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In Conversation with Elly Howse

Co-author of ‘Upholding human rights, defending multilateralism and promoting global solidarity: reasons for supporting WHO post COVID-19’

Interview and article by Alice Stafford

Elly Howse is a PhD candidate in the School of Public Health at The University of Sydney and a Research Fellow at The Australian Prevention Partnership Centre. Alongside her research into chronic disease prevention and health policy, Elly has worked in both federal and state politics. Her article written for Evatt’s COVID-19 publication was co-authored by Professor Adrian Bauman. Adrian is an Emeritus Professor at The University of Sydney, Director of the Prevention Research Collaboration and has extensive experience working for the World Health Organisation (WHO).

Elly and Adrian’s article, Upholding human rights, defending multilateralism and promoting global solidarity: Reasons for supporting WHO post COVID-19 is featured in the 2020 edition of the Evatt Journal.

How has your work up to this point in your career aligned with the Evatt Foundation?

Public health is a field in which social justice and equality are very major values. Often, poor health is the result of structural, social and economic factors rather than a failure of someone's biology. While medicine has predominantly said that if someone gets sick it's because there's something wrong with them, public health is all about saying that, actually, there is something wrong with the system in which we live. Coming from this background, the Evatt Foundation obviously has a really clear alignment with public health.

I have also been involved with the Labor movement for over 10 years now, so working with the Union movement and the Labor Party has given me the opportunity to live those values as well.

What is the key takeaway from your article?

Adrian and I want people to understand that however challenging the situation may be with coronavirus and the consequences of the pandemic, we need an organisation like the WHO now more than ever. It is in times of crisis – particularly health crises – that we need those multilateral, international organisations.

Your article focuses on the need to defend multilateralism, promote global solidarity and reduce inequalities. In the COVID-19 era, why must these issues be brought to the attention of members of our community?

The decision of the United States (US) to defund WHO and remove themselves as a member state is the kind of discussion that is influencing Australia. There is a certain variety of Australian politicians on the far right of the spectrum who look at the US and question Australia’s involvement with WHO. So, this article seeks to explain to people exactly what WHO does and that we don't financially contribute to WHO to benefit ourselves – we actually do it as an act of global solidarity.

Funding WHO and supporting its aims and efforts is a really important collective action that we can all contribute to. Low and middle-income countries do not necessarily have the resources to go off and perform their own evidence briefs and get scientists and health experts to give them the latest advice. Often, they are dealing with a skeletal government system as well as massive inequalities and inequities. To have something like the WHO actually helps you and offers a lot of those things to make decisions for the health of your population. I think sometimes in Australia, we forget what it is used for.

The takeaway message is around collectivism and global solidarity. Funding the WHO is an act of solidarity by Australia and shows our collective action in the region and also globally.

Could you talk to the ongoing ramifications of the US’ decision to pull out of WHO?

There are two main ramifications of the US’ decision around the WHO. The first one is economic – the US is a significant contributor and to have a portion of that funding removed from the WHO would cause a major imbalance. We’ve already seen countries like France, Germany and the UK step up and say that they'll increase their contributions. It would be great if Australia did this as well.

The second point surrounds the geopolitical ramifications of the US. A group like the WHO or the United Nations is effective because of their ability to bring together both the big players and the small players. There is a major focus on the equity of voices between different countries and nation states. The US’ increasingly isolationist approach makes us question: what happens when there is that kind of vacuum in a global health policy landscape?

When we're trying to make sure that the tensions between China and the US don’t boil over, something like this decision further inflames that. These geopolitical ramifications also drastically impact the way we make health policy – on an international and regional level.

Looking to the future, what are your predictions for where we are going in terms of multilateralism? And how can we practically apply some of the ideas from your article to this current climate?

I think that the natural response to COVID-19 is for countries to close their borders, which WHO has always resisted. The natural inclination of countries, like Australia, is to close borders, become more locally focused and to stop looking internationally and regionally. I can understand why this happens, but I don’t think this is what the next few years will involve.

Australia needs to work with WHO and our regional South East Asian office. A major reason for this is to ensure that COVID-19 does not reach the Pacific Islands. If it reaches any of these island nations – which have a lot of pre-existing comorbidities and chronic disease as well as very fragile health systems – it is going to be absolutely disastrous. So, Australia has a really important role even locally in our region to work cooperatively with our neighbours. This role extends to being a global citizen and a leader in our region in terms of supporting other countries. And it is through the WHO that we direct a lot of that funding and organisation.

While countries will become more isolationist in the short-term, I think in the long-term countries will realise that they actually can't close off their borders forever. There is going to have to be continued cooperation in terms of the movement of people and of goods and services.

Elly and Adrian’s full article can be found here.


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