HEALTH
The Salzburg Statement on Equity-Centered Health Science Knowledge Systems Reframing Health and Well-Being
Challenging Current Approaches
Health and well-being are dynamic and historical processes that extend beyond the mere absence of disease. Yet global health science knowledge systems remain entrenched in reductionist biomedical frameworks that often do not consider knowledge from different ontologies. This includes different understandings of health, healing, and wellbeing, as well as the unique contexts of individuals and communities. This focus sidelines a diversity of perspectives, including traditional, Indigenous, and community-based knowledge systems.
Current approaches in health science knowledge production systems perpetuate inequities and ignore contexts, histories, traditions, and knowledge of communities in and from the Global South.
We call for a reframing that understands health and well-being as health knowledge production’s goal, driven by equity, contextualization, and diversity of human experience. This requires that health science learns from and integrates other forms of knowledge production, methodologies, and ways of knowing.
This has hindered advancements in public health and medical sciences, and reinforced power imbalances in governance and patterns of exploitation, distrust, and exclusion in broader socio-economic development. The mainstream health science production system propagates extractive research practices, inequitable funding mechanisms, and deficient and exclusionary leadership at all levels, from global to hyper local. This lack of integration serves to compound the triple planetary crisis of climate change, pollution, and biodiversity loss, threatening our social, economic, and ecological well-being.
*Global South: We use the term “Global South” throughout this Statement to refer to regions historically subjected to colonialism, structural inequities, and economic exploitation. We recognize that this terminology is contested, as it may simplify complex geopolitical dynamics and power relations. However, we retain its usage here to highlight persistent global inequities and historical injustices. This aligns with current equity-centered and decolonial conversations, emphasizing the importance of explicitly naming systems of power, historical exploitation, and systemic inequality.
Find out more about the Salzburg Global session on "Centering on Equity: Transforming the Health Science Knowledge System."
Since time immemorial, Global South communities have studied, analyzed data, and proposed actions that support their health and well-being. However, they have been marginalized and dismantled as part of colonial practices of domination, exploitation, destruction, and expropriation of knowledge and territories.
Global health governance structures were set up to promote dominant biomedical knowledge and exclude the diversity of health knowledge. Health science can deliver on its goal to support health and well-being if it includes and draws upon a plurality of health knowledge systems that exist across the world. Without richer and deeper knowledge that serves health systems locally and globally, countries will continue to fall short of serving their populations equitably and achieving health and well-being for all. The fragmentation and breakdown of the global health order requires a call to build together, both to mitigate the current negative effects and to build participatory governance options that support the growth of cultural plurality in the knowledge of healthcare. Tackling the enormous differences of accumulation of money and power is an imperative for other ways of building health systems.