One week ago, the World Health Organization’s theme for World Health Day, 7 April 2026, carried unmistakable urgency: “Together for Health. Stand with Science.” In recent years, public trust in scientific institutions has been eroded by political polarization, disinformation, and uncertainty in research funding across many countries. The call to defend the integrity of science is therefore understandable. Yet the slogan also raises a question rarely discussed openly, one that touches on the current hegemony of global knowledge systems: whose scientific system is actually being defended, and under what political conditions are other countries expected to produce scientific knowledge?

Evidence suggests that scientific capacity does not always track with full integration into research systems dominated by high-income countries. Cuba, for instance, under prolonged economic embargo, developed CIMAvax-EGF, a therapeutic lung cancer vaccine that subsequently attracted collaboration from the Roswell Park Comprehensive Cancer Center in the United States. Iran, amid a sanctions regime restricting access to laboratory materials and international transactions, also managed to develop a domestic COVID-19 vaccine during the early phase of the pandemic. These facts do not suggest that any country can be fully independent from the global scientific ecosystem. But they do show that scientific capacity can continue to grow even under severe external constraints, and that the singular narrative about where credible science can originate deserves to be questioned.

The question grows more complex when barriers to knowledge production stem not only from domestic limitations but from international geopolitical decisions. US sanctions against Iran have directly obstructed the import of medical equipment and laboratory reagents. The blockade against Cuba has severed pharmaceutical supply chains for decades. To this day, the systematic destruction of health infrastructure in Palestine has been documented in WHO’s own reports, yet the institutional response from the global health community has been notably more muted than the outcry generated by cuts to the United States’ own NIH budget. This hierarchy of public attention is often driven by the power of media, and it also lays bare a bitter structural reality: global health governance as it currently exists is shaped disproportionately by the policy preferences of a small number of high-income countries, whose political decisions reverberate outward as conditions that other nations must absorb and even comply with.

Indonesia experienced its own version of this problem during the COVID-19 pandemic, though it is rarely named as such. Public debates surrounding GeNose, Ivermectin, and Vaksin Nusantara were frequently framed as nothing more than a battle between science and misinformation. In many respects, that framing was correct, as a number of the claims advanced did not meet the required methodological standards. But stopping there leaves the analysis incomplete. Several of those scientific initiatives emerged as responses to the need for low-cost screening tools at a time when molecular testing capacity remained severely limited, and arose from genuine frustration with the fragility of global vaccine supply chains during the early phases of international distribution. Acknowledging this structural context does not mean lowering scientific evidentiary standards. More broadly, we must understand that scientific controversies frequently emerge under conditions of real capacity inequality, and that this inequality is itself the product of long-term policy choices that never seriously invested in domestic capability because external infrastructure was always available, until it was not.

The causal relationship here is genuinely complex. Countries with underdeveloped research infrastructure tend to adopt external validation standards because domestic systems have not yet matured, while that very adoption can slow the building of independent capacity. This cycle does not break on its own, and it will not break through moral appeals alone.

Seventy-one years ago, the Bandung Conference placed intellectual capacity at the heart of political independence. Sukarno, Jawaharlal Nehru, and Gamal Abdel Nasser understood that sovereignty was not only a matter of territorial control but also of the ability to produce one’s own knowledge. In today’s global health debates, that historical dimension rarely surfaces, even as much of the underlying inequality persists in new forms. Global scientific collaboration remains indispensable. Virtually no country can sustain modern biomedical innovation entirely on its own. But collaboration never takes place in a fully neutral space. The distribution of research funding, access to scientific journals, laboratory capacity, and regulatory authority remains profoundly uneven.

Indonesia should push for three shifts within global health forums. The global health community must formally recognize that sanctions obstructing access to medicines and medical devices constitute violations of the right to health, not merely permissible instruments of foreign policy. Scientific evidence validation standards must be proportionally calibrated to the research capacity contexts in which knowledge is produced, without sacrificing scientific integrity. And serious investment in domestic scientific infrastructure must reduce structural dependence on systems that can be severed at any moment by political decisions made elsewhere.

Standing with science means standing with the conditions that make science possible for everyone. That commitment is far more demanding than any slogan suggests.