it's not as though if someone sat us down, and I'm describing experiences here, if someone sat us down and explained this to us, that we wouldn't recognize it. But it's also not as though, even after having recognized it, that we would change what we do the following day. Or that we would revert to status quo ante the following day.

Desmond Jumbam (25:20)
Mm-hmm. Mm-hmm.

Hmm.

Seye Abimbola (25:30)
And again, you may have noticed in my answers to you so far that I'm concerned about individual brains a lot. it's something that's been bothering me. It's one thing to know what is true and what is right. It's another thing to believe it. It's another thing to refuse to know it or be unable to know it because to know it is to disturb.

Desmond Jumbam (25:39)
Hmm.

Mm-hmm.

Seye Abimbola (25:58)
one's soul in ways that are not conducive for the wholeness with which you live our lives.

Desmond Jumbam (26:09)
All right.

Okay. There's a lot unpacked there. But I must say that when I first read your piece, it was extremely helpful personally for me, because I was going through a similar journey as you're talking about, there's a lot of talk about authorship in global health. was like, well, that's not really the problem, right? And I'd seen...

how easy it is for somebody to do the research, write the paper, finish, and then realize that there's no first author, there's no author at all from that community and you're going to get chastised on Twitter or, you know. So I realized that surely that is not the fundamental problem. So your paper really helped me in processing what I was

thinking through. And even then, I realized that a big part of it is kind of unconscious. Now, for example, I wrote a piece of fiction. I like writing, and so I started doubling into fiction. And I wrote a piece, a very innocent piece called The Five Stages of Balding. It's meant to be funny. And so I'm describing this.

Seye Abimbola (27:33)
Thank

Desmond Jumbam (27:38)
setting in Cameroon. And I'm describing this caramel. We call it caramel. are ground nuts with peanuts around the outside. And I'm giving a lot of kind of elaborate detail about this very common thing in Cameroon. I write the piece and I publish. send it to our mutual friend, Emily. And she asked me, why do you take so much time to describe?

a peanut, or caramel, right? And she was like, you're right as though you have a particular audience who don't know what caramel is, right? So subconsciously in my mind, I had an audience that I was writing, at least maybe that section of the piece too. And that audience had a significant role in shaping what I was saying in that piece.

Right? And so your point being that consciously or subconsciously, the audience that you're doing your research for plays a significant role in the outputs and even the utility of whatever you produce. And so.

Can you tell us about the audience? It may not necessarily be that the audience is bad, but it's inappropriate. So for example, you talk about the local gaze and the local pose being ideal. But it doesn't mean that it's always the right audience or the right pose. So can you explain a little bit about how do you?

Seye Abimbola (29:22)
So.

Desmond Jumbam (29:29)
How do you go about thinking about which pose and which gaze is ideal and problematic?

Seye Abimbola (29:39)
In the conclusion of the book...

And it's fascinating to me that it took me.

having to write the conclusion to land at the particular framing of the problem that is about disconnection and connection.

which is the sense that after all is said and done, if health inequity or any form of inequity at all is going to go away.

If we are to achieve justice in health and in systems, political systems, then we are going to need the system to be very well connected within itself.

And history certainly bears me out on this question. But if you want things to change in a place, make sure that people cannot avoid listening to one another, especially the powerful cannot avoid listening and taking seriously and being scared by the not so powerful.

But also just in my health systems work, often separate artificially accountability lines from information. In other words, that my relationship with someone who's powerful could be the way that a powerful actor serves a not-so-powerful actor could be because they are responding.

in an accountability way. Like it's my responsibility, if I don't do it, they will vote for me, they will protest against me, they will fight me, I will lose, etc. Another one would just be, I attend to what they really need because I have the information about it. Like I really know it.

Desmond Jumbam (31:43)
Mm-hmm.

Seye Abimbola (31:44)
which even while being accountable, you may still not know, or we're trying to be accountable. In other words, while they are very similar, I often draw a line between them. But anyway, so when it comes to this local system or its specific particular system, and local could mean the entire country of Nigeria, so local does it, it's a matter of scale as much as a matter of circumscribing it in particular. That you want the actors in that space to be able to speak to one another.

Primarily. And so if a study was being conducted in Nigeria about certain mass and mortality, et cetera, you want the primary audience to be the primary responsibility bearers or service providers, as the case may be, in that space.

Desmond Jumbam (32:13)
Mm-hmm.

Mm-hmm.

Seye Abimbola (32:40)
Which means that they have a configuration of knowledge in their head. Again, not necessarily individual heads, that could be a collective head. There are things that they know, there are things they don't know. And that configuration will be different from that of USAID.

Desmond Jumbam (32:50)
Mm-hmm.

Mm-hmm.

Seye Abimbola (33:03)
We'll be from that of the Gates Foundation. We'll even be different from that of the civil society actors in Nigeria who are fighting and campaigning for the government to do XYZ. So there are different ways of thinking about audience and the conversion of knowledge that you're trying to enhance. Now if...

Desmond Jumbam (33:15)
Mm-hmm.

Seye Abimbola (33:31)
So if I set out to do such a study, and my primary audience is civil society slash activists in Nigeria, my research question is very different. My method will be very different. My channel of dissemination will be very different. Two, if it was even within Nigeria, policy makers. Again, it's completely different set of considerations. And at least for Nigeria, in so far as we are thinking about a particular place, you want...

Desmond Jumbam (33:40)
Mm-hmm.

Seye Abimbola (34:01)
the knowledge generation to be speaking to the relevant actors in that space first and foremost. And that's why I consider it ideal. Again, when you look back in history, you know, to, I often look back at the mid-19th century when statistical systems were being created.

Desmond Jumbam (34:24)
Mm-hmm.

Seye Abimbola (34:25)
And it was their ability to connect a system to more of itself, as I was describing, that allowed them to be consequential for improvements in social conditions. And for turning, in many ways, for turning health into a political issue. Because then you could compare. You compare one village, one town to another in its performance. You compare one year to another.

Desmond Jumbam (34:48)
Mm-hmm.

Seye Abimbola (34:51)
You could campaign based on how well you've done or how badly the other guy has done. It became a subject of debate in parliament, in, I'm describing England especially now. And journals played a very, very important role in helping to move that knowledge around, as were government officials. I often remind people that there were no public health academics at the time.

Desmond Jumbam (35:10)
Mm-hmm.

Seye Abimbola (35:17)
And it was also a time of some of the most significant improvements in health and equity, the world has ever seen. And I'm speaking just broadly here in the Western hemisphere, of Northern America, Western Europe, especially. Anyway, so for me, I'm thinking about how a system could be connected within itself in that way. And I see very well how the way we do both global and public health today.

Desmond Jumbam (35:26)
Hmm.

Seye Abimbola (35:47)
does the opposite of that.

Desmond Jumbam (35:49)
Hmm.

Seye Abimbola (35:50)
But even when you go out to set up a statistical or health information system for a place, look at the random HIV program on the continent. It is set up to speak to US Congress.

speak to anyone who works in that. And I've worked in that space, I know. Instead of speak to US Congress, to connect whatever is going on in Nigeria to US Congress, not to connect what's going on in Nigeria, to actors in Nigeria. So I'm always concerned about the ways in which we either forget or don't bring those lessons of history, and just the lessons that I would hope were intuitive.

Desmond Jumbam (36:14)
Mm-hmm.

Mm-hmm.

Seye Abimbola (36:38)
to determine how we do things with you. So, local, To my mind, ought to be at the center of things, very primary, very, you know, this is how we roll. Now, there are circumstances in which other connections become potentially important, right? But it's important to say that to focus on those other connections primarily,

Desmond Jumbam (36:56)
Mm-hmm.

Seye Abimbola (37:06)
deoptimizes you for doing the primary ideal one.

So if I'm going to try to understand why women are not going to an antinatal care facility in Nigeria.

There are things that the district artificial intelligence, know, All those things will not get me a paper in an elite journal. They won't.

Desmond Jumbam (37:25)
Mm-hmm.

Mm-hmm.

Seye Abimbola (37:34)
And they are often basic things, often really basic things. But we want to do complex and fancy things because that's what we've been trained to do, that's what we've trained to think of as grand. So we do those things. And when those things come to a journal like BMJ Global Health, I know that in some way the journal has been complicit, or is the institution of the journal, what it represents, has been complicit in diverting people's...

Desmond Jumbam (37:49)
Mm-hmm.

Mm-hmm.

Seye Abimbola (38:02)
attention in a way that makes them less useful to where they come from. But the other instances in which it may be useful to speak to a foreign audience or to be constructed by

Desmond Jumbam (38:08)
Mm-hmm.

Seye Abimbola (38:19)
for once after it's been constructed by a foreign audience, there may be political repression where it doesn't make sense to do the local or where doing the local itself is a problem or just not useful. So you can speak to a foreign in a very geographical sense of Nigeria, international foreign.

There will be times when the most important lesson you can take from the place is actually not for the place because people in the place already know. So it ought to speak elsewhere. So there are those instances. But again, those are the exception. But now they are the rule. That is how we do our work all the time. That's where you set, where you set device to do our work.

Desmond Jumbam (38:50)
Mm-hmm.

Mm-hmm.

Hmm.

Seye Abimbola (39:09)
we are praised for the network and I think that's a challenge.

Desmond Jumbam (39:13)
And do you think that this distortion in the system or distortion in the way communities develop is that a result of global health being built on this colonial systems of colonial love? Because even in all local communities, that is the way these conversations are had, right? If you listen to the local newspaper, you read the local newspaper,

local, you you listen to local radio, that debates that are being had, but the Lancet doesn't care about those debates, right? But those are the debates that in the long term really lead to sustainable change. So the question is, do you think that this system that we currently using to operate global health is as a result of its foundation?

Seye Abimbola (40:10)
First,

My view is that the Lancet shouldn't care. It is not the Lancet's job to care about those debates. It's not the Lancet's job. If anything at all, Lancet caring is a problem. I wish Lancet would get out of the business of trying to care for those things.

Desmond Jumbam (40:29)
You

Seye Abimbola (40:35)
but in terms of public health itself.

The way I'm thinking about this problem increasingly these days, it's about how people who do public health and global health have been educated. And I was deliberately giving the example of civil society organizations earlier, but more specifically about activists and advocates for change in any system. If you look at how we are trained to do public and global health, those people...

Desmond Jumbam (40:49)
Mm-hmm.

Mm-hmm.

Seye Abimbola (41:13)
They're not part of our knowledge ecosystem.

they are on the side, sometimes an irritation, you know. But you don't get equity-oriented change, without that push from people who are trying to reimagine reality and reimagine the world and change things.

Desmond Jumbam (41:37)
Mm-hmm.

Seye Abimbola (41:38)
Now, we follow the history of academia.

and the field that it creates or serves, like public health.

you would detect a comfortably...

conservative tendency. That if you are an activist, then you're not doing science. If you generate knowledge for activists, then there's something problematic in what you're doing. If you set up a health or care system and the people you are focusing on are helping you to decide what you do, your priority, your strategies are people who are in the community or people who are trying to change things, then that's not normal.

Desmond Jumbam (42:00)
Mm-hmm.

Seye Abimbola (42:27)
Now, I see that construction as a very colonial thing. So that's how would make the connection you are trying to make there. That's something about the way we've been educated and socialized, that keep things as they are. Let us don't trouble the waters. If you're going to do it, just do it a little bit. I notice this a lot when I sort of say to people,

Desmond Jumbam (42:35)
Hmm.

Mm-hmm.

Mm-hmm.

Seye Abimbola (42:57)
Let the people who are local or let the people who are proximate to a particular place or issue or situation lead, direct, help construct things. If you say this to a public or global health person and you say take notes, they will say involve community. It will change the meaning of what you said.

Desmond Jumbam (43:22)
Mm-hmm.

Seye Abimbola (43:26)
Because what I said was not involve community. What I've said was let community lead direct via the driver's seat. But what they will write down.

which takes the products for what they will understand as having heard is we involve community. So there's something going on. And again, for some reason, I didn't plan for this to be the case throughout this podcast episode, I've been thinking about how things work in people's head. For some reason, something has happened in that box that is the brain that just cannot hear that thing, compute that, and I take that thing to be even more possible, necessary. And that's what...

Desmond Jumbam (43:41)
Right.

Hmm.

Seye Abimbola (44:06)
you get and I feel that that is colonial in a way goes back to our discussion about colonial love that you don't trust these people or you don't expect that they should have this role in doing what you do so even when someone says let them have it you don't hear it or you can't take it

Desmond Jumbam (44:14)
Mm-hmm.

They know. All right.

Seye Abimbola (44:29)
I was in a meeting recently where something like this was happening. We discussing health for equity and how research needs to change so that you can better serve equity. I was inside, you know...

We had the session into groups and each group was discussing different things. I said in the group I was in, what I've just said to you that let it be the exception that academics decide what the research question is. Let that be the exception. And someone answered and said, but bad things will happen.

Desmond Jumbam (45:02)
Mm-hmm.

Mm-hmm.

Seye Abimbola (45:12)
And I said, but bad things, yes, if academics are not deciding. And I said, but bad things happen now.

Desmond Jumbam (45:12)
Bad things will happen.

Seye Abimbola (45:21)
The fact that bad things happen is not a reason to not do anything. Bad things happen now. Anyway, it's these things that we've been trained deeply, deeply to be suspicious of the people we serve.

Desmond Jumbam (45:43)
Yeah, I think I've had similar interactions, you know, where I've been in meetings with American kind of leaders of global health organizations and I insist that the programs should be decided by the people on the ground. And often the question I get is who are the people on the ground? Who are you talking about? And then the issue of corruption comes up and

So it always seems like there's one kind of excuse after another to justify what you already want to do. Or in your case, it's changing the world, the word, let the community lead to let them be involved, which is a very different thing. Letting somebody being involved is very different from letting them lead. You're still the one leading. They can have a say. They can say something.

So you can discard it, and oftentimes you discard it, or you use it to kind of make yourself look good that you listen to the community when in fact you didn't. Because you already know what you want to do, or you already know what you think the community needs. And so think we find that there's a plethora of ways to justify what we already want to do in the community. So I want to bring it.

bring it to current events, this discussion to current events, specifically the new developments in US foreign policy towards global health. We have the Trump administration pulled out of the World Health Organization and the global health community had a reaction to that. The Trump administration has mostly stopped all funding.

to USAID and Global Health and a bunch of development programs. So there's been different reactions to that. I would love to hear your analysis of those reactions based on this framework that you're talking about.

Seye Abimbola (47:55)
If we take it that USAID comes as a foreign intervention.

paid for, supported, championed by foreign people.

And if we take it, that intervention, as we both know, comes from the United States, and that a lot of the people who work within it and who serve it as academics, potentially as practitioners, are also American. So you have an ideal, my way, my, to my mind, an ideal scenario to think about local and foreign in terms of gaze and pose with the reactions.

There was a line of reaction in which Americans were addressing themselves to the American government.

what will happen if they no longer do aid in the way that they were doing it. And it was shocking to me. And I've been beating myself up for that I found this shocking at all, but I did. And it's a moment of confession that, know, Che, why did you find this so shocking? mean, this, happens, know, these are Americans. Anyway, people would say, you know, the risk here is that global health will no longer be done according to American values.

Desmond Jumbam (49:07)
Ha ha ha.

Seye Abimbola (49:24)
thinking, when did we agree that, when did we see that we agree that American, first, that we even know where they are, because we don't know where they are. But second, that we want them and that the global will function according to it. Or that it's not good for American security or for the health of American people. So again, this is that talking past that I described earlier when the foreign talks to the foreign.

Desmond Jumbam (49:32)
All right.

Mm-hmm. Mm-hmm.

Seye Abimbola (49:51)
You

would almost think, not know that they were talking about an aid program. You'd think that they were talking about something else. In the way that I heard many Americans, many, not a few, many, and people whom I had assumed thought more deeply about the world.

Now, again, this may be just the impact of your audience, again, the gaze problem, where you are trying very hard to align what you have to say to what the person who is trying to hear will understand. That may be just as simple as that. But the way that these things were being said, it's hard to believe that...

Desmond Jumbam (50:20)
Mm-hmm.

Seye Abimbola (50:38)
Given how it was, said that the people who saying it did not believe it at some level in their hearts. There's this greatness.

Desmond Jumbam (50:43)
Mm-hmm.

Seye Abimbola (50:48)
in what USAID was doing that applied particularly to America's greatness. This is a tool of our greatness and let us preserve our greatness. Anyway, so there's that foreign thing going on.

Desmond Jumbam (50:58)
Mm-hmm. Mm-hmm.

So you would say that that is like a foreign pose for a foreign gaze? you describe? Yeah. Okay.

Seye Abimbola (51:09)
Yes, yes, yes. that's

how we interpret that. There's some foreign post by foreign gaze kind of relationship. But there was also a...

a local to foreign going on. So I've had many people from different parts of the global south speaking to, against, about the US government. Sometimes saying what they think the US government wants to hear, which is, you know, people are going to die. This is such a great thing for us. Don't let it go. Or being very angry at the US government, saying, you know, how dare you.

Desmond Jumbam (51:50)
Mm-hmm.

Mm.

Seye Abimbola (51:58)
And in a sense, almost by so doing, talking again past what whom I would consider to be the primary responsibility bearers, which are the people who are local, the people governing those local spaces. If USAID withdraws funding for HIV services in Nigeria and the people I'm angry at is Trump and the US government, there's something wrong with me.

Desmond Jumbam (52:21)
you

Seye Abimbola (52:23)
can be angry at Trump, but in a very secondary, remote sense that my primary person who has offended me is the president of Nigeria or the governor of the state of Nigeria, where I come from. So there's something almost misdirected in that way and distracting in the local foreign sort of, local post foreign gaze line in that sort of two by two matrix. And there's also,

Desmond Jumbam (52:33)
Right. Yeah.

Mm-hmm.

Mm-hmm. Mm-hmm.

Seye Abimbola (52:55)
a sense in which the people who are powerful in the US government will, I'm talking about the foreign post-local gaze now, will address themselves to local people and say, you know, it's your responsibility, know, sort yourself out, you know, do what you're supposed to do, et cetera.

Desmond Jumbam (53:07)
Mm-hmm.

Hmm

Seye Abimbola (53:25)
And my reaction to that is that, keep quiet, I'm bugger off. In other words, and I say that recognition that look, you know, there's this expression in the Bible about the guy who was trying to remove the speck from someone else's eye and has a log in the eye. That one, you have no standing.

Desmond Jumbam (53:43)
Sure, sure.

Seye Abimbola (53:50)
to do that. And second, a lot of the problems in the global South were made, created, and sustained by the United States. So you don't have a place to stand to tell me or my government that they are corrupt. They are corrupt, but you are corrupt too. They are not corrupt without your corruption. that foreign post-local gaze thing, I also have a big problem. But the local to local.

Desmond Jumbam (54:05)
All right.

Sure, sure.

Yeah.

Mm-hmm.

Seye Abimbola (54:19)
which is people speaking to their own government, their own service provider saying, why does a middle income country need to rely on the US for basic primary health care services? Why? Why are you shocked? What have you been waiting for? That, that,

Desmond Jumbam (54:35)
Mm-hmm.

Seye Abimbola (54:43)
That line of argument and communication is for me again, goes back to the concept of ideal, is ideal. Every other thing has a secondary to that. And you may have reason to shout at anyone else, but if you are not shouting 80 times more to the people who have the primary responsibility there, I don't want to get what you have to say. So it's been interesting to me personally to observe these different sort of configurations of.

Desmond Jumbam (54:48)
That's it.

Right.

Seye Abimbola (55:12)
of articulating things in response to Trump. And I honestly...

You know, when I think it was Burke, Edmund Burke, I may be wrong now, who was asked to assess the state of the outcome of the French Revolution. And he said it was too early to tell. I'm not sure if was Edmund Burke, Burke who wrote it. Anyway, so it's too early to tell what this is to my mind. It's too early to tell.

Desmond Jumbam (55:43)
Hmm.

Mm-hmm. Mm-hmm.

Seye Abimbola (55:53)
And again, this may just be the response of someone who questions himself and questions things a lot. But I don't know how to, I'm not a believer. And I say that both literally and figuratively. I lost my very, very well curated Christian faith as a teenager. I've not recovered it back. I can't believe it.

Desmond Jumbam (55:54)
All

That's a topic for another episode,

I'm sure.

Seye Abimbola (56:21)
I know.

I can't believe in the US government's benevolence and generosity. And I can't believe that that unbalance is a good thing for the world.

Desmond Jumbam (56:27)
Right.

Right. I think was Uhuru Kenyatta who in a viral post or speech that he gave recently was lamenting why Africans are crying about this withdrawal of foreign aid, right? And asking what we think the US government owes us.

And he made the point that the primary concern of the US government is the US, the American people. Would you say that that is, like this America first, I don't know to what extent you follow American politics, but would you say that this kind of America first mindset is a local pose for local, like let's take care of ourselves first.

before we care so much about, which is I think a reason that they've used to justify the pulling out of foreign aid. Why are we sending money overseas when we have all these homeless problems here in the US, right? Would you characterize that as a local post for local gaze in the US?

Seye Abimbola (57:54)
Yes, but without sending money overseas, America will still have homeless and very poor people. The reason why America has homeless and poor people is not because they send money. They very little overseas. So that's not the problem. They can lie to themselves that that's the problem and believe it, but that's not the problem. The problem we know is a different structural, deep historically conditioned things going on in the US.

Desmond Jumbam (58:03)
Sure, yeah, yeah. Right, right.

Seye Abimbola (58:22)
Now, of course, America has always served America. Again, there's nothing new there. The problem that perhaps America doesn't know how to think about clearly is that the America that is serving America is a very elite, powerful, typically white, typically male America serving the same America. And others tend to slowly or suffer the consequences. So it's a...

I don't mind if a country like the USA says I want to serve myself. It's their problem, it's their responsibility. And as Yurul Kayata said, you know, what do they owe us? It's a good question to ask. They owe us a lot. And this is where it gets complicated. Which is again, for me, partly why this is also difficult to talk about. On the one hand,

Desmond Jumbam (58:54)
Mm-hmm.

Mm-hmm.

Seye Abimbola (59:19)
the US serves the US. The US gives aid to serve the US. Now, the way aid serves the US, can, many ways, right? But ultimately, the point of aid is to serve the US. And when the US decides that they want to be served in a different way, they can pull it. And so the problem with aid is not

Desmond Jumbam (59:37)
yeah, absolutely.

Mm-hmm.

Seye Abimbola (59:49)
It's not that the US gives it or that serves the US. It is that we've understood it to be charity. Which it ought not to be. If we are placing all of this in the proper political context, right? It's that you destroy countries. You destroy economies.

Desmond Jumbam (59:57)
Which it is not.

Mm-hmm.

Mm-hmm. Mm-hmm.

Seye Abimbola (1:00:16)
and you have a responsibility to the people and the places and the lives you destroyed in different ways. mean, this is the way things happen. Now, if we had a global order or system in which this is how it is rationalized, then we are in a different world. And again, I think the problem we in global public health have is that even that statement I've just made, right?

Desmond Jumbam (1:00:27)
Right.

Mm-hmm.

Seye Abimbola (1:00:46)
that aid ought to be thought of in reparative terms. It's controversial. And if I said it to a room of USAID or global health, American global health people, they would look at me like, is this guy crazy? And they would say, but this won't work in Washington. This won't speak to anyone. As if, by the way, what Trump is doing now was imagined to be workable in Washington three years ago.

Desmond Jumbam (1:01:06)
Mm-hmm.

Seye Abimbola (1:01:19)
I'm seeing a lot of complexity. The underlying thing here is that I feel that those of us who are in global health public health, we are not bold enough, we are not brave enough. We are not, I don't think we put ourselves in a position to construct the reality that we want to see. We don't make the arguments we want to make. And sometimes it seems to me like we are just, many of us are just like Trump. That we believe we are great in the world and we're doing great in the world.

Desmond Jumbam (1:01:19)
You

Mm-hmm. Mm-hmm.

Seye Abimbola (1:01:49)
And that is the rationale for what we do. And not that we are in service in large parts because the privilege that we enjoy derives from the dispossession and disadvantage of the people that we are serving. The consciousness of why we are doing what we do, and I'm sort of hinting at this in the book probably, is that we are given. And when you are given, you have liberty.

Desmond Jumbam (1:01:53)
Hmm.

Mm-hmm.

That's right.

Hmm.

Seye Abimbola (1:02:14)
It's colonial law again. They are very free. They want me, they need me. I'm going to do this. I'm going to serve them. I'm going to save their lives. And if they say no to me, then they've insulted me. They've not appreciated me. So for me, all those connections that says to me that we have not done our homework well enough and figured out the ways in which we want to talk about it.

Desmond Jumbam (1:02:16)
Mm-hmm.

Mm-hmm.

Mm-hmm.

Seye Abimbola (1:02:41)
Because if we keep talking about it as charity, when it goes away, we should keep our mouth shut. There's no responsibility in charity in that sense. You're just taking. Or you're in position to give without a sense of responsibility for why you are giving. Because America cannot tell itself why the biggest aid spending is military and goes to Israel. It can't tell itself that. That when you talk about aid,

Desmond Jumbam (1:02:52)
All right.

Hmm.

Seye Abimbola (1:03:10)
It's in the aid budget, but it's not talked about as aid. Or why a big chunk of the money goes to Egypt, for example. Or why a large chunk of the money that goes to countries go to militaries. Or is spent by DOD, Department of Defense in the US. So there are these things that we have accepted over time, us global health people, public health people, that the normal way of doing things.

Desmond Jumbam (1:03:18)
Mm-hmm.

Mm-hmm.

Mm-hmm. Mm-hmm.

Seye Abimbola (1:03:41)
And again, when that acceptance comes to bite us, we throw our hands up and we're not reexamining. But why? Why did we allow and accept these narratives about the work that we do? That again, if you were to drill deeper and deeper, we can see that it's not a true narrative or ought not to be true, given how the world works.

Desmond Jumbam (1:04:02)
All right.

Right.

And it seems as though, yeah, it's all about narratives, you know. And those narratives, the narrative about USAID has changed over the past couple of decades because when it was John F. Kennedy who founded USAID, it was quite explicit. He did not describe it as aid, right? This was during the times when

there was this Cold War and the fight over ideas between communism and capitalism and the perceptions of Americans overseas was kind of seen as the ugly American, the ugly kind of diplomat. And Joseph Kennedy saw USAID as a way of reshaping the way

people saw Americans overseas. It had very little to do with AIDS itself. Like I would actually, when we see global health, what many in global and who practice global health perceive it to be doing, John F. Kennedy was very explicit in why it was creating USAID, right? But somehow over the decades, that's

has been, we've changed that narrative, right? So there's a lot that we can analyze about what is happening now.

Seye Abimbola (1:05:43)
Just

a second there. And it would be useful for us to imagine, to explain to ourselves why we changed the narratives. Because again, we want to feel good. And it's hard for someone who works for the US government to go overseas.

Desmond Jumbam (1:05:55)
why the narrative changed.

Seye Abimbola (1:06:11)
and with the intent in their head that I'm going to improve the image of America in the world. It's harder to do that, but it's easier to say I'm going to provide needed aid and service to suffering people of the world.

Desmond Jumbam (1:06:29)
colonial off.

Seye Abimbola (1:06:31)
Bless you. there is that, there's also, again, the ways in which we manage to convince ourselves, even if the politicians are not saying that, or of course they too, Saka, say that, is important.

Desmond Jumbam (1:06:32)
You

sure.

Right. Yeah, exactly. And you talked about how during colonial times, there were the missionaries. And so perhaps those of us practicing global health, and I put us there because I am part of it, we're all, but we're like the missionaries of today, justifying the injustice that persists.

Right, because it makes us feel good even though deep down we know that these systems, these agencies were not set up to do what they're doing. Right, so we become kind of agents in perpetuating the injustice and the extraction and.

So I'd like to end with this question. You were the editor in chief of BMJ Global Health for many years. And you recently left that post last year. Can you tell me how your views of academic global health research and publishing has changed from

Well, before you joined BMJ Global Health as an editor, I'm sure you had big dreams and big aspirations about what was possible. So when you left.

Seye Abimbola (1:08:20)
My

Something I was lucky to be thinking about before I was appointed was the role that journals play in the world and the extent to which they should be in the business of publishing research.

This sounds really counterintuitive, course, because of journal's foolish research. before, so when I was a medical student, I spent time at the BMJ as something called a Clegg Scholar. They still have a Clegg Scholarship Program where they bring in medical students from around the world to hang out at the BMJ and see how and learn how and work on the journal.

And at the time the BMG was having this interesting internal debate about whether they should become a magazine magazine or remain a journal journal. And at the time, in fact, the bulk of the printed BMG was very magazine-y. The research part was perhaps three, four pages out of about 30, 40 pages. So it had become a magazine. And I think they were trying to reconcile themselves to what it was at the

I think it had always been a magazine kind of thing. We actually remember that when those journals had a BMG Lancet, they were like magazines. The research infrastructure we have today was not even there. Even the structure of writing a research paper was rudimentary at the time. And it became something. It became research publication and magazines. So anyway, so when I was appointed, I was already asking myself before,

Desmond Jumbam (1:09:48)
Right.

Mm-hmm.

Seye Abimbola (1:10:14)
whether journals should get out of business of publishing research and I still believe they should. And I hope this happens soon enough that I don't think journals should be publishing research. I think research should be posted on pre-print servers or other kind of openly accessible online platforms where those for whom it was done can reach them and where this power of that gaze that journals

can exert is neutered in large part. Anyway, and I us to focus very much on ideas and discussion and debate and engagement in so far as it helps to connect a particular community of scholars and of practitioners and activists to one another. So I went into that role with that sense.

Desmond Jumbam (1:10:45)
Hmm.

Mm-hmm.

Seye Abimbola (1:11:10)
of what will be important, what it means to be important about this journal.

Now, my whole conviction about journals no longer publishing research strengthened through the years. And it began, in a sense, with me almost wishing that a journal like BMJ Global Health could serve Nigeria or Zambia or India. And even as I listed those countries, you can see how cringy and colonial it sounds.

but we behave, we are set up to function that way, even now. There is simply colonial, there's no reason, I can't imagine one, where a study done in India needs to be published in the EMJ Global Health or Lancet Global Health or Lancet or New England Journal of Medicine. It doesn't make sense, it only makes sense in a world that is structurally colonial. That's the only world in which it makes sense.

Desmond Jumbam (1:12:02)
Mm-hmm.

Hmm.

Seye Abimbola (1:12:14)
Anyway, the strength of my conviction on this point grew over time. But also the sense of fulfillment that BMG Global Health could serve as a place where discussions and debate and ideas could be championed, especially from people who have for a very long time been marginalized in the field.

Desmond Jumbam (1:12:19)
Mm-hmm.

Seye Abimbola (1:12:41)
their voices and ideas could help, in fact, shape the field, what was being had. So two things were happening almost at the same time. So trying to have a journal where there was this rich, vibrant discussion and debate, which I sort of, by year three or so, I felt like we were getting there, and that gave us a good sense of joy. And on the side was this wish that we could serve as a platform that supported

Desmond Jumbam (1:13:01)
Mm-hmm.

Seye Abimbola (1:13:11)
countries and the realization that we couldn't do that and we couldn't possibly do that well. And it was not the role of the journal of the global health to do that. And to expect that is to expect the perpetuation of what is deeply fundamentally colonial. So that sort of grew about. Yeah, that's how I would answer your question.

Desmond Jumbam (1:13:21)
Mm-hmm. Mm-hmm.

Mm-hmm. Mm-hmm.

Okay, so it was like at some point probably trying to fit a square peg in a circle kind of thing, right? You realized that it was not possible. So then what do you see as the role of these journals now?

Seye Abimbola (1:13:53)
to the extent that I can describe their role, it would be aspirational. In other words, I don't think we currently live in a world in which the role that I wish for them was immediately realizable. But the role that I see for them is residual function.

or subsidiary function, because I use that concept that I beat in the book as well, where they are primary function and they're subsidiary ones. But I think, you know, if you have a paper, it's worth asking the question, where does this belong primarily? You have your research question that's been answered, an idea that you want to share. Where does this belong? In other words, which system?

whether it's a system of academics or a system in terms of a location, ought it help connect to more of itself? And then place it on a platform whose job it is to help connect that system to more of itself.

And that things that don't belong in those sort of situated platforms for whatever reason, couldn't be taken up and served by platforms that are removed from them. And you can imagine that removing in layers or scales, right? An Africa paper, you belongs in Africa journal. If they vaguely defined global paper that speaks

Desmond Jumbam (1:15:24)
Mm-hmm.

Seye Abimbola (1:15:34)
not to a particular location, but to a particular set of ideas that connect a particular set of people together could belong in a place that is not locationally defined in that way. And I believe that the day will come, I may be long dead, the day will come when we will see that's unethical, to violate what I've just described. In other words, unethical and strange.

Desmond Jumbam (1:15:57)
Mm-hmm.

Mm-hmm. Mm-hmm.

Seye Abimbola (1:16:02)
to do that, I believe that day will come. And I hope it comes before I die. so there is, you know, there's a rule, the same way there's a rule for WHO, right? But WHO cannot be Minister of Health in Nigeria. And that's what the last of the BMG is trying to do. You see what I mean? It can't, it's, yeah. So that we are.

Desmond Jumbam (1:16:13)
Sure, sure.

No.

Sure.

So

go ahead.

Seye Abimbola (1:16:32)
We have to have a clear way of delineating these things. As we ought to have a clear way of delineating many other things. Again, just going back. I'm sorry, I'm going back to this.

Desmond Jumbam (1:16:35)
All right.

Seye Abimbola (1:16:49)
to the US government's new adventure in global health. An African journalist reached out to me and asked, how do you think this will affect research for health in Africa?

And I said, you know, as one says to these questions, I don't know. But to the extent that I can offer insight, I would say that we ought to be able to separate what is good and useful research from what is bad and useless research. And in my time, I've seen way too many, in fact, far more bad and useless research than good and useful ones on the continent.

Desmond Jumbam (1:17:26)
Mm-hmm.

Seye Abimbola (1:17:27)
In international global spaces, I'm not just talking about research that we might say, okay, little people in Africa are doing little things. I'm about big people in big places doing useless and bad things. If USAID money for research or US money for research goes to all of those things, good and bad, then it's time for us to be able to define clearly what good and useful is.

Desmond Jumbam (1:17:52)
Mm-hmm.

Seye Abimbola (1:17:53)
And there's no way of

defining that without thinking about gaze, without thinking about the service to people, including where it's published and how it's published and how it connects systems to themselves. And this may be a moment, this may be a moment, I hope it is, I'm not convinced it's going to be, where we can be honest with ourselves. What is good about what we do? What is useful about what we do? How can we optimize the good and the usefulness of it?

Desmond Jumbam (1:17:55)
All right.

Mm-hmm.

Seye Abimbola (1:18:22)
including thinking in layers as I described, including thinking in terms of how it speaks to particular needs and audiences and how we almost theorize the value of the work from the beginning, including from where the research question comes from, how the work is written up, where it is published, what happens after it's been published, etc.

Desmond Jumbam (1:18:42)
Hmm. It sounds like the system needs to be flipped on its head. Right. What do we value? Because a lot of the value now is in these global health journals that are global in nature, but really the value should be at the local level first, or the local pose and the local gaze and invert it that way.

Shea, thank you so much for coming on the podcast. We need to make this kind of a recurring thing because every time you come, it's a wonderful conversation, so many great insights. So again, thank you very much for joining us on Global Health on FieldTest.

Seye Abimbola (1:19:17)
Thank you.

Thank you very much, Jasmine. It's been fun.

Desmond Jumbam (1:19:34)
Thank you. And thank

you to all of you for tuning in. If you enjoyed listening to the podcast, listening to the insights from Shea Mimbolla, please be sure to subscribe and give us a rating because that goes a long way to support the work that we're doing at Global Health Unfiltered. But also, we will be sharing the link to Shea Mimbolla's book, The Foreign Gays, Essays on Global Health.

in the show notes so please feel free to check that out. Thank you again, Shieh, for joining us and thank you all. See you next time.

Seye Abimbola (1:20:16)
Thank you.

Desmond Jumbam (1:20:18)
Right. That was great. Thank you so much.

Seye Abimbola (1:20:23)
Thank you very much.

Yeah, it's, you know, there's a lot to say about what is going on right now.

Desmond Jumbam (1:20:30)
There really is.

And I think there needs to be more discussion. I actually have been a bit, there have been a few pieces that have been published, but I've been a bit kind of, I don't know, sad or something about how little debate and discussion there is on this particular topic. So I think the next episode that we'll have will actually dive a little bit.

into this and actually bring different perspectives from people who see things differently, mostly from Africa. So if you have any people that you recommend, please let me know.

Seye Abimbola (1:21:08)
I saw your email I've been trying to think If you can get I mean Do you know this guy? is South African guy I think he's the director of South African MRC Yeah Yes, yes he did Yeah, he may be someone interesting to talk to

Desmond Jumbam (1:21:22)
I don't think.

okay. Did he publish a piece recently about this? Okay, I think I saw it. Okay.

Seye Abimbola (1:21:35)
But again, South

Africa is peculiar, right? So this is a country that can pay for its own things if it wants to. And actually very similar about Nigeria. There are countries that can pay for their things. don't need, just, know, whatever reason they're taking the money, should. But there countries that really need this.

Desmond Jumbam (1:21:40)
All right.

Absolutely.

Yep.

And that's the nuance that I would want for us to talk about. again, it's easy to put a blanket statement to say this is good, this is bad. But that's not really the reality. So if any people come to mind, do let me know. Yeah. All right. Well, Shire, thank you again so much. We'll get this out soon. And we'll let you know when it's out.

Seye Abimbola (1:22:18)
Yeah, that's very nice.

Okay, thank you.

Desmond Jumbam (1:22:24)
All right, have a good weekend. Bye.