G20 Summit 2023: India may take the lead to achieve G20 health goals

G20 nations have also prioritised tackling antimicrobial resistance (AMR) through research and development, infection prevention and control

Emerging from the recent pandemic, the G20 New Delhi Leaders’ Declaration emphasises future pandemic preparedness and the improvement of essential health services and systems beyond pre-pandemic levels in the next two to three years.

Experts assert that such solutions will not only require investment but also significant global coordination.

India has already taken the lead in vaccine manufacturing and research on antimicrobial resistance (AMR).

The joint declaration by G20 leaders on Saturday stated: “We remain committed to strengthening the global health architecture, with the World Health Organization (WHO) at its core, and building more resilient, equitable, sustainable, and inclusive health systems to achieve universal health coverage, implement the One Health approach, enhance pandemic preparedness, and strengthen existing infectious disease surveillance systems.”

To achieve this, member countries will focus on strengthening primary health care, the health workforce, and improving essential health services and systems to surpass pre-pandemic levels within the next two to three years. They will also continue progress toward polio eradication and ending ongoing epidemics, including AIDS, tuberculosis, malaria, hepatitis, water-borne diseases, and other communicable diseases. The declaration also recognises the importance of research on long Covid.

Experts like Gagandeep Kang, an eminent virologist and professor at the Department of Gastrointestinal Sciences at Christian Medical College, Vellore, point out that while achieving such an ambitious target needs investment and coordination, “there are numerous challenges in strengthening manufacturing systems, procurement systems, and technical capacity, so investment is essential, not just funding but government and industry attention and interaction”.

The G20 nations have committed to promoting the One Health-based approach driven by the Quadripartite’s One Health Joint Plan of Action (2022–2026). The Declaration also states that G20 members anticipate a successful outcome of ongoing negotiations at the Intergovernmental Negotiating Body for an ambitious, legally binding WHO convention, agreement, or other international instrument on pandemic prevention, preparedness, and response by May 2024, as well as amendments to better implement the International Health Regulations (2005).

Furthermore, the G20 nations will facilitate equitable access to safe, effective, affordable, and quality-assured vaccines, therapeutics, diagnostics, especially in low- and middle-income countries (LMICs), least developed countries, and small island developing states.

The G20 nations support the WHO-led inclusive consultative process for the development of an interim medical countermeasures coordination mechanism. This initiative aims to ensure the effective participation of LMICs and other developing countries, leveraging local and regional research and development and manufacturing capacities, and strengthening last-mile delivery.

India, a leader in vaccine manufacturing, has already taken proactive steps. For instance, Adar Poonawalla’s Serum Institute of India (SII) is constructing a plug-and-play vaccine-making facility in Pune, which will be available to any country in need of urgent vaccine supplies in the event of an outbreak. Prior to the pandemic, SII had a capacity to produce 1.5 billion annual doses, which significantly increased during the pandemic.

Poonawalla, the chief executive officer and brain behind the new-age SII, previously stated that he is offering this 300,000-square-feet pandemic facility to all world leaders and countries in case they need to stockpile vaccines or require any product.

“It is designed as a pandemic facility capable of handling various technologies,” he had said.

Speaking to Business Standard, Poonawalla expressed his determination not to be in a situation like during the second wave in India when SII had to halt exports to meet local demand. He stressed the importance of having enough vaccine supply for everyone, given the constant emergence of outbreaks and endemic-type diseases worldwide.

“I decided that I don’t want to be in that situation again; I don’t want to make a choice between an African country or a South American country and India. There should be enough for everybody. Outbreaks and endemic-type diseases will keep emerging, and the world will always need someone to manufacture them at a low cost,” he had said.

The G20 nations have also prioritised addressing AMR through research and development, infection prevention and control, and antimicrobial stewardship efforts within their respective national action plans through AMR and antimicrobial consumption surveillance.

Dr Abdul Ghafur, consultant in infectious diseases at Apollo Cancer Institute, Chennai, and the managing trustee of the AMR Declaration Trust, stated, “This forward-looking vision is crucial in the global fight against AMR. In this context, it is noteworthy to mention that India is progressively establishing itself as a pivotal player in the discovery of new antibiotics and the development of groundbreaking diagnostic tools.”  Ghafur emphasised the importance of global collaboration and innovation in addressing such challenges.

VITAL SIGNS

·         Focus on strengthening primary health care and improving essential health services to surpass pre-                pandemic levels within the next 2–3 years

·         Recognise the potential role of evidence-based traditional and complementary medicine in health

·         Ensure effective participation of LMICs and other developing countries, leveraging local and regional              R&D and manufacturing capacities

·         Promote and improve access to mental health services and psychosocial support inclusively

·         Implement and prioritise addressing antimicrobial resistance through R&D, infection prevention, and                control