The most difficult issues in cooperation between states have long been about security and military conditions, trade and business interests. This is an area where national interests are strongly dependent on other countries and where the states’ interests can quickly come into conflict with each other. But in recent years, health has become an both more important and more difficult issue in international politics.

  • Do we as cages in Norway need to care about the health of people in other countries?
  • Is the health of a population just a matter for this country?
  • How have health issues become internationalized?
  • Why has health become more important in international politics?

Health has most often been seen as a national policy area, even though there is a lot of good intergovernmental cooperation through the World Health Organization (WHO). Admittedly, there has been a lot of discussion in the WHO about how best to promote health, but the states have largely agreed on the major issues. Everyone has a common goal of the best possible health. Basic good health has been defined as a human right since 1948 , but it is one of those rights that has largely been thought to be a matter for national health authorities and not for international politics. In other words, health has not had a particularly high priority in international negotiations.

In the last decade, health has become both an important and more difficult issue in many countries’ foreign policy. It has become clearer that health in one country depends on how health is handled in other countries . Thus, national health has also become a foreign policy issue. In addition, a number of conflicts have arisen which make health a demanding political-diplomatic challenge.

2: Disease in one country – a threat to the whole globe

Globalization means that we can buy goods and many services from almost the whole world, and those who can afford it can travel where they want in a short time. But when tens of thousands of people cross the continent by plane every single day, it also happens from time to time that dangerous viruses join the journey . This means that if one country is affected by a dangerous, contagious disease, the disease quickly becomes a threat in other countries as well, it can happen all over the world.

We see this when the flu epidemic sweeps across the globe for almost a quarter of a year. Fortunately, most are fairly harmless, but some infectious agents – such as viruses and bacteria – are new and unknown, such as the bird flu in 2005 and the swine flu in 2009. Both bird and swine flu were well-known diseases. The new thing in these years was that there were new variants of the diseases that quickly spread all over the world.

The rapid spread quickly puts health authorities in almost all countries on alert. It went reasonably well in these cases, but we never know when similar threats will reappear. This shows that close international cooperation is necessary to ensure a rapid response. Furthermore, the spread illustrated that the health services in a country are not just a matter for the country itself.

China has received a lot of criticism for not having handsama bird flu well enough in its own countries and for not sharing important information. The country is known for reacting strongly to what they see as other countries’ interference in “internal conditions”. But in this question, for once, the government was quite humble and accepted the criticism. It seems that health is an area where diplomacy can go the other way and achieve greater impact than when it comes to other human rights , trade and security.

But health issues can also be particularly sensitive : international organizations have invested heavily in eradicating polio in Nigeria, as a country located in Africa according to It is a form of aid that is not primarily about helping Nigerians, but about protecting the rest of the world from polio. Nigeria is one of the few countries in the world where this disease is still present. In 2003, however, rumors spread that this was a Western plan to reduce the Muslim population, and even spread HIV infection. The rumor may seem ridiculous to us.

At the same time, they can also be interpreted as an expression that poor local people understand polio vaccination not only as a question of helping, but also as an expression of a Western-driven agenda. Extensive diplomatic efforts were made to persuade local leaders that the rumors were untrue. This effort failed, and polio came on the rise again.

3: Patent on medicine

International patent agreements
mean that a pharmaceutical company that has developed and taken out a patent for a drug also has the exclusive right to produce it. Companies can then set a very high price adapted to patients in rich countries, who often get the treatment paid for by the state or an insurance company. This pricing has been a source of long-standing conflict between rich and poor countries, especially when it comes to the HIV / AIDS epidemic. Both the risk of infection and the development of disease can be severely limited by medicines, but these have long been far too expensive for poor countries. Many have therefore reacted to the fact that business supervision – supervision of companies in rich countries – seems to be more important than saving lives in poor countries.

The international trade agreements allow for exceptions. A country may be granted an exemption from the patent rules in a crisis situation. Then the country can produce copies of the drugs that are patented. Member Landa in the World Trade Organization (WTO) stated, moreover, in 2001 ( the Doha Declaration ) that the right to health core in front of trade agreements . Thus, the patent rules can be broken if life and health are at stake. But it was long unclear whether the HIV / AIDS crisis could be defined as a crisis situation and what the Doha Declaration means in practice.

When it comes to HIV and AIDS, the problem is partly solved by a combination of exceptions from the patent rules and Western assistance in buying medicines (but not always the best and most expensive). Large international organizations, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria , have negotiated very good prices for medicines. In return, they have had to assure pharmaceutical companies that cheap medicine will only be sold in poor countries. A new, international organization, Unitaid , was established with Norwegian support to make large purchases of medicines to poor countries. In this way, buyers get much better terms than if many poor countries were to trade on their own. This organization is partly funded through taxes on flights in rich countries.

Many questions remain, not least when it comes to diseases other than HIV / AIDS. The international picture is quite complicated. It may seem that patents are the only way to ensure the development of new drugs. Hardly any country or company is willing to pay the enormous costs that are often required to develop a new medicine. And private companies are only willing to do the job if they can patent it when it is fully developed. There is therefore no final decision on what is the right balance.

This is an international policy area where there is not only disagreement between rich and poor countries. Countries such as Brazil and India are in an intermediate position because both countries have their own pharmaceutical industry with commercial interests, but also large poor populations.