Norway: National and International Health
His Excellency Jon Elvedal Fredriksen’s Zoom talk on September 22 was enlightening and thought-provoking. As Norway’s ambassador to Canada with years of experience as a diplomat, he was quick to explain that his expertise focused on Norway’s role in global health, but he was happy to give an overview of Norway’s national health system as well.
Norway’s health system, like Canada’s, is a public one that is financed by the government through taxes. All Norwegians have access to free health care which is organized through a system of regional health co-operatives. A few private hospitals do exist but they are very strictly regulated. Most long-term care is also public.
Norwegian citizens do pay a small fee for each medical visit, unless they cannot afford it. There is some variation in the accessibility of health care between various regions in Norway, but less so than in Canada because Norway is so much smaller and more densely populated.
Norway is a rich country with an economic surplus due to its exports of oil, fish, and other commodities. The Government Pension Fund, established in 1990 to invest the surplus revenues of Norway’s petroleum sector, is now the world’s largest sovereign wealth fund. There is an understanding in the Norwegian government that this wealth needs to be shared globally. Of the international development aid provided by Norway, a very large portion is spent on health-related issues.
Mr. Fredriksen pointed out the vast number of people who die of preventable diseases each year, estimated to be about 5 million. This is why better available health care globally is so essential.
The World Health Organization (WHO’s) handling of the COVID pandemic has faced a great deal of scrutiny by the media. Norway’s position is that the WHO is functioning well, but there is always room for improvement. And of course not all countries rely totally on the WHO for health-related information. Impressively, Norway is the third largest financial contributor to the WHO and is prepared to do even more. The WHO’s “Global Action Plan for Healthy Lives and Well-being for All” is intended to improve co-ordination efforts and avoid duplication to achieve results.
The Global Financing Facility, under the World Bank, supports low-income countries in investing in their own health systems by topping up their own financing and providing administrative resources. Results have shown that those countries who have done so were better prepared to meet the challenges of the pandemic.
Mr. Fredriksen stressed the importance of health in the sustainable development goals of the United Nations as well as the need for private-public partnerships. With respect to pandemics, there is a strong need to invest in preparedness as well as in research and development. Diversified manufacturing capacity and the ability to transfer resources must already be available when a crisis occurs. The pandemic has shown that these investments are small compared to the eventual cost of inaction. Financing should be done collectively since the impact is in fact a shared burden.
Norway and Canada have both done well in vaccinating their populations but the rest of the globe must also have access to vaccines. A multi-lateral co-operative approach is necessary to accomplish this. The Access to COVID-19 Tools Accelerator (Act-A) was initiated by the G20 as a framework for co-operation in this regard and Norway has been a major contributor.
The United Nations platform to ensure vaccine access for children and youth receives strong support from Norway and this will continue in the years to come.
Following his talk, Mr. Fredriksen replied frankly and fully to a number of questions regarding Norway’s health system, its participation in improving global health, and the pandemic. We were all impressed by the ambassador’s in-depth knowledge and commitment to these issues, not to mention the very significant role that Norway has assumed on the global stage when it comes to health.