As a newcomer in the field of public health, I applied for the Emerging Voices in Global Health (EV4GH) fellowship and the Health Systems Research (HSR) 2024 symposium with two main goals: (i) to meet and network with professionals in the field, and (ii) build my capacity as an emerging public health researcher. The EV4GH programme was an immersive and fun experience. Field trips, formal and informal interactions with other fellows, facilitators and participants at the HSR symposium enabled rich and meaningful cultural and intellectual exchanges and learning. In this article, I reflect on my experience of the EV4GH 2024 venture, and lessons that I learnt about navigating global health as an emerging voice in the field.

Global health challenges require solutions that are informed by knowledge of both local contexts and global dynamics. They also need diverse teams both in terms of discipline, nationality, culture, age, gender, race among other factors. Both the EV4GH programme which brought together 37 fellows from diverse backgrounds, and the HSR symposium enabled a rich exchange of perspectives about local and global health problems. For me, these platforms challenged assumptions and prejudices that are often reinforced within silos. However, this exchange also surfaced challenges that often arise from an intermingling of diverse backgrounds- a clash of values and opinions, and in some cases, an overstepping of boundaries. Both the learnings and tensions revealed that intercultural awareness and competence is a key value and skill required of global health actors. At the HSR symposium, I was reminded of the need to reinforce values and concerns such as health, that unite us on deeply polarizing issues.

One valuable aspect of the EV4GH programme and HSR symposium was an opportunity to ‘zoom out’ and get a bird’s eye view of the global health landscape; the multitude of interests and competing agenda at the global level. It was both intriguing and disheartening to learn how political and economic priorities – which may be at odds with evidence-based public health needs – shape global health agenda, and influence approaches to programming and resource allocation at national and local contexts.

As EV4GH fellows grappled with the question of how best to deploy our energies and resources to address this, Prof Ooms Gorik, from the Institute of Tropical Medicine (ITM), Belgium posed a thought-provoking question to EV4GH 2024 fellows: Should global health actors aim to align with political and economic agenda-being the path of least resistance-, or double down on advocating for the adoption of evidence based, needs driven priorities – even if this proves to be time consuming and resource intensive with no guaranteed outcomes.

I left Nagasaki without a clear answer to this question, but with the realization that emerging global health actors such as myself cannot shy away from being politically active and engaged. In addition, I was reminded of the value of communities such as the HSR symposium, the EV4GH network which renew our sense of purpose and hope as global health actors. They are also spaces that support peer learning, exchange and support. For example, in my field of sexual and reproductive health (SRH), the backlash on and rights across the globe has been discouraging. Yet, at the HSR symposium, I was intrigued by a session in which participants shared innovative strategies to expand access to SRH and rights in restrictive contexts in the global south. Spaces such as these can inspire action, innovation and movements that can positively impact global health agenda.

A major frustration for researchers such as myself is the devaluation of intellectualism and the blatant disregard for scientific evidence in the ‘post-truth’ era that we exist in. Currently, global health actors not only grapple with effective public health messaging amidst reduced attention spans but also countering misinformation. I was pleased to learn tools for effective communication, which consider who, why and how evidence is communicated. For public health researchers, evidence generation and dissemination through scientific journal articles is not enough. Storytelling –repackaging and re-telling key public health messages in ways that resonate with those from who action is desired can move us closer to achieving our desired impact. A lingering question, however, was whether it is effective to engage in social media spaces to counter misinformation despite challenges posed by algorithms or divest from such spaces altogether.

Explicit in the EV4GH and HSR goals was advocacy for the concept of one health – an ecosystem view of health that acknowledges the interconnectedness of human well-being with that of the planet and other living creatures. One experience that elaborated on this was the horse therapy study tour that we took part in as part of the EV4GH venture. During this tour, officials at Farm Unzen shared compelling study findings which demonstrated how equine-assisted therapy can enhance mental and physical well-being. They argued that understanding horses’ natural characteristics and providing appropriate care, such as not confining them, is not only beneficial for their health, but that of people, and the environment. They called for an integration of horse therapy into the Japanese health insurance system.

For me, and some other EV4GH fellows from low- and middle-income countries, we could not help but notice that animals being part and parcel of everyday life ‘in their natural state’ is commonplace in many rural communities in the global south. What was striking and particularly relevant for global South public health actors, however, was the valuing of ‘informal/traditional’ practices and systematic data collection on the same to support their integration into health systems. Indeed, a decolonial approach to health systems.

Overall, the EV4GH 2024 venture highlighted for me that intercultural competence, political engagement, effective communication-beyond evidence generation and a decolonial lens are essential skills and perspectives that I need to navigate global health as an emerging global health actor.