The Other Front Line: A People’s Movement and a Social Vaccine?

Professor Fran Baum Co-Chair of the global People’s Health Movement & Director of the WHO Collaborating Centre on the Social, Political and Commercial Determinants of Health Equity at Flinders University, Adelaide, Australia argues for a social vaccine to address inequalities moving out of the pandemic and how stories from the Other Front Line Alliance journalists can contribute.

A life with security is a possibility for all citizens of planet Earth. The reason national and international policies don’t make it possible is not because there are not enough resources to go around but rather because they are not distributed equally. The stories from the Other Front Line journalists and bloggers are testaments to the consequences of these inequalities.  Already climate change is threatening the livelihoods of people in low lying countries like Bangladesh and Pacific Island nations and extreme weather events are impacting on people worldwide. These comprise floods, bushfires, extreme heat and extreme storms all of which affect poor people more than those with resources.

A few years ago, a group of us from the People’s Health Movement wrote an article[i] advocating for the concept of a social vaccine as a means of pushing our message about social determinants of health in a bio-medical world. We envisaged such a vaccine as comprising government and other institutional policies that would 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.

When COVID-19 struck a social vaccine again seemed highly relevant.  Together with my colleague Sharon Friel I wrote an opinion piece[1]  which noted the inequities that had been revealed by the pandemic and argued that a social vaccine would be just as important as a biological one. In rebuilding the post COVID world we felt action was needed on four key fronts to ensure that the post-pandemic work was better than pre-COVID. We identified the target of the social vaccine as 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.

Governance is vital to ensuring that resources are distributed fairly and that the interests of the powerful (especially Trans-national Corporations) do not dominant public policy decision making. Social vaccines would support action in each of these four areas to ensure the post-COVID world is fairer, more sustainable and healthier.

Achieving such social vaccine action will not be achieved by evidence alone (although there is plenty of evidence which demonstrates that rapidly growing inequities are bad for health and equity). It will also require a powerful social movement which demands the kinds of changes a social vaccine will bring.  The People’s Health Movement (PHM) is one such movement that over the last twenty years has grown from a meeting of 1,500 people in December 2000 to a world-wide network of health activists demanding change to achieve health for all. Our vision is laid out in the People’s Health Charter (https://phmovement.org/wp-content/uploads/2020/06/phm-pch-english.pdf) we adopted 20 years ago and which is more relevant than ever. The Other Front Line Alliance and the stories they are collating are a welcome addition to the pressure for greater social justice.

The aims of the Other Front Line are very compatible with those of the PHM. Since its outset PHM has used people’s testimonies about the factors affecting their health to provide evidence from people’s lived experience. These testimonies have proved powerful in illustrating the ways in which structural inequities have invisible yet powerful impacts on people’s health. For instance, people living near mines which despoil agricultural areas and traditional lands or those living near chemical plants which make their air and water toxic. The testimonies also tell of the collective action that people take to protect their health and use political and other measures to bring about social transformation. PHM conducted a study of civil society action which yielded many lessons for future movement building (see full reports here https://phmovement.org/cse4hfa/). In response to COVID-19 the PHM has been funded by Open Society to develop a project – EACT – Equitable Access to Essential Health Technologies (https://phmovement.org/eact/) – in the context of COVID-19 – which is researching and advocating on the need to ensure that low and middle income countries do not miss out on vaccines to prevent and technologies to treat COVID-19.

The Other Front Line alliance is an important movement which aims to document, through the work of citizen journalists, the stories of those whose structural inequities have been revealed by COVID-19. From a PHM perspective we are pleased that the intent of the initiative is to use the collective agency of people to contribute to political change and eventually social transformation to a fairer and healthier world. With this transformatory intent the OFL is part of the social vaccine required to bring about such a world.

[1] https://insightplus.mja.com.au/2020/36/covid-19-the-need-for-a-social-vaccine/#:~:text=Achieving%20these%20transformative%20goals%20requires,to%20populations%20rather%20than%20individuals

[i] Baum, F., Narayan, R., Sanders, D., Patel, V.,and Quizhpe, A.,(2009) Social vaccines to resist and change unhealthy social and economic structures: a useful metaphor for health promotion. Health Promotion International, 24, 4: 428-433