This Reparations and distributive justice in global health article highlights how health inequities are not the result of gaps in resources or capacity, but rather of historical and ongoing injustices, including colonialism, racism, and economic exploitation. The authors argue that achieving health equity requires moving beyond traditional aid models toward reparative justice, which centers accountability, redistribution of resources and power, and structural transformation.
Importantly, the article distinguishes between acknowledgment, responsibility, and liability, noting that even when direct lines of liability are difficult to establish, this does not diminish the obligation to act. Meaningful change must include recognition of past harms and material redress, such as institutional reform, debt relief, and sustained investments in communities most affected by injustice. Reparative justice requires that those who have benefited from these injustices commit not only to recognition, but to actively dismantling and replacing systems of extraction and exploitation rather than repackaging them in new forms. The article calls for a shift in global health from technical problem-solving to justice-centered systems change that addresses the root causes of inequity and supports long-term healing and equity.
What would it mean for global health practitioners and institutions across the Global North to move beyond acknowledgment and actively relinquish power, redistribute resources, and be held accountable for repairing the harms they have benefited from? What are we willing to give up and how should we be held accountable if we don’t?