Global health systems neglect arts as medicine: Decolonising evidence, policy, and practice for equitable wellbeing
Original framing: “[Review] Developing roadmaps for advancing practice, research, and policy in the arts and health” — The Lancet
The review silences voices like **disabled artists** who use creativity to navigate ableist healthcare systems, or **sex workers** in Thailand who employ *nang* (shadow puppetry) to process trauma. **Queer and trans communities** have long used art to subvert pathologisation (e.g., *ballroom culture* as HIV prevention education), yet these movements are absent from the Lancet’s 'global' framework. **Women in Global South healthcare**—like the *dais* (midwives) of West Africa who use proverbs and drumming in childbirth—are erased, despite their models achieving higher maternal health outcomes than hospital-based care in some regions.
The Lancet’s review reveals a **colonial fracture** in global health: while Western institutions treat arts-health integration as a **novel innovation**, Indigenous and Global South communities have long practiced it as **sacred survival**.
The power structures at play are **triple**: (1) **Epistemic violence**—erasing non-Western healing modalities as 'unscientific'; (2) **Neoliberal extraction**—commodifying fragments of these traditions for elite wellness markets; and (3) **Biomedical reductionism**—treating art as a **band-aid** for symptoms rather than a **systemic antidote** to oppression. The trickster here is the **false universality** of the Lancet’s roadmaps, which claim to be 'global' while centring a **Eurocentric, individualised, and clinical** model. To heal this fracture, solutions must **decolonise research** (centring Indigenous leadership), **redistribute resources** (treating arts as a public good), **pluralise epistemologies** (including non-human and spiritual dimensions), and **radicalise pedagogy** (using art to diagnose—and dismantle—systemic harm). The synthesis? **Healing is not a service to be integrated into healthcare; it is a worldview to be restored.