Meld. St. 11 (2011–2012)

Global health in foreign and development policy

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1 Summary

This white paper highlights the challenges and establishes clear priorities for a coherent Norwegian policy on global health towards 2020 with particular focus on three priority areas:

  • Mobilising for women’s and children’s rights and health

  • Reducing the burden of disease with emphasis on prevention

  • Promoting human security through health

The cornerstone of Norwegian policy is to promote and respect fundamental human rights. The principle of equal access to health services based on comprehensive, robust health systems serves as a guideline.

Health is a global public good. Through political leadership, diplomacy and economic support, Norway will be at the forefront of efforts to mobilise a strong and broad global consensus on cooperation to address national health needs. At the same time, we will encourage national authorities to take responsibility for establishing and securing universal access to health services.

One of the objectives of Norway’s global health policy is a better integration of health objectives into foreign and development policy. The various meeting places for heads of state and government and the UN system, including the WHO, are important arenas. Political networks that cut across traditional forums and alliances are also important. One example is the network of foreign ministers from seven countries, including Norway, which focuses on the links between heath and foreign policy.

Mobilising for women’s and children’s rights and health is the Government’s foremost priority. The UN’s Millennium Development Goals (MDGs) – specifically MDGs 3, 4, 5 and 6 – contain ambitious targets in this area, and the Government recognises that health is essential for development and poverty reduction. The global strategy Every Woman Every Child, which was launched by the UN Secretary-General in 2010, forms the basis for these efforts. This priority applies primarily to our development policy. This strategy is also important for WHO’s normative work and for the health component of the EEA and Norway Grants. A strong commitment to women’s and children’s right to health is laid down in several instruments of international law. The promotion of women’s and children’s rights and health is one of the main themes of political mobilisation efforts, both internationally and in our dialogue with national authorities.

Efforts to reduce the burden of disease with emphasis on prevention are directed particularly at diseases that account for a large proportion of lost life years in the poorest countries, and to strengthening health systems with universal access to health care. Vaccination – with GAVI and routine vaccination as the flagship – is, and will remain, a key strategy. Great progress has also been made in treating and preventing the major life-threatening communicable diseases – HIV/AIDS, malaria and tuberculosis. Norway will remain in the forefront of these efforts. Weak and vulnerable health systems and the global health workforce crisis are the greatest challenges to reducing the burden of disease, particularly in low-income countries. The Government will promote health systems where the national authorities assume overall responsibility for public health services, and where services are geared towards meeting the needs of vulnerable groups. A coherent approach to the health workforce situation is part of this effort. A key theme in our dialogue with the authorities of low-income countries that are moving into the group of middle-income countries is the importance of overall government responsibility for health services.

Non-communicable diseases, including lifestyle diseases, account for a growing proportion of the global burden of disease. They entail challenges that are to some extent different to those connected with communicable diseases, as there are significant economic interests behind the marketing of harmful products like tobacco, alcohol and unhealthy food. Preventing and reducing non-communicable diseases requires not only coherent national health policies, but also regional agreements that promote global solutions. WHO has an important role in this work.

Promoting human security through health involves identifying how health goals can be more closely integrated into general foreign and development policies. Climate change, pandemics, lack of access to pharmaceuticals and sexual violence are all threats to health. Climate change could have huge negative impacts on health. Efforts to prevent these, with emphasis on food security, water supply and sanitation, will be strengthened. Control of communicable diseases and pandemics is also vital for maintaining safety and security, and can be bolstered by including health on the foreign policy agenda. Norway will strengthen and support WHO’s work in the field of pandemic preparedness. Furthermore, the Government will continue its efforts to improve access to pharmaceuticals for poor countries, for example by ensuring that this aspect is taken into account in our trade policy and by supporting innovative arrangements for improving developing countries’ access to effective pharmaceuticals within the framework of the patent system. Sexual violence in conflicts is a complex problem that must be addressed by prevention, by providing adequate medical treatment, and through instruments and institutions of international law and international political mobilisation.

The Government’s approach to global health is described in Chapter 5. Norway’s global health policy will be knowledge based. A strong knowledge base and sound analyses are essential for making good decisions with regard to innovation and willingness to take risks, and for setting the right goals and criteria for results. In the global cooperation on health, Norway will actively promote frequent reviews to identify effective ways of organising cooperation, and develop new instruments, including innovative instruments that require a willingness to take risks. The goal is a broad political and economic mobilisation for global health. These efforts will be results driven. Norway will be a predictable and credible partner, and will take responsibility through leadership and dialogue.