NEW YORK CITY – Brazil is advancing two major health-related declarations – on climate and One Health and on local medicines production – that it hopes to have ready for the upcoming G20 Summit that it is hosting in Rio in November.

Despite political pushback, Brazil’s Deputy Minister of Health expressed hopes that the two declarations would be ready in time for the November Summit, marking the end of Brazil’s G20 Presidency. 

“I’m a believer. So I think that in the end of the June 20 presidency, we will have these two declarations in place,” said Vice Minister Dr Ethel Maciel.

She was speaking at a side event Tuesday on Pandemics, Climate and Conflict hosted by the Pandemic Action Network (PAN),  ahead of a UN High Level Meeting on Antimicrobial Resistance (AMR), scheduled for Thursday. 

The G20 Leaders’ Summit is scheduled for 18-19 November in Rio de Janeiro, and will be attended by 19 member states, plus the European Union and the African Union. 

The declaration on local production of medicines and vaccines aims to accelerate the recent drive to expand  pharma manufacturing in low- and middle-income regions that found themselves unable to secure significant supplies of critical health products during the COVID pandemic, Maciel said.

“The pandemic showed us the importance of local production in the regions, because if we cannot depend on only one or two countries for our pharmaceutical components; we need to have capacity-building in the region.”

G20 Climate and health declaration to have AMR focus

The declaration on Climate and One Health. meanwhile, will have a specific focus on AMR  – the growing trend of superbugs that do not respond to available antibiotics, antiviral or anti-parasitic medicines, she noted. 

“Health is a very important argument to climate change, because the health sector is at the frontier of climate change; we are the first sector that has the impact, that has suffered the impact of the climate change,” Maciel said.  “And we took AMR as a pathway for work on the One Health approach,” she added.  

The wide-ranging event featured over a dozen global health government and agency leaders, as well as ‘Elders’, Helen Clark, former New Zealand Prime Minister; Ellen Johnson Sirleaf, former Liberian President; and Juan Manuel Santos, Former President of Colombia.

Climate change, AMR and pandemics

Maciel and other panellists underlined how the issue of climate change, AMR trends, and pandemic risks are all deeply interlinked but not well understood. 

An estimated 1.14 million people died in 2021 from drug resistant bacterial diseases alone, while a total of 4.71 million people die from bacterial conditions that may have some association to drug resistant pathogens. And that number could double by 2050, with a total of 39 million AMR-related deaths between 2025 and 2050, according to the latest estimates, published by The Lancet, in mid-September.  

So far, most of the policy emphasis on combatting AMR has been focused on the more judicious health sector use and administration of antibiotics, antivirals and other drugs in humans – as well as research to develop new drug solutions. 

However, the even wider use of such drugs in industrial livestock and fisheries production, as well as plant agriculture, has been largely neglected by global health leaders. 

More than 73% of all antimicrobial drugs sold globally are used in animals not people – highlighting their large contribution to AMR trends – and pandemic risks.  Even so, targets for reducing animal antibiotic use were dropped at the last minute from the draft text of the UN High Level declaration on AMR, to be approved Thursday, under pressure from a coalition of meat-producing nations.  

Unsustainable practices in these sectors also contribute to deforestation, coastline degradation, and biodiversity loss – which in turn drive climate change.  

These, in turn, exacerbate conflicts over land and resources when communities face drought, a loss of livelihoods and displacement. 

It’s a complex web of connections that gets far too little attention, said Joanne Liu, former International President of Médecins sans Frontières and now a professor of global health at McGill University in Canada.

“Climate and conflict, that’s really, honestly, a toxic mix,” Liu said. “It’s an amplifier of existing problems.” 

Tackling AMR to address One Health and climate 

Brazil is currently at a nexus of many One Health and climate issues, which have also been highly politicized, Maciel noted.

The country is battling wildfires, many set deliberately by loggers, ranchers and others who support the policy lines of former president Jair Bolsonaro,. They aim to continue deforesting the Amazon and the Pantanal, the world’s largest tropical wetland, to expand grain, livestock and mineral production – without any regard to the climate impacts. 

The number of fires in the country have more than doubled compared to last year – darkening the skies over cities from Buenos Aires to La Paz, Bolivia. The fires are so vast – with one-half burning in pristine forests – that critical tipping points for some of the world’s most important carbon sinks may soon be breached. 

“In Brazil, we have a very polarized country as here in the US and people that follow one politician, they don’t believe in climate change,” Maciel said. “We have a lot of wildfires that people are setting by themselves. More than 50 people are under investigation by the Supreme Court for setting fires… because they don’t believe in climate change.”

Health on the pathway to COP30 in Rio

Against this background, Brazil’s push in the G20 to win approval for a declaration on One Health and Climate aims to bring this complex thicket of issues down to a more practical level, the Brazilian vice minister said. 

One Health is a ‘very abstract’,” she noted, whereas AMR is beginning to be understood as a tangible health threat. “We hope, with this declaration, that climate change and a One Health approach will be linked with AMR.” 

At the same time, the G20 resolution is not a foregone conclusion. The negotiations to arrive at a diplomatic consensus on the text have been much more difficult than expected. There will be another meeting of G20 negotiators in Rio, ahead of the Summit, to attempt to finalize a text. 

If consensus is achieved, Brazil also hopes it will build momentum toward a major emphasis on health at next year’s UN Climate Conference (COP30), which the country is hosting in Rio. 

A first-ever Climate and Health Day was convened at last year’s COP28 Conference in Dubai.  A second health day is now planned for COP29 in Baku – with the possible launch of a new Health and Environment Coalition, according to WHO. 

But health and climate advocates are looking to the Rio conference in 2025 to outshine everything else – an aspiration shared by Brazil.  

“We started in the Cop 28 with the Health Day, and now in COP 29 [Baku 2024] there will be a Health Day.  And at COP 30, we want a big Health Day in the climate change conference,” said Maciel. 

Trust in science 

Although evidence about the vast array of linkages between climate, health, and disease risks is constantly expanding, disinformation remains a huge problem in terms of getting policymakers to accept the evidence, and move on it, Maciel observed.  

Trust in science remains a key challenge, agreed John-Arne Røttingen, CEO of the UK-based Wellcome Trust, one of the world’s largest philanthropic funders of research.  

“Climate is also worsening climate sensitive infectious diseases, and people are concerned about climate,” he said.

“So how can we better really understand the already existing health impacts from climate both directly due to heat and extreme weather events. And how can we take climate action that will also deliver health benefits here and now? 

“I think people need to see a here and now benefit.

“And although this is driven by science and scientific solutions, we also need to work on the broader issue of trust in science, trust in scientific knowledge, and the solutions that can be derived from science.”

Image Credits: Staicon Life/Flickr, TB Alliance, Van Boeckel et al, Diego Baravelli/GRAB via Environmental Justice Foundation (EJF)., Commons Wikimedia.