The world's best insurance: How investments in global health security protect both Norway and the world

Summary

The next health crisis is coming -- we just don't know when or where. It could be a new pandemic, antibiotic resistance that makes common infections deadly, or climate-driven disease outbreaks that cross borders. But one thing we know for sure: although the crisis is unlikely to start in Norway, it will probably hit us.

Health safety should therefore be part of Norwegian security policy — on a par with defence and community preparedness. For Norway is a small, open country; we are vulnerable when other countries' health systems fail, and diseases spread rapidly through trade, travel and migration. It's not just about aid and solidarity, it's about protecting ourselves.

If a new pandemic strikes now, we could be even more vulnerable than in 2019, according to a recent report by the Global Preparedness Monitoring Board (GPMB) - an expert group on health security under the WHO and the World Bank. We were too ill-prepared back then, according to the corona commissions, and apparently have not learned from it. The GPMB warns that”the world is dangerously unprepared” and urges countries to integrate health preparedness into their national security strategies. It is not enough to invest in visible and acute crises.

World military spending is more than a hundred times the size of all funding for pandemic prevention. Adequate global pandemic preparedness is estimated to cost £100—150 billion in additional investment annually, according to the World Bank and WHO. That's around 0.01 percent of world GDP, and Norway's share of this is less than the price of a combat aircraft per year. This could save many lives, even in Norway.

In low-income countries, especially sub-Saharan Africa, weak health care systems are overburdened, barely rebuilt after covid-19. Now they are being hit by new disease outbreaks in parallel with climate-driven disease changes and humanitarian crises. These countries do not have the resources needed to prevent small outbreaks from developing into global crises.

The WHO has estimated that health crises cost the world NOK 13,000 billion annually, and that the amount will increase without sustained and coordinated increased funding for health preparedness. According to the Pandemic Fund, however, one penny invested in emergency preparedness can save society up to NOK 17 in avoided future costs.

This memo presents ten concrete recommendations to Norwegian politicians to insure us against new health crises. And most importantly, there are three overarching steps:

1. Treat health safety as a security policy and part of Norwegian total preparedness.
2. Fund health security from multiple budget areas (not just the aid budget), as we do for defense and community security. NATO's percentage target is relevant.
3. Norway should help establish a global agreement on health security — inspired by the Paris Agreement, which brings together countries, donors and institutions behind common goals, national commitments and coordinated funding.

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Greater investment in health security can be the world's best insurance -- and cheap in the long term. The question is not whether we can afford to bet, but whether we can afford not to.

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The full paper is currently only available in Norwegian.