All (Rich and Poor Nations) Deserve Good Health: India’s G20 Presidency is Creating a Fairer Global Health Architecture

Context

• The first Joint Finance and Health Task Force (JFHTF) meeting under India's G20 Presidency was held recently in virtual mode.
• The article highlights this as an opportunity for India to set an agenda for healthcare as policymakers from member countries and medical fraternity experts unfold the framework of a Global Health Architecture (GHA) at subsequent JFHTF meetings.

Background: Efforts Advancing Global Health Agenda

• The Berlin Declaration of 2017 of the G20 health ministers provided a holistic approach focusing on pandemic preparedness, strengthening health systems and tackling anti-microbial resistance.
• The Covid-19 pandemic however added urgency to the pandemic preparedness and the G20 leaders under Indonesian Presidency in 2022 made it a major focus by launching Pandemic Fund to tackle the next global pandemic.
• The Bali Leaders’ Declaration 2022 also extended the mandate of JFHTF to continue the collaborations between Finance and Health Ministries for Pandemic Prevention, Preparedness, and Response.
• The Indian Presidency need to advance these agendas as GHA envisages equipping countries to face the next health emergency with robust healthcare systems and setting Global Health Priorities for 2023.

Need for Global Health Architecture (GHA)

• The Covid -19 pandemic made world leaders realise that a single country, however well-equipped with medical infrastructure, may not be able to tackle a crisis like the pandemic.
• Moreover, the situation in such times worsened for low and middle-income countries (LMICs) as their access to basic health has been limited and uneven.
• For example, while high-income countries raced to buy billions of doses of Covid vaccines, people from LMICs hence stayed unprotected and vulnerable during pandemic year with no access to vaccines.
• Hence, Indian PM has defined the central objective of India’s G20 presidency as “healing, harmony and hope” and envisaged a more human-centric globalisation where universal healthcare is a key priority.

How India’s Presidency Will Help in Forging GHA?

• While several countries endowed with better healthcare infrastructure faced challenges during Covid-19, India administered more than 2 billion doses to its citizens in an affordable, equitable manner.
• This was made possible through timely planning, efficient management of cold chains, good R&D, focused policy decisions and integrated implementation through strong Centre-state collaboration.
• India’s role in addressing life-saving vaccines inequity has also been appreciated worldwide.
• For instance, India provided critical doses of Covid vaccines to more than 100 countries during the Covid phase through the ‘Vaccine Maitri’ initiative without loss in quality or hiking the prices of vaccines and drugs.
• Hence, with this enriched experience, the G20 presidency provides India the mandate to assume a leadership position globally and propose a fresh vision of a healthier world order.

Key Priorities Related to GHA for India

• Priority 1: Strengthen national capacities to prevent, prepare for and respond to major outbreaks, synergizing existing strengths and identify bottlenecks in the system.
  • For example, a One Health Approach is critical for addressing the linkages between human, animal and environment sectors to resist the impact of Antimicrobial Resistance (AMR) on communities.
  • Partnerships with multiple organizations like WHO, World Bank, G7, etc.
  • Access to Covid-19 Tools (ACT) Accelerator that comprises four components namely Diagnostics, Health Systems, Response Connector and Therapeutics.
  • G20 India Health Track also aims to facilitate seamless interweaving towards a global health emergency architecture.
• Priority 2: Strengthen Pharma cooperation to improve equitable access to quality vaccines, therapeutics and diagnostics.
  • In FY 2022, pharma products worth $24. 47 billion were supplied by India to 200 countries.
  • Indian generics are valued across the world and India also provides affordable HIV drugs and anti-TB generics to several LMICs.
  • The government also introduced production-linked incentive schemes to promote domestic manufacturing of Drug Intermediates and Active Pharmaceutical Ingredients (APIs) to strengthen the pharma sector.
  • Bulk Drug Parks and Medical Device Parks are also being set up that will reduce the costs of production and enhance availability and affordability of medical devices.
• Priority 3: Digital solutions and innovations to aid universal health coverage.
  • The global Covid-19 experience demonstrated how digital technologies could help in remote data capture, medical diagnosis and virtual care.
  • The experience was transformative in India as millions of citizens used the CoWin App to access vaccines and India shared it with several countries as a digital public health good.
  • The online medical consultations in remote areas, Indian government’s free telemedicine service, eSanjeevani also proved to be life-saving.
  • For example, eSanjeevani has recently crossed a remarkable milestone of 90 million tele-consultations.
  • Under the universal health coverage initiatives such as Ayushman Bharat-PMJAY, more than 500 million people eligible for free-of-cost tertiary healthcare, backed by technology to make it portable, scalable and paperless across states.
  • India is also planning to draw a framework for the Global Initiative on Digital Health and harness the potential of artificial intelligence in building more resilient health infrastructure.

Conclusion

• While Italy (2021 presidency) and Indonesia (2022 presidency) concentrated on setting up regional manufacturing and research hubs, India’s G20 presidency proposes to address the gaps in the availability, accessibility and affordability of medical countermeasures globally.
• India’s presidency and collective efforts of G20 members will thus create an ecosystem that provides open access to several LMICs for more equitable healthcare.