Global Health Spotlight: Dr. Erica Di Ruggeiro
Erica Di Ruggiero (she/her) is a white settler of European descent, currently an associate professor of global health and Director, Centre for Global Health, Dalla Lana School of Public Health, University of Toronto.
Learn more about her here.
How did you come into your position as the Director of the Centre for Global Health? What is the mission of the centre and its role at the Dalla Lana School of Public Health?
I joined the Dalla Lana School of Public Health (DLSPH) as an Assistant Professor and Director, Office of Global Public Health Education & Training in December 2016. Shortly after I joined, I was asked to lead a review of global health at the School and make recommendations for strengthening the coherence and impact of these initiatives. The review involved an extensive scan and consultations with faculty, students and staff. The Centre was launched in late February 2020 (a few weeks before the WHO declared COVID-19 a global pandemic), and I was appointed as its inaugural Director. The Centre’s vision is “to be an interdisciplinary knowledge hub that catalyzes excellence in global health research, education, and service, and prepares future public health and health system leaders to make a global societal impact”. It delivers on this vision through collaborative, interdisciplinary, and equity-informed global health research, global health education, training and co-curricular offerings and by building a global heath network across the DLSPH and with strategic partners.
As a Centre, we enact a set of core principles that guide our partnerships such as attention to equity, power and privilege, mutual benefits, respect and reciprocal learning, sustainability and effectiveness.
For more information about the Centre for Global Health, please see: https://www.dlsph.utoronto.ca/institutes/centre-for-global-health/
It has been over two years since the start of the COVID-19 pandemic. What are your thoughts on the current state of global health?
This is a very complex and important question. Global health issues are inherently complex and know no boundaries. If the COVID-19 pandemic has taught us anything so far, it is that it is far-reaching and continues to an undeniable impact on people here at home and around the world. COVID-19 is also part of a pattern of increasingly frequent epidemics that have coincided with several pre-existing crises, including rising gender, racial, social, environmental and health inequities. COVID-19 was therefore not the great equalizer. It only further surfaced the fragility and the failures of our social, economic and health systems that continue to make many groups vulnerable – from precarious migrant workers to racialized personal support workers to people experiencing homelessness, food insecurity or sexual discrimination. Yet the Sustainable Development Goals’ (SDG) cross-cutting theme – leave no one behind has been calling on all countries including Canada since 2015 to do much better. This call is not new, and it predates the SDGs.
The global health community must therefore continue to centre equity and its realization for all peoples. While global health may be used to enable policies and actions with genuinely universal and equitable benefit, it can also be used to justify measures that are neither progressive nor just – this is contested global arena shaped by vested interests, and competition for power and resources, equity runs the risk of falling off the agenda. The second area requiring attention is to move beyond performative leadership to advance equity and decolonial practices. It means taking a hard look at the roots of our disciplines, practices and how they are promoting and reinforcing colonial practices that perpetuate discrimination and how they continue to leave historically marginalized groups behind. If we really want equity, diversity and inclusion strategies to be fully scaled through our global health and other efforts, we need to conduct and act on historical and power analyses to more fully understand and transform the contexts in which we live, work and learn.
How can we work to address global health issues using the Sustainable Development Goals?
One of the ways global health has been defined is through the establishment of global goals and related targets and indicators. A current example is… the 2030 Global Agenda or the 17 Sustainable Development Goals. In 2015, the SDGs were ratified by 193 member countries. While the SDGs (which are directed at all countries) hold promise, they also challenge all of us to generate contextually sensitive evidence to respond to and solve implementation problems facing policymakers, practitioners, communities, and other social actors. They provide a global framework for action for people, planet, prosperity, peace, and partnership. While they are more comprehensive than the previous goals (the Millennium Development Goals), they are not without criticism. For instance, they are silent on the need to tackle racism. The goals should not also need to be addressed but by deploying interdisciplinary, intersectoral and intersectional strategies. For example, the pandemic has provided a stark reminder of the social and economic value of women’s paid and unpaid healthcare work, and multiple caregiving responsibilities. However, we also know that progress has been slow in advancing gender transformative reforms that better value women’s work in order to make meaningful progress towards multiple SDGs including but not limited to SDG5 (gender equality). To ensure success, we also need more initiatives that promote global solidarity and shared humanity and shared agendas across countries rather than a siloed approach. This can be achieved through improved bilateral and multilateral negotiations, and stronger global institutions (SDG16).
Do you have any advice for undergraduate students who hope to pursue a graduate education and/or career in global health?
The field of global health requires the engagement of multiple disciplines and sectors. I would encourage students to look for opportunities to engage and critically debate with other students and faculty across disciplines, to question the underlying assumptions and economic rationalities of our policies and systems.
Advocate for systems change through community coalitions, student groups and University initiatives (see links below), and other forums that give meaningful voice and attention to those who are historically underrepresented at decision-making tables
Get involved in research that doesn’t only seek to describe the problem but seeks to uncover systemic causes of gender, racial or health inequities and works to generate equitable and ethical solutions with and for communities