Global Health and Foreign Policy

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Introduction to World Health Day debate
Singapore, 2 April 2007

Prime Minister, Director General, Excellencies, Ladies and gentlemen,

First of all, allow me to say how pleased I am to be here today, and to thank the WHO and the Government of Singapore for their kind invitation to take part in this World Health Day event on international health security.

Secondly, let me answer the question perhaps nobody will ask me, but is probably at the back of your minds: Why would the Norwegian Minister of Foreign Affairs travel half way around the world to participate in a couple of hours’ debate on health issues in Singapore? 

The answer is the importance of the issue and globalisation. Globalisation is rapidly changing the scope of foreign policy and international relations.

Growing interdependence means that the major challenges we are facing today are common challenges, requiring a concerted response and stronger collaborative efforts.

Nobody today can seriously claim that environmental degradation and climate change can be addressed by national measures alone. Nobody can claim that economic development can be achieved in isolation, or that poverty is only the problem of the poor, or of poor countries. And nobody should think that just by closing borders or building walls we can protect ourselves against disease.

In the era of globalisation and interdependence, health is one of the major challenges we have to face together.

There is a growing awareness that investment in health is fundamental to economic growth and development. It is generally acknowledged that threats to health may compromise a country’s stability and security. In fact, health is one of the most important, yet still broadly neglected, foreign policy issues of our time.

This is why I am here and this is the reason why I took the initiative last summer, together with my French colleague Philippe Douste-Blazy, to explore and to highlight the relationship between health and foreign policy. We invited our colleagues from Brazil, Indonesia, Senegal, South Africa and Thailand to join us, and together we launched the Global Health and Foreign Policy Initiative in New York in September last year.

Our aim was not to conduct an academic study. Our ambition was certainly not to cover the full breadth and depth of these complex issues.

But our political goal was indeed an ambitious one: to contribute to a stronger strategic focus on health as part of the international agenda.

We wanted to build this case in two ways. Firstly, by exploring how foreign ministers and foreign policy could add value to health issues of international importance. Secondly, by showing how a focus on health could harness the benefits of globalisation, strengthen diplomacy and international relations, and respond to threats to human security.

A group made up of experts and representatives of the ministers was set to work. Two weeks ago the foreign ministers met again in Oslo and adopted a political declaration and an agenda for action. Both documents are available in this room. Meanwhile I would like to highlight a few points.

In the declaration, we agree to make “impact on health” a point of departure and a “lens” for identifying key elements of foreign policy and development strategies.

In the agenda for action, we have set out ten priority areas that offer new scope for foreign policy – where we believe that a stronger, more direct involvement of foreign policy could make a tangible contribution to protecting and promoting health.

Many of these areas are closely interrelated. We have organised them in three main clusters:

Firstly, under the heading “Capacity for global health security”, we point to how national preparedness increasingly includes global mechanisms and other measures that enable countries to make a coordinated response. We underline the need to strengthen our commitment to joint efforts to control emerging infectious diseases. We highlight the critical importance of having skilled and well-equipped health workers on the ground. And we point to the need to develop a global framework to address the global shortage of health workers, which is a preparedness and health security issue.

Then, secondly, in the cluster on “Facing threats to global health security” we highlight the direct and indirect consequences of conflict on health, and the need to strengthen the focus on health in post-conflict reconstruction. We point out that health could be a good entry point for cross-border dialogue and resolution of conflict. We underline the need for health focus in response to natural disasters. We point to the threats to health security posed by HIV/Aids and the need to take up the challenges this presents to human rights, trade, peacebuilding and humanitarian action. We also recognise the severity of health threats related to climate change, and the need to support appropriate foreign policy action in this respect.

Finally, we have called the last cluster “Making globalisation work for all”. We recognise the need to deal with the potentially negative consequences of globalisation and to develop the necessary mechanisms to ensure that globalisation is beneficial to all countries. A focus on health in development strategies and in trade policies can play an important role in this respect, and foreign policy needs to take this into account. Finally, the field of health offers a platform for exploring how we can best govern our interdependence. Governance in relation to health is an important area with regard to deepening global democracy within regional and global institutions.

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Those of you who have studied the papers prepared by WHO for this event will recognise a number of the issues I have just presented. We do not pretend to be original or revolutionary. And our message is certainly not that anyone else – not even foreign ministers – should take over the responsibilities of WHO. The approach we take in the Agenda for Action is to focus on ways in which foreign policy and the involvement of foreign ministers could make a difference. I believe there is important potential.

Before I conclude, a few words on the way forward for our initiative. Clearly, seven foreign ministers cannot “change the world” alone. But a small group like ours – representing different regions but working together across continents, across traditional alliances, bringing different perspectives but sharing the same commitment – a group like this can act as a catalyst.

That is what we want. We are committed to pursuing these health issues in our respective regional settings and in relevant international bodies.

And we invite our colleagues from all regions to join us in an open-ended process that we plan to initiate at a meeting in the margins of the UN General Assembly in New York in September.

Thank you.

The Lancet
Oslo Ministerial Declaration - global health: a pressing foreign policy issue of our time