This essay is part of Ways of working for more peaceful futures: A global health humanities roundtable, an effort through the Future of Peace program to bring perspectives from global health humanities into conversation with questions of peace. Read Michelle E. Anderson’s introduction to the series, or explore the full roundtable paper bringing all six contributions together.
In times when there is little consensus on what is “right” and “wrong”, the search for meaningful responses to future challenges calls for a (re)examination of the normative foundations of global health: what grounds our obligations toward the health of people beyond national borders?
Global health, a field of scientific and political practice, must be understood as an agent: it categorizes, prioritizes, intervenes. This agency is based on decisions that inevitably involve value judgments. Global health thus operates within a field of moral and ethical tensions, which must be navigated through assumptions, definitions, and generalizations. To do so in a meaningful way, global health requires a normative point of reference.
“Health” alone cannot provide this reference. It is not an end in itself; health derives its value from its contribution to human life. If the value of health lies in this contribution, then the human person becomes the normative reference point for global health. But whom exactly do we mean by the “human person,” and what form of humanism are we drawing upon?
Scholars have criticized traditional humanism as a Western construct that can shift from benevolence and care to paternalism and coercion; global health for universalizing European conceptions of the human person; humanitarianism for reproducing power imbalances through compassion for the misery of others; and totalizing frameworks for concealing the complex particularity of lived realities. How, then, can global health commit to humanism, as a general moral obligation toward human beings, without reproducing a Western universalist concept of the human person?
This is only possible if humanism continuously and critically questions its own assumptions. Crucially, the universality of a fundamental moral commitment to human dignity must be distinguished from a universalism of human existence: the universal commitment does not, in fact, require that people everywhere understand health, the good life, autonomy, needs, or self-conception in the same way.
Human persons can never be fully captured by external categories. They are always relational, socially embedded, structurally situated, and shaped by lived experience, actions, individuality, and historical context. Building on the premise that human categorization is necessarily incomplete, several cornerstones of a normative orientation emerge:
- Our knowledge of a person is limited: epistemic humility
- Our assumptions about what a person is are situated: ontological modesty
- People experience life in multiple ways: pluralism
- People are knowing and acting subjects: participation
- People are relational and structurally situated: structural critique
- Our knowledge is position-dependent: reflexivity
These are essential components for understanding the constitutive assumptions underlying the production of global health knowledge; how that knowledge can be applied to people; how interventions are developed and implemented; and what kinds of power relations arise in the process.
Obviously, certain generalizations and simplifications- from epidemiological classifications and population-level indicators to treatment guidelines- are inevitable. They are vital to modern public health, just as universal standards and health rights are fundamentally valuable. Global health must abstract human reality and reduce it epistemically to create a starting point for research and shared discourse.
However, critical humanism may serve as a corrective to such abstractions when they become ontologically superior to the human person itself. In other words, epistemic reduction must not turn into ontological reduction. Categories are not power-neutral and must not be confused with the persons they partially describe. Structures matter, but do not exhaust personal realities. Categories like “suffering” or “vulnerability” must not be granted definitional power over persons; rather, they establish moral claims on society independent of the person. At the same time, the human person as a point of reference in global health does not imply a return to individualism or anthropocentrism: A person can never be socially or ecologically decontextualized.
There is already an abundance of frameworks in global health; my aim is not to propose yet another one. Rather, critical humanism in global health may provide a normative orientation for navigating the challenges of our time: by insisting that the human person remains the reference point for all global health action, while continuously scrutinizing how global health defines and operationalizes this person, how it produces and uses knowledge about them, and how it acts in relation to them.
The tension between a universal moral obligation toward the human person and the ongoing questioning of our conceptions of what it means to be human cannot ultimately be resolved. Nor is resolving it the aim of critical humanism in global health, or in other fields of action with a collective moral commitment to justice and equality. In fact, the aim itself is simple: the willingness to hold and continually negotiate this tension.
