Reimagining open science for global health: epistemic power and the pursuit of health equity

This paper critically examines how current forms of Open Science (OS) fall short of advancing health equity in global health. While OS is promoted as a public good, promising transparency, efficiency, and inclusive, current practices often reproduce rather than dismantle entrenched inequities. Data-sharing infrastructures and open-access policies, largely shaped by high-income countries, frequently extract from but fail to empower low- and middle-income countries. Appeals to transparency likewise overlook deeper asymmetries in whose knowledge is recognized, whose labor is valued, and whose communities benefit from scientific advances. We argue that in the context of global health, OS must be re-imagined not as a technical reform but as a political and epistemic project oriented toward health equity. Drawing on feminist, de-colonial, and Black feminist scholarship, we show how global health knowledge has been structured through histories of exclusion that continue to shape categories, standards, and priorities. Building on these critiques, the paper advances five guiding commitments for re-imagining OS: epistemic plurality, redistribution of resources, accountability to marginalized communities, co-creation and participatory governance, and reflexivity and care. Rather than a prescriptive model, these commitments offer enabling conditions for a more equitable and pluralistic science, reclaiming imagination as a vital resource for collective transformation.