Ladies and gentlemen,

I have the pleasure of welcoming you all to this seminar on globalisation and health – the way forward. It is the fourth seminar organised by the Ministry of Foreign Affairs’ Globalisation project. This particular seminar has been planned in collaboration with the World Health Organisation. The WHO established The Commission on Macroeconomics and Health in January 2000 to assess the place of health in the global economy. The report Macroeconomic and Health: Investing in health for economic development was presented to the general-secretary of the WHO, Gro Harlem Brundtland, on 20 December last year. This seminar represents the Scandinavian launching of this report.

Each of the seminars of the MFA’s Globalisation project have dealt with broad issues and challenges raised by globalisation. After this seminar we feel that the time has come to start writing the planned white paper on globalisation. It is intended that the White paper will be presented to the Norwegian parliament in December this year. When elaborating the white paper, we will draw on the information presented during these seminars, and in the reports we have commissioned.

What is more fitting than that the key note speaker at the first seminar was the general secretary of the United Nations, Mr. Kofi Annan, while I have the pleasure of welcoming the general secretary of the World Health Organization, Ms. Gro Harlem Brundtland, as the key note speaker here today.

Globalisation refers to processes that take place globally. Increased trade across national borders and increased foreign investments combined with increased free trade are generally considered among the core characteristics of present day globalisation. Swift technological innovation, not the least in the field of information technology, and increased travel, migration, and culture contact, is part of the picture. New possibilities arise in the area of health. The increased creation of value allows for improved financing of health. The technological development within medicine is immense, as is the increased understanding of causes and cures for sickness. Globalisation also strengthens some of the challenges we have to cope with. In particular, I will like to bring three of these to your attention:

1. Marginalisation and poverty

2. Institutional challenges

3. Increased health vulnerability through communicable diseases

1. Marginalisation and poverty

Good health is a crucial element in human well-being and development. Good health is also crucial as a foundation for human well-being and development. In Norway we have a proverb that is often mentioned half as a joke. Unfortunately, it also describes a rather grim reality. The proverb goes: Det er bedre å være rik og frisk en fattig og syk. In English: It is better to be rich and healthy than to be poor and sick.

What the proverb does not directly allude to is the fact that there is a strong correlation between income and health. The donor community has agreed on trying to reach what is often referred to as the international development goals by the year 2015. Some of these are directly related to improving the health of the poor people of the world. There is great concern that these targets will not be met. This also puts other development goals in jeopardy, because populations in good health better achieve these.

In developing countries, the production is too low to sustain even basic health services. There is a growing concern that globalisation increases marginalisation of the world’s poorest. It may increase poverty and marginalisation within rich nation states, as it may cause the divide between rich and very poor nations to widen. The challenge is to improve the situation of those who are negatively affected by globalisation. In her intervention the Minister of International Development, Ms. Hilde Frafjord Johnson, will focus on the strong emphasis that the present government places on poverty reduction in its development collaboration.

2. Globalisation challenges nation states and nation-based institutions

Secondly, I mentioned that globalisation raises institutional challenges. Independent of globalisation, the nation states of many developing countries have low legitimacy. Among other factors, this is related to their failing capacity to build functioning institutions and provide basic services. Health institutions are a salient example. Globalisation offers new challenges to nation states and the multilateral system. An increasing number of decisions that affect people’s lives are taken by international business corporations. Both nation states and the multilateral system will strengthen their ability to govern processes and provide services if able to collaborate with corporations for common public goods. And health is a salient public good. The report to be presented today offers a new strategy for investing in health. A new global partnership between developing and developed countries is envisioned. The intervention of Prof. Jeffrey Sachs from Harvard, leader of the commission, will elaborate upon the commission’s model for arriving at financing for health development. This proposition is certainly worth looking into.

Globalisation also raises the concern that both nation states and the multilateral system, based on the legitimacy of nations, are inadequate in handling challenges that know no borders but are global in their expression.

3. Globalisation and communicable diseases

I mentioned that increased travel and trade across borders characterise globalisation. Both open for new possibilities: more contact, increased exposure to other cultures, peoples and organisms. At the same time these contacts open for health-related risks, in the form of exposure to unknown organisms abroad, or the swift spreading of micro-organisms causing communicable diseases to spread. The AIDS pandemic and the outbreak of foot and mouth disease among livestock last year are but the most staggering examples. We are fortunate to have the minister of health, Mr. Dagfinn Høybråten, with us. His presentation will focus on how globalisation challenges the Norwegian health system, and how these challenges are handled in Norway.

The commission places a strong emphasis on the developing country’s national level. Ms. Anne Mills from the London School of Hygiene and Tropical Medicine led one of the working groups of the commission. In her intervention, she will focus on the problematic, yet crucial, national level.

In my short note of welcome I have emphasised that Globalisation is presenting the world with new challenges related to health, and new opportunities to improve health. I now ask our moderator, ambassador Torbjørn Frøysnes, to introduce our first speaker.