Contemporary uses of artificial intelligence (AI) in global health are shaped not only by technical expertise but also by embedded narrative logics such as assumptions about whose experiences count, whose perspectives define the problem, and whose futures are imagined in algorithmic attempts to provide solutions. This paper examines the narrative machine embedded within AI-driven health technologies and argues that the epistemological foundations of such systems are deeply entwined with colonial-era patterns of knowledge extraction, abstraction, and representation. Through a theoretical lens informed by postcolonial and decolonial studies as well as narrative ethics, this paper proposes a decolonial analytic of AI systems as narrative machines: tools that not only process data but also inscribe particular worldviews. I explore how these systems often exclude or distort local health epistemologies, particularly in the Global South, leading to interventions that are technologically sophisticated but culturally disembedded and ethically fraught. In practical terms, the paper examines case studies of AI-enabled diagnostic platforms, epidemiological modeling tools in the Caribbean and Africa. It identifies three domains where decolonial intervention is possible: (1) Participatory design methodologies that center narrative sovereignty; (2) Ethical audit frameworks that account for epistemic inclusion; and (3) Policy structures that resist data extractivism in favor of relational, consent-based data practices. This paper contends that addressing global health inequities through AI demands not just better data or fairer algorithms, but a transformation of the narrative structure through which technological futures are conceived and operationalized.

This study investigates the ability of science fiction to address issues that emerge in public health. The issues that form the focus of this paper include the spread of misinformation and disinformation, dependence on technology, and competent public-private partnerships that serve the interests of society. Each of these issues is brought under the spotlight by Barbadian sociologist Karen Lord in ‘The Plague Doctors’ and American psychiatrist Justin C. Key in ‘The Algorithm Will See You Know’. The stories, although set in unrealized futures and describe as yet inconceivable advancements in technology, contain real-world problems involved in accessing healthcare. In doing so, both writers attend to the viability of literature, and the humanities in general, as a vehicle for encouraging reform to public health policies that face challenges such as inequities in healthcare and raising greater awareness of health concerns. My study bridges public health and literature, specifically science fiction, to get certain messages across. These messages include effectively communicating risks to people’s health, increasing understanding of social responsibility, and addressing uncertainty with transparency. The stories in question reveal futures where public health management has, for the most part, either got it right, in the case of ‘The Plague Doctors’, or not quite, in the case of ‘The Algorithm Will See You Now’. Because I consider the COVID-19 pandemic to be less of a disruptor to public health and more of a revealer of what public health needs to focus on, I foresee interdisciplinary projects such as mine as crucial to bridging the disconnect between people and public health policies.

The rapid integration of Artificial Intelligence (AI) into healthcare has generated significant global debate on its benefits, risks, and ethical implications. While much of this discourse centres on technological performance and clinical outcomes, far less attention has been paid to the managerial and governance challenges regarding AI adoption, particularly in small states with constrained resources. This paper takes Trinidad and Tobago as an illustrative example to explore the dual nature of AI in healthcare, both as an ethical and a managerial issue. Drawing on initiatives such as robotics, oncological diagnostics, and e-health platforms, the paper examines how external factors, including workforce competence, administrative capacity, leadership, cultural trust, and institutional governance, shape AI adoption outcomes. Ethical pillars, autonomy, beneficence, non-maleficence, and justice, are mapped onto managerial concerns such as risk management, strategic alignment, stakeholder trust, and resource allocation. We propose an integrated framework of policy and organisational recommendations, strengthening regulatory frameworks, building workforce competence, institutionalising audits, incentivising responsible practices, and ensuring transparency. By bridging ethics and management, the paper positions small states not as peripheral actors but as examples of how to enact responsible AI governance through globally relevant lessons regarding digital transformation in healthcare and beyond.

Caribbean Futurism and Beyond is a tripartite combination of interviews with writers of the sf (speculative fiction, science fiction, fantasy, and folklore) genre, literary and cultural analysis of those interviews within the context of seven discrete yet overlapping dimensions – folklore, mythology, children’s and young adult literature, science, technology, climate disaster, and identity; and a theoretical basis of Caribbean futurism as an esthetic practice reflecting not just future but also past and present experiences of Caribbean people. The combination of interviews, analysis, and theory contributes to the ongoing questions that have been and will likely remain central to being and belonging to the Caribbean. The authors share their creative processes, inspirations, and the unique ways they address Caribbean experiences through stories that expand the boundaries of the genre. <!----> <!----> <!----> <!---->