Importance of fighting inequality: Julia Gillard on lessons learnt from pandemic

Former Prime Minister Julia Gillard speaks of how addressing inequitable access to advances in healthcare can help prevent the cracks of inequality in society.

In her address at the 2022 David Cooper Lecture, former Prime Minister Julia Gillard spoke of the need for the global community to enact policy that helps our most vulnerable, to ensure we emerge from the pandemic as a healthier and fairer society.

The event, a conversation between Ms Gillard and ABC Science and Health reporter Tegan Taylor, was broadcast to an online audience and was co-presented by the UNSW Centre for Ideas, Kirby Institute and UNSW Medicine & Health.

"It was a privilege having Julia Gillard as the guest speaker for this year's David Cooper Lecture. She is a truly motivational speaker and her conversation on how infectious diseases disproportionately affect the most disadvantaged in society and what that means for how we respond was fascinating. Her observations on how Covid has helped reduce the stigma attached to mental health were particularly pertinent," Professor Anthony Kelleher, Director of the Kirby Institute at UNSW Sydney, said.

Following her time serving as 27th Prime Minister of Australia, Ms Gillard has dedicated herself to advocacy, governance roles, and writing. Last year she was appointed Chair of Wellcome, a global charitable foundation based in the UK, which supports science to solve urgent worldwide health challenges.

"The pandemic has had the biggest impact on those most disadvantaged in the world. Because we are here in Australia and we've had good access to vaccines it's easy to forget that in many parts of the world people are still waiting to be vaccinated, even those at most risk of catastrophic health consequences from Covid have not yet been reached by vaccines," Ms Gillard said.

"In the health response there has been an inequity in vaccine access, and we know in societies around the world that those who get the most urgent access to care are often those with the most information and the most resources.

"What we want to do as a global community, as an Australian community, is eradicate that disadvantage."

Lessons learnt from the pandemic

Ms Gillard said that whether we use the pandemic as a wake-up call about inequalities is still to be determined but we are having the right debates around global and local health inequities, mental health, and the circumstances of women.

She said that during the long lockdowns of the pandemic it was women in the majority who stepped up to take on extra domestic burdens and assist with home schooling, and this is a necessary conversation we need to have post pandemic.

"One good thing about the pandemic is the discussion about mental health happened alongside the discussion about physical health. I think if this pandemic happened ten or twenty years ago then it wouldn't have been like that.

"I think that is telling us that there is more maturity in the conversation. There is less stigma than there used to be. People are much more mindful about their own mental health and reaching out when they are in trouble. I hope we take that with us as we are forming patterns of connection again which come with a freer form of life in this stage of the pandemic… that this sense that our mental health is something we should be thinking about every day stays with us."

Looking back on the pandemic Ms Gillard said that "the science" worked and scientists did remarkable things, while on the other hand we need to look at public policy and ask ourselves some hard questions globally.

She said that scientists came up with the vaccines, the therapeutics, and better ways of keeping the community safe. However, global public policy didn't step up as well as the scientists, which is evident in ongoing vaccine inequities.

"Science needs the resourcing, and our thanks, public policy and global politics needs us to really bear down on and think about how we should be doing these things better for the future."

Addressing inequitable access to healthcare

Ms Gillard said that to avoid a future with huge discrepancies in healthcare between the rich and poor we need good public policy and a preparedness to view healthcare as a right for all.

She said the greatest challenge in ensuring the equitable access to advances in health and science is resourcing, stressing the importance of multidisciplinary teams working together to not only address inequitable access to healthcare, but problems of the future.

"The problems that we need to solve today, and the problems of the future, are generally so complex that you need diverse and multidisciplinary teams to get anywhere near the answer.

"It's about constant innovation and systems redesign and thinking, and also about putting lived experience at the centre."

Ms Gillard reflected on a lesson Australia has learnt over time about health access for Indigenous Australians. She said we have learnt that it needs to be done through community-controlled health organisations where Indigenous Australians are at the heart of decision making. Similarly, she said we know that homelessness policies that fail to take into account the voices of people who are homeless miss the mark. The importance of lived experience in mental health is also extremely important.

Ms Gillard said that that pandemic preparedness is a real focus for the future. Wellcome is involved in pandemic preparedness in three areas: support for the Financial Intermediary Fund at the World Bank (a new global funding structure to add to pandemic preparedness), improving pandemic surveillance systems so that we can be more aware if another pandemic is on the horizon, and looking at ways to strengthen the World Health Organisation and the Global Vaccine Alliance.

The annual David Cooper Lecture honours the legacy of the Kirby Institute's founding director Professor David Cooper, who passed away in 2018. He was an internationally renowned scientist and HIV clinician.

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