Thank you to the organizers for this kind invitation to speak to this high level audience on behalf of Norway about some of the Norwegian activities connected to the Global Health Security Agenda.
The Global Health Security Agenda initiative has come at a most timely point. In January 2014 Norway received an invitation letter from the United States Secretary of Health and Human Services to become partner in this initiative. At this time Norway was in the process of developing a similar project, only on a much smaller scale. We saw the opportunity for mutual strengthening by pulling these initiatives together. We became partners of the Global Health Security Agenda from its inception. We are now in the lead of one cross-cutting Action Package about supporting the implementation of the International Health Regulations, as well as being a member of two others, about Antimicrobial resistance and Surveillance.
Norway is a strong supporter of the WHO, and we think its role is key to further positive development of public health and health security globally. We have worked closely with WHO to plan and prepare the content of what we call the Global Health Preparedness Program from Norway, which constitutes a twinning model with public health institutes in low and middle income countries.
We are facing both the challenges and the opportunities that globalization represents for the global health community. We live in an interdependent world. Animal health and human health are closely intertwined, and 75 % of new and emerging diseases have a zoonotic origin. Food and feed are transported around the globe, people travel and of course our microflora travels with us, and the air and the oceans bind us all together in one chemical and microbiological milieu.
For the purpose of securing our own health and for the purpose of securing everybody’s health, global collaboration is needed, - it is a necessity!
Given Norway’s resources and commitment to global health, we have over the past few years, begun a systematic, long term collaboration with other public health institutes in low and middle income countries. The number of health personnel is significantly unequal in the world and close to inversely proportional with the health burden of the world. Many LMICs have very fragile health systems to handle public health challenges and incidents. Paragraph 44 of the IHR, puts some clear expectations on countries to support each other both professionally and financially to fulfill the obligations set by WHO for full IHR implementation.
It is our opportunity and obligation to support other and less resourceful countries, but it is also for our own- and our mutual global benefit, as has clearly been demonstrated by the Ebola outbreak recently. Collective health security is the sum of individual health security, as expressed in the Lancet by Heyman and colleagues recently. The Ebola outbreak in West-Africa is a strong reminder of the importance of investing in health systems and health preparedness before the emergency occurs. The only way to secure Global Health Security is also to make basic health services available, affordable and accessible for all.
We all know that a new outbreak will come, new disasters will appear, and climate change and environmental disturbances are likely to exacerbate such incidents. But we do not know when it will happen or where. That is why we found the International Health Regulations to be such a useful tool to start working from, - to get in place a minimum set of capacities to prepare each nation and the international community for every day challenges and for emergency incidents – building sustainable horizontal structures of health systems. But these regulations call for more than a minimum of resources and priorities to be implemented, and by the last reporting only 64 countries had reported all IHR capacities in place.
Norway has started working with Palestine and Malawi; an agreement is written with Moldova and we are currently exploring opportunities for collaboration with other countries in Africa.
The goal for this twinning program is full implementation of the IHR in designated countries to make the health systems capable of rapid detection and management of crises, disease outbreaks and disasters and to strengthen national public health institutes.
The specific objectives of the project are country-context dependent and contingent upon the baseline of the IHR core capacities in each country, and include activities such as: 1) projects to implement or improve specific core capacities of the IHR, 2) training modules, and 3) twinning projects related to preparedness, surveillance and research
Our commitment is a long term peer-to-peer collaboration over five years or more. So far funding has been provided by the Norwegian government to partner with up to six countries. (Country selection has been conducted after consultations with WHO, Ministry of Foreign Affairs, Ministry of Health and Care Services, previous collaboration with NIPH and based on a needs assessment, and the size and language of the country).
In Palestine we have supported the establishment of the Palestinian Public Health Institute and engaged in activities such as water and sanitation, infection control, birth registries and preparedness.
In Malawi we have supported the establishment of the Public Health Institute of Malawi and we are now conducting a full IHR assessment together with Malawi to set priorities for further collaboration.
We work together under the heading of the Global Health Security Agenda and through a range of international collaborations with WHO, CDC, PHE, IANPHI and our Nordic sister institutions. By working together on these globally important issues, we will be able to accomplish far more than any one of us alone. Our program aims at exploring how we best can support low and middle income countries in achieving public health preparedness and global health security. Twinning between sister organizations in South and support to the implementation of IHR is a promising way forward.