Mr. Chairman, Dear colleague, Ladies and Gentlemen,

I am privileged to be in beautiful Karelia, with its rich yet dramatic history. Soon 150 years ago this city got connected to the sea by the Saima Canal. Perhaps surprisingly, Joensuu grew to become one of the most important port cities in the country.

Today, I am honoured to be invited by my colleague and friend Paavo Lipponen to address this distinguished audience of politicians and experts from Finland, Russia, the Baltic republics as well as European Union Member States.

A small but clear majority of my countrymen decided in 1994 for the second time that Norway should not become a member of the EU.

Yet my country and my Government richly share in our common tasks ahead. Norway this year chairs the Nordic Council of Ministers, we forcefully pursue our joint ambitions in the Baltic Sea States cooperation, we build on common objectives in our broad and constructive relationship with Russia, and indeed, my country fully participates in the single market of the European Union.

When my colleague Paavo so professionally chaired the presidency of the EU three and a half years ago, my Government and I were impressed with the way you brought your concept of a Northern Dimension forward. Yes, indeed, in order to realise a broader coordination of our ambitions we must pool our resources. We must call upon our best people to meet with colleagues from around Europe.

When Finland first initiated a Northern Dimension five years ago, I immediately shared the ambitions of the concept and the urgency of the task. My country as do all our neighbours need to bring our strategically important partner Russia closer, we need to channel our many initiatives and good wills into a larger context.

My country’s approach was one of political support and concrete participation. On the basis of the Action Plan adopted by the Feira European Council two years ago, the Norwegian Government identified bilateral and multilateral programmes and projects that would support the Northern Dimension.

It is key that the network of regional bodies - the Council of the Baltic Sea States, the Barents Euro-Arctic Council, the Arctic Council and the Nordic Council of Ministers - is fully mobilised in implementing the Feira Action Plan.

The Northern Dimension is a success. Firstly, it has developed into a comprehensive framework for cooperation in a number of sectors and involves many different actors. Secondly, and perhaps even more important, is has promoted a mode of thinking, a concept of bringing our common ambitions together, firmly anchored in a broader Europe-wide framework.

Under this larger umbrella every nation will have to focus on specific sectors. Health – the theme of our gathering - is one such key sector. Let me briefly highlight another: Nuclear safety and energy.

Norway has for a long time given full priority to nuclear safety projects on the Kola Peninsula and in other parts of Northwest Russia. Nuclear safety is crucial to the environment, and from a non-proliferation point of view. Nuclear safety is also linked to our efforts fighting international terrorism. I welcome the newly established Northern Dimension Environment Partnership Fund. I am confident that the Fund, with its combination of donations and soft loans, will prove a useful instrument for intensified efforts.

The Northern Dimension is instrumental in furthering energy cooperation. Around the Baltic Sea, that cooperation has developed well since my Government and myself sought to systematise our common efforts at the Heads of Government meeting in Riga four years ago. A successful integration of energy markets in our region will considerably improve the security of supply. It will enable us to make cost-effective environmental improvements.

In the Barents Euro-Arctic framework, its Energy Working Group’s overall objective is to promote sustainable exploitation, production, transmission and use of energy in the Barents region.

Norway currently chairs that Energy Working Group which includes representatives of Finland, Sweden and Russia.

Such closer energy collaboration in our regions, reaching out to old and new partners, is truly in line with Northern Dimension thinking.

Mr. Chairman,

I fully respect the candidate countries’ strong wish to join the European Union. Enlargement will make an important contribution to stability and welfare in Europe. It will also affect the Northern Dimension when several of today’s partner countries will join the EU.

The Danish EU Presidency has initiated a discussion on the role and substance of the Northern Dimension following EU enlargement. Over the next few months a set of guidelines will be drawn up for the next Northern Dimension Action Plan. That plan will take effect on 1 January 2004, in parallel with the expected enlargement.

I wish Norway to take an active part in these efforts. Late last month, a ministerial conference on the Northern Dimension and its “Arctic Window” took place in Greenland. It offered an opportunity for a first exchange of views on the contents of the next Action Plan.

I am grateful to Denmark and the Home Rule Government of Greenland for their advocacy of the Arctic Window of the Northern Dimension. I strongly encourage its further development. The Arctic is part and parcel of the Northern Dimension. It is our common challenge to protect traditional Arctic ways of life and communities and ensure that they enjoy standards of living comparable to those in the rest of the region. And we must protect the fragile Arctic environment.

Global warming has become a key issue on the Arctic agenda. Scientists tell us that significant climate changes are taking place and that the Arctic is particularly susceptible.

Indeed, the Arctic Window will have to be an integral and operative part of the next Northern Dimension Action Plan, also in light of environmental concerns.

Mr. Chairman,

Let me turn to our particular objective - social protection and public health.

I am impressed with this conference, its participation and crucial themes. I will thank the organisers and the Government of Finland for taking on the obligations, for raising the torch for all to follow.

Without social safety and health no cooperation in our broader region will take place.

Public health is fundamental to any progress.

Public health is soft security. Health issues are vital for the development of society. The health of our neighbours is their concern as well as ours.

Today, whole continents are being ravaged by HIV/AIDS. Large segments of the educated population are being lost to the pandemic. Large numbers of people within the police and armed forces, teachers, civil servants, men and women who normally keep society going and bring up their children are being lost to AIDS. This also poses a threat to our own region where considerable efforts are made to gain control of the spread of HIV.

Infectious diseases, with few exceptions, can never be eliminated. Yet we can protect populations by raising an invisible wall - vaccines, interrupted transmission, effective antibiotics, and better living conditions. Such a wall does not necessarily stand for long. It needs continuously to be rebuilt.

The recent increase in tuberculosis in our region, especially the multiresistant type, is a serious reminder of this fact.

This is why the Norwegian Government took the initiative, at the Summit of the Baltic Sea States two years ago, to create a Task Force on Communicable Disease Control. That Task Force’s mandate was renewed at our Heads of Government meeting in St. Petersburg in June this year. My Government is contributing directly to the work of the Task Force to the tune of 2.7 million euro each year.

In addition, Norway has over the last four years contributed close to 7 million euro to the Barents Health Programme. Substantial improvements have been made in public health. Several hundred enthusiastic health workers from the countries involved are meeting colleagues, exchanging knowledge and working together to improve the health situation in the region.

The Nordic Council of Ministers is cooperating in Russia and the Baltics, and is supporting social and health projects with a special focus on improving the situation of children and young people.

These are significant contributions. We are on the right track. We can be pleased with our efforts together with partners.

Yet, we could do more.

The health situation will not necessarily improve in our neighbouring areas in step with increased financial support. There is broad agreement that resources are generally available. But they need to be redirected. There is need for reforms in the health sector: In Russia and the Baltics, a costly hospital-based system, fragmented by many specialities, needs to be transformed. The aim should be highly competent primary care, with broad-based general healthcare that is accessible to people where they live or work. Legislation to this effect is largely in place in all countries in the region.

Change takes time, however. And change is always met with resistance.

We need to refocus our attention. Therefore, I support the establishment of a Partnership in Public Health under the Northern Dimension.

In order to pursue that initiative, a clear political and financial commitment from all relevant partners must be obtained.

In light of the magnitude of the task at hand, the European Commission’s active involvement is key.

We must draw upon the resources of the European Bank for Reconstruction and Development, the Nordic Investment Bank, and the World Health Organisation.

The objectives of a Northern Dimension Partnership are clear and evident, and crucial to all future contact and growth: To reduce the incidence of tuberculosis, gain control of the HIV epidemic, reduce smoking and alcohol consumption and improve nutrition.

Post-graduate training, study trips and joint health programmes are all good ways of gradually achieving these objectives.

A major challenge will be to involve health professionals in the process of change. It is their lives and livelihoods that are at stake. Only when their professional concerns are thoroughly taken into account in the reform process will we see real progress.

Let me also point out the importance of social welfare measures. The health problems I have mentioned are all largely caused by living conditions and attitudes. They are influenced more by public policy than by individual action.

You can tell a person to smoke or drink less, but if he or she is jobless, homeless, hopeless, they are unlikely to change their behaviour.

Hopelessness is most often rooted in poverty, a problem that goes far beyond HIV prevention. It is the core concern of every state to improve the economy and distribute opportunities and wealth between its citizens. These are the central objectives of governance and politics.

Living conditions and social welfare are, then, determinants of health and, at the same time, aspects of policy that go far beyond pure health concerns.

There is an obvious potential for partnership between the health sector and other sectors of society. It is clear that better hygiene and ventilation in prisons will have a direct impact on health. Attractive youth clubs and other leisure activities can spread information on healthy lifestyles. Role models can influence young people’s attitudes towards drugs. Access to clean needles can eliminate the risk of HIV infection in intravenous drug users. Nutritional supplements improve the outcome of tuberculosis treatment. The workplace is a very effective place for addressing smoking and drinking problems.

The Task Force on Communicable Disease Control in the Baltic Sea Region was established, initially for six months, to submit proposals for concerted action to the Heads of Government. Participation has been uneven when it comes to financing. Yet, experience has shown that the working methods of the Task Force are good.

Now, let us seek an even stronger basis for a Partnership in Public Health and Social Well-being. We will have to develop a framework that can attract broad support. The partnership model presented at this conference will serve as a good starting point for further, more detailed discussions.

My Government is looking forward to taking part in such talks and to contributing with all we have got, drawing on our experiences of the Baltic Sea cooperation. We will together with our friends and neighbours assist.

Next year, we should seek a follow-up of this year’s conference. My Government will look forward to hosting such an event. Let us go to our task. Let us all make health a fundamental part of the Northern Dimension.

Thank you, Mr. Chairman.