Making health systems fair and efficient

Ole Norheim brings leadership skills to a new role as the Mary B. Saltonstall Professor of Behavioral and Population Health.

November 5, 2024 – Last month, Ole Norheim joined other world health leaders at the World Health Summit in Berlin to share a message of hope: Countries around the world, to regardless of income level, they can reduce their 2019 rate of death before age 70 by focusing on a few key health benefits. Norheim is a co-author, along with several colleagues at the Harvard TH Chan School of Public Health, on Global Health 2050, a new report by the Lancet Commission on Investing in Health.

The report recommends investment in the drugs, vaccines, and tests needed to control 15 conditions responsible for the world’s largest life expectancy disparities, including tuberculosis, diabetes, maternal conditions, and road traffic accidents. . It’s the latest effort in Norheim’s 25-year career aimed at helping decision-makers provide scarce health resources.

Norheim joins the Department of Global and Population Health full-time as the Mary B. Saltonstall Professor of Ethics and Population Health in January, after ten years as a part-time adjunct professor. He is based primarily at the University of Bergen, Norway, where he currently works as a professor of medical ethics and director of the Bergen Center for Ethics and Priority Setting (BCEPS).

“I have known many special people [in GHP],” he said. “I think it is possible to have an even higher impact in the field and in the practice of global health by being part of their network and the wider network of Harvard.”

Much of Norheim’s research has focused on the ethics of prioritizing health systems, with an emphasis on addressing inequities in low-income countries that are developing health care programs. she is beautiful. He has worked to develop frameworks to answer difficult health care questions at the clinical and health systems level, for example, how to prioritize transplant recipients. His work deals with what happens when there is a gap between the needs of citizens and what their health system can provide. In such cases, how can services be fairly distributed?

Guiding difficult decisions

Norheim traces his interests to ethics and global health from his childhood. Her parents were both teachers, and they filled their home in Norway, near the Arctic Circle, with books and good conversation. They also spent time as missionaries in Ethiopia, where Norheim was born. He said the extreme poverty and inequality he saw while living in Africa left a lasting impact on his future path.

As a medical student at the University of Bergen, Norheim worked on a study of bone marrow transplant patients and became fascinated by the complex issues surrounding treatment decisions. He then went on to obtain a PhD in medical ethics at the University of Oslo. After graduation, he split his time between clinical and academic work at the University of Bergen and its affiliated hospital, before eventually moving into full-time public health research at review medical regulations at the level of the health system.

He founded a research group on medical law and precedent in 2004, and in 2019 founded BCEPS. He and his colleagues have provided training to doctors and policy makers in Ethiopia, Ghana, Nepal and Tanzania, in addition to providing decision support to health ministries in those countries. The agency has also worked with the Norwegian government on setting priorities in their public health system, for example on developing new expensive drugs and charging for other services.

Norheim has been working as a consultant around the world. In 2014, he led a WHO advisory group on developing guidelines that address emerging equity and equity issues for countries on the path to universal health care. During the COVID pandemic he was part of the Norwegian government’s vaccine advisory group, and worked with an international group of ethics experts to publish recommendations on making global vaccine distribution possible. be equal.

“Medical ethics deals with difficult, contested questions. There is no one standard answer,” Norheim said. “That’s why in my research I aim to develop ethical frameworks for fair and efficient prioritization.” Recognizing how trust is critical to successful health systems, Norheim’s guidelines include ways to engage the public in discussions about difficult priority decisions, and he has written op- ed many on important issues and participated in public debates.

At Harvard Chan, he plans to continue his work as the chief organizer of the Disease Control project, which works with partners in low-income countries to develop strategies and methods to prioritize a health care and producing evidence to help guide decisions. He also intends to expand his research into questions about climate change and health.

Norheim added that he hopes that with his new position he can establish a partnership with the Bergen Center that brings young researchers from low countries to the School. Currently, the grant from NORAD (Norwegian Agency for Development Cooperation) fully supports four postdocs, five PhD students, and 15 master’s students from Ghana, Nepal, and Tanzania and from African CDC.

He is also eager to teach more. During his years as a part-time assistant, he often spent six to eight weeks teaching a behavior course on campus in the fall. He said: “I really enjoy working with the students here. “I find it very motivating.”

A quick beat

Your hero: Professor Amartya Sen has been my intellectual hero since I was a student because he is a great philosopher and a great economist. His approach to integrating advanced ethical thought with multiple methods and analysis has been an inspiration to me.

Favorite place on campus: I’m interested in art, so I like the little rock garden next to the Kresge entrance that has a nice mural.

Entertainment: I paint abstract pictures. I get a lot of inspiration from going to art museums and galleries, and reading about art.

Book recommendation: The last book I really liked was Nights of Plague by Orhan Pamuk. It is about an earlier epidemic when the Ottoman Empire was at its end – a historical story of great importance for public health by an experienced author.

– Amy Roeder

Photo: Kim E. Andreassen / UiB