India’s G20 presidency is gathering momentum. It is focussed on harnessing shared responsibilities and collaborative governance to make the world safer from pandemics. India is seeking to leverage this forum to bridge the gap between the Global North and Global South, especially because the G20 and several other plurilateral arrangements have memberships that cut across the global community.
The Covid-19 pandemic has affirmed that health is a global public good. It has also underlined the critical role of the State in shaping and delivering a public health vision, especially because market forces often fail to address the medical needs of people, particularly the poorest and the most vulnerable, in full measure. The pandemic also highlighted the centrality of the World Health Organisation (WHO) in shaping the contours of responses to disease outbreaks.
The blueprint framed in the process can apply to national governments and multilateral institutions such as the G20. Its critical elements include helping countries to respond promptly, providing accurate information, ensuring vital supplies reach frontline healthcare workers, training and mobilising medical professionals and developing and delivering vaccines, diagnostics, and therapeutics.
India demonstrated a whole-of-society and whole-of-government approach in dealing with Covid. The devastating first and second waves intensified national solidarity and led to increased focus on medical care and vaccine research, production, and rollout. With Covid transforming from a health emergency to a disease that’s likely to be with us, albeit in a less virulent form, the focus has shifted to reviving and rebuilding the economy, education and social services as well as caring for those who suffer long-Covid and fully operationalising the non-Covid essential health services.
A year into the pandemic, the World Bank set up an umbrella programme to help some countries and regions improve their capacities to prepare for, prevent, respond, and mitigate the impact of epidemics on people. India and several other members of G20 and the Global South are a part of this effort.
In January 2022, the 150th meeting of the WHO’s executive board committed to strengthening the Health Emergency Preparedness and Response (HEPR) architecture. The health emergency management ecosystem has moved beyond dealing with threats from infections and taken an all-hazards perspective. The core values of managing such emergencies include equity in access and outcomes, inclusivity of ownership and engagement and coherence in financing, governance, and constitutional mandates. The foundational requirements, therefore, include inter-sectoral coordination (economic, social, agricultural, environmental) and a “One Health” approach with whole-of-government and whole-of-society responses.
There is a growing recognition and worry that the world is off track in its journey towards Universal Health Coverage (UHC) by 2030 on account of a lack of concrete operational steps and inadequate public financing. The lessons from the public health response to the Covid pandemic and the innovations that came up during the period, such as digital health technologies and community-based services, are being drawn upon to strengthen and scale up primary healthcare approaches for progressive realisation of UHC. India is working overtime to achieve the milestone through innovation and collaboration, especially on four SDGs: No Poverty, Zero Hunger, Good Health and Wellbeing, and Gender Equality.
Strengthening primary healthcare is crucial to the roadmap ahead for health emergencies. India’s G20 presidency would facilitate synergy with the WHO’s 10 “bold proposals” for a more safe and equitable world. Effective and timely strengthening of HEPPR will require deepening the agreement and convergence amongst stakeholders. The theme of India’s G20 presidency — “One Earth, One Family, One Future” — is in that spirit.
The three pillars of HEPR are governance, collaboration, and financing. India has played key roles and demonstrated political commitment in some of the recent initiatives on strengthening global health governance — these include the Intergovernmental Negotiating Body (INB) for the pandemic treaty, the Muscat Manifesto on AMR in Oman (2022), and the Friends of Medical Countermeasures Platform in South Africa (2023). The operational readiness of five interconnected multi-sectoral HEPR systems — collaborative surveillance, community protection, safe and scalable care, access to countermeasures, and emergency coordination — is another priority area that India’s G20 presidency is focusing on.
G20 has already contributed to the WHO and World Bank Pandemic Fund that was launched during the Indonesia presidency in November 2022. The Fund has secured more than $1.6 billion in donations, mostly from G20 members, and will strengthen the HEPR in several countries of the Global South.
India is engaged closely with Japan’s G7 presidency and Prime Minister Modi will participate in the G7 Hiroshima Summit. The Hiroshima G7 Global Health Task Force is in synergy with these objectives. Two of its main themes are Resilient, Equitable and Sustainable UHC and Global Health Architecture Development. The words of Japanese Prime Minister Fumio Kishida is a reminder of our shared responsibilities: “I believe that human security remains critical to strengthen the global capacity to prevent, prepare for, and respond to public health emergencies and contribute to achieving UHC.” They find a harmonious resonance in the words of Prime Minister Modi: “Our priorities will focus on healing our one earth, creating harmony within our one family and giving hope for our one future”.
The writer is Secretary, Ministry of Health and Family Welfare, GoI. Views expressed are personal
