Decolonizing global health—what is the plan?

A few months ago, an old friend from my home town sent me a message asking for help. As part of his duties as a faculty in one Brazilian university, he had to take part in a working group aiming to create a new curriculum for the school of medicine. He is a biologist and some concepts were quite new to him, such as evidence-based medicine (EBM)—‘Is this a new trend? Medicine was based on what before? Witchcraft? And what does “patient-first” even mean?!’ I was not familiar with ‘patient-first’, so he told me ‘Having the patient as part of the treatment, I just learnt’. ‘Oh! they are talking about patient-centered care (PCC)’, I realized. Announcing the obvious, he asked me ‘And where was the patient this whole time?’After laughing for a while, I tried to tell him the history behind these concepts. None of them represented an actual paradigm shift but rather reinforced the importance of practitioners relying both on the best scientific evidence and on having patients’ experiences, values, possibilities and expectations as guiding principles for taking care of their patients. Doctors were not unfamiliar with scientific methods nor they were too arrogant to not listening to their patients’ opinions, before these two concepts appeared. Of course, it was not the case that physicians automatically started to use number needed to treat to prescribe a new medicine nor they realized the importance of shared decisions making. However, by showing how to put EBM and PCC in practice, these concepts have been changing the way medicine is taught and practiced around the world.