In June 2025 Fatou Wurie MPP, FAPH, a Sierra Leonean doctoral student at Harvard, should have been celebrating a major academic milestone. After years of rigorous research and raising $200,000 with the help of her community to fund her education, she was set to defend her thesis and walk at graduation. But unfortunately, she could not make it.
Under newly reinstated U.S. travel restrictions, Fatou was denied re-entry to the country, despite holding a valid student visa and having passed all required screenings. Her story, featured in The Guardian, exposed the deep injustice of what she called “bureaucratic racism”, a system that failed her not because of merit, but because of nationality.
Fatou’s case is not an exception. It is emblematic of a broader and long-standing pattern.
Public health professionals, researchers, and students from low- and middle-income countries (LMICs) have for years been denied access to global platforms that shape policy, funding, and collaboration. Whether to attend a scientific conference, defend a dissertation, or take part in a short-term fellowship, countless individuals have faced insurmountable visa hurdles: tedious processes, delayed interviews, unexplained rejections, and escalating costs. In too many cases, “no” is the default answer even when every box has been checked.
The “visa wall” has become one of global health’s most persistent and under-addressed equity failures.
The Geography of Opportunity
Global health’s center of gravity remains strongly rooted in the Global North. The overwhelming majority of conferences, high-level panels, and advanced training programs take place in countries where entry is not guaranteed for many Global South professionals. This geographic centralisation leads to asymmetries in who gets to speak, network, and ultimately who gets to shape the future of health policy and practice.
While some conferences offer virtual access, in-person participation still carries more weight as it opens doors to funding conversations, career opportunities, and cross-border collaboration that often happen in the margins during side meetings and informal encounters. When visa systems shut people out, they are not just missing a session; they are missing an entire ecosystem of opportunity.
This exclusion is not limited to early-career professionals. Even senior academics, government officials, and practitioners with strong institutional support are frequently denied visas without explanation. For those who make it through, the process is often dehumanising and involves long waiting times, intrusive questioning, last minute approvals, and unaffordable fees.
The consequence is not just individual disappointment. It is a systemic loss. Knowledge generated in the Global South is less likely to be considered in policy making when those best positioned to advocate for it are absent from the table. Instead, their realities are interpreted and represented by others, reinforcing a dynamic in which LMIC professionals are “participants” in global health, but rarely agenda-setters.
A System Built to Exclude
Visa restrictions are not incidental. They are part of a larger structural bias that disproportionately affects Global South professionals. Policies claiming to be about security or migration control are often used as tools of discrimination, grounded in colonial legacies and outdated assumptions about who belongs in elite spaces.
The reintroduction of sweeping travel bans by the US in 2025 further illustrates this point. Nationals from over a dozen countries, many in Africa, the Middle East, and South Asia, found themselves barred from entry, including students, medical residents, and fellows. Even individuals with long-standing academic ties and full sponsorships were denied access. Their work was paused. Their research collaborations collapsed. Their future plans derailed.
But this is not new. In 2017, Dr. Khaled Almilaji, a Syrian doctor known for his public health work during the 2013 polio outbreak in Syria, was barred from returning to the US to continue his studies and eventually had to relocate to Canada to pursue his degree. These incidents, spanning years and continents, show how systemic and persistent the problem is.
Behind every denied visa is not just an individual, but also a lost opportunity for the global public good.
The Cost of Exclusion
When we exclude professionals from the Global South, we diminish the quality and relevance of our collective work. Policies and programmes risk becoming detached from the realities they aim to improve. Contextual knowledge is missed. Important questions go unasked. Critical voices remain unheard.
Exclusion also reinforces power asymmetries in knowledge production. Researchers from LMICs are often reduced to “local collaborators” or data collectors, while analysis, authorship, and recognition remain concentrated in the Global North. These inequities are not just academic; they influence the direction of funding, intervention priorities, and the sustainability of solutions.
This is not about inclusion for its own sake. It is about building systems that are more representative, more just, and ultimately more effective.
Towards a Decolonized Model of Access
What would it look like to dismantle these barriers and build a more equitable global health ecosystem?
First, we must decentralise knowledge exchange. Investing in regional hubs, locally organised conferences, and South-South learning networks can help shift power and amplify LMIC leadership.
Secondly, organisers of major conferences and trainings must prioritise equitable access. This includes issuing visa support letters early, liaising with immigration authorities, offering hybrid participation as a norm, and providing funding for travel and accommodation.
And finally, institutions and donors must challenge the status quo. They should advocate for visa facilitation agreements, support scholars at risk, and fund long-term collaborations that embed LMIC leadership at every stage.
Most importantly, we must move beyond symbolic gestures. Decolonizing global health means confronting the systemic inequities that determine who gets to learn, lead, and be heard.
I would love to hear your thoughts. What changes have you seen, or hope to see, in how we approach power dynamics in global health?
Additional reading on this topic:
- Fatou Wurie, What it’s really like … to know I’m going to miss my Harvard graduation because of Trump’s travel ban, The Guardian, 20 June 2025. Link
- Kyobutungi C, et al., From vaccine to visa apartheid, how anti-Blackness persists in global health, PLOS Global Public Health, 27 February 2023. Link
- IIED, Paper walls: how visa barriers are silencing the Global South, 2024. Link
- Global Health Justice (University of Washington), Visa Injustice: Silencing Critical Voices in Global Health, July 2024. Link
- Paquette S, et al., Imagining a future in global health without visa and passport inequities, PMC, 2023. Link
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