Nordic health co-operation

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Karin Beate Nøsterud/
The Nordic Region is in good health. The average life expectancy in the region is greater than 80 years, and more of us are staying healthier for longer. Infant mortality in the Nordic countries is among the lowest in the world, with all five countries among the top 20, and four of them in the top five or six.

There has proven to be great interest in increased Nordic co-operation in the health-care and social care sector.

Former Swedish minister Bo Könberg has written an independent report on how Nordic co-operation on health can be developed and underpinned over the next five to ten years. He puts forward 14 concrete proposals for future Nordic co-operation on health:

From the outset the report stresses that these proposals depend on the identification of which health-care and social-care issues are best served through Nordic co-operation. In addition, there must be an assessment of the issues that are best handled at a European level. 

Since the report was presented to the Nordic Council of Ministers in 2014, the Nordic ministers for health and social affairs have regularly discussed and decided to implement initiatives related to the report’s proposals. The proposals and their current status are outlined below.


1. Adopt robust measures against increasing antibiotic resistance

Reduce the use of antibiotics in the Nordic Region to the lowest level in Europe within five years. Provide economic stimuli for research on new antibiotics.

Status: In 2016 the Nordic Council of Ministers for Health and Social Affairs (MR-S) established a cross-sectoral Nordic strategy group together with the Nordic Ministers for Food and Agriculture to combat antimicrobial resistance. The group will support international efforts and joint Nordic efforts to combat antimicrobial resistance. In addition, Nordic experts in this field will meet regularly and provide the strategy group with prioritised recommendations. The Norwegian presidency of the Nordic Council of Ministers in 2017 has also initiated a project to develop a common Nordic generic communication plan for antibiotic resistance.


2. Boost co-operation on highly specialised treatments in the Nordic Region

Establish a high-level Nordic standby team for regular dialogue between the countries regarding the needs and potential for co-operation in this area. 

Status: The Committee of Senior Officials for Health and Social Affairs (EK-S) has appointed a Nordic group for highly specialised treatment. The group started its work in 2016. The group consists of representatives from the Nordic health authorities and will consolidate and support Nordic co-operation in this area.


3. Establish a Nordic network for rare diagnoses Create a network for future-oriented co-operation on rare diagnoses to underpin and better co-ordinate current and new joint efforts.

Status: The Committee of Senior Officials for Health and Social Affairs (EK-S) has established a Nordic network for rare diseases. The group started its work in 2016. The network is tasked with developing existing and new forms of Nordic co-operation on rare diseases, initiating Nordic co-operation in the area, and improving the coordination of joint initiatives.


4. Establish a Nordic virtual centre for registration-based research

Strengthen research co-operation on data registers, biobanks, and clinical intervention studies. Introduce a model for mutual recognition of ethical tests for Nordic research projects.

Status: The Norwegian presidency of the Nordic Council of Ministers in 2017 has initiated a three-year priority project: “Nordic research co-operation for better health”. The project includes several activities relating to this proposal.


5. Increase co-operation regarding measures to improve public health

Increase the sharing of experiences with regard to public-health issues, particularly with regard to the use of tobacco and alcohol abuse.

Status: The Nordic ministers for health and social affairs have decided to address proposals 5 and 6 together (see status below).


6. Establish a Nordic public-health policy platform to reduce inequalities in health

Create a platform for proposals for Nordic projects and activities aimed at reducing inequalities in health.

Status: The Nordic ministers for health and social affairs have decided to address proposals 5 and 6 together. In 2016 they agreed to establish a Nordic public health arena consisting of representatives from the Nordic ministries responsible for public health issues. The arena will help to support policy development and the implementation of measures that promote good and equal health in the individual countries. The Nordic Centre for Welfare and Social Issues serves as the secretariat for the arena.


7. Increase patient mobility in the Nordic Region

Evaluate the effect on patients of the Nordic countries’ implementation of the EU Patient Mobility Directive, and work to increase patients’ right to treatment and care in another Nordic country.

Status: The proposal is expected to be addressed by the council of ministers in the future.


8. Strengthen co-operation on welfare technology

Create common Nordic definitions and common guidelines for welfare technology, with the aim of harmonising standards for welfare technology products. Involve users in the development process.

Status: The proposal is expected to be addressed by the council of ministers in the future.


9. Increase co-operation on eHealth

Continued co-operation on e-prescriptions. Create an online Nordic health library and develop a Nordic search tool for “Min patient”.

Status: The proposal is expected to be addressed by the council of ministers in the future.


10. Bolster Nordic co-operation in the field of psychiatry

Hold annual Nordic summits in the field of psychiatry, increase knowledge procurement, and improve exchanges of experience of models for best practice.

Status: The council of ministers has appointed a Nordic working group in the area of psychiatry, which will develop a framework for ongoing Nordic co-operation on initiatives for people with mental illnesses. The group has the objective of organising a Nordic summit every other year. The Danish presidency of the Nordic Council of Ministers held a Nordic summit on psychiatry in 2015, and the Norwegian presidency held a summit on mental health in Oslo in February 2017.


11. Increase the mandate for co-operation within the field of health preparedness

Increase the mandate for the existing health preparedness group (the Svalbard group) and include all aspects within the framework for Nordic co-operation on health preparedness.

Status: The Nordic health preparedness group has been given a new and expanded mandate as of 1 January 2017.


12. Expand Nordic pharmaceutical co-operation to boost cost-efficiency and improve safety

Create a joint dispensary for uncommon drugs and increase co-operation on rare drugs. Increase the exchange of information on purchasing agreements and applications for new drugs.

Status: A survey of the Nordic countries’ experience in the pharmaceutical sector was conducted in 2016. The survey and its conclusions were presented to the council of ministers in March 2017, which decided to appoint a Nordic working group for the exchange of information and experience regarding prices and subsidies in the area of pharmaceuticals.


13. Establish a new Nordic exchange of officials

Reinforce the existing agreement on the exchange of officials through a three-year pilot project that facilitates shorter exchange periods for officials working with health issues in relevant ministries.

Status: A pilot project enabling short exchanges of officials within the Nordic ministries for health and social affairs began in 2015 and was evaluated at the end of 2016. Based on this evaluation, the council of ministers has decided to extend the project through 2017 and to consider the possibility of including these kinds of exchanges as part of the regular exchange programme.


14. Establish Nordic co-operation between national experts in the European Commission

Enter into new, informal co-operation on the appointment of national experts in the field of health and social affairs to the European Commission, in order to improve utilisation of the countries’ resources.

Status: At its meeting in March 2017, the council of ministers decided to continue working with this proposal.

The Nordic Council of Ministers’ action plan for Vision 2030

The action plan describes how the Nordic Council of Ministers will work to achieve the objectives of the vision through a series of initiatives linked to the vision’s three strategic priorities: a green Nordic Region, a competitive Nordic Region, and a socially sustainable Nordic Region. There are 12 objectives linked to the strategic priorities. The strategic priorities and objectives govern all the activities of the Nordic Council of Ministers over the next four years. The action plan is divided into 12 sections, each one linked to one of the 12 objectives.