The Norwegian Institute of Public Health (FHI) has become well known throughout Norway through the pandemic. FHI has monitored the burden of disease, the effect of the measures on infection, hospitalization and mortality, but also how the burden of the measures has affected the population’s physical and mental health. Professionals from the Institute of Public Health have contributed to the government’s press conferences, appeared in the media and participated in debates about the pandemic. And perhaps even more important: FHI has been an important professional support and sparring partner for the municipal health service and the municipal chief medical officers who have been responsible for handling the pandemic locally. During the pandemic, FHI has received additional funds, and more professionals have been recruited. Despite this, the work pressure on FHI’s employees during the pandemic has been enormous. We are not done with covid-19. It is still possible that new variants of the virus cause more serious illness. Data from other countries indicate that experienced covid-19 can cause long-term problems and an increased risk of, among other things, cardiovascular disease and dementia. We do not know how long the vaccines against covid-19 protect, or whether the vaccines have other unknown long-term effects. The social inequality in health has presumably increased as a result of the pandemic and the measures. These are just a few of the areas that FHI should monitor. FHI also has a large backlog of other statutory tasks that have been on hold throughout the pandemic. Nevertheless, the government believes that enough is enough. Now FHI will return to the financial framework from before the pandemic. In short, the government’s budget proposal means that FHI will have to get rid of approximately 300 professionals during 2023. That is significantly more than those who were recruited due to the pandemic. If the budget is adopted as the government proposes, FHI will have a poorer capacity to fulfill its social mission at the end of 2023 than it had before the pandemic. The municipalities depend every day on the dialogue with FHI. How to manage outbreaks and monitor antibiotic-resistant bacteria such as MRSA? What measures should be taken when some of our residents become ill due to tuberculosis, legionella or other “unusual” cases of infection? A professionally strong FHI creates a knowledge base for decisions in the municipalities, which themselves do not have the specialist expertise that the specialist health service can draw on. We know new pandemics will come, we just don’t know when. An unknown new disease-causing virus X with great spreading ability can astonishingly quickly threaten both people’s health and critical societal functions. As we have now experienced, strong infection control measures against such infections have large social, economic and health costs. When SARS-CoV-2 appeared in China in December 2019, it took only three months for the WHO to declare that we had a pandemic. When the pandemic hit, FHI was not as well equipped as it should have been. In the previous years, FHI had gone through several major reorganisations, and in addition they had received the Solberg government’s general “de-bureaucratisation and efficiency” cuts (ABE). The government should take inspiration from the immune system’s handling of a new health threat. After the first acute mobilization to make large quantities of antibodies against the virus, efforts are gradually scaled back when the danger is over, to make room for other challenges. But the competence and ability to react against the virus is retained and further developed for a long time after the threat is over. It requires resources. Questions we must plan for before the next pandemic include: How can the negative consequences of infection control measures be minimized for everyone? How can individuals and population groups with medical or socio-economic challenges be better protected against serious illness? How can we reduce social inequality in disease? To be prepared for the next pandemic, we need a well-functioning public health institute with sufficient resources. We need the medical expertise and the memory of what we did well and what we can do better next time to be taken care of. We need the professional diversity in infection prevention work to be strengthened. Forcing FHI to lay off professionals in order to balance the budget in 2023 is not the way to go. It’s not too late to turn around.
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Bad policy for the next pandemic – Speech
