When India assumed the presidency of G20, the world was rising from the worst section of a devastating Covid-19 pandemic, seeking to restore international connectivity, and revive financial development which had stalled or sagged below the crushing strain of a novel however nasty virus. The international public well being group was apprehensive as as to if the pandemic catalysed consideration of policymakers to well being (by way of concentrate on programs, companies, financing and analysis) would dissipate as financial and political priorities crowd the agenda of G20.

While there was international dedication to arrange nations to forestall and reply to future pandemics higher than they did with Covid-19, would that be addressed solely on the degree of the World Health Organisation (WHO)? A brand new Pandemic Prevention, Preparation and Response Treaty (PPR) and revision of International Health Regulations (IHR) have been below worldwide negotiation at WHO, with completion timelines set for 2024. As that course of continues, would the agendas of G7 and G20 preserve well being apart and be full of different priorities?

The G20 course of shortly dispelled these apprehensions. The wealthy nations of G7 might solely want to defend themselves from spillover of future pandemics into their territories. However, different members of G20 have been additionally involved about lowering the worldwide inequities that impeded their response to the Covid-19 pandemic and wished to repair systemic flaws which may undermine the worldwide cooperation wanted for future public well being emergencies.

India ensured that well being was not sidelined at G20. Discussions on well being featured not solely in conferences convened by the well being ministry but in addition in these convened by scientific academies (S20), civil society (C20), suppose tanks (T20), and different teams too. Recommendations from all of those conferences streamed into the method of shaping the ultimate declaration. The remaining declaration, unanimously adopted by heads of G20 nations on September 9, 2023, supplied a distinguished place for well being. That declaration dedicated to strengthen global health structure and ‘building more resilient, equitable, sustainable and health systems to achieve Universal Health Coverage’. It known as for strengthening the first care and well being workforce whereas enhancing important well being companies and well being programs to ‘better than pre-pandemic levels.’

The G20 reaffirmed its religion in WHO because the world’s premier public well being company, putting it on the core of coordinated international well being efforts. Emphasis was laid on infectious illnesses, from eradication of polio to ending AIDS, TB, malaria, hepatitis, water borne illnesses and different communicable illnesses.

The ‘One Health’ programme is to be promoted by way of the ‘Quadripartite’, a coalition of WHO, World Organisation of Animal Health (WOAH), United Nations Environment Programme (UNEP), and Food and Agriculture Organisation (FAO). Anti- microbial resistance (AMR) is to be combated and contained as a part of the One Health initiatives at nationwide and international ranges. Ongoing efforts on the pandemic PPR and IHR have been welcomed.

The crucial of offering equitable entry to secure, efficient, high quality assured and inexpensive vaccines, therapeutics, diagnostics (VTDs) and different medical countermeasures was inscribed within the declaration. This was recognised to be particularly essential for low and center earnings nations, least developed nations and small island growing states. Development of native capacities for analysis and improvement, manufacturing, and final mile supply have been recognised as important for an environment friendly response to public well being emergencies. Creating a community of networks connecting low and center earnings nations (LMICs) and different growing nations was listed as an essential space of motion. This effort can be led by WHO.

Recognising the significance of reconfiguring well being programs as a part of the response to local weather change, the G20 known as for the event of climate-resilient and low carbon well being programs. Since well being programs globally generate 5.3% of greenhouse gases, by way of healthcare amenities and their provide chains, the necessity for ‘greening’ of healthcare turns into an essential measure of local weather change mitigation. At the identical time, healthcare amenities need to turn into local weather resilient as rising temperatures and excessive climate occasions threaten to influence their security and functioning. Multi-lateral improvement banks (MDBs) just like the Asian Development Bank and the World Bank have introduced their assist to those efforts. G20 may even assist the work of the WHO led Alliance for Transformative Action on Climate and Health (ATACH) in advancing improvement of local weather responsive well being programs.

Potential function of evidence-based Traditional and Complementary Medicine (TCM) was recognised by G20, which acknowledged ongoing international initiatives on this space. The declaration additionally known as for selling psychological well being and enhancing entry to psychological well being companies in addition to provision of psychosocial assist in an inclusive method. It highlighted the necessity for sturdy worldwide counter-narcotics cooperation to curb the rising menace of addictive medicine.

While the declaration highlights many very important areas of motion for shielding and selling international well being, it surprisingly doesn’t confer with non-communicable illnesses (NCDs), that are the most important contributors to the worldwide toll of deaths and incapacity. While the excessive earnings nations have configured their well being programs to cope with NCDs over a number of many years, it’s the LMICs who’re presently confronting the rising burdens of NCDs with underprepared well being programs. The Covid-19 pandemic additionally made it clear that NCD associated co-morbidities contribute most to extreme sickness, hospitalisation, and loss of life. That is true additionally of influenza and different respiratory viruses. If the LMICs represented in G20 don’t demand consideration to NCDs, that are severely difficult their well being programs, why will the wealthy nations increase the problem when they’re already well-prepared?

Similarly, the Joint Finance and Health Task Force (JFHTF), to which the G20 commits itself, offers solely with strengthening the worldwide well being structure for pandemic PPR. There is not any dedication to strengthening of well being programs general. The welcome addition of the African Union to the membership of G20 from this yr might convey forth such LMIC priorities strongly in future G20 deliberations. For now, we should congratulate India for protecting well being in focus at G20 and in reaching consensus on many essential areas of world well being the place worldwide cooperation is important.

The author is heart specialist, epidemiologist, and distinguished professor of public well being, PHFI