GDP, at some 8-9 per cent. Sweden now spends about 10 per cent on health and the USA is spending around 17 per cent, but, as Könberg points out, Sweden still maintains “a good service”. In fact, he says, Sweden still out-performs many countries in the world and if you look at life expectancy, child mortality and other indicators, then the Nordic region as a whole performs very well on the global scale. So while money spent on health is clearly a factor in
the quality of service, policy, strategy and available expertise also play their parts – and this is why Könberg believes cooperation in the region is so important. “It makes sense to cooperate when we have a relatively low population in the region,” he explains. “The country with the highest population is Sweden and that is only around 10 million people,” he continues. “And with modern medical technology it makes
sense expertise to rather share research, than concentrate resources and them in one
country – and this is particularly the case when dealing with highly developed medical technologies.
face, not only in the Nordic countries, but all over the world. “This is why I made the investment into research development
and of new antibiotics my first
recommendation in the report,” he says. “It may be the best way we can avoid a catastrophic future.” Könberg, of course, is not alone in his gloomy
outlook of antibiotic resistance. A number of studies since his recommendation was made have, in fact, concluded that the situation is getting worse and more urgent action is needed. It is clear that regional and global cooperation is needed to address this issue. As he put it in his report, we need to take “vigorous measures against increasing antibiotic resistance”. The report makes 14 recommendations in total and
the Council of Ministers selected five proposals on which to focus. “My brief was to make proposals that would be
“Investment into research and
Bo Könberg development of new
antibiotics was my first recommendation in the report”
“It seems to me,” he continues, “that investments
into this technology
should not be made by individual countries before they speak with the other countries in the region. That way, the pooling of resources and the setting up of centres of excellence can take place, which is sensible and much more efficient when populations are small as they are in each country.” Despite his inside knowledge of
Nordic health systems and the received wisdom that the systems were generally good,
when Könberg started working on his report, he says he was “shocked” by the situation he discovered in relation to antibiotics and in particular the growing resistance to them. This, he believes, is one of the greatest health challenges we
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possible to implement within five to 10 years so I was pleased with the fact that after only a few months the council was able to select five, plus the antibiotics issue,” says Könberg. “That, to me, seems like a realistic selection for now. I hope that further recommendations can be looked at in the future.” The five recommendations of areas that would
benefit from further Nordic cooperation that the council selected were:
• Highly specialised treatments – linking a new Nordic review group for future projects to the Council of Ministers to ensure that cooperation projects are increasingly part of national strategies for specialised treatments, promoting efficiency, quality and the better use of economic resources.
• Rare diagnoses – calling for a a Nordic network for forward-looking cooperation in the area of rare diagnoses, which can secure the continuity that is required in the work.
• Psychiatry – establishing an annual Nordic Summit on psychiatry that will improve exchange of experiences and best practice, while also developing an extended database of knowledge needed for good, collaborative research.
• Contingency planning – to increase and fine- tune the mandate given to the existing Nordic public health preparedness group, known as the Svalbard Group. This will increase collaboration in terms of joint R&D, training, purchasing and contingency stocking.
• Exchange programmes for civil servants – developing a programme of increased exchange of health officials between the Nordic countries and the development of more networks designed to increase Nordic expertise and competitiveness.
Könberg points out that the antibiotic issue will also
become an increasingly important part of Nordic cooperation, but also recognises that it is a global issue and one that requires global cooperation. So where does he see the Nordic countries in this global picture?
“I put forward proposals that the five 17
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