In countries and communities around the world there are organizers, leaders, and experts who are working to remove the barriers to health that are rooted in racism and structural discrimination. They are creating anti-racist strategies to respond because today too many people are limited by racism and discrimination based on ethnicity, caste, tribe, gender identity, sexual orientation, ability, and religion. The evidence is clear that racism and discrimination baked into our societies causes sicker lives and earlier deaths.

Dr. Tlaleng Mofokeng has been working for years to support those who have been marginalized due to racism and discrimination by providing care directly in South Africa, and advocating, teaching, and organizing at a regional and global level as the United Nations Special Rapporteur on the right to health and co-chair of the O’Neill-Lancet Commission on Racism, Structural Discrimination and Global Health.

Dr. Karabi Acharya, senior director of the Global Ideas for US Solutions strategic portfolio at the Robert Wood Johnson Foundation, sat down over Zoom with Dr. Mofokeng to discuss how anti-racist policies and practices in communities and countries around the world can inform efforts in other places as we work to build a more equitable, healthy world. The conversation has been lightly edited for length and clarity.

Acharya: It sounds like where you grew up, and specifically the sociopolitical environment of apartheid, gave you almost an intuitive understanding of the social determinants of health and an early recognition that health care alone was not going to solve these problems.

Mofokeng: I remember being in primary school and having a helicopter drop toothbrushes and toothpaste in the yard of the primary school from the air. And I’m like, why does this make sense to anybody? If you want to give us toothbrushes and toothpaste, give it to us. Why are you dropping it from the sky? So life was already not making sense. But I didn't have the cognitive ability to make it make sense at the time. That feeling of confusion and disbelief has followed me throughout my whole life.

In medical school, I knew that the medicine I was also being taught and the kind of doctor I was being groomed to be was not the doctor that I needed to be. I knew that I had to pass medical school, I had to nod and say yes and do what I needed to do. But I knew that I would have to relearn parts of medicine and reteach myself how to be a better doctor.

I also knew that just because I’m Black doesn’t mean that I am destined for disease or for incarceration or for drug use. And yet a lot of the public health messaging had that framing. There was no dignity there.

We also need to be honest in the fact that the difficulties many people face are not of their making. That’s why I started reading up about racial justice and race as a determinant of health, and segregation and how town planning happens where you have particular communities where you have asthma and eczema, and all these allergic and inflammatory conditions because of the water and air and land pollution.

Read the full article about anti-racist practices for healthy communities by Tlaleng Mofokeng and Karabi Acharya at Stanford Social Innovation Review.