Norway - Global health

Global health remains a key priority, with Norway taking international leadership on multilateral initiatives

 

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Norway’s official development assistance (ODA) to health stood at US$639 million in 2020, making it eighth-largest Organisation for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC) donor to health in absolute terms. This represented 15% of its total ODA, above the DAC average of 10%, putting Norway in seventh place among OECD DAC countries. Health ODA has increased by 38% between 2019 and 2020, after remaining at a rather stable level in previous years. The increase can largely be explained by the additional funding dedicated toward combatting COVID-19 and its impacts in low-income countries.  

For 2022, the government’s budget line for health ODA stands at NOK3.9 billion (US$415 million) remaining at a stable level over the past few years. It is important to note that this budget line only covers parts of Norway’s total health contributions (additional funding comes from multilateral and bilateral cooperation budget lines).   

In 2021, NOK 2.9 billion (US$308 million) was earmarked for fighting the pandemic and its consequences for developing countries. Of this, NOK 2.3 billion (US$244 million) went to the health sector, including Norway’s delivery of 6.6 million COVID-19 vaccines globally, valued at NOK 380 million (US$40 million). Norway has also been particularly supportive of the Access to COVID-19 Tools Accelerator (ACT-A). It is one of its four leaders (along with South Africa, the WHO, and the European Commission), and by August 2022 has pledged a total of US$727 million to the facility. The majority of this funding (US$496 million) goes toward the ACT-A vaccine pillar. (Note that not all ACT-A funding is reportable as ODA).  

Over the past ten years, Norway has been an international champion and influential actor in the field of global health. Prime Minister Jonas Gahr Støre is committed to maintaining health as a key priority. His government’s ambition is to contribute to stronger international health cooperation and strengthened global health preparedness so that the world can prevent, detect, and respond quickly to new or persistent threats of infection and the development of resistance.  

Global health is one of five development policy priorities spelled out in the Ministry of Foreign Affairs’ (MFA) 2016 white paper, ‘Common responsibility for a common future – the Sustainable Development Goals and Norwegian Development Policy.’ The strategy paper ‘Global health in foreign and development policy’ (2012)—which remains the most comprehensive summary of Norway’s focus areas in global health—outlines three priorities for the sector: 1) Mobilizing at an international level for women’s and children’s rights and health; 2) reducing the burden of disease, with an emphasis on prevention; and 3) promoting human security through health. 

In early 2020, the Norwegian government published its strategy specifically on non-communicable diseases, titled ‘Combating Non-Communicable Diseases in the Context of Norwegian Development Policy’ (2020-2024). This document highlights three priorities: 1) preventing and reducing risk; 2) strengthening health systems, with a focus on primary healthcare; and 3) supporting global public goods. Norway increased its support for combating non-communicable diseases beginning in 2021, entering a two-year agreement with the World Health Organization (WHO) to allocate NOK220 million (US$26 million) to activities addressing cardiovascular diseases, cancer, diabetes, respiratory diseases, and mental health conditions in low- and middle-income countries. Norway also tackles global health issues through its work on gender equality. Core components are sexual and reproductive health and rights (SRHR; for more details see our Donor Tracker’s insights piece: ‘Generation Equality? Trends from a decade of donor funding for SRHR’), maternal health, and safe and legal abortions.  

In addition, health is a key component of Norway’s humanitarian efforts. In its 2018 humanitarian strategy, the government committed to supporting lifesaving and basic health services in connection with Norway’s humanitarian efforts. This commitment aimed to increase support for SRHR in crisis situations, as well as to promote closer coordination between humanitarian and development efforts in health. 

In line with its overall ODA policy, much of Norway’s funding for health goes through the multilateral system. In 2020, Norway channeled 41% of its total health ODA as core contributions to multilaterals (DAC average: 44%). In addition, it provided 34% as earmarked funding through multilateral organizations (funding channeled through multilateral organizations, but earmarked by Norway for a specific purpose). Norway’s commitment to multilateral funding for global health was cemented in the white paper entitled ‘Norway’s Role and Interests in Multilateral Cooperation,’ published in June 2019. 

Key multilateral partners include Gavi, the Vaccine Alliance (Gavi; 21% of Norway’s health ODA in 2020) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund; 13%). In 2020, Norway announced a pledge of US$683 million in direct contributions to Gavi for 2021-2025. Norway also committed US$326 million to Gavi’s International Finance Facility for Immunisation (IFFIm) over 10 years, and US$24 million to the Matching Fund for 2021-2025. Norway has pledged US$141 million for phase I and II of Gavi COVAX Advance Market Commitment (AMC), and another US$56 million for phase III. This includes Direct Contributions, IFFIm proceeds (US$116 million) and matched contributions. Norway’s pledge for the Global Fund amounts to US$303 million for 2020 to 2022.  

Other important multilateral recipients of Norway’s ODA include the United Nations Population Fund (UNFPA; 3% of Norway’s health ODA in 2020), and the Global Financing Facility (GFF). In November 2018, Norway co-hosted the GFF replenishment conference (of which it is a founding member) and pledged US$360 million to the organization for the 2019-2023 period, the largest commitment made by any donor.  

In 2020, Norway’s bilateral ODA to health amounted to US$374 million according to OECD data. However, 59%, or US$219 million, of this was channeled as earmarked funding through multilaterals, which is reported to the OECD as bilateral ODA. This share has been steadily increasing since 2015, when it stood at 47%. Bilateral ODA investments focus on COVID-19 control (40% in 2020), basic health care (19%), infectious disease control (9%), health policy and administration (8%), and reproductive healthcare (7%).  

Strategic orientation for global health is set within the MFA 

The MFA traditionally sets Norway’s global health priorities. Norway’s Ambassador and Permanent Representative to the United Nations (UN) and other international organizations in Geneva, is a key actor in the implementation of Norway’s multilateral funding for health. The Mission in Geneva represents Norway at the World Health Organization (WHO) and participates in the governance of global health organizations. Within the MFA, the Department for Sustainable Development has a ‘Section for Global Health, Education and Inclusion,’ which has responsibility over global health investments. Bilateral global health programs are handled directly by the individual bilateral departments, under the Department of Regional Affairs. At Norad, global health issues fall under the mandate of the Department of Global Health and Education. Norad manages funds in accordance with annual allocations from the MFA.