Experience in recent years shows how quickly a local incident can develop into a global crisis. Pandemics, antimicrobial resistance, climate change, war and instability place new demands on emergency preparedness.

Through international cooperation, Norway can, among other things, receive early warnings of health threats, share knowledge and coordinate measures with other countries, monitor and analyse potential crises, and safeguard access to essential medicines, vaccines and medical equipment during crises.

Active Norwegian participation

Norway participates actively in a range of international forums and cooperative frameworks to strengthen health emergency preparedness. This includes cooperation with the World Health Organization (WHO), the EU/EEA, the Nordic region, and NATO.

The 2023 white paper "A Resilient Health Emergency Preparedness" (Helseberedskapsmeldinga) highlights six priority areas of risk and vulnerability:

  • hybrid threats and war
  • digital security
  • security of supply chain
  • pandemics and infectious diseases
  • safe water supply
  • nuclear and radiological incidents that threaten life and health

Across all areas, the white paper emphasises the importance of international cooperation in preventing, detecting, and managing incidents.

The EU/EEA

Health emergency preparedness and crisis management are national responsibilities for countries within the EU/EEA. Nevertheless, there is broad agreement on the need for cooperation to strengthen health preparedness.

This includes consultations, alert systems, and standardisation efforts to facilitate cross-border communication and crisis management.

Norwegian cooperation with the EU

Norway cooperates closely with the EU in the field of health. This cooperation is particularly vital because the vulnerabilities we face are increasingly shared.

The pandemic and the war in Ukraine demonstrate that Norway cannot address these vulnerabilities alone. To gain better control over critical supplies and supply chains, strategic autonomy has become a key priority. Health emergency preparedness cooperation within the EU has developed at record speed since the Covid-19 pandemic struck Europe.

The Government is negotiating with the EU regarding participation in the EU’s extended health emergency preparedness cooperation. During the pandemic, Norway received valuable support from the EU. When the next health crisis arises, it is crucial that an agreement is in place to ensure that Norway is integrated into the EU’s joint health emergency preparedness and crisis response mechanisms.

It is essential that Norway and its population are covered when the EU procures vaccines, medicinal products, and medical equipment during a major health crisis.

Nordic cooperation on health emergency preparedness

Norway participates in Nordic cooperation governed by the Nordic Public Health Preparedness Agreement of 2002 (lovdata.no) (Nordisk helseberedskapsavtale). Under the agreement, the Nordic countries are obligated, as far as possible, to:

  • provide mutual assistance to one another in a crisis
  • inform and consult one another regarding measures implemented in crises
  • promote cooperation by removing obstacles in national regulations, etc.
  • cooperate on the exchange of experience and competence development

The agreement facilitates the establishment of joint projects between the countries, covering areas such as exercises, responses to crises abroad, pandemic preparedness, nuclear and radiological preparedness, and veterinary preparedness. The Nordic Health Emergency Preparedness Group (the Svalbard Group / Svalbardgruppa) is the cooperative body responsible for following up the agreement.

The chairmanship rotates among the member countries. Matters relating to the agreement are reported to the Nordic Council of Ministers via a committee of senior officials.

The World Health Organization (WHO)

Many different actors collaborate on global health emergency preparedness. The World Health Organization (WHO) plays a leading role. The WHO establishes professional standards, collates knowledge, and coordinates efforts to enable the international community to prevent and manage health crises more effectively.

In crises and humanitarian situations, the WHO also takes part in operational work on the ground. To prevent future pandemics, individual countries and the global community must improve their capacity to prevent and manage infectious diseases. When a health crisis occurs, the ordinary health services are responsible for managing the response. Effective preventive healthcare, robust health services, and public trust in health authorities are crucial to the preparedness of each individual country.

The International Health Regulations (IHR), established by the WHO, entered into force in 2007. The regulations apply to disease outbreaks and other serious cross-border health threats. They set out guidelines for how countries and the WHO must act, and they oblige countries to notify one another and cooperate on infection control measures. The regulations outline the measures member states may implement to prevent the spread of disease, including restrictions on travel, transport, and trade.

NATO

Civil preparedness and resilience form part of Article 3 of the North Atlantic Treaty (nato.int). The underlying principle is that resilient societies contribute to deterrence. NATO’s civil preparedness requirements are expressed through three core functions: continuity of national government; continuity of essential services to the population; and civilian support for military operations.

The Norwegian health authorities participate in NATO’s Joint Health Group and follow up NATO’s expectations and plans on the basis of Norway’s total defence concept. This means that Norway does not establish parallel health services for wartime situations. Through planning and exercises, the regular health service must ensure that it is also able to operate during war. Cooperation between the civilian health services and the Norwegian Armed Forces is overseen primarily by the Committee for Civil-Military Health Emergency Preparedness Cooperation [in Norwegian] (Utvalet for sivilt-militært helseberedskapssamarbeid).

National resilience is emphasised as both a national responsibility and a collective commitment for the Alliance’s member countries. This is reflected in NATO’s requirements for host nation support and preparedness plans, including the Medical Action Plan.

Civil resilience

NATO has defined seven baseline requirements for civil resilience. The Ministry of Health and Care Services holds primary responsibility for two of these:

  • resilient food and water resources
  • ability to deal with mass casualties

Norway meets these requirements through its total defence concept (totalforsvaret). This means that parallel health services solely for wartime use are not established. Instead, the ordinary health and care services must plan and conduct exercises to ensure their capability to handle crises and war.

The International Atomic Energy Agency (IAEA)

The International Atomic Energy Agency plays a central role in the international management of nuclear and radiological incidents, as well as in relations between various UN bodies (IAEA, OCHA, WMO, WHO), the EU, and NATO.

The Norwegian Radiation and Nuclear Safety Authority (Direktoratet for strålevern og atomtryggleik) serves as the Norwegian national contact point for the IAEA conventions on early notification and assistance.