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G20's Leadership for Global Health Security and Pandemic Preparedness

Purvaja Modak, Research Fellow, International Relations – Geoeconomics, Centre for Public Policy Research
September 29, 2021

The Group of 20 (G20), often referred to as the 'economic steering committee' for the world, has been credited to provide coordinated responses to economic and financial crises since its inception in 1999. The grouping was also successful in steering the world during the 2008 Global Financial Crisis. Likewise, the G20, that is representative of the developed world and the developing world, through its membership, is best suited to be the steering committee for the world in the times of a health crisis and its role becomes important now more than ever, as the world is still dealing with the COVID-19 pandemic. 

The G20's structure, involving various stakeholders – governments, business leaders, think tanks and academia, civil society representatives, labour unions, women representatives, the scientific community etc. makes it the right forum to collate well thought out and wholistic solutions and responses from policy makers, technical experts and practitioners. It can enable member countries and their representatives from different sections of society to share information and best practices, both of which are crucial to international cooperation. 

Also, G20's informal nature allows a considerable amount of flexibility to the G20 process, giving member countries the option to craft and lead agendas and create interdisciplinary approaches to global policies. This is needed during a pandemic, when uncertainty and losses, both to life and commerce, are huge and vary across countries, and so continuous policy revisions could be expected.

The G20 can contribute by lending political support to existing multilateral bodies and agreements, particularly to the World Health Organization, the IHR and the SDGs. It can set norms on healthcare as a global public good and mandate a globally representative task force to evaluate and improve the IHR.

The G20's support can help revive the credibility of the WHO and restore its position as the designated global body to act at a time of a health crisis. Political will coming from the highest levels of government, displayed at the G20 can drive the renegotiation of existing WHO arrangements and agreements and can facilitate the introduction and quick ratification of new ones. The speeding up of the procedural aspects of global agreements is needed during a health crisis. 

The WHO can be a special invitee at G20 summits every year. A special G20 taskforce or engagement group on Health, the H20 (Health20) can be convened to increase international awareness of health as a global issue and promote research, joint partnerships and a collaborative response in case of future pandemics. The G20 should emphasize the nexus between health governance and other policy areas. 

The G20 can continue to encourage its member countries to increase their contributions to WHO's funding to avoid disproportionate contributions and power plays by its larger donors. The G20 can display its support for the worldwide implementation of the IHRs. The G20 can encourage its member countries to make concrete commitments to provide vaccines, medical equipment, drugs and technical and financial assistance to countries in need, even outside the G20. This will improve global pandemic preparedness. 

The G20 must work towards extracting commitments from member countries to contribute vaccines to the COVAX initiative and to increase their voluntary funding contributions to the WHO. In fact, in June 2021, at the G7 summit, world leaders pledged 1 billion COVID vaccine doses for developing countries. Despite it being a small amount in comparison to the evident demand, this pledge is still a start. Similar pledges from countries who have the capacity are extremely essential. 

Some initiatives to that effect are already in the works. The World Bank (WB), World Health Organization (WHO), International Monetary Fund (IMF), and WTO have formed a taskforce on COVID-19 vaccines, therapeutics and diagnostics for developing countries. 

The G20 High Level Independent Panel on Financing Global Commons for Pandemic Preparedness and Response, formulated in January 2021, to ensure that the world is better prepared for future health threats has submitted its report titled, 'A Global Deal for our Pandemic Age', to the G20's Finance Ministers and Central Bank Governors at their recent meeting on July 9-10, 2021. The panel calls for a public funding increase in international financing of at least US$75 billion over the next five years, or US$15 billion per year, to plug major gaps in pandemic prevention and preparedness, doubling current spending levels. The panel has identified four pressing preparedness gaps: infectious disease surveillance, resilience of national health systems, global capacity to supply and deliver vaccines and other medical countermeasures, and global governance. 

The ministers and governors also committed to working with International Financial Institutions (IFIs) and relevant partners, in particular the WHO, to develop proposals for sustainable financing to strengthen future pandemic preparedness and response, and to improve international governance and coordination between global health and finance policy makers. The G20 Joint Finance and Health Ministers' meeting will be held in October 2021 and the G20 has tasked experts from the Ministries of Finance and Health of the member countries to follow up with concrete proposals to be presented at that meeting. 

One way to further global health diplomacy can be the appointment of health officers or attaches at diplomatic missions. Diplomatic missions usually have a political, economic and security attaché that serves as a bridge between governments on issues of political or economic importance. A health attaché, at the cusp of global health and foreign affairs, can carry out diplomatic engagements and exchanges between governments on health issues by identifying common areas of cooperation, fostering agreements on healthcare and coordinating with different stakeholders. 

To enable this, every country must introduce a unit for global health diplomats as part of its diplomatic corps. Training and capacity building workshops to teach them how to align public health and foreign policy must be given to deserving candidates. The health ministry and Foreign Affairs ministry can work in tandem with the WHO and forums like the G20 to formalise this programme and conduct training and skill development workshops in each country. 

Such dedicated officers will be best suited to provide that first speedy response to any future health crises. This will be beneficial, not just for countries to receive or share medical supplies, but also to factor in the needs of their diaspora in other countries. 

The G20's role in containing the COVID-19 pandemic and furthering the global health agenda, to be better prepared for future pandemics, must be taken seriously by all the member countries. WHO's Director General, Dr Tedros Adhanom Ghebreyesus at the G20 Health Minister's Meeting in September 2021 called for commitment & support of G20 countries to reach the WHO's global target for every country to vaccinate atleast 10% of its population by end of September, at least 40% by end of 2021 and 70% by mid-2022. 

He spoke of four critical areas for immediate action, beginning with better global governance:

  1. An international instrument on pandemic preparedness and response will strengthen the foundation for global cooperation, setting the rules of the game, and enhancing solidarity among nations.
  2. More and better financing for national and global preparedness and response.
  3. Financing facilities must be built using existing financial institutions, rather than creating new ones that further fragment the global health architecture.
  4. The need for a “strengthened, empowered and sustainably financed WHO” to fully realize the Organization's broad mandate.

In the current scenario, the security of every country lies in its global health security. Global health security and pandemic preparedness in today's times is just as important as countering terrorism and building financial resilience. It has thus far remained on the side-lines of discussions at global forums like the G20 or has been limited to debates on sexual health and reproductive health. But now, health policy must hold a crucial place in such global policy debates. Discussions on equitable access to healthcare systems and drugs, universal health coverage, capacity building programmes, training of medical professionals and funding for health care R&D are probably the most essential initiatives at the moment. This requires strong leadership and a long-term commitment from global leaders and heads of multilateral institutions. 

A grouping like the G20 is best suited to take on this leadership role. India must push the global health agenda at the G20 in the lead up to and during its 2023 presidency of the G20, leaving a mark on the G20 discourse and ensuring that the grouping can steer the world during any health crises, just as it did during the Global Financial Crisis of 2008.









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Views expressed by the author are personal and need not reflect or represent the views of Centre for Public Policy Research.
Reprinted from CPPR with permission.

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Purvaja Modak is a Research Fellow, International Relations – Geoeconomics at CPPR. Her research focuses on issues of global economic governance, international trade and finance, economic diplomacy and multilateral financial institutions. Prior to joining CPPR, she was a Researcher for Geoeconomic Studies and the Manager of the Research Office at Gateway House: Indian Council on Global Relations, a Mumbai based foreign policy think tank.. She was a fellow at the 2nd G20 Global Leadership Programme 2019, hosted by the Korean Development Institute (KDI) and the Korean Ministry of Strategy and Finance. Purvaja has also held Research Assistant and Research Associate positions in her academic departments at both Bachelors and Masters levels. She has also interned at Reliable Investments, an exclusive franchisee of Motilal Oswal Securities Ltd. She holds a Masters degree in Economics (MA) from the University of Mumbai with a focus on international trade, finance and regional monetary arrangements and a Bachelors Degree in Economics (BA) from Jai Hind College, Mumbai.

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