Interview November

Making Sweden a stronger player in implementing the 2030 Agenda

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“A development aid perspective on global health will not suffice. Our work has to do so much more. The new report is intended to reinforce the implementation of existing policies, commitments, and contributions made by Sweden so far. It also identifies important actors and highlights how cooperation can be improved, clarifying the available resources and areas where Sweden can act further on. The foundation of the document is health as a tool in implementing the goals of the 2030 Agenda”, says Anders Nordström, Ambassador for Global Health at Ministry for Foreign Affairs of Sweden. Credit: Samuel Unéus

The 2030 Agenda contains 17 goals. The SDG3 focuses on healthy lives and well-being for all. In June 2018, the Swedish government presented its action plan for the implementation of the Agenda 2030. The Ministry of Social Affairs and the Ministry of Foreign Affairs have now launched a report that summarises Sweden’s work on global health implementing the 2030 Agenda.

By Ulrica Segersten • Photoes: Samuel Unéus

A milestone was reached as the report “Sweden’s Work on Global Health – implementing the 2030 Agenda” was launched at the Government Offices in October 2018, with two state secretaries present and some 120 stakeholders from universities, public authorities, private sector, and civil society organisations that had contributed in various ways to the document. As one of the facilitators during the process, SIGHT was also present.

Just after the launch, SIGHT met with Anders Nordström, Ambassador for Global Health at the Swedish Ministry for Foreign Affairs, one of the key players in the creation of the report.

“It’s not a new policy we are presenting. What is new is the description of the health challenges, how we present them, and how everything is linked to the 2030 Agenda. We connect the national and regional with the global, pointing out that global health is not only about development aid, but that our resources as a whole must be used to strengthen global health,” says Anders Nordström.

He sees tremendous potential in bringing together the many stakeholders active in work on global health.

“This is merely a start, not the end. The goal is to make Sweden a stronger player in implementing the 2030 Agenda,” he adds.

Anders Nordström believes that Sweden’s’ ambition to implement the 2030 Agenda opens up an opportunity to emphasise the health focus of SDGs.

“The SDGs point out that we need to focus on health, rather than disease, healthcare and the health sector alone. It’s a focus that neither the world in general nor Sweden really has picked up. We are still envisioning medical care or traditional development aid to meet global health challenges, “says Anders Nordström.

In this context the document clearly outlines what health actually means, how to work with risk factors and how to create conditions for as many as possible to increase their healthy life years.

“The other driving force is about young people, about the students. I have been working for a long time with global health issues, but in recent years I have seen an increased commitment to global health in students from different disciplines. It is an engagement that is quite distinctive from when I was a (medical) student myself. This commitment needs to be taken care of.” 

State Secretary at the Ministry of Foreign Affairs
State Secretary at the Ministry of Foreign Affairs. Credit: Johan Schiff

Eva Svedling, State Secretary at the Ministry of Foreign Affairs, said in her speech that the Ministry’s hope is that Sweden will be a powerful global player in implementing the 2030 Agenda. She highlighted that the 17 goals are integrated and indivisible, which means that all countries have a common responsibility to implement them, but that Sweden’s role and status in promoting sustainability, equality, and sexual and reproductive health and rights brings with it significant influence – but also responsibility – to take on the Swedish resource base available in science, politics, and business. She said that, especially regarding the relationship between food, health, and climate, the world is facing a huge challenge requiring accountability.

“Health depends on how we produce and consume food. 2.5 billion people are overweight, one-third of the food bought is thrown away while over 800 million are suffering from malnutrition”, she pointed out.

Agneta Karlsson, State Secretary at the Ministry of Social Affairs
Agneta Karlsson, State Secretary at the Ministry of Social Affairs. Credit: Kristian Pohl, Regeringskansliet

Agneta Karlsson, State Secretary at the Ministry of Social Affairs, also emphasised the Swedish ambition to be a leader in implementing the 2030 Agenda.

“This document shows that national work is clearly linked to what is being done globally. For example, the Ebola crisis or measles outbreak shows how different matters are interconnected and how events outside our country affect Sweden. The 2030 Agenda offers the opportunity to show this nexus”, she said, a propos why the health goals should be intimately linked to the other SDGs. They are based on the rights perspective of health according to WHO: everyone is entitled to healthy lives everywhere.

In his presentation, Anders Nordström started by highlighting the global health challenge: while the global health situation has shown a clearly positive trend over the last 30 years, we are not getting healthier at the same rate. The new major health risk factors are linked to lifestyles. 15 million people die prematurely, due to chronic diseases (NCDs).

The goal of Sweden’s work on global health is to contribute to healthy lives and promote well-being for all through societies that create conditions for well-being and health equality, effective, sustainable and resilient health systems, as well as increased preparedness and capacity to detect and manage outbreaks and other acute health threats.

“And in all this equality and equity are obvious areas of ​​performance,” explains Anders Nordström.

He returns several times to what is required to make Swedish actions even more effective:

“We need to create better conditions for different actors to collaborate on global health and raise awareness of potential contributors. There are resources that we may not yet see clearly. For example, the government’s focus on internationalisation of universities and colleges creates opportunities for international exchange. We also need to see the importance of business investment in products and services that contribute in a positive way to global health development. Government as well as private research funds contributing to obesity and diabetes research are important. Nowadays lifestyle-related health problems do not only affect our own part of the world but have also become a major health issue of poorer countries.

A global challenge, where Sweden, according to Anders Nordström, has already built a valuable knowledge base and innovative collaborations, is in antimicrobial resistance and, in particular, antibiotic resistance. Swedish scientists, authorities, and politicians are involved. Another area where Sweden distinguishes itself is work on sexual and reproductive health and rights (SRHR).

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Ole Petter Ottersen, President of Karolinska Institutet. Credit: Erik Cronberg

At the time of launch, Ole Petter Ottersen, President of Karolinska Institutet, made a first reflection on the document, as he expressed:

“This is a big day. We (Sweden) are known to be ambitious in global health and about the 2030 Agenda, and there is international interest in how Sweden will act now. This coincides with an intriguing event in Berlin two days ago, where the WHO and eleven organisations signed a document setting out to accelerate progress for healthy lives and well-being for all according to SDGs.

Ole Petter Otter’s conclusion was that the Swedish document is right on time. That it will inspire. However, he lacked three words: education, political impetus, and implementation, but at the same time noted that on the education side, that he represents himself, there is now urgent work to do.

“We need to introduce SDGs into our education programs, and Sweden could, through soft power, such as trade agreements, strengthen the political determinants of health.

The question now is how Sweden can find incitements to work both nationally and internationally with global health. According to Anders Nordström, Sweden needs to zoom in specific areas where Sweden can act to make a difference and create examples.

“We have painted the big picture of what we can and want to do. But this journey has just begun. We will invite various players to round-table discussions. There is still a lot of hard work ahead of us, work that requires that we  catalyse and invites new actors, “says Anders Nordström.

One such area, mentioned by Anders Nordström, is to look at health financing including involving more people with expertise in taxes and international legislation connected to global health work. There is also a need to strengthen the work on antimicrobial resistance building on the Swedish initiatives so far.

Anders Nordström hopes that the report will be a starting point for identification of new areas where global health and the 2030 Agenda interlinks. For example, he mentions the importance of understanding the correlation between food, food industry and global health, a work which still remains unorganised, although it is clear that food and food production are risk factors, both in terms of health and environment.

“But whatever area we will be focusing on, it’s obvious that we cannot continue to work in silos. We need to cooperate across departments, authorities and scientific disciplines in order to succeed. And sometimes we must have the private sector with us. It is obvious,” says Anders Nordström.