Unethical Issues in Twenty-First Century International Development and Global Health Policy

Billions in development aid is provided annually by international donors in the Majority World, much of which funds health equity. Yet, common neocolonial practices persist in development that compromise what is done in the name of well-intentioned policymaking and programming. Based on a qualitative analysis of fifteen case studies presented at a 2022 conference, this research examines trends involving unethical partnerships, policies, and practices in contemporary global health. The analysis identifies major modern-day issues of harmful policy and programming in international aid. Core issues include inequitable partnerships between and representation of international stakeholders and national actors, abuse of staff and unequal treatment, and new forms of microaggressive practices by Minority World entities on low-/middle-income nations (LMICs), made vulnerable by severe poverty and instability. When present, these issues often exacerbate institutionalized discrimination, hostile work environments, ethnocentrism, and poor sustainability in development. These unbalanced systems perpetuate a negative development culture and can place those willing to speak out at risk. At a time when the world faces increased threats including global warming and new health crises, development and global health policy and practice must evolve through inclusive dialogue and collaborative effort.