Can we unplug global health education from The Matrix?

Citation: Bandara S, Banerjee AT, Pai M (2025) Can we unplug global health education from The Matrix? PLOS Glob Public Health 5(2):
e0004307.

https://doi.org/10.1371/journal.pgph.0004307

Editor: Julia Robinson, PLOS: Public Library of Science, UNITED STATES OF AMERICA

Published: February 25, 2025

Copyright: © 2025 Bandara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The authors received no specific funding for this work.

Competing interests: We have read the journal’s policy and the authors of this manuscript have the following competing interests: SB and ATB are academic editors of PLOS Global Public Health. MP is a co-Editor-in Chief of PLOS Global Public Health. He also serves on the Editorial Board of PLOS Medicine. 

In one of the most iconic scenes in the film The Matrix (2001), Neo, the protagonist is offered a choice between a red pill and a blue pill. This choice is offered by Morpheus, a leader of the resistance against the machines. In this story, machines have taken over the world. Human bodies are used as ‘batteries’ for electricity, and humans are kept alive by plugging them into a virtual world known as The Matrix. The blue pill allows Neo to stay within the illusion created by The Matrix, while the red pill would unplug him, show him the reality – and offer a choice to fight for liberation of humans.

The red pill and blue pill are metaphorical choices that represent a choice between critical examination of our status quo or remaining oblivious. The red pill has taken on various philosophical and social meanings since the release of The Matrix – and can be used as a tool in global health education to explain the two possible ways of teaching global health.

Within the last decade, a growing number of calls and acts of resistance have been made by the global health community, especially by students to change the curricula to reflect and address the deep power asymmetries in global health [1,2]. Essentially, these relentless calls ask us to ‘unplug’ global health education from ‘The Matrix,’ by providing an education that accurately represents the colonial histories and neo-colonial contemporary geopolitical and contextual factors affecting all determinants of health [2]. An argument can be made that the absence of such an education has directly or indirectly perpetuated downstream inequities we see today within representation, funding, global governance choices and more [3,4].

Building on these strong and necessary calls to action, we compare the usual ways of apolitical and ahistorical teaching that perpetuate the status quo (i.e., the blue pill way of teaching) versus the reimagined ways of teaching that consider the roots of global health inequities and challenges the status quo (i.e., the red pill way of teaching). While recognizing that global health curricula may not fall neatly into these binary categories, we hope that this juxtaposition can provoke a critical discussion we need to have to reconstruct global health education. We provide eight points of juxtaposition for consideration to educators (Table 1).

First is tackling the perpetuation of “white saviour industrial complex” in the way global health is taught [5]. Coined by Teju Cole, this term indicates an ongoing feature of global health where participation is motivated by “big emotional experiences that validate privilege” with minimal consideration of justice [5]. There is a need to shift global health education away from the framing of global health and humanitarian aid as a global charity project built to save the poor, where the powerful and wealthy countries “help” the less powerful, on their own terms and benefit [2]. The current crisis in global health and development, caused by the Trump administration’s abrupt withdrawal from the World Health Organization, Paris Agreement and freezing of health aid, is a good example of why global health need this shift. The new framing posits global health should commit to a collective goal which aims to shift such structures of imbalance to address historical and contemporary injustices through reparations, genuine partnerships, power shifting and mutual trust building [2,5,6].

Second is confronting the sanitized version of global health where challenges are framed only as technical, medical or scientific problems without geopolitical or social contexts. The old way of framing largely focuses on disease burden or “silver bullet” solutions, often ignoring historical and contemporary contexts. The new framing intentionally and actively highlights geopolitical, historical, commercial and social contexts that tells the complete story behind the disease burden [5,7]. Examples of such teaching can include examining the genesis of tropical medicine as a colonial project or analyzing root causes of inequities that stem from a combination of historical injustices, structural, and systemic factors. A prime example is the global inequity in COVID-19 vaccine distribution during the pandemic.

Third is building an understanding that inequities exist everywhere and also exist transnationally – not just in Global South countries. Thus, global health courses need to counter the outdated deficit-centred framing of stark inequities existing only in low- and middle-income countries (LMICs) and reinforce the understanding that inequities are prevalent within high income countries (HICs) as well [5,8]. This approach allows us to address cross-cutting equity challenges better, learn from all countries, and help students view global health work as inclusive of addressing ‘glocal’ challenges [5,8]. This also creates further space for LMIC partners to share best practices and strengthens genuine global bi-directional knowledge flow.

Fourth is promoting the examination of power, including persuading institutions in the Global North to introspect on their role of perpetuating harmful power hierarchies [6,9,10]. The current status quo leans towards dismissing the need to examine power dynamics and encouraging the elite capture in global health [6,9,10]. Countering the process of dismissal via power analysis helps to highlight the value of shifting power towards the Global South [6].

A closely interconnected fifth challenge that deeply impacts global health institutions and instruction in the Global North is the trend of devaluing anti-racism, inclusion and other anti-oppression teachings and practices [6]. If we are to realistically push towards equitable global health structures, using a critical consciousness lens to consider our own power and positionalities to disrupt oppressive structures often grounded in white supremacy remain essential [1,11].

Another practice that needs to be reconsidered in global health education is the short-term global health missions, experiences that may be unsustainable and potentially harmful. As the sixth point we highlight the best practice of long-term partnerships with country partners in LMICs and equity-denied populations in HICs, geared towards benefiting local communities [12].

For global health curricula to be truly global, we must move away from seeing Euro-centric knowledge systems as the standard, where academics “defer to a distant, powerful, foreign gaze, whose power shapes our pose and what we can see or say” [13–15]. Thus, as our seventh point we highlight the need to center experts who are racialized, Indigenous, caste-oppressed from the Global South, and individuals in systemically marginalized communities in our courses [5,13]. We also need to share relevant knowledge that they have been producing as readings – shifting the knowledge monopoly away from the colonial knowledge structures [13].

Our final point builds on all the points above. For us to succeed, global health requires education curricula that actively encourages un-learning, uncomfortable dialogue, supports critical allyship, and cultural humility. This is the anti-thesis of an education system that minimizes voices of international or racialized or Indigenous students and promotes a singular high income country perspective of LMICs rooted in colonial and neo-colonial ethos.

In summary, in this commentary, we compare the “red pill” versus “blue pill” versions of global health education which represents the choice to radically reimagine global health education or remain comfortable with the status quo, respectively. We invite educators, including us, to take the “red pill”, to critically examine our global health curricula and find ways to reimagine them. We note that shifting global health education is not as easy as taking the “red pill.” To truly imagine a red pill version (a more just, inclusive, collaborative form) of global health education, we need a collective, continuous, and long-term effort.