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Abstract
This essay examines the history of European empire building and health work in sub-Saharan
Africa, focusing on four patterns that shed light on the ethics of outside interventions:
(1) the epidemiological and bodily harms caused by conquest and economic development;
(2) the uneven and inadequate health infrastructures established during the colonial
era, including certain iatrogenic consequences; (3) the ethical ambiguities and transgressions
of colonial research and treatment campaigns; and (4) the concerted and inadvertent
efforts to undermine African healing practices, which were not always commensurable
with introduced medical techniques. This kind of historical analysis helps us home
in on different kinds of ethical problems that have grown out of past asymmetries
of power-between people, professions, states, and institutions-that shape the nature
of international health systems to this day.