Offline: Ukraine: Hard Lessons for Global Health

It is easy to condemn Russia for its criminal war against Ukraine. For his attacks on health workers and hospitals. For its violations of international humanitarian law. For his acts of murderous cruelty against civilians. To increase the risk of a nuclear conflagration. It is right to call for an immediate ceasefire and the withdrawal of Russian forces from Ukraine. Accelerate the delivery of humanitarian aid. Provide safe haven for refugees. To document atrocities and counter misinformation. And to hold the Russian and Belarusian Governments accountable for their crimes of aggression. For scientists and their journals, it is simple to say that we will not enter into cooperation agreements with the institutions of the aggressor countries. It’s not difficult. But what to say and what to do with these countries that have chosen to be neutral in the face of the war in Ukraine?

On March 2, 2022, 141 of the 193 UN member states voted to condemn Russia’s decision to go to war against Ukraine. Five countries voted against: Belarus, Eritrea, North Korea, Russia and Syria. 35 countries abstained, including China and India. 12 countries did not vote. Of the countries that abstained or did not vote, half (23) were in sub-Saharan Africa. Western nations encouraged the Chinese government to persuade Vladimir Putin to end the conflict. The EU said China would suffer “major reputational damage” if it undermined sanctions against Russia. The US government has warned China of “serious consequences” if it provides military assistance to Russia. Western commentators say Ukraine is a moral test for Xi Jinping. Its failure to intervene for peace, they argue, will render its promise of “win-win cooperation” with the West utterly worthless. But although Xi called for “maximum restraint”, he refused to condemn Russia’s actions. His government accused the United States of being “the main instigator of the Ukrainian crisis”. Chinese Foreign Minister Wang Yi met with his Russian counterpart, Sergei Lavrov, last week and, perhaps aware that China is Russia’s largest trading partner, noted that “Chinese-Russian cooperation is n has no limits”. Reports are emerging that China launched cyber attacks on Ukraine shortly before Russia’s February 24 invasion. India presents an even more complex challenge. Again, Western nations pressured Prime Minister Narendra Modi to condemn Russian aggression. But while Modi declined to meet Britain’s foreign secretary, he did grant an audience to Lavrov, who hailed India’s neutrality on Ukraine. If China is so intimately complicit in the war against Ukraine, and if India’s neutrality is maintained, what should be the position of Western scientists (and journals) regarding collaborations with Chinese and Indian institutions? Does complicity or neutrality require institutional excommunication?

Figure thumbnail fx2
Figure thumbnail fx3

Some Western observers claim that the Ukrainian crisis marks the end of globalization. Or that this conflict is a war between democracy and autocracy. It’s neither. I don’t believe there is an active desire on the part of China, India and much of Africa to side with Putin. Instead, what their declared “neutrality” means is a resistance to American and European expectations of conformity. The clue came from India’s External Affairs Minister, Subrahmanyam Jaishankar. In his meetings with foreign ministers last week, he underscored the importance of an evolving multipolar world, no longer constrained by any superpower or ideology. He spoke about the diffusion of global power and the legitimacy of the G20 compared to the G7. Yes, we in global health must condemn Russia’s crimes of aggression. But we should no longer support those who seek to preserve a unipolar world order. Our global health institutions must not be the embodiment of such unipolarity. We should actively reject the convention that only Americans can be president of the World Bank and executive director of UNICEF. We should ask ourselves why the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the CEO of Gavi, the Vaccine Alliance, have always been European or American. We should ask ourselves why the leaders of leading academic institutions of global health (and, yes, scientific journals) lack the diversity one would expect in a truly multipolar world. The war in Ukraine is certainly savage and illegal. But the international response to this illegal conflict also reflects deep and persistent power inequities that global health cannot ignore.

Comments are closed.