Unveiling Colonial Legacies in Epidemic Responses: A book review of Lioba Hirsch’s Anti-Blackness and Global Health – A response to Ebola in the Colonial Wake

By guest contributor Yasmine M. Elmi

The legacy of colonialism is not just a historical footnote; it is a persistent force that continues to shape today’s outcomes. Lioba Hirsch’s book, Anti-Blackness and Global Health: A Response to Ebola in the Colonial Wake, offers a compelling critique of how colonial legacies of anti-Blackness have shaped global health responses, particularly in the context of the Ebola outbreak (1). This book is more than a simple critique; it is a call to action for those committed to health justice…now more important than ever.

Colonial Foundations and Their Modern Legacy

Hirsch begins her analysis with an examination of the historical foundations of global health, tracing them back to exploitative structures of colonialism. The health systems established during colonial rule, designed to serve imperial interests, have left impacts on contemporary global health practices. An example Hirsch discusses is the establishment of the first hospitals in Sierra Leone that were strategically made accessible primarily to European settlers in well-ventilated and elevated areas that were considered healthier environments, while the health of African communities was largely ignored. This segregation was justified under the guise of preventing the spread of disease from the ‘native’ population to the European settlers, yet it was clearly rooted in the racist ideologies that devalued Black lives. These systems, Hirsch argues, perpetuate the inequities we witness today, particularly in how Black populations are treated during health emergencies.

Anti-Blackness and Global health

Hirsch draws on Christina Sharpe’s concepts of “weather” and “wake” to understand how anti-Blackness operates not just as a series of discrete events or overt acts of racism but as a pervasive, atmospheric force that shapes the lived experiences of Black people continuously. The “weather” of anti-Blackness is an all-encompassing and ongoing presence that shape the lived experiences of Black people in ways that are often invisible yet deeply felt. The concept of “wake” refers to the enduring effects of historical traumas, particularly those related to slavery and colonialism, which continue to shape the present by influencing how Black people are treated in global health contexts.

Hirsch examines how deeply ingrained racialized assumptions about Africa and African bodies influenced the global response to the outbreak. She discusses the dehumanizing ways in which African people were portrayed and treated, arguing that these actions were underpinned by a long history of anti-Black racism. For example, Hirsch discusses how African bodies were often portrayed in Western media as vectors of disease, reinforcing harmful stereotypes of Africa as a ‘dark continent’ plagued by illness and backwardness. Hirsch argues that these dehumanizing treatments were not anomalies but rather consistent with a global health system that has historically viewed African lives as less valuable. She calls for a radical rethinking of global health practices, one that moves away from paternalistic, top-down approaches and instead embraces strategies that are informed by the experiences, knowledge, and agency of the communities most affected by health crises.

Ongoing Relevance: Black Lives During Epidemic Emergencies

Why are Black people in formerly colonised countries more likely to be left to die in epidemic emergencies?

Hirsch’s answer is clear: the structures of anti-Blackness and colonialism that shaped the global response to Ebola continue to influence how health crises are managed today. These structures result in a system where Black populations are systematically neglected and deprived of the care and resources they need during health emergencies because anti-Black biases manifest in underfunded health infrastructures, delayed responses, and a lack of investment in long-term solutions for affected communities.

This pattern was evident during the COVID-19 pandemic, where life-saving mRNA vaccines were hoarded by Global North countries, leaving millions in the Global South without timely access (2,3). The parallels between the global response to the mpox outbreak and the Ebola crisis suggest that the same colonial dynamics and racial biases are at play. Scholars believe that the mpox outbreak, like the COVID-19 pandemic, will highlight the same deep rooted inequities in global health, where African nations do not have the same access to the necessary resources despite the global nature of these crises (4,5). They argue that the international community’s response to such outbreaks continues to be driven by a colonial hierarchy that prioritizes the health of wealthy and predominantly white nations over that of Black populations in the Global South.

Thus, this is not merely a historical issue but an ongoing crisis.

Target Readership

Hirsch’s book is a rallying cry for those committed to health justice. It resonates with individuals and communities who are engaged in the ongoing struggle to dismantle oppressive systems and build solidarities across diverse contexts. By connecting with others who are doing similar work, the book fosters a shared fight for health equity.

Hirsch remarks white supremacy often leaves us questioning ourselves, feeling anxious, and unsure. It has established an epistemic hierarchy that devalues and discounts Black experiences as ‘unscientific,’ pushing them to the margins. Hirsch confronts and dismantles this hierarchy beautifully.

This book empowers readers by offering a comprehensive critique of how anti-Blackness operates within global health, equipping them with the intellectual tools needed to challenge and resist these oppressive structures. As Seye Ambiola aptly notes, Hirsch provides “a compelling account of how anti-Blackness and colonialism maintain a grip on the infrastructure of global health, showing us where to aim the hammer in our efforts to knock them off.” Hirsch equips readers with the hammer through knowledge and direction to actively challenge and dismantle the anti-Black systems at play.

For those committed to transforming global health into a more equitable and just field, this book is an indispensable resource.

References 

1.           Hirsch L. Antiblackness and Global Health: A Response to Ebola in the Colonial Wake. Pluto Press; 2024. 208 p.

2.           Yamey G, Garcia P, Hassan F, Mao W, McDade KK, Pai M, et al. It is not too late to achieve global covid-19 vaccine equity. BMJ. 2022 Mar 24;376:e070650.

3.           Pai M, Abimbola S. Science should save all, not just some. Science. 2024 Aug 9;385(6709):581–581.

4.           Nachega JB, Sam-Agudu NA, Ogoina D, Mbala-Kingebeni P, Ntoumi F, Nakouné E, et al. The surge of mpox in Africa: a call for action. The Lancet Global Health. 2024 Jul 1;12(7):e1086–8.

5.           Adetifa I, Muyembe JJ, Bausch DG, Heymann DL. Mpox neglect and the smallpox niche: a problem for Africa, a problem for the world. The Lancet. 2023 May 27;401(10390):1822–4.

About the blog post author:

Yasmine Elmi is a student in McGill University’s MD-PhD program, soon to earn a Master of Science in Family Medicine with a focus on global health. Her research centers on health equity, maternal and child health, and racial health disparities. She also plays an active role in mentorship and diversity initiatives within STEMM. Her work has been featured in academic journals like The Lancet and achievements highlighted by CBC, CTV, and Radio-Canada.

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