In today’s globalised landscape, as the Covid-19 pandemic has starkly illustrated, an event in one region can send shockwaves around the world. The indiscriminate spread of the virus, unbounded by national lines or economic status, has brought home the realisation that our world is interconnected through shared health concerns, mutual pursuit for prosperity, and collective environmental challenges.

While dialogue around shifting power dynamics is vital, the success of such a shift depends on collective commitment and understanding. It is crucial for all of us to perceive the adjustment in power structures, and the associated relinquishing of privilege, not as a loss, but as necessary steps towards a more equitable, healthier, and sustainable world — a contribution, not a tax.

The archaic worldview that richer nations provide aid to low- and middle-income countries (LMICs) is fading. And just as well, because the concept of aid and charity binds us to obsolete ideas of scarcity and is often wrapped up in colonial ideologies and legacies. In contrast to the colonial mindset, we need international development to adopt the philosophy of Ubuntu which sees humanity as inherently connected. In essence, your pursuit of justice becomes mine.

‘Ubuntu’ is a term rooted in the Nguni Bantu language, typically interpreted as ‘humanity.’ It is also frequently conveyed through phrases like ‘I am because we are.’ It is a philosophy that supports collectivism over individualism. Ubuntu asserts that society gives human beings their humanity. Despite its profound implications, this philosophy has not received sufficient recognition in academic discourse or within the broader framework of global sustainable development policy. This needs to change.

‘National-interest-first’ policies, as evidenced by vaccine hoarding during the pandemic, are ineffectual against global threats and serve only to widen global inequality. Shutting your doors when your next-door neighbour’s house is on fire is not a strategy. Not an effective one anyway.

Similarly, chronic illnesses and non-communicable diseases (NCDs) are the emerging global health crisis requiring a concerted global response. The persistent, outdated perception that chronic illnesses are the preserve of the affluent or those living in wealthier nations must be dismantled. According to the World Health Organization (WHO), a staggering 77 per cent of all NCD deaths occur in low- and middle-income countries, highlighting the urgent need to revise our understanding.

The acute disease burden shouldered by LMICs, coupled with political instability and the heightened threat of climate-induced disasters, amplifies their vulnerability exponentially. This necessitates substantial investment in both immediate humanitarian relief and long-term strategies towards strengthening health systems. The care and management of chronic illnesses must take precedence in these strategies, embodying an empathetic and foresighted approach to international health policy.

Moreover, it is crucial that we not overlook the escalating political and climate crises experienced in higher-income countries (HICs). By no means can we consider any of these pressing issues as remote or irrelevant to HICs. The increasing rates of chronic illnesses and NCDs in high-income countries, compounded by political instability and very real climate threats, affirm that this is a universally shared challenge.

Ubuntu offers a way of thinking and acting that can help us address these challenges, together. It invites us to see ourselves as part of a larger whole, where our well-being depends on the well-being of others and of nature. It encourages us to act with compassion, generosity, and solidarity. These are the values we need to centre in a reformed international development system.

For this solidarity and global good to show up practically in global health, we propose the following strategic approaches:

• Enhance global collaboration to bolster primary healthcare capacity, focusing on managing chronic diseases and making pharmaceuticals and diagnostics more affordable across all income levels. This can be done by promoting international dialogues that encourage a shift from aid to investment and advocating for equitable funding from high-income countries to global funds dedicated to chronic disease management
• Foster knowledge sharing and research to generate solid evidence on best practices for chronic disease prevention and management, and to formulate effective climate change mitigation strategies. We can further this by encouraging research collaborations between high-, low-, and middle-income countries, and sharing the generated knowledge freely and equitably
• Prioritise equity in global health policies, ensuring that both high- and low-income countries contribute to and benefit from shared solutions. This should involve lobbying for changes in international patent laws that restrict access to crucial medications for chronic diseases in low-income countries
• Develop robust measures to monitor and hold nations accountable for their commitments to global health and environmental protection.

While we know that the Ubuntu philosophy can guide us to higher levels of consciousness and understanding, implementing its values on a global scale will inevitably face political, economic, and logistical challenges. Overcoming these obstacles requires acknowledging them and devising practical strategies to address them, embedding them in our strategic universal call to action and international political, economic, and planetary commitments. From a global health perspective, this is especially pertinent when discussing issues such as international patent laws and global financing.

Implementing robust and sustainable solutions to our global health challenges requires a paradigm shift in how we view ourselves and our relationships with others. To spur and sustain this shift, we need an international development system which embraces Ubuntu. This will underscore our universal connectedness and interdependence. By strengthening global collaboration, fostering knowledge sharing, and prioritising equity, we can collectively build a healthier, fairer, and greener world. As Nelson Mandela once said, ‘It is in your hands to create a better world for all who live in it. We must act with both urgency and compassion for the future depends on us today.’

Steve Murigi, CEO of Primary Care International.
@stevemurigi
As the Chief Executive Officer of PCI, Steve leads the organisation’s efforts to improve primary care delivery worldwide through innovative and cost-effective models. He is a public health leader and advocate of development practice that is inclusive, adaptive, localised, and people centred. He has extensive experience in international development across Africa and Europe. Before joining PCI, he was the Head of Programs and Strategic Partnerships at Amref Health Africa UK.