Professor Fran Baum, one of Australia’s leading researchers on the social and economic determinants of health has been quite vocal recently about the importance of a ‘social vaccine’ to rebuild a fairer and more sustainable world post Covid-19.
Hauora asked Prof Baum who is the Matthew Flinders Distinguished Professor of Public Health at Flinders University in Adelaide, Australia to explain about what the vaccine is and how it would work.
We also asked the foundation Director of the Southgate Institute of Health, Society and Equity about the role of health promoters in helping to rebuild a better world after Covid, as well as the role of good governance and leadership.
Hauora: I read in an article you wrote recently about when the Covid-19 pandemic eventually ends the inequities it has highlighted will remain, unless a ‘social vaccine’ is developed and applied. Can you please explain what a ‘social vaccine’ is and how this will help to shape the world post-Covid?
Prof Baum: A social vaccine comprises government and other institutional policies which aim to keep people well and mitigate the structural drivers of inequities in daily living conditions, which make people and communities vulnerable to disease and trauma. It also includes the importance of civil society groups who advocate for such policies. The target of the social vaccine is the conditions that underpin four basic requirements for global health and equity to flourish. These are: 1) A life with security; 2) Opportunities that are fair; 3) A planet that is habitable and supports biodiversity, and 4) Governance that is just.
Hauora: You also explain that ‘the delivery of public policies at the heart of a social vaccine require considerable civil society advocacy to ensure their development and effective implementation’. Can you please elaborate on this?
Prof Baum: I have always believed (supported by evidence) that civil society advocacy is vital in bringing about healthy public policy in all sectors. I have used the metaphor of a nutcracker (see illustration) to show that improving health and health equity requires both top-down policy action and bottom-up advocacy. Historical examples make this very clear. For example, in the cases of the abolition of slavery and franchise for women, civil society was vital in arguing for these changes and ensuring politicians listened to them. For an examples from Covid-19 I would give the People’s Health Movement which has launched a campaign to ensure equal access to Covid-19 Essential Health Technologies (EACT) including vaccines (see here).
Hauora: What contributions do you think health promoters can make in helping to shape a better future?
Prof Baum: I think they can ensure that the debate about Covid-19 goes beyond the need for a vaccine to considering how the inequities that have been laid bare by Covid-19 can be reduced. For example, the pandemic has shown the weaknesses that casualised employment introduces. In India, many migrant workers did not have secure work and had to walk to their home villages often hundreds of miles away. On the way many become sick, had little food, were subjected to police brutality and some even died. In Australia workers in the gig economy have no sick leave or secure employment and have been shown to be a weak link in our defences against a pandemic.
On a broader scale, health promoters can look to the underlying causes of Covid-19 and point to the importance of taking an ecological view of health. There are an increasing number of emerging infectious disease and the evidence suggests that deforestation is a key way in which infectious agents jump from animals to humans.
Hauora: If there is one thing this pandemic has highlighted it is how crucial good governance and leadership is? What is your view on this?
Prof Baum: Yes, the politics of the pandemic are vital. Political will to accept public health advice is crucial. We have seen in the US how a leader who rejects this advice creates catastrophic consequences with Covid-19 deaths in the US topping a quarter of a million. By contrast other countries like Vietnam, Thailand, Australia, and New Zealand have had very low rates.
Hauora: Women leaders, especially, have been lauded for effectively guiding their countries through the Covid-19 pandemic. What common threads do you think have contributed to their success in responding to this crisis?
Prof Baum: In New Zealand you have, of course, the wonderful example of your Prime Minister Jacinda Ardern who has led with empathy, compassion, clear communication and also taken the hard public health advice. I think those characteristics of a political leader are the key to dealing with a pandemic.
Hauora: Is there anything else you would like to add?
Prof Baum: The most central thing for health promoters to keep emphasising is that we need to ensure that our political leaders govern for health not profit in each sector of society.
I argue this point in my book Governing for Health: Advancing Health and Equity through Policy and Advocacy.