THE COVID-19 pandemic is a bleak reminder of the enduring inequity in global public health. Fifa Rahman/ Felivita Hikuam/ Nyasha Chingore-Munazvo/ Gisa Dang Despite early warnings, the global response does not take into account the racial inequality underpinning health outcomes, nor that diagnostic tools such as pulse oximeters are not accurate on non-white skin. Glaringly, global north responses to COVID-19 have not been the most efficacious nor the most effective. For example, the United Kingdom, the United States and Sweden have failed to adequately protect their populations, while global south countries such as Rwanda and Taiwan quickly instituted systems and deployed technologies to respond effectively. Yet in the global health security index, the United States and the United Kingdom were ranked first and second in the world for pandemic preparedness. This underscores the need to decolonise and redefine global health by addressing existing power imbalances within global health structures and debates. The white global north perspective is innate in global health, yet only recently has the impact of race and whiteness on global health governance, hiring, and programming come into focus. Why do white-dominated organisations “believe that we know how to solve the health problems of people in other countries”? Why do they remain “so clearly neo-colonialist”? We can’t solve this by solely hiring more black, indigenous and people of colour. We need to recognise that there is intersectionality of oppression and inclusion. Rather than focusing mainly on tokenistic diversity hires, we need to tackle “how the structures and operations of our organisations are part of white supremacist culture”. Covert racism affects global health deliverables and decision-making. White people are seen as reliable to lead on important guideline documents for implementation and diagnostics planning. White people are considered more prompt, more eloquent for example in project design and communications, are thus promoted into leadership positions and end up representing the views of black and brown implementers. This de facto modus operandi would never be uttered in such plain language. 2020 presented several examples of institutional white supremacy culture. In June, a Médecins Sans Frontières internal statement highlighted that while 90% of their staff was hired locally in countries where MSF works, most of its operations were run by European senior managers. Based on absolute numbers alone diverse hiring doesn’t appear to be an issue. But of course it is an issue when, much like colonial times, positions of power are overwhelmingly filled by white people. An insider wrote that MSF senior managers assuming national staff were “intellectually lazy”, explicitly referring to them as being “vulnerable to corruption” complaints of racism were met by the accusation of “reverse racism”, a recognised signifier of white supremacy. Also in June 2020, the Women Deliver chief executive officer took a leave of absence after allegations of a toxic work e