The Group of Twenty, or G20, has emerged as a powerful multilateral forum for cooperation between advanced and emerging economies. The member countries account for 85% or more of global GDP and serve two-thirds of the global population. The G20 is committed to promoting and fostering policy coordination to achieve global economic stability, sustainable growth, and prevent future crises.
The agenda of 2017, which included strengthening health-care systems, reducing malnutrition, health-crisis management and scaling up the fight against pandemics, has been expanded by India to include emerging trans-border and trans-sectoral challenges such as antimicrobial resistance (AMR) and impact of climate change on health. Prime Minister Narendra Modi has reiterated that India’s G20 Presidency will be inclusive, action-oriented and decisive. The theme “One Earth, One Family, One Future” is based on India’s philosophy of “Vasudhaiva Kutumbakam”, and is a catchphrase for people across the world to collectively work towards building a healthier post-pandemic world. India’s current G20 Presidency is tasked with rebuilding, re-energising, and recalibrating the global health challenges in the post-pandemic context.
The Health Working Group meetings under the Indian Presidency sought to underscore the imperative for a more robust health architecture at the global, regional and national levels. This is an urgent imperative in order to be able to enhance an effective, responsive and accountable health system that is geared to prevent, detect, and quickly respond to epidemics, pandemics, and other health emergencies.
The First Health Working Group Meeting in January 2023 focused on health systems strengthening, in specific on integrated surveillance models that adopt a One Health approach, the Quadripartite’s [i.e. the Food and Agriculture Organization of the United Nations (FAO), United Nations Environment Programme (UNEP), World Health Organization (WHO) and World Organisation for Animal Health (WOAH)] technical role in One Health implementation, the World Health Organisation’s (WHO) convening role in health emergencies, an appropriate design for multi-disciplinary and multi-sectoral AMR surveillance and enabling the inclusion of antimicrobial stewardship in National Action Plans.
The Second Health Working Group Meeting in April 2023 was wider in scope, inviting countries and international organisations to contribute to India’s G20 Presidency’s proposed convergence of parallel initiatives in the Health Emergency Prevention, Preparedness and Response (HEPPR) agenda. As the initial areas for convergence, the critical task areas included One Health based collaborative surveillance systems, tracking Antimicrobial Resistance (AMR) and Antimicrobial Consumption (AMC). These received unstinted support and appreciation from the participating countries and international organisations like the UNICEF and others.
These need to be understood in the light of the need for greater alignment with the Pandemic Fund’s core task of making long-term strategic investments to strengthen health systems for pandemic readiness and the UN General Assembly’s High-Level Meeting on Pandemic Prevention, Preparedness and Response. India is also deeply invested in the Intergovernmental Negotiating Body (INB) to draft and negotiate a WHO convention or agreement on pandemic prevention, preparedness and response and relevant amendments to International Health Regulations (IHR) 2005.
The Third Health Working Group Meeting that was recently held in Hyderabad was significant for its deep-dive discussions into the proposed convergence exercise. The focus was on One Health-based early warning system that is supported by laboratory networks and skilled health workforce; global AMR and AMC surveillance platforms; and, end-to-end pandemic management IT platforms.
CONVERGENCE MATTERS
The Covid-19 pandemic has brought to the fore the limitations in response capacities of stakeholders to effectively mount a time-sensitive response. India’s G20 Presidency is building consensus towards converging stakeholders, instruments, and initiatives in the wider landscape of HEPPR (Health Emergencies Prevention, Preparedness and Response). These stakeholders interact and intersect at global, regional, and national levels. National level convergence entails working more effectively across governments and social structures to enable the response machinery that can prevent, prepare, detect, and respond to health emergencies. At the regional and global levels, the task is to streamline and strengthen mechanisms for prevention, preparedness, detection and response that build on underlying trust, cooperation, solidarity, and accountability amongst governments and other global health stakeholders, including the UN agencies, regional public health institutes, and other international partner organisations. G20 member states shall play a critical role in the mapping exercise that is a critical starting point.
The results of such exercises shall be important ingredients to the development of the Global Medical Countermeasures Coordination Platform while contributing to the discussions of the Intergovernmental Negotiating Body. This will eliminate duplication of resources while averting the loss of crucial time.
India’s G20 Presidency under the visionary leadership of Prime Minister Narendra Modi is uniquely positioned to bridge the efforts and contributions of the G20 member states on the convergence exercise and the consequent shaping of a roadmap.
Dr Bharati Pravin Pawar is Union Minister of State for Health and Family Welfare.