This Viewpoint considers the implications of incorporating two interdisciplinary and burgeoning fields of study, settler colonialism and racial capitalism, as prominent frameworks within academic global health. We describe these two modes of domination and their historical and ongoing roles in creating accumulated advantage for some groups and disadvantage for others, highlighting their relevance for decolonial health approaches. We argue that widespread epistemic and material injustice, long noted by marginalised communities, is more apparent and challengeable with the consistent application of these two frameworks. With examples from the USA, Brazil, and Zimbabwe, we describe the health effects of settler colonial erasure and racial capitalist exploitation, also revealing the rich legacies of resistance that highlight potential paths towards health equity. Because much of the global health knowledge production is constructed from unregenerate contexts of settler colonialism and racial capitalism and yet focused transnationally, we offer instead an approach of bidirectional decoloniality. Recognising the broader colonial world system at work, bidirectional decoloniality entails a truly global health community that confronts Global North settler colonialism and racial injustice as forcefully as the various colonialisms perpetrated in the Global South.
The Lancet Global Health, Volume 11, September 2023,