6 Perspectives on the future

Alex Webb/Magnum Photos/All Over

Health is a global public good, and national public health cannot be safeguarded by states in isolation. Regional and international cooperation are therefore vital. However, cooperation is no simple task in a political field that ranges from provision of adequate health services at national level, through health cooperation between the Nordic countries, to major international political processes and large-scale vaccination programmes in the poorest and least developed countries. Approaches and measures must be tailored to their context, for example the local disease burden, the available resources such as health personnel, budget allocations and pharmaceuticals, in addition to the political situation and other local conditions. The large number of different national and international institutions responsible for global health efforts further complicates efforts.

These factors point to a key challenge in following up this white paper: to further develop a coherent Norwegian global health policy. This work involves a large number of actors in the public administration, particularly the Ministry of Foreign Affairs, the Ministry of Health and Care Services, and their underlying agencies. Other actors in society, like NGOs, research communities and the business sector are also involved. Principles, guidelines, approaches, priorities and the use of resources, including risk management and governance, must be viewed as a whole. A coherent policy encompassing the whole range of problems and policy instruments must be developed and pursued. The Government’s political commitment to global health and the report on coherent policy in the Ministry of foreign Affairs’ budget proposal1 form a solid foundation for ongoing work on strengthening coordination between national and international efforts. The Government will actively follow up this work, for instance in the future budget proposals.

Decisions on directions and priorities for Norwegian global health policy after 2020 are yet to be taken, but the outlines of new challenges and changes to existing ones are already visible. The problems of lifestyle and other non-communicable diseases have already been mentioned. A larger proportion of the world’s poorest will be living in middle-income countries, which means that poverty reduction should be targeted less at poor countries and more at poor groups. The rise in prosperity in poor and middle-income countries will have consequences for the division of tasks, for national responsibilities and for the focus of international aid. The threats posed by pandemics and climate change will compound the uncertainty created by political instability and fragile states. Urbanisation and other changes in life-styles and settlement patterns will also have consequences for health. The capacity to deal with change is therefore a critical factor for success in both safeguarding national public health and guaranteeing health for all.