Ministry of Foreign Affairs

BACKGROUND: A five-year prospective study was conducted in North Iraq and Cambodia to test a model for rural prehospital trauma systems in low-income countries. RESULTS: From 1997 to 2001, 135 local paramedics and 5,200 lay First Responders were trained to provide in-field trauma care. The study population comprised 1,061 trauma victims with mean evacuation time 5.7 hours. The trauma mortality rate was reduced from pre-intervention level at 40% to 14.9% over the study period (95% CI for difference 17.2-33.0%). There was a reduction in trauma deaths from 23.9% in 1997 to 8.8% in 2001 (95% CI for difference 7.8-22.4%), and a corresponding significant improvement of treatment effect by year. The rate of infectious complications remained at 21.5 percent throughout the study period. CONCLUSION: Low-cost rural trauma systems have a significant impact on trauma mortality in low-income countries.

There are over 250,000 international treaties that aim to foster global cooperation. But are treaties actually helpful for addressing global challenges? This systematic field-wide evidence synthesis of 224 primary studies and meta-analysis of the higher-quality 82 studies finds treaties have mostly failed to produce their intended effects. The only exceptions are treaties governing international trade and finance, which consistently produced intended effects. We also found evidence that impactful treaties achieve their effects through socialization and normative processes rather than longer-term legal processes and that enforcement mechanisms are the only modifiable treaty design choice with the potential to improve the effectiveness of treaties governing environmental, human rights, humanitarian, maritime, and security policy domains. This evidence synthesis raises doubts about the value of international treaties that neither regulate trade or finance nor contain enforcement mechanisms.

The global pandemic response has typically followed cycles of panic followed by neglect. We are now, once again, in a phase of neglect, leaving the world highly vulnerable to massive loss of life and economic shocks from natural or human-made epidemics and pandemics. Quantifying the size of the losses caused by large-scale outbreaks is challenging because the epidemiological and economic research in this field is still at an early stage. Research on the 1918 influenza H1N1 pandemic and recent epidemics and pandemics has shown a range of estimated losses (panel).1Taubenberger JK Morens DM 1918 influenza: the mother of all pandemics.Emerg Infect Dis. 2006; 12: 15-22Crossref PubMed Scopus (24) Google Scholar, 2Madhav N, Oppenheim B, Gallivan M, et al. Pandemics: risk, impacts, and mitigation. In: Jamison DT, Nugent R, Gelband H, et al, eds. Disease Control Priorities, 3rd edn, Volume 9. Washington, DC: World Bank (in press).Google Scholar, 3Centers for Disease Control and PreventionFact sheet: basic information about SARS.https://www.cdc.gov/sars/about/fs-sars.pdfGoogle Scholar, 4Lee J-W McKibbin WJ Estimating the global economic costs of SARS.in: Knobler S Mahmoud A Lemon S Institute of Medicine Forum on Microbial Threats. National Academies Press, Washington, DC2004Google Scholar, 5World Bank2014–2015 West Africa Ebola crisis: impact update.http://pubdocs.worldbank.org/en/297531463677588074/Ebola-Economic-Impact-and-Lessons-Paper-short-version.pdfGoogle Scholar, 6PAHOZika cases and congenital syndrome associated with Zika virus reported by countries and territories in the Americas, 2015–2017 cumulative cases.http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=38164&lang=enGoogle Scholar, 7World BankThe short-term economic costs of Zika in Latin America and the Caribbean (LCR). World Bank Group, Washington, DC2016Google ScholarPanelHealth and economic impacts of epidemics and pandemicsH1N1 influenza (1918)•50 million deaths;1Taubenberger JK Morens DM 1918 influenza: the mother of all pandemics.Emerg Infect Dis. 2006; 12: 15-22Crossref PubMed Scopus (24) Google Scholar gross domestic product (GDP) loss of 3% in Australia, 15% in Canada, 17% in the UK, and 11% in the USA2Madhav N, Oppenheim B, Gallivan M, et al. Pandemics: risk, impacts, and mitigation. In: Jamison DT, Nugent R, Gelband H, et al, eds. Disease Control Priorities, 3rd edn, Volume 9. Washington, DC: World Bank (in press).Google ScholarSevere acute respiratory syndrome (SARS) (2003)•774 deaths;3Centers for Disease Control and PreventionFact sheet: basic information about SARS.https://www.cdc.gov/sars/about/fs-sars.pdfGoogle Scholar global economic loss of US$52·2 billion4Lee J-W McKibbin WJ Estimating the global economic costs of SARS.in: Knobler S Mahmoud A Lemon S Institute of Medicine Forum on Microbial Threats. National Academies Press, Washington, DC2004Google ScholarEbola (2013)•10 600 deaths and a GDP loss of US$2·8 billion across Guinea, Liberia, and Sierra Leone5World Bank2014–2015 West Africa Ebola crisis: impact update.http://pubdocs.worldbank.org/en/297531463677588074/Ebola-Economic-Impact-and-Lessons-Paper-short-version.pdfGoogle ScholarZika (2015–16)•20 deaths6PAHOZika cases and congenital syndrome associated with Zika virus reported by countries and territories in the Americas, 2015–2017 cumulative cases.http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=38164&lang=enGoogle Scholar and an expected loss of US$3·5 billion in the Latin American and Caribbean region7World BankThe short-term economic costs of Zika in Latin America and the Caribbean (LCR). World Bank Group, Washington, DC2016Google Scholar H1N1 influenza (1918) •50 million deaths;1Taubenberger JK Morens DM 1918 influenza: the mother of all pandemics.Emerg Infect Dis. 2006; 12: 15-22Crossref PubMed Scopus (24) Google Scholar gross domestic product (GDP) loss of 3% in Australia, 15% in Canada, 17% in the UK, and 11% in the USA2Madhav N, Oppenheim B, Gallivan M, et al. Pandemics: risk, impacts, and mitigation. In: Jamison DT, Nugent R, Gelband H, et al, eds. Disease Control Priorities, 3rd edn, Volume 9. Washington, DC: World Bank (in press).Google Scholar Severe acute respiratory syndrome (SARS) (2003) •774 deaths;3Centers for Disease Control and PreventionFact sheet: basic information about SARS.https://www.cdc.gov/sars/about/fs-sars.pdfGoogle Scholar global economic loss of US$52·2 billion4Lee J-W McKibbin WJ Estimating the global economic costs of SARS.in: Knobler S Mahmoud A Lemon S Institute of Medicine Forum on Microbial Threats. National Academies Press, Washington, DC2004Google Scholar Ebola (2013) •10 600 deaths and a GDP loss of US$2·8 billion across Guinea, Liberia, and Sierra Leone5World Bank2014–2015 West Africa Ebola crisis: impact update.http://pubdocs.worldbank.org/en/297531463677588074/Ebola-Economic-Impact-and-Lessons-Paper-short-version.pdfGoogle Scholar Zika (2015–16) •20 deaths6PAHOZika cases and congenital syndrome associated with Zika virus reported by countries and territories in the Americas, 2015–2017 cumulative cases.http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=38164&lang=enGoogle Scholar and an expected loss of US$3·5 billion in the Latin American and Caribbean region7World BankThe short-term economic costs of Zika in Latin America and the Caribbean (LCR). World Bank Group, Washington, DC2016Google Scholar A limitation in assessing the economic costs of outbreaks is that they only capture the impact on income. Fan and colleagues8Fan VY Jamison DT Summers LH The inclusive cost of pandemic influenza risk.http://www.nber.org/papers/w22137Google Scholar recently addressed this limitation by estimating the “inclusive” cost of pandemics: the sum of the cost in lost income and a dollar valuation of the cost of early death. They found that for Ebola and severe acute respiratory syndrome (SARS), the true (“inclusive”) costs are two to three times the income loss. For extremely serious pandemics such as that of influenza in 1918, the inclusive costs are over five times income loss. The inclusive costs of the next severe influenza pandemic could be US$570 billion each year or 0·7% of global income (range 0·4–1·0%)8Fan VY Jamison DT Summers LH The inclusive cost of pandemic influenza risk.http://www.nber.org/papers/w22137Google Scholar—an economic threat similar to that of global warming, which is expected to cost 0·2–2·0% of global income annually. Given the magnitude of the threat, we call for scaled-up financing of international collective action for epidemic and pandemic preparedness. Two planks of preparedness must be strengthened. The first is public health capacity—including human and animal disease surveillance—as a first line of defence.9Sands PS Mundaca-Shah Dzau VJ The neglected dimension of global security—a framework for countering infectious-disease crises.N Engl J Med. 2016; 374: 1281-1287Crossref PubMed Scopus (154) Google Scholar Animal surveillance is important since most emerging infectious diseases with outbreak potential originate in animals. Rigorous external assessment of national capabilities is critical; WHO developed the Joint External Evaluation (JEE) tool specifically for this purpose.10WHOJoint external evaluation tool: International Health Regulations.http://apps.who.int/iris/handle/10665/204368Date: 2005Google Scholar Financing for this first plank will largely be through domestic resources, but supplementary donor financing to low-income, high-risk countries is also needed. The second plank is financing global efforts to accelerate research and development (R&D) of vaccines, drugs, and diagnostics for outbreak control, and to strengthen the global and regional outbreak preparedness and response system. These two international collective action activities are underfunded.11Schäferhoff M Fewer S Kraus J et al.How much donor financing for health is channelled to global versus country-specific aid functions?.Lancet. 2015; 386: 2436-2441Summary Full Text Full Text PDF PubMed Scopus (32) Google Scholar Medical countermeasures against many emerging infectious diseases are currently missing. We need greater investment in development of vaccines, therapeutics, and diagnostics to prevent potential outbreaks from becoming humanitarian crises. The new Coalition for Epidemic Preparedness Innovations (CEPI), which aims to mobilise $1 billion over 5 years, is developing vaccines against known emerging infectious diseases as well as platforms for rapid development of vaccines against outbreaks of unknown origin. The WHO R&D Blueprint for Action to Prevent Epidemics12WHOR&D Blueprint for Action to Prevent Epidemics.http://www.who.int/csr/research-and-development/blueprint/en/Google Scholar is a new mechanism for coordinating and prioritising the development of drugs and diagnostics for emerging infectious diseases. Consolidating and enhancing donor support for these new initiatives would be an efficient way to channel resources aimed at improving global outbreak preparedness and response. Crucial components of the global and regional system for outbreak control include surge capacity (eg, the ability to urgently deploy human resources); providing technical guidance to countries in the event of an outbreak; and establishing a coordinated, interlinked global, regional, and national surveillance system. These activities are the remit of several essential WHO financing envelopes that all face major funding shortfalls. The Contingency Fund for Emergencies finances surge outbreak response for up to 3 months. The fund has a capitalisation target of $100 million of flexible voluntary contributions, which needs to be replenished with about $25–50 million annually, depending on the extent of the outbreak in any given year. However, as of April 30, 2017, only $37·65 million had been contributed, with an additional $4 million in pledges.13WHOContingency Fund for Emergencies income and allocations.http://www.who.int/about/who_reform/emergency-capacities/contingency-fund/contribution/en/Google Scholar The WHO Health Emergencies and Health Systems Preparedness Programmes face an annual shortfall of $225 million in funding their epidemic and pandemic prevention and control activities.14WHOProgress report on the development of the WHO Health Emergencies Programme.http://www.who.int/about/who_reform/emergency-capacities/who-health-emergencies-programme-progress-report-march-2016.pdf?ua=1Date: 30 March 2016Google Scholar Previous health emergencies have shown that it can take time to organise global collective action and provide financing to the national and local level. In such situations, a global mechanism should offer a rapid injection of liquidity to affected countries. The World Bank's Pandemic Emergency Financing Facility (PEF) is a proposed global insurance mechanism for pandemic emergencies.15World BankPandemic Emergency Facility: frequently asked questions.http://www.worldbank.org/en/topic/pandemics/brief/pandemic-emergency-facility-frequently-asked-questionsGoogle Scholar It aims to provide surge funding for response efforts to help respond to rare, high-burden disease outbreaks, preventing them from becoming more deadly and costly pandemics. The PEF currently proposes a coverage of $500 million for the insurance window; increasing the current coverage will require additional donor commitments. In addition, the PEF has a $50–100 million replenishable cash window. As the world's health ministers meet this month for the World Health Assembly, we propose five key ways to help prevent mortality and economic shocks from disease outbreaks. First, to accelerate development of new technologies to control outbreaks, donors should expand their financing for CEPI and support the WHO R&D Blueprint for Action to Prevent Epidemics. Second, funding gaps in the WHO Contingency Fund for Emergencies and the WHO Health Emergencies Programme should be urgently filled and the PEF should be fully financed. Third, all nations should support their own and other countries' national preparedness efforts, including committing to the JEE process. Fourth, we believe it would be valuable to create and maintain a regional and country-level pandemic risk and preparedness index. This index could potentially be used as a way to review preparedness in International Monetary Fund article IV consultations (regular country reports by staff to its Board). Finally, we call for a new global effort to develop long-term national, regional, and global investment plans to create a world secure from the threat of devastation from outbreaks. This article summarises the recommendations of a workshop held at the National Academy of Medicine, Washington, DC, USA, co-hosted by the Center for Policy Impact in Global Health at Duke University, Durham, NC, USA and the Coalition for Epidemic Preparedness Innovations, Oslo, Norway. Participants' travel and accommodation were supported by the Center for Policy Impact in Global Health. BO is a consultant to Metabiota, a private company engaged in infectious disease risk modelling and analytical services. In this capacity, he has led the development of an index measuring national capacity to respond to epidemic and pandemic disease outbreaks.

The escalation of conflict in the Middle East coincides with an emerging trend of attacks on healthcare. Protection of health personnel, health services and humanitarian workers is no longer respected. This compromises the achievement of the United Nations Sustainable Development Goals 3 - towards health for all, and 16 - towards justice and peace. The Centre for Global Health at the University of Oslo, the Peace Research Institute Oslo and the Norwegian Red Cross co-organised a meeting exploring how conflict impacts health systems and potential solutions to protect and maintain health care services.

Abstract No Abstract

Abstract The exclusive rights of the coastal state over the natural resources in the exclusive economic zone ( EEZ ) coexist with the high seas freedoms of communication of other states. This particular coexistence of state competences is a distinguishing feature of the 200-mile zones. Articles 56(2) and 58(3) United Nations Convention on the Law of the Sea ( LOSC ) require that coastal states have ‘due regard’ to the rights, freedoms and duties of other states in the zone, and vice versa. It is suggested that the two provisions are not ‘dormant’. State practice indicates the contrary, as well as future paths for clarification. The obligation to have ‘due regard’ constitutes a linchpin in the conceptual underpinnings of the EEZ , and requires an interpretation of the concrete provisions that are applicable, in keeping with the Convention’s nature as a strategic ‘package deal’ with a particular bearing on international peace and security.

Public health voluntary licensing of intellectual property has successfully been applied to increase access to medicines in certain disease areas, producing health benefits and economic savings, particularly in low-income and middle-income countries. There is however limited understanding of the intricacies of the approach, the modalities by which it works in practice, its levers and the trade-offs made. Such knowledge may be critical in deciding what role licensing should have in pandemic preparedness and equitable access to health technologies more broadly. This paper examines the case for licensing, the considerations for balancing public health needs, the challenges of negotiations, and the processes for validating proposed agreements. No access mechanism is perfect, but evidence suggests that public-health licensing has an important role to play, although it remains underused. Understanding some of the realities, strengths, limitations and complexities of applying the model may help calibrate expectations and develop incentives to expand its applications.

The success of the Millennium Development Goals (MDGs)1UNThe Millennium Development Goals report 2013. United Nations, New York2013Crossref Google Scholar on health has been due to their being easy to understand, ambitious, and achievable and, therefore, suitable for the purposes of advocacy and political mobilisation. The MDGs have brought quantitative targets and measurement of results—previously the domain of the scientific community—to centre stage for politicians worldwide. The three health MDGs (MDG 4, MDG 5, and MDG 6) have acted as a scorecard to measure progress on health, thus providing an empirical basis for the formulation of policy. For example, this scorecard has made it possible for Norwegian Prime Minister Erna Solberg and her colleagues in the MDG Advocacy Group to provide such strong advocacy for continued efforts to reach the MDGs before the deadline of 2015.Work on the health MDGs has been based throughout on close collaboration between the scientific and political communities. Politicians have been able to convey documented progress towards the goals to the general public, and voters in both donor and recipient countries alike have been happy to support public funding for these efforts.The world community is currently negotiating a new set of goals—the Sustainable Development Goals (SDGs)—for the post-2015 period. So far, 17 goals and 169 targets have been proposed by the Open Working Group.2Sustainable Development PlatformOutcome Document—Open Working Group on Sustainable Development Goals.http://sustainabledevelopment.un.org/focussdgs.htmlDate: 2014Google Scholar For politicians this number of goals is far too many. To win popular support for a comprehensive and coordinated effort for development, the goals must be easy to communicate. With regard to health, we have faced the additional challenge of combining three goals into one SDG, with an attempt to put the whole range of health issues under one coherent goal. This process, in turn, has contributed to the present "shopping list" of 13 targets within the Open Working Group proposal for a goal on health (SDG 3): "ensure healthy lives and promote well-being for all at all ages".Of course, it is politics that led to such a long list of health targets in the first place, but ultimately it is politics that has to resolve this situation. Politicians have to set priorities. We need a more limited set of goals and targets that are ambitious, easy to understand, and realistic. Importantly, measurement of progress towards the goals and targets must also be possible. To this end, we need contributions from the scientific community.One plausible way forward is shown in a Lancet study by Ole Norheim and colleagues3Norheim OF Jha P Admasu K et al.Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health.Lancet. 2014; (published online Sept 19.)http://dx.doi.org/10.1016/S0140-6736(14)61591-9Google Scholar on quantification of the overarching 2030 SDG for health to avoid 40% of premature deaths in each country. In their review of mortality rates and trends in 25 countries, four country income groupings, and worldwide, Norheim and colleagues show that it is possible to consolidate targets in various areas, such as child health (MDG 4), maternal health (MDG 5), major infectious diseases (MDG 6), non-communicable diseases (NCDs), including mental health and injuries, and universal health coverage, under one universal and quantitative health goal. The simplicity of this approach is beautiful. Following this pattern, we could develop a tool to measure convergence in health globally, in line with the principle of universality to which we are all committed.This approach seems to make sense from a scientific point of view as well. The proposal to set an overall indicator of avoiding 40% of premature deaths in each country is based on trends in mortality rates over the past 40 years and an estimate of what can be achieved by scaling up current cost-effective approaches. This quantification of a goal on health includes the major targets relating to MDGs 4, 5, and 6 and targets on NCDs proposed by the various communities, notably a 25% reduction in premature mortality from NCDs by 2025. This indicator is evidence based and ambitious yet achievable. It is, therefore, a good starting point for future political action and initiative.Norheim and colleagues' study3Norheim OF Jha P Admasu K et al.Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health.Lancet. 2014; (published online Sept 19.)http://dx.doi.org/10.1016/S0140-6736(14)61591-9Google Scholar shows what an important part science could play in the negotiations at the 69th Session of the UN General Assembly. We, therefore, strongly urge the medical community to consider the approach outlined by Norheim and colleagues3Norheim OF Jha P Admasu K et al.Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health.Lancet. 2014; (published online Sept 19.)http://dx.doi.org/10.1016/S0140-6736(14)61591-9Google Scholar and develop a common position that can enable us to arrive at a single health SDG with a limited number of simple, understandable, and measurable targets. We would also welcome similar approaches for other SDGs by the relevant communities.We believe that the health SDG could provide the key framework for global health and prosperity. In anticipation of this framework, Norway is already taking concrete action. First, we are taking steps to improve public health in Norway. Our aim is to reduce NCDs, including mental disorders, by 25% by 2025. Second, Norway is working together with partner nations, the UN Secretary-General Ban Ki-moon, and World Bank President Jim Yong Kim to develop financial frameworks both for the current MDGs and for the future SDGs. Third, Norway is actively promoting projects that focus on both education and health, reflecting the aim of the SDG agenda of realising synergies between sectors. Fourth, later in September, 2014, we will launch a national initiative called Vision 2030 to encourage researchers, commercial actors, civil society, and others to produce innovative ideas that could play a part in achieving the education and health SDGs both in Norway and abroad. Finally, together with partners in global health, Norway will explore ways to accelerate the deployment of innovations that are currently in the pipeline, and how investments can be catalysed to harness these innovations for promoting global health in the longer term.4Furtwangler T Help us envision how innovation will change the world. PATH blog.http://www.path.org/blog/2014/08/envision-innovationDate: Aug 27, 2014Google ScholarWith so much left to do in the field of global health, by scientists as well as politicians, there is no time to lose. It is, therefore, vital that we all take action now.BB is Norwegian Minister of Foreign Affairs. BH is Norwegian Minister of Health and Care Services. The success of the Millennium Development Goals (MDGs)1UNThe Millennium Development Goals report 2013. United Nations, New York2013Crossref Google Scholar on health has been due to their being easy to understand, ambitious, and achievable and, therefore, suitable for the purposes of advocacy and political mobilisation. The MDGs have brought quantitative targets and measurement of results—previously the domain of the scientific community—to centre stage for politicians worldwide. The three health MDGs (MDG 4, MDG 5, and MDG 6) have acted as a scorecard to measure progress on health, thus providing an empirical basis for the formulation of policy. For example, this scorecard has made it possible for Norwegian Prime Minister Erna Solberg and her colleagues in the MDG Advocacy Group to provide such strong advocacy for continued efforts to reach the MDGs before the deadline of 2015. Work on the health MDGs has been based throughout on close collaboration between the scientific and political communities. Politicians have been able to convey documented progress towards the goals to the general public, and voters in both donor and recipient countries alike have been happy to support public funding for these efforts. The world community is currently negotiating a new set of goals—the Sustainable Development Goals (SDGs)—for the post-2015 period. So far, 17 goals and 169 targets have been proposed by the Open Working Group.2Sustainable Development PlatformOutcome Document—Open Working Group on Sustainable Development Goals.http://sustainabledevelopment.un.org/focussdgs.htmlDate: 2014Google Scholar For politicians this number of goals is far too many. To win popular support for a comprehensive and coordinated effort for development, the goals must be easy to communicate. With regard to health, we have faced the additional challenge of combining three goals into one SDG, with an attempt to put the whole range of health issues under one coherent goal. This process, in turn, has contributed to the present "shopping list" of 13 targets within the Open Working Group proposal for a goal on health (SDG 3): "ensure healthy lives and promote well-being for all at all ages". Of course, it is politics that led to such a long list of health targets in the first place, but ultimately it is politics that has to resolve this situation. Politicians have to set priorities. We need a more limited set of goals and targets that are ambitious, easy to understand, and realistic. Importantly, measurement of progress towards the goals and targets must also be possible. To this end, we need contributions from the scientific community. One plausible way forward is shown in a Lancet study by Ole Norheim and colleagues3Norheim OF Jha P Admasu K et al.Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health.Lancet. 2014; (published online Sept 19.)http://dx.doi.org/10.1016/S0140-6736(14)61591-9Google Scholar on quantification of the overarching 2030 SDG for health to avoid 40% of premature deaths in each country. In their review of mortality rates and trends in 25 countries, four country income groupings, and worldwide, Norheim and colleagues show that it is possible to consolidate targets in various areas, such as child health (MDG 4), maternal health (MDG 5), major infectious diseases (MDG 6), non-communicable diseases (NCDs), including mental health and injuries, and universal health coverage, under one universal and quantitative health goal. The simplicity of this approach is beautiful. Following this pattern, we could develop a tool to measure convergence in health globally, in line with the principle of universality to which we are all committed. This approach seems to make sense from a scientific point of view as well. The proposal to set an overall indicator of avoiding 40% of premature deaths in each country is based on trends in mortality rates over the past 40 years and an estimate of what can be achieved by scaling up current cost-effective approaches. This quantification of a goal on health includes the major targets relating to MDGs 4, 5, and 6 and targets on NCDs proposed by the various communities, notably a 25% reduction in premature mortality from NCDs by 2025. This indicator is evidence based and ambitious yet achievable. It is, therefore, a good starting point for future political action and initiative. Norheim and colleagues' study3Norheim OF Jha P Admasu K et al.Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health.Lancet. 2014; (published online Sept 19.)http://dx.doi.org/10.1016/S0140-6736(14)61591-9Google Scholar shows what an important part science could play in the negotiations at the 69th Session of the UN General Assembly. We, therefore, strongly urge the medical community to consider the approach outlined by Norheim and colleagues3Norheim OF Jha P Admasu K et al.Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health.Lancet. 2014; (published online Sept 19.)http://dx.doi.org/10.1016/S0140-6736(14)61591-9Google Scholar and develop a common position that can enable us to arrive at a single health SDG with a limited number of simple, understandable, and measurable targets. We would also welcome similar approaches for other SDGs by the relevant communities. We believe that the health SDG could provide the key framework for global health and prosperity. In anticipation of this framework, Norway is already taking concrete action. First, we are taking steps to improve public health in Norway. Our aim is to reduce NCDs, including mental disorders, by 25% by 2025. Second, Norway is working together with partner nations, the UN Secretary-General Ban Ki-moon, and World Bank President Jim Yong Kim to develop financial frameworks both for the current MDGs and for the future SDGs. Third, Norway is actively promoting projects that focus on both education and health, reflecting the aim of the SDG agenda of realising synergies between sectors. Fourth, later in September, 2014, we will launch a national initiative called Vision 2030 to encourage researchers, commercial actors, civil society, and others to produce innovative ideas that could play a part in achieving the education and health SDGs both in Norway and abroad. Finally, together with partners in global health, Norway will explore ways to accelerate the deployment of innovations that are currently in the pipeline, and how investments can be catalysed to harness these innovations for promoting global health in the longer term.4Furtwangler T Help us envision how innovation will change the world. PATH blog.http://www.path.org/blog/2014/08/envision-innovationDate: Aug 27, 2014Google Scholar With so much left to do in the field of global health, by scientists as well as politicians, there is no time to lose. It is, therefore, vital that we all take action now. BB is Norwegian Minister of Foreign Affairs. BH is Norwegian Minister of Health and Care Services. Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for healthModerate acceleration of the 2000–10 proportional decreases in mortality could be feasible, achieving the targeted 2030 disease-specific reductions of two-thirds or a third. If achieved, these reductions avoid about 10 million of the 20 million deaths at ages 0–49 years that would be seen in 2030 at 2010 death rates, and about 17 million of the 41 million such deaths at ages 0–69 years. Such changes could be achievable by 2030, or soon afterwards, at least in areas free of war, other major effects of political disruption, or a major new epidemic. Full-Text PDF Open Access

As part of the PLoS Medicine series on Global Health Diplomacy, Sigrun Møgedal and Benedikte Alveberg provide a diplomatic perspective on how foreign policy can make a difference to global health challenges.

Establishing separate executive bodies of a confederation or of a nascent federation of states (outside a council of ministers) seems in many respects to be the 'hard case' of institution building. The reason for this may be that it creates a capacity for action and execution of policies and not just for talk and formal decision making and that the action of separate executive bodies may be perceived as particularly threatening by constituent governments less eager to transfer power upward. It seems to have been easier to form (parliamentary) assemblies and courts of justice.

BACKGROUND: Several countries allocate official development assistance (ODA) for research on global health and development issues that is initiated in the donor country. The integration of such research within domestic research systems aligns with efforts to coordinate ODA investments with science, technology and innovation policies towards achieving the Sustainable Development Goals (SDGs). METHODS: Through a document synthesis and interviews with research funders in ODA donor and recipient countries, we evaluated the performance of this funding approach across seven donor-country programmes from five donor countries and examined the institutional design elements that increase its chances of advancing development goals and addressing global challenges. RESULTS: We found that carefully designed programmes provide a promising pathway to producing valuable and contextually relevant knowledge on global health and development issues. To achieve these outcomes and ensure they benefit ODA-receiving countries, programmes should focus on recipient-country priorities and absorptive capacity; translate research on global public goods into context-appropriate technologies; plan and monitor pathways to impact; structure equitable partnerships; strengthen individual and institutional capacity; and emphasize knowledge mobilization. CONCLUSIONS: Global health and development research programmes and partnerships have an important role to play in achieving the SDGs and addressing global challenges. Governments should consider the potential of ODA-funded research programmes to address gaps in their global health and development frameworks. In the absence of concrete evidence of development impact, donor countries should consider making increases in ODA allocations for research additional to more direct investments that have demonstrated effectiveness in ODA-receiving countries.

(1994). Whaling: A Sustainable Use of Natural Resources or a Violation of Animal Rights? Environment: Science and Policy for Sustainable Development: Vol. 36, No. 7, pp. 12-31.

When the Consultative Parties started their herculean task of creating a minerals regime for the Antarctic in 1981 nobody believed that commercial activity was imminent. On the contrary, it was a common view that such activity, if it were ever to take place, would certainly not occur until well into the next century. It was regularly pointed out that cost, climatic and operating conditions, distance, availability elsewhere, as well as technological difficulties all led to the same conclusion. Representatives of petroleum companies were somewhat bemused when asked whether their companies entertained plans about Antarctic endeavours. Neither the general public nor most politicians showed much interest in this esoteric subject1.

The 2006 Highly Pathogenic Avian Influenza (HPAI) outbreak in Egypt saw the adoption of a fierce stamping-out policy with the culling of 30 million birds in a matter of weeks. This was coupled with an ad hoc compensation scheme that led to wide misuse and rapid depletion of allocated funds. Since September 2006, no compensation has been paid.HPAI in Egypt is now believed to be endemic and a comprehensive, transparent and fair compensation policy is needed to encourage disease reporting. With or without compensation, rehabilitation of the poultry producing units will occur. Strong veterinary engagement in the start up activities of small producers could be a means to improve biosecurity and establish trust. This paper outlines FAO's activities related to an extensive exercise undertaken to support the government of Egypt in formulating and implementing a compensation policy and strategy, which ensures that poor backyard poultry producers (usually women) are fairly compensated; and an investigation into how smallholder poultry producer rehabilitation activities are currently operating and how these activities can be supported.

Abstract The article explores the current stagnation in multilateral law-making based on an analysis of recent treaty attempts across various subfields of international law. It further examines why the law of the sea has continued to evolve despite this trend. The article demonstrates that states still regularly seek multilateral treaties to address new challenges. While there is some evidence of general treaty saturation, it is the current inability of traditional great powers to negotiate new binding norms which is the most constraining factor on multilateral law-making. This in turn is related to deeper geopolitical shifts by which traditional great powers, notably the United States and its allies, have seen their relative influence decline. Until the current great power competition ends or settles into a new mode of international co-operation, new multilateral treaties with actual regulatory effect will rarely emerge. The law of the sea has avoided the current trend of stagnation for primarily three reasons (i) a global commitment to the basic tenets of the law of the sea; (ii) a legal framework that affords rights and obligations somewhat evenly disbursed, allowing less powerful states to use their collective leverage to advance multilateral negotiations, despite intermittent great power opposition; and (iii) the avoidance of entrenched multilateral forums where decisions are reached by consensus only.

Abstract In the summer of 2006 Norway carried out enforcement measures on the high seas against a fishing vessel that was assimilated to a ship without nationality. Afterwards, cooperation was moreover established with a new flag State and a port State. The course of events provides a rare illustration of the practical relevance of rules on stateless vessels, including in the context of the UN Fish Stocks Agreement of 1995.

Abstract In line with Norway's overall rights-based approach to development, education is regarded as a human right. It is a precondition for economic, social and cultural development. Quality education is the most important weapon against poverty. In keeping with the main targets of Education for All (Dakar 2000) and the relevant MDGs (Millenium Development Goals), Norway emphasises in particular education for girls, support for vulnerable groups, as well as good teachers and textbooks. While primary education remains Norway's main focus, a holistic approach is applied towards the development of the education sector. As for other areas within development co-operation, Norway will use multilateral organisations, governments and NGOs as channels for its support to the education sector. Principles of harmonisation and co-ordination on the part of international donors must apply, as well as a clear focus on national ownership. Furthermore, strengthening developing countries' administrative capacity and institutional systems is an essential part of contributing to the sustainable development of the education sector, and remains a Norwegian priority.

Click to increase image sizeClick to decrease image size Notes 1 Kvistad, Det unge Norges fylking klar til slag. 2 Kirkebæk, Schalburg.

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