natgillin/translations-raw huggingface dataset:
So global health security is only as strong as the weakest link.
So global health security is only as strong as the weakest link.
Are we prepared, as foreign ministers, to face a global health crisis?
Are we prepared, as foreign ministers, to face a global health crisis?
Norway closed its border with Sweden for the first time in modern history during the outbreak of mouth and foot disease in 2000.
Norway closed its border with Sweden for the first time in modern history during the outbreak of mouth and foot disease in 2000.
And we were completely puzzled by the question “how do we reopen borders?
And we were completely puzzled by the question “how do we reopen borders?
When are you certain that the epidemic is over and we can do so safely?”
When are you certain that the epidemic is over and we can do so safely?”
This is a foreign policy issue.
This is a foreign policy issue.
It is easy to deal with Sweden, our neighbour, in such cases.
It is easy to deal with Sweden, our neighbour, in such cases.
But there can be other settings were this is more complicated.
But there can be other settings were this is more complicated.
As foreign ministers, we need to review government structures and systems and adapt them to better respond to global interdependence.
As foreign ministers, we need to review government structures and systems and adapt them to better respond to global interdependence.
When I became Foreign Minister, I called six of my colleagues in different corners of the world and asked them to join me in an informal setting to address this issue.
When I became Foreign Minister, I called six of my colleagues in different corners of the world and asked them to join me in an informal setting to address this issue.
And to try to highlight what it means to be a foreign minister in an era where health problems are global.
And to try to highlight what it means to be a foreign minister in an era where health problems are global.
I approached France, Thailand, Indonesia, South Africa, Senegal and Brazil.
I approached France, Thailand, Indonesia, South Africa, Senegal and Brazil.
And they all responded favourably.
And they all responded favourably.
We met at the UN in 2006 and appointed experts to work out an agenda, identify the problems and to advise us on a plan of action.
We met at the UN in 2006 and appointed experts to work out an agenda, identify the problems and to advise us on a plan of action.
We came together in Oslo in March last year to adopt the Oslo Agenda, the Oslo Declaration and a plan of action.
We came together in Oslo in March last year to adopt the Oslo Agenda, the Oslo Declaration and a plan of action.
We singled out ten foreign policy areas where we need to take a look at the health implications.
We singled out ten foreign policy areas where we need to take a look at the health implications.
Are health concerns being given the necessary priority?
Are health concerns being given the necessary priority?
Are we applying the foreign policy tools at our disposal to get to grips with them?
Are we applying the foreign policy tools at our disposal to get to grips with them?
Against the backdrop of an evolving health and development agenda, I believe we have something new emerging here.
Against the backdrop of an evolving health and development agenda, I believe we have something new emerging here.
At the UN General Assembly last September, we were 30 foreign ministers who came together to discuss these fields.
At the UN General Assembly last September, we were 30 foreign ministers who came together to discuss these fields.
In order for us to make these ideas workable, we need to continue take a broader view and work out new perspectives.
In order for us to make these ideas workable, we need to continue take a broader view and work out new perspectives.
We still take a very traditional approach in the debate on national and global health security.
We still take a very traditional approach in the debate on national and global health security.
We discuss our own country’s perspective – with the main focus on protecting our own population.
We discuss our own country’s perspective – with the main focus on protecting our own population.
That is our responsibility as governments.
That is our responsibility as governments.
Even the threats of pandemic flu can be seen in this light.
Even the threats of pandemic flu can be seen in this light.
We buy drugs for our populations.
We buy drugs for our populations.
But as we all know, viruses and bacteria know no borders.
But as we all know, viruses and bacteria know no borders.
So if we include the perspective of interdependence and shared vulnerability across nations and regions, we need to add a broader dimension to this debate.
So if we include the perspective of interdependence and shared vulnerability across nations and regions, we need to add a broader dimension to this debate.
More than anything, it calls for solutions in which the benefits of preparedness are equitably distributed.
More than anything, it calls for solutions in which the benefits of preparedness are equitably distributed.
Because my insecurity does not depend on the Norwegian health system, it depends on systems far beyond Norway.
Because my insecurity does not depend on the Norwegian health system, it depends on systems far beyond Norway.
All of this has to influence our development policy, our UN policy and also our Norwegian foreign policy.
All of this has to influence our development policy, our UN policy and also our Norwegian foreign policy.
As a final observation, one important insight of this group of experts is that health security cannot be interpreted narrowly.
As a final observation, one important insight of this group of experts is that health security cannot be interpreted narrowly.
What we need is an understanding of the determinants of health.
What we need is an understanding of the determinants of health.
Poverty is of course intuitively recognised as a core determinant even though we have failed to address it fully.
Poverty is of course intuitively recognised as a core determinant even though we have failed to address it fully.
Two more direct determinants of health that are often overlooked are trade and intellectual property rights.
Two more direct determinants of health that are often overlooked are trade and intellectual property rights.
In many countries, HIV and AIDS are overloading already weak health systems and having impacts on capacity, preparedness, human rights and movement across borders.
In many countries, HIV and AIDS are overloading already weak health systems and having impacts on capacity, preparedness, human rights and movement across borders.
This has foreign policy implications.
This has foreign policy implications.
We also have to address how fragile states might collapse under what we call “the double burden of disease”.
We also have to address how fragile states might collapse under what we call “the double burden of disease”.
Poor countries struggling with the burden of infectious diseases are increasingly being burdened with non-infectious diseases – which often cripple a poor health system.
Poor countries struggling with the burden of infectious diseases are increasingly being burdened with non-infectious diseases – which often cripple a poor health system.
Another dimension is that rich countries are recruiting health workers from poor countries to take care of an aging population.
Another dimension is that rich countries are recruiting health workers from poor countries to take care of an aging population.
This gives rise to a number of very serious, ethical and economic issues.
This gives rise to a number of very serious, ethical and economic issues.
These, too, must be brought into the foreign policy agenda.
These, too, must be brought into the foreign policy agenda.
I would like to conclude by mentioning a concrete example that I never thought I would deal with as foreign minister the issue of virus sharing.
I would like to conclude by mentioning a concrete example that I never thought I would deal with as foreign minister –¬ the issue of virus sharing.
Indonesia has been hard hit by avian influenza.
Indonesia has been hard hit by avian influenza.
Bird flu is widely considered to be one of the most likely sources of the next global pandemic.
Bird flu is widely considered to be one of the most likely sources of the next global pandemic.
And global preparedness relies heavily on monitoring the outbreaks, particularly that which affect humans.
And global preparedness relies heavily on monitoring the outbreaks, particularly that which affect humans.
A year ago, Indonesia felt that it was being short-changed by the international community and asked bluntly why it should contribute to the production of a vaccine it will not be able to afford and would be unlikely to ever have access to by sharing its virus.
A year ago, Indonesia felt that it was being short-changed by the international community and asked bluntly why it should contribute to the production of a vaccine it will not be able to afford and would be unlikely to ever have access to by sharing its virus.
– Good question.
– Good question.
I disagree with Indonesia’s decision to stop sharing the virus from local outbreaks, because I believe that Indonesia and all other countries should contribute fully to global preparedness.
I disagree with Indonesia’s decision to stop sharing the virus from local outbreaks, because I believe that Indonesia and all other countries should contribute fully to global preparedness.
But I also understand and agree that we must make sure that the benefits of preparedness are shared equitably and sustainably.
But I also understand and agree that we must make sure that the benefits of preparedness are shared equitably and sustainably.
One of the most shocking observations I was met with when I got to the WHO was that there is no opportunity to prepare malaria drugs, because where there is no money there is no market for these drugs.
One of the most shocking observations I was met with when I got to the WHO was that there is no opportunity to prepare malaria drugs, because where there is no money there is no market for these drugs.
But for a disease that strikes somewhere between a half and one billion people each year, how can we say there is no market?
But for a disease that strikes somewhere between a half and one billion people each year, how can we say there is no market?
And if we accept that there is no market for malaria medicine simply because people can’t afford to buy it, that is also a market failure.
And if we accept that there is no market for malaria medicine simply because people can’t afford to buy it, that is also a market failure.
What this all adds up to is that this is a matter of political will, of knowledge, and of partnership.
What this all adds up to is that this is a matter of political will, of knowledge, and of partnership.
Thank you for accompanying me on this personal journey.
Thank you for accompanying me on this personal journey.
Global Health and the Foreign Policy Agenda
Global Health and the Foreign Policy Agenda
Today is 7 April – World Health Day.
Today is 7 April – World Health Day.
It is a special pleasure for me to speak here again at the CSIS – and to be speaking on health.
It is a special pleasure for me to speak here again at the CSIS – and to be speaking on health.
A fair question from the audience would certainly be: “Why invite a Foreign Minister to speak on health?
A fair question from the audience would certainly be: “Why invite a Foreign Minister to speak on health?
What does he know about medicine, health systems, health budgets, hospitals, mental health and diseases?”
What does he know about medicine, health systems, health budgets, hospitals, mental health and diseases?”
The answer is not much, and certainly far less than any health minister, and – hopefully – far less than many of you.
The answer is not much, and certainly far less than any health minister, and – hopefully – far less than many of you.
But here is the point: While I was serving at the World Health Organization with Dr Brundtland from 1998, I discovered how much more there is to health – and global health – than the strict medical side of the issue.
But here is the point: While I was serving at the World Health Organization with Dr Brundtland from 1998, I discovered how much more there is to health – and global health – than the strict medical side of the issue.
I did so by seeing, listening and experiencing, and by working with some extraordinary people from the global health community – a few of which are here today.
I did so by seeing, listening and experiencing, and by working with some extraordinary people from the global health community – a few of which are here today.
I learned some very important lessons – and here are a few of them:
I learned some very important lessons – and here are a few of them:
I learned that health is more than a budget expenditure.
I learned that health is more than a budget expenditure.
It is an investment in human dignity, human development – and thus in economic development and the welfare of people, communities and nations.
It is an investment in human dignity, human development – and thus in economic development and the welfare of people, communities and nations.
I learned that investing wisely in health was a powerful tool in the fight against extreme poverty.
I learned that investing wisely in health was a powerful tool in the fight against extreme poverty.
Poor health breeds poverty – that is something we have always known.
Poor health breeds poverty – that is something we have always known.
But we are now much more aware than before that improved health leads to growth and development.
But we are now much more aware than before that improved health leads to growth and development.
The equation works both ways.
The equation works both ways.
This offers us a unique opportunity to both fight poverty and stimulate development.
This offers us a unique opportunity to both fight poverty and stimulate development.
I learned more about the amazing work that is carried out by health workers all around the world, from the modern and sophisticated clinics in Oslo and Geneva where my wife has given birth, to the primitive, local facility in an Indian village where a brave midwife helps a mother to save both her newborn baby’s life – and her own – because she gives birth there and not at home on a dirty floor.
I learned more about the amazing work that is carried out by health workers all around the world, from the modern and sophisticated clinics in Oslo and Geneva where my wife has given birth, to the primitive, local facility in an Indian village where a brave midwife helps a mother to save both her newborn baby’s life – and her own – because she gives birth there and not at home on a dirty floor.
I learned how much more we could accomplish by working differently, by reaching out to other partners beyond health – by assembling the evidence necessary for Dr Brundtland to call to presidents, prime ministers and finance ministers to tell them: “You too are health ministers.
I learned how much more we could accomplish by working differently, by reaching out to other partners beyond health – by assembling the evidence necessary for Dr Brundtland to call to presidents, prime ministers and finance ministers to tell them: “You too are health ministers.
Your decisions have an impact on health.
Your decisions have an impact on health.
Get to work, get involved!”
Get to work, get involved!”
I learned about the opportunities and complexities of the new partnerships and about the additional financial resources we could mobilise through creations such as GAVI and the Global Fund to fight AIDS, TB and Malaria.
I learned about the opportunities and complexities of the new partnerships and about the additional financial resources we could mobilise through creations such as GAVI and the Global Fund to fight AIDS, TB and Malaria.
But also about the very complex landscape private–public interaction creates, and that sometimes leads to a lack of overview and unity of purpose.
But also about the very complex landscape private–public interaction creates, and that sometimes leads to a lack of overview and unity of purpose.
Having foreign policy as my main field, I learned how much global health matters to foreign and security policy.
Having foreign policy as my main field, I learned how much global health matters to foreign and security policy.
How health tells perhaps the strongest story of globalisation, how the outbreak of a pandemic would immediately challenge our diplomatic and security systems, how modern states might be brought to closing borders, how the ownership of a virus quickly becomes a diplomatic struggle between the North and the South, how a polio immunisation campaign can offer the opportunity for a truce and perhaps be the first step towards a peace process.
How health tells perhaps the strongest story of globalisation, how the outbreak of a pandemic would immediately challenge our diplomatic and security systems, how modern states might be brought to closing borders, how the ownership of a virus quickly becomes a diplomatic struggle between the North and the South, how a polio immunisation campaign can offer the opportunity for a truce and perhaps be the first step towards a peace process.
And finally I learned what it takes to make a difference in health.
And finally I learned what it takes to make a difference in health.
Bill Foege explained this masterfully when he described all the efforts that have to fall into place to immunise a child – from the initial research in a laboratory, through testing, production, transport, establishment of a cold chain in a tropical country, to the training of the nurse at a local health station who gives the injection with a clean and safe needle – all of this and many more elements in a long chain that has to be in place before the lucky child can be protected for life against fully preventable diseases.
Bill Foege explained this masterfully when he described all the efforts that have to fall into place to immunise a child – from the initial research in a laboratory, through testing, production, transport, establishment of a cold chain in a tropical country, to the training of the nurse at a local health station who gives the injection with a clean and safe needle – all of this and many more elements in a long chain that has to be in place before the lucky child can be protected for life against fully preventable diseases.
Dr Foege referred to the saying from Tanzania – which also became the title of a book by Secretary Clinton some ten years ago: “It takes a village to raise a child.”
Dr Foege referred to the saying from Tanzania – which also became the title of a book by Secretary Clinton some ten years ago: “It takes a village to raise a child.”
Dr Foege elaborated on that beautifully by stating: “It takes a whole world to immunise a child!”
Dr Foege elaborated on that beautifully by stating: “It takes a whole world to immunise a child!”
So this is me – a Foreign Minister who had the privilege of discovering the world of global health and the ambition to continue dealing with it – as an interested person and also as a Foreign Minister – with other colleagues and in settings not always accustomed to these issues.
So this is me – a Foreign Minister who had the privilege of discovering the world of global health and the ambition to continue dealing with it – as an interested person and also as a Foreign Minister – with other colleagues and in settings not always accustomed to these issues.
And in this context let me add another thing that I learned, and am still learning: how important it is that professions break out of their boxes and dramatically improve their interaction.
And in this context let me add another thing that I learned, and am still learning: how important it is that professions break out of their boxes and dramatically improve their interaction.
And this applies to health professionals in particular, if I may say so.
And this applies to health professionals in particular, if I may say so.
Let me illustrate this be quoting a famous Norwegian public health official, Mr Karl Evang, who took part in the drafting of the World Health Organization’s constitution.
Let me illustrate this be quoting a famous Norwegian public health official, Mr Karl Evang, who took part in the drafting of the World Health Organization’s constitution.
He said that to him economists were worse than TB!
He said that to him economists were worse than TB!
In these times of financial crisis he might perhaps have had a point.
In these times of financial crisis he might perhaps have had a point.
But another point, far more relevant I believe, is what the health profession and the economics profession can do by maximising their efforts and potential.
But another point, far more relevant I believe, is what the health profession and the economics profession can do by maximising their efforts and potential.
I believe the report of the Commission on Macroeconomics and Health made a contribution to this by highlighting the potential of investing wisely and strategically in health as a strategy to fight extreme poverty.
I believe the report of the Commission on Macroeconomics and Health made a contribution to this by highlighting the potential of investing wisely and strategically in health as a strategy to fight extreme poverty.
Global health is therefore more than an “issue”; it has to do with managing complex international relations, important principles and major challenges of inequality and injustice.
Global health is therefore more than an “issue”; it has to do with managing complex international relations, important principles and major challenges of inequality and injustice.
It involves changing economic priorities and establishing organisations and working relationships.
It involves changing economic priorities and establishing organisations and working relationships.
In short: “We must reach beyond our grasp to fulfil our task.”
In short: “We must reach beyond our grasp to fulfil our task.”
Let me say a few words about the Norwegian approach:
Let me say a few words about the Norwegian approach:
Health has always played a major role in our development policy.
Health has always played a major role in our development policy.
Since 2000 we have scaled up.
Since 2000 we have scaled up.
We have focused on taking the lead in three concrete initiatives:
We have focused on taking the lead in three concrete initiatives:
First there is GAVI, an alliance of major UN organisations, governments in developed and developing countries, the vaccine industry, and private actors such as the Bill and Melinda Gates Foundation.
First there is GAVI, an alliance of major UN organisations, governments in developed and developing countries, the vaccine industry, and private actors such as the Bill and Melinda Gates Foundation.
Prime Minister Jens Stoltenberg was the first prime minister to engage his government actively in this effort, and we have ever since been a staunch supporter of this effort with the ambitious vision of helping to immunise every child in the world.
Prime Minister Jens Stoltenberg was the first prime minister to engage his government actively in this effort, and we have ever since been a staunch supporter of this effort with the ambitious vision of helping to immunise every child in the world.
This is a new way of working, based on public–private partnership, focusing on performance and new incentives for partners to work together.
This is a new way of working, based on public–private partnership, focusing on performance and new incentives for partners to work together.
In my view, the results have been impressive: WHO estimates that between 2000 and 2008, some 3.4 million future deaths have been prevented through immunisation campaigns supported by GAVI.
In my view, the results have been impressive: WHO estimates that between 2000 and 2008, some 3.4 million future deaths have been prevented through immunisation campaigns supported by GAVI.