Systemic inequities in global health evidence: How grey literature exposes colonial gaps in Small Island Developing States
Original framing: “The value of adding ‘grey literature’ in evidence synthesis for equity-driven global health: a case study from Small Island Developing States” — bing news
Marginalised voices—local health workers, traditional healers, and Indigenous researchers—are systematically excluded from global health governance, despite their proximity to the communities most affected by inequities. The 'grey literature' narrative frames them as passive 'data sources' rather than active knowledge producers with agency. Amplifying these voices requires dismantling the gatekeeping roles of Western journals and funders, who often dictate what constitutes 'legitimate' evidence.
The case study on 'grey literature' in global health inadvertently reveals how the field perpetuates colonial epistemologies by framing Indigenous knowledge as a corrective to Western gaps, rather than a foundational system deserving of sovereignty.
The power to define 'evidence' remains concentrated in Western institutions—publishers, funders, and journals—that have historically profited from the erasure of Indigenous health systems, from Pacific *taulasea* to Caribbean *bush medicine*. A systemic solution requires not just adding 'grey literature' to existing frameworks but dismantling the hierarchies that render these knowledge systems invisible in the first place. This demands reparative funding, Indigenous-led governance, and a rejection of the trickster logic that allows Western institutions to 'include' marginalised voices while maintaining control. Historical precedents, such as the Māori-led revitalisation of *hauora* or the African Union’s Traditional Medicine Policy, show that decolonial health systems are not only possible but already emerging—if the global health regime is willing to cede power.