Health: a shared responsibility
Twenty-five years ago, I was working as chief of staff to Gro Harlem Brundtland, who was serving as director-general of the World Health Organization. At the time, the concept of health as an investment was gradually taking shape. The message emerging then – that investing in health is both the right thing to do and the smart thing to do – remains equally relevant today. Global governance for health also encompasses issues relating to equity, human rights, macroeconomic development and security.
Since the early 2000s, historic progress has been made in improving global health. Average global life expectancy increased by more than six years between 2000 and 2019. The adoption of the United Nations’ Millennium Development Goals paved the way for significant advances in child and maternal health and the control of infectious diseases. Millions of lives were saved through cost-effective interventions, such as vaccines and HIV treatment. Norway took part in such efforts together with other governments, philanthropists and the private sector. We also helped to establish new partnerships such as Gavi, the Global Fund, the Global Financing Facility and the Coalition for Epidemic Preparedness Innovations. New funding and a dedicated commitment to saving lives complemented the important work of WHO, the UN, the World Bank and others.
When Covid-19 hit in 2020, people fell ill, schools were closed and businesses suffered. The pandemic reversed the positive trend in life expectancy. Many countries have still not recovered. Norway and South Africa co-chaired the Access to Covid-19 Tools Accelerator, established in response to the acute phase of the pandemic. With that phase now behind us, we must act on the lessons learned. It is evident that the impacts of a pandemic extend far beyond the health sector. Investing in robust health systems and pandemic preparedness thus also involves investing in socio-economic development, equality, resilience and security – all core issues on the G20 agenda. As a G20 guest country in 2024, Norway welcomes the strong focus on health and equity under Brazil’s presidency, and looks forward to seeing this carried forward under the South African presidency in 2025.
As we count down to the 2030 target for implementing the UN Sustainable Development Goals, we must again join forces on health. Is the current global health governance system fit for purpose? Climate change, conflicts, new disease outbreaks and antimicrobial resistance all pose key global health challenges. The initiatives set up to deliver on the MDGs are still saving lives, but the current configuration is prone to fragmentation. From a governance and financing perspective, the international health architecture should move from disease-specific initiatives to enhanced support for national health and welfare systems. To realise the right to health, we must work together to build robust health systems and sustainable financing, as is outlined in the Lusaka Agenda for universal health coverage that has been championed by Norway and others.
Under its G20 presidency, Brazil has given priority to the fight against climate change. We live in a time when the impacts of climate change are posing a fundamental threat to human health. The importance of joint efforts to support climate change adaptation and mitigation cannot be overstated, also from a health perspective.
Some 2.3 billion people lack access to clean cooking facilities, relying instead on traditional cooking fuels such as solid biomass, kerosene or coal. Household air pollution, mostly from cooking smoke, is linked to roughly 3.7 million premature deaths annually. Progress to remedy this has been very limited. Together with representatives of 54 other governments, I attended the Summit on Clean Cooking in Africa, which took place in Paris in May, and which highlighted the need for strong collective efforts to address this challenge. Collective efforts to address clean cooking are key to preventing deaths, reducing emissions, reducing biodiversity loss, improving productivity, triggering economic growth and promoting gender equality. We greatly appreciate Brazil’s focus on this crucial development and health issue in this year’s G20 agenda.
The world is contending with many challenges. Multiple crises, interlinked risks and geopolitical tensions all create obstacles that hamper global governance. Multilateral collaboration is the backbone of good global governance, and there is a need for effective, representative multilateral institutions. Norway supports the ongoing reform efforts of the UN and the multilateral development banks.
Looking ahead, we must use and adapt existing partnerships to address present and coming challenges. We have made progress in recent years. Health is no longer just a ‘health sector issue’. Its relevance in policy areas such as finance and foreign affairs is more widely understood – as are the impacts of these areas on health. I am pleased that the G20 is strengthening its engagement in global health issues. The Covid-19 pandemic was an eye-opener. It showed us that we need to maintain our focus on health as a global common good. Improving global health governance is to the benefit of us all.
