Innlegg på ministerfrokost om helse og utenrikspolitikk

Ministeren baserte sin innledning på følgende punkter 

• I am delighted to welcome the ministers of the Foreign Policy and Global Health Initiative to this breakfast.
• The fact that we have all made time to meet in the middle of the UN General Assembly week shows our commitment to the initiative and confirms its relevance. It is a pleasure to be co-hosting this breakfast with my Brazilian colleague – since, as you know, Brazil is currently coordinating the network. I would also like to thank Thailand and South Africa for their excellent leadership and coordination efforts.
• Four years have passed since our initiative was launched here in New York. Elections have taken place, governments have changed, and new faces have come on board. It is an achievement in itself that five Ministers of Foreign Affairs are present here, ready to recommit to the Foreign Policy and Global Health Initiative.
• Other countries are also showing a keen interest in joining our efforts.
• The attraction of this circle is its varied composition. We belong to different regional groups and represent different interests. This makes our cooperation interesting and relevant. Working across established groups is helpful.
• It is three and a half years since we adopted the Oslo Declaration, recognising that investment in health is fundamental to economic growth and development, and that threats to health can compromise a country’s stability and security.
• Economists and public health experts now work well together. But in the area of security and health we still have a long way to go. We know that collapsing health systems are a threat to peace and security.
• Building capacity for global health security, dealing with threats to global health and making globalisation work for everyone are all tasks that require the deliberate use of foreign policy instruments. And, of course, political will.
• We have agreed that rather than forming an organisation or a fixed structure, we should seize opportunities to make a political difference wherever and whenever they arise. This may be in an organisation, on a board, in a political movement or in bilateral relations between countries.
• In my view, this initiative is all about engagement and outreach, and about building political alliances among states with different outlooks, different priorities and different geographical affiliations, but with a shared political will to promote the common cause of global health.
• So, what have we accomplished?
• One of our main goals was to give global health a more strategic place on the international agenda. And this is indeed happening. The G8 summit in June gave a big boost to work on child and maternal mortality. The African Union meeting in Kampala in July made a commitment to allocate 15% of government budgets to health by 2015.
• These decisions are obviously the results of joint efforts involving many actors. They also show that global health is now placed firmly on the agenda of presidents, prime ministers and ministers of finance. They have become health ministers, too. This is a major step forward.
• So as a group, we have managed to set a global agenda.
• The reports and resolutions we have initiated in the UN General Assembly have received broad support across all regions.
• There is a growing body of academic institutions exploring the links between health and foreign policy. We should continue to support these efforts.
• We have had the opportunity as a group to advocate, facilitate and broker deals.
• We are also involved in various processes where the positions and interests of our group are not fully aligned. If we use these opportunities to find solutions that work for us, they may also work for others.
• As regards expansion of the group, I suggest that we retain this core group of seven members. However, when we convene on a particular theme, we can expand the group.

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(Further remarks)

• Threats to health do not respect national borders. This is why health is clearly a foreign policy issue.
• We also know that developing countries carry the heaviest burden of disease but have the lowest capacity for prevention, treatment and control. Global health security is only as strong as the weakest link.
• Last year, the pandemic flu outbreak showed us the shortcomings of the international community in dealing with a global health crisis. Complex questions arose about equal access to vaccines and medicine and the issue of virus sharing. As an emergency measure, Norway, along with others, agreed to donate 10% of its national vaccine stocks to developing countries.
• However, we still have a long way to go before we have a better, more equitable international system that can deal properly with a pandemic and ensure the fair distribution of vaccines and medicines. Our group has played a role in the negotiations on pandemic influenza preparedness and should continue to do so as we seek to create a framework that is suitable for all countries.
• Violence and crises seriously affect people’s health. And a lack of access to health care can have a destabilising effect on a society. (There is a reason why the CIA uses child mortality rate as an indicator of which countries are to be considered as fragile states.)
• Any emergency, whether natural or man-made, can make health systems break down. It is essential to ensure access for health personnel during a crisis, to mobilise resources for health, and to ensure a focus on health in post-conflict reconstruction.
• This requires close links between efforts in the areas of health, humanitarian assistance, and peacebuilding.
• Women’s health is often most severely affected. Rape is used as a tactic of war and sexual violence spreads as social structures break down. The effects can be devastating, and we must recognise that conflict-related sexual violence is a serious impediment to peace and security.
• This year is the tenth anniversary of Security Council resolution 1325 on women, peace and security, and we are marking the occasion by taking stock of where we are and what needs to be done.
• We must do more to ensure that women can play their rightful role in international peace and security. And we must do more to protect women and respond to their needs in the midst of conflicts and crises.
• We know that health interventions such as campaigns for child vaccination can be a good entry point in conflict resolution, creating a space for dialogue. Health initiatives often have additional benefits such as contributing to conflict prevention, promoting reconciliation and peacebuilding, and consolidating peace.
• There are useful lessons to be learned here from the WHO programme “Health as a Bridge for Peace”. The review of the UN Peacebuilding Commission should be used to strengthen the health focus in peace processes.
• We do know something about the dynamics of health in crises and conflict, but we need to learn more. However, we can already start to put our current knowledge into practice.
• Another important issue that has received much attention over the past few years is the recruitment of health workers. The fact that rich countries are recruiting health workers from poor countries to take care of an aging population in rich countries gives rise to a number of ethical and economic issues. “There are more nurses from Malawi in Manchester than in Malawi.” It creates an imbalance, because the majority of health workers are not in the countries where the burden of disease is the heaviest. This issue cuts across many sectors and needs to be followed up at various levels.
• Some progress has already been made. The adoption of the Code of Practice for the International Recruitment of Health Workers in the World Health Assembly is an important development, which we welcome. We will explore options in the foreign policy domain to support its effective implementation.
• Climate change may have a severe impact on health in a number of countries. Changing weather patterns affect access to water and food, patterns of disease, and people’s livelihoods. There is great potential for exploring the links between environmental policies and global health in relevant policy processes.
• The global food crisis is obviously having a major impact on people’s health. In addition, the financial crisis has made funds for development scarce and is threatening to undermine or reverse some of the gains made in improving global health.
• As I am sure you all agree, these are major international challenges that can have a huge impact on global health. As Foreign Ministers we should make sure that health has a prominent place on the agenda wherever these issues are discussed. It is a matter of political will, knowledge and partnership.