Sweden\u2019s engagement in global health: a historical review

Rachel Irwin

doi:10.1186/s12992-019-0499-1

Abstract

BackgroundSweden is a long-standing and significant contributor to overseas development aid. This commitment to global health and development is part of Sverigebilden, or the view of Sweden in the world that is formally promoted by the Swedish government. Sweden is seen by many in the global health community as leader on human rights and health and has traditionally been one of the most engaged countries in multilateral affairs more broadly.ResultsThis article places Sweden’s engagement in global health within the wider context of domestic changes, as well as transitions within the broader global health landscape in the post-World War Two (WWII)- era. In doing so, it reviews the globalization of health from a Swedish perspective. It also addresses broader questions about what it means for a country to be ‘active’ or ‘engaged’ in global health and responds to recent suggestions that Swedish influence in health has waned. The article finds that in Sweden there is wide political consensus that international development and global health engagement are important, and both are part of the maintenance of Sverigebilen. While there is a not one single Swedish approach to global health, there are norms and values that underpin global health engagement such as human rights, solidarity, equity and gender equality. A sustained focus on key issues, such as sexual and reproductive rights and health (SRHR), creates a tradition which feeds back into Sverigebilden.ConclusionsThe Swedish experience demonstrates the linkages between foreign and domestic policies with regard to international health and development, and to the globalization of public health practice and diplomacy. In global health Sverigebilden is tied to credibility. Sweden is able to exercise influence because of a successful welfare model and strong research traditions; conversely, long-standing and new threats to this credibility and to Sverigebilden pose challenges to Sweden’s future engagement in global health.

Highlights

Sweden is a long-standing and significant contributor to overseas development aid
The pre-history of Sweden’s engagement in global health In the 1800s and early 1900s, many Swedes lived in the context of poverty and inequality
Northern Sweden suffered from a famine so severe (1867–1869), that aid was sent to Sweden from abroad [30]

Summary

Introduction

Sweden is a long-standing and significant contributor to overseas development aid This commitment to global health and development is part of Sverigebilden, or the view of Sweden in the world that is formally promoted by the Swedish government. Sweden is a long-standing and significant contributor to overseas development aid, consistently in the top 10 donor countries in total spending and at the top of the list when measured as a percentage of Gross National Income (GNI) [1, 2]. Sweden was one of the six original donors to Gavi, the Vaccine Alliance and has “steadily” increased its “political and financial commitment [5].” It is the eight largest government donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), behind much larger countries such as the US, Canada and Germany [6]. Public opinion on aid is high, with 96% of Swedes believing that ‘it is important to help people in developing counties.’ [7] Beyond traditional development assistance for health, the government of Sweden, supported by research and civil society, has been active in pushing for solutions to global health challenges, such as sexual and reproductive health and rights and antimicrobial resistance

Objectives

Methods

Results

Discussion

Conclusion