Geir Honneland - Health as International Politics: Combating Communicable Diseases in the Baltic Sea Region

First published 2004 by Ashgate Publishing

Reissued 2018 by Routledge

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Geir Hnneland and Lars Rowe 2004

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ISBN 13: 978-0-815-38943-9 (hbk)

ISBN 13: 978-1-351-15668-4 (ebk)

The dramatic rise in tuberculosis and HIV/AIDS in some of the former East Bloc countries caused great concern among Western experts around the turn of the millennium. To combat the emerging threat, the Council of Baltic Sea States (CBSS) launched in 2000 the Task Force on Communicable Disease Control in the Baltic Sea Region (the Task Force). During the period 2001-04, the Task Force implemented more than 100 projects to combat tuberculosis, HIV/AIDS and improve primary health care in the north-western parts of Russia and the Baltic states. As the projects were being implemented, several small evaluation teams of experts in medicine and social science were put together. This book represents the outcome of one of these evaluation teams. More precisely, it presents the results of the study of the Task Force from an international relations point of view. It is the contextual evaluation, as it came to be known in Task Force circles.

The work was financed by the Norwegian Ministry of Health through the Secretariat of the Task Force. We wish to extend our most sincere thanks to the three members of the Secretariat, Harald Siem, Andreas Skulberg and Janicke Fischer, for enthusiasm and active support during our work. They have in no way tried to influence the conclusions of our study, but provided the necessary practical guidance and medical expertise. Martin McKee at the London School of Hygiene and Tropical Medicine was kind enough to read and comment the manuscript and proved an invaluable source of suggestions for further reading. We enjoyed many fruitfiil discussions with Vanja Ohna at the Institute for Nutrition Research at the University of Oslo concerning several aspects of the work. Ain Aaviksoo, Jon Elvedal Fredriksen, Viktoras Meizis, Denis Pyzhikov, Sanita Sivicka and Veronika Vorobyova provided assistance during our field trips to Russia and the Baltic states. Our colleague Jorgen Holten Jorgensen conducted interviews in Petrozavodsk for us and his expertise on Russian affairs made him an obvious choice for broader-ranging discussions. FNI Director Arild Moe assisted us in the initial phases of the project and retained a lively and practical interest in the study as it progressed. Kari Lorentzen, Chris Saunders and Maryanne Rygg were, as always, indispensable in the library, in finding the right linguistic balance for the text, and in the technical formatting of the typescript. Thanks to you all! Thanks also to Kirstin Howgate at Ashgate and the two series editors Nana K. Poku and Robert L. Ostergard, Jr, for accepting the manuscript for the Global Health series.

One technical detail: Transcription from Russian to English is done according to the popular rather than official linguistic standard, as the latter often results in spelling that is difficult to understand for people with little knowledge of Russian. Russian e is written as ye at the beginning of words and after vowels, buty is skipped in proper names with an established English form, e.g. Karelia. The hard and soft signs used in Russian are not transcribed.

The book builds on interviews with approximately 100 people involved in the Task Force in different ways and at different levels, mainly in Russia and the Baltic states. The opinions of individual interviewees do not always match the impressions we gained at the aggregate level. Reality is fickle and elusive, but here is one story of how the Task Force began as an idea, was formed into a plan and put in motion.

Geir Hmeland
Lars Rowe
Lysaker, January 2004