Epistemopolitics in health: a contemporary debate

Abstract

This article addresses the need to dismantle the theoretical and practical structures that have stripped health of its collective, historical, and ecosystemic dimensions, situating the discussion at the intersection of political epistemology, hermeneutic justice, and complex systems thinking. The central hypothesis argues that the dominant biomedical paradigm is not a neutral reflection of scientific progress, but rather an epistemological construct that serves capitalist accumulation and the interests of transnational pharmaceutical corporations. This model reduces the complexity of the health-illness process to a purely biological, local, and individual dimension, generating epistemic disorder and hermeneutic injustice that expropriates the cognitive authority of individuals and alternative forms of knowledge. Through an interdisciplinary analysis grounded in political epistemology, critical epidemiology, the ecosocial approach, and complex systems thinking, this study reviews the specialized literature to deconstruct the attributes of mechanistic determinism—temporal precedence, covariation, and isolation—and contrasts the hegemonic model with the ancestral practices of the Mé'pháá and Tu'un Savi peoples in Guerrero, Mexico. The work concludes that overcoming biomedical reductionism requires the articulation of a new health paradigm, conceived as a collective, historical, and ecosystemic process of preserving life. The convergence of critical epidemiology, the ecosocial approach, and community-based herbal practices opens the possibility of a symmetrical epistemological pluralism, which restores autonomy and cognitive dignity to communities in the face of the pharmaceutical and industrial monopoly.