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‘If we want things to stay as they are, everything needs to change’

In Italian, ‘Se vogliamo che tutto rimanga come è, bisogna che tutto cambi .

In the lead up the Power of Knowledge event, Sandra Alba, Senior Epidemiologist at KIT, grapples with what redressing the power imbalances in knowledge exchange means to her and why it’s vital we address this issue now.

This famous Italian saying comes from the Italian classic Il Gattopardo by Giuseppe Tomasi di Lampedusa. The book chronicles the changes in Sicilian life during the late 1800s, when the Italian peninsula was going through a period of social and political upheaval that culminated in the unification of Italy. 

The saying appears to be relevant even today. Particularly the attitude of ‘gattopardism’, derived from the book, defined by a leading Italian dictionary as “the attitude typical of those who having been part of the ruling class or comfortable in a previous regime, adapt to a new political, social or economic situation, by playing the role of promoter or advocate, in order to maintain the power and the privilege inherent to their class”

As a global health epidemiologist with Sicilian roots, I often think of this saying and this attitude – particularly within the context of decolonizing knowledge. Many global health actors in the Global North have been rushing to engage with the concept of ‘decolonisation’. 

Spurred by the Black Lives Matter movement and Covid-19 vaccine inequity, the movement has gathered momentum. The number of publications on decolonizing global health peaked in 2021. Universities, across Europe are establishing committees to decolonize their curriculum, organising courses and seminars, promoting toolkits . Donors are mobilising principles for equitable health research.

Our own work at KIT on the BRIDGE guidelines for good epidemiological practice is to a certain extent aligned with much of the discourse on decolonising global health. Especially, its emphasis on responsiveness to local needs and local stakeholders, as a precondition to achieve long-lasting impact in local societies and health systems. 

But, as Global North actors appear at the forefront of efforts to decolonise global health, are we facing  yet another an example of ‘gattopardism’? How can we, actors in the Global North and at KIT, ensure we do not fall prey to this cynicism? 

One precondition seems, first and foremost, to be humble and recognise that we are not, we cannot, and we should not be the key actors of change in other people’s countries and lives. Our role in partnerships needs to shift from leading to following, from speaking to listening. We need to be genuinely willing to let go of power, and accept that funding flows and decision making structures need to change. 

Without this, we risk merely being those who are “playing the role of promoter or advocate” while actually trying to “maintain the power and the privilege”.  And it is unlikely that we will achieve meaningful improvement in the health and well-being of those considered disadvantaged and marginalised.  One way to read the Gattopardo is to think that “If you don’t change with the times, the times are going to change you”.  

Let us not reach that stage, let change be of our own volition, and because we genuinely wanted things to change.