Interviewing Prof. Aileen Clarke “It’s basic public health, because it’s about infectious diseases, communicable diseases, pandemics, they don’t respect borders”

By Nora Lorenzo

Prof. Aileen Clarke works at the universities of Oxford and Warwick. She studied medicine in the University of Oxford, then got a MSc in Public Health at the London School of Hygiene &Tropical Medicine and then worked in the field in the field of public health at regional level in the North London before becoming an academic in Public Health. She is a public health expert with extensive experience in different fields from research to policy action through active collaboration with national and international bodies. She was until recently Chair of the Picker Institute, and of the Faculty of Medicine at Warwick, and President of the Society for Social Medicine. She is founder of Warwick Evidence, a Health Technology Assessment group and more recently, was Deputy Director of the ARC WM (NIHR Applied Research Collaboration West Midlands).

Prof. Aileen Clarke’s research interests focus on assessing the quality of health services using multidisciplinary methods to find the best evidence, and putting evidence into practice through policy and at organizational, population and individual levels.

At the European Public Health Conference, Prof. Aileen Clarke was invited to speak in the “Health care systems, health service provision, and equity in health” round table. Aligned with this topic, one of EUPHAnxt’s fellows interviewed Prof. Aileen.

How do you think health equity can be integrated in emergency plans for future pandemics?

That’s a really good question and I think that one of the things we didn’t cover in our session was about emergency plans. What came through from the session is that the background/setup of health systems is so important, it informs everything that happens in the health services on the ground: how services are delivered immediately to people, who gets the services and how inequity is built up and develops in that way. So, I suppose the links between these three different areas in reality should be considered in each area of healthcare. Particularly when you have emergency provision, when you have to start thinking very quickly about how to change services and where inequities become dangerous and important for the whole population.

Telemedicine has revolutionised the way that health care systems work especially for the epidemiology of infectious diseases. However, it comes with limitations especially for the inequalities we see on access to internet. How do you envision equity in the future in this regard? How should health services be provided to the communities with less digital literacy?

In the UK most certainly, we have had a real move towards digital Primary Care and digital consultation in Primary Care and some of these systems are very excluding. For example, you have an online form which is complex and awkward, maybe small font, and so many groups of potentially excluded people will not be able to use it (people with sight problems, with disabilities, the very elderly and those who aren’t very digitally capable). It’s a real problem. What you can do is you can start to target digital interventions which can be transformative to those people that are excluded, but what we have got at the moment in primary care, is a swing  - it’s almost like the spotlight has moved away from those in need to people who are more digitally capable, who are younger, potentially healthier.

So, it’s really about going back to basics and starting to think about who are the populations in need and how can we access each group and make sure that they get the care that they need.

Vaccine nationalism was a big topic during the Covid-19 pandemic especially in Europe where countries worked independently and not altogether. How do you think we can manage this better in the future?

It’s basic public health, because it’s about infectious diseases, communicable diseases, pandemics, they don’t respect borders and we saw that in such a big action in this pandemic.

How the infection came from China, then it went to Italy, to the UK, to the US, so quickly and each of those started spreading back again to all the different countries across Europe. I think it’s about having the security and confidence between the different agencies involved in the pandemic to believe that this is important and to convince their governments that we have to work across borders. And, European Communicable Diseases Control has a role to play on that, to make sure that this happens and it’s working now already to think about vaccination strategies and the next pandemic!

Written by Nora Lorenzo (interviewer), BSc in Nutrition and Dietetics in the University of Barcelona, and currently in her last year of Master’s in Public Health at the University of Porto; and EUPHAnxt fellow at the 15th European Public Health Conference, held 9-12 November 2022 in Berlin, Germany.

Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or HaDEA. Neither the European Union nor the granting authority can be held responsible for them.