3 steps to public health reform
With a world embattled by COVID-19, news of efficacious vaccines bring needed hope—but vaccinations are merely step #1 in the journey to protect us from this and future pandemics.
Basic problems with the vaccine rollout hint at why: confusion over who can get vaccinated and when, as well as uncertainty of vaccine supply, are examples of deeper issues at play.
Being able to make our own vaccines in Canada, instead of solely relying on the global supply chain, is key. We used to have that capacity—in the 1950s we made our own polio vaccines, for instance.
"However, through privatization and globalization, 'we lost that capacity,' said Scott Halperin, director of the Canadian Centre for Vaccinology at Dalhousie University in Halifax. Now, Halperin said, 'we need to reverse that trend.'"
Canada also needs to rethink its approach to public health, to ensure a more coordinated, cohesive response to public health crises, such as a pandemic, and to address the health inequities that COVID-19 has exposed.
Lindsay McLaren, professor in the Department of Community Health Sciences and the O'Brien Institute for Public Health at the University of Calgary, teamed up with me to sketch out a broader vision for public health post-COVID-19.
In this Canadian Centre for Policy Alternatives' Monitor essay, we lay out three key steps toward a comprehensive vision for public health that acts on what we know from the social determinants of health and community well-being.
In it, we call out the cracks in our federation: "Creating a coherent, national response to COVID-19 was very much like herding cats while walking on eggshells. No jurisdictional response was alike."
We call out the magical thinking behind re-opening our economy while the virus was still raging: "Political delay in following public health advice contributed to a strong second wave, which came with exponential costs to people’s well-being, the health care system and an economy that has no chance of thriving without a healthy public."
And we lament the fact that most people don't really understand what public health is all about—it's frequently conflated with individual health and/or with Canada's public health system.
So we call for three broad steps to reform public health:
1. Identify the contours of an integrated, coherent vision of public health;
2. Coordinate the broader public health vision across political jurisdictions;
3. Work from the ground up to uncouple "health" with "health care".
You can read the full essay here.
I can't wait to get the COVID-19 vaccine in my arm, but it's just the first step toward Canada dealing with the current pandemic, learning from it, and ensuring we're better prepared in future.