Today’s role, challenges and future issues.
Medicor has caught up with the Swedish ambassador for Global Health, Anders Nordström, to further discuss the role of Sweden in global health and foreign aid.The Swedish Ministry of Foreign Affairs comprises numerous international and experienced staff members; Anders Nordström is one of them. Graduating as a medical doctor from Karolinska Institute, he then undertook a number of work placements that would take him around the globe. Anders Nordström began his career with the Red Cross in Cambodia; he then worked for SIDA and subsequently he was recruited by WHO where he worked for five years in Geneva. He is now the Swedish ambassador for Global Health within the Ministry of Foreign Affairs. In his latest job position, he acts as an active board member for two international organizations: GOBI and the Global Fund for AIDS, TB and Malaria, as well as representing Sweden in global health policy work.
The global agenda and the new epidemic of non-communicable diseases (NCDs) in low and middle income countries were at the centre of the discussion. There has been an explosion in NCDs in the past decade in regions that are still struggling with weak economic growth, high levels of corruption and high illiteracy rates. Places in which there was practically no diabetes 20 years ago, are now reporting much higher disease prevalence. According to Nordström: “The Global agenda has been focusing on survival rather than prevention lately; reducing child mortality, reducing maternal mortality and lowering the burden of AIDS, TB and malaria. However, there is need to focus more on long term prevention given the epidemic of non-communicable diseases (NCDs) in low and middle income countries”.
Physical activity, a healthy diet and changing the attitude of people is what is needed; however, it is the poorest people who suffer the most from NCDs. There is a trend is in place, whereby when most economically disadvantaged people get a little extra cash, they will purchase a coke and a hamburger; if they get a little more they will buy cigarettes; and if they have even more, they’ll buy a car. All of these activities are unhealthy and risk factors for developing NCDs. The trend goes hand in hand with the economic boom in China, India, South-East Asia, Latin America and parts of Sub-Saharan Africa. Changes of attitude cannot occur without a change in society and in most low and middle income countries, this change in society is something that cannot be predicted and may take generations in order to occur.
“Infrastructures are needed now more than ever in order to face the increase of NCDs”, argues Nordström. Infrastructures that are now used for treatment of HIV/AIDS, which is currently considered a chronic disease, could be used for the treatment and diagnosis of NCDs.
From a development perspective, little has been done so far in the field of NCDs by Sweden; however, “it is beginning to take off now,” Nordström affirms. One of the Swedish priorities in the aftermath of the Millennium Development Goals (MDGs) is to put NCDs on the global agenda. This process will take time and effort, however, it is a process that will begin soon enough.
Moreover, the MDGs have achieved great success in lowering maternal mortality, increasing new-born health and lowering the burden of malaria, TB and HIV/AIDS; however, great failures have also occurred. Whereas, for instance maternal and new-born health has been increased greatly in Uganda, HIV/AIDS has also spiked up to a 7.2% national prevalence. In Zimbabwe, maternal mortality is at its highest now- five times higher than 20 years ago. According to Nordström “political leadership is the reason why in some regions MDGs have not yet been achieved”. In those regions that are dealing with ongoing conflicts, aftermath of conflicts, weak capacity and weak leadership, we understand that the MDGs are far from being reached; DRC and Somalia for instance. Nonetheless, there have been also remarkable exceptions such as Afghanistan, considering its poor security on the ground, and economy. Furthermore, where there has been strong political leadership and good management, a progress has been recorded in the achievement of the MDGs; Ethiopia is a good example of good management and good leadership.
However, the situation and attitude is different in every country and varies even within countries. According to Nordström: “Botswana has not done well in lowering the rate and incidence of HIV/AIDS considering that it is one of the most politically stable and economically developed country in Sub-Saharan Africa. They have just not addressed the issue efficiently”.
Moreover, when discussing the future challenges of global health, the rise of NCDs and mental diseases are undoubtedly the future tasks that the global agenda needs to address. People are now living longer and getting richer; therefore obesity, cardiovascular diseases and diabetes are on the rise. Lastly, “Prevention and management of diseases”, he added “need to be tackled in the future by cooperation rather than just foreign aid. We have to cooperate with other countries in order to face future challenges and outbreaks”.