Paper short abstract:

How the epistemic inequities in the global division of knowledge labour that marginalise African knowledge and expertise contributes directly to the high rates of premature mortality and chronic morbidity on the continent.

Paper long abstract:

Recent reforms proposed (e.g. by Thomas Pogge 2005, 2012 inter alia) to augment those WTO* agreements (e.g. TRIPS)* which cripple access to 'essential' prescription drugs in Africa appear unlikely to fulfil the aims of integrating public health issues worldwide in the post-2015 Millennium Development Goals.

Today's global approaches to African epidemics bear some remarkable continuities with policies since political Independence and with treatment responses initiated by British colonial administrators of the Gold Coast since the 1880s—policies such as volunteerism, behaviour modification, residential segregation, and now increasingly militarized incarceration. My first hand evidence is restricted to contemporary data derived chiefly but not exclusively from Ghana; my presentation of Gold Coast colonial policy relies upon the medical historiography of Stephen Addae (1996).

Influential elites in academia and industry, comprising the global advocacy of international health rights, promote ethical arguments and development schemes that betray an uneasiness and unfamiliarity with the experiences, the expertise, i.e. the first hand knowledge of human physical conditions and acculturated interests, that these global responsibility advocates purport to serve (MarthaNussbaum 1997). I will apply Miranda Fricker's (1999, 2014) and Elizabeth Anderson's (2012) analyses of transactional and institutional epistemic injustices to global discourse about health. I hope to demonstrate that marginalisation of Africans' subjective agency, hermeneutic authority, and complex systems of modern and traditional expertise contributes directly to the disproportionate burden of premature mortality and chronic morbidity on the African continent.

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