The United States, backed by Argentina, was reportedly blocking the G20 consensus on the final G20 Health Ministers’ statement – following their fourth and final working group meeting of the year Friday in Limpopo, South Africa, Health Policy Watch has learned. 

In a visible snub to the rest of the group, the US delegation also walked out of the meeting shortly after delivering their opening statement as part of the “Troika” of past, present and upcoming presidents of the Group of 20 annual meetings.  The G20 group of the world’s leading economic players, includes the European Union as well as 19 other nations, accounting for 85% of the world’s economic output and 75% of trade. 

The US is scheduled to host the G20 talks in 2026, while Brazil hosted the meeting last year. 

Rather than a ministerial declaration, approved by consensus, an “Outcome document and Chair’s Statement” was due to be released by the G20 group, sources told Health Policy Watch on Friday evening.  

Statements on climate and multilateral cooperation on pandemic prevention 

The draft statement, seen by Health Policy Watch on the G20 letterhead, includes key references to prioritising universal health coverage (UHC) through primary health care systems; investments in health financing and health protection (e.g. insurance) systems; investments in the health workforce; as well as initiatives to combat noncommunicable diseases (NCDs) and antimicrobial resistance.  

However, the statement also stresses multilateral action on climate change as well as pandemic prevention, preparedness and response (PPPR) – to which the US Administration of President Donald Trump is vocally opposed. 

“The recently adopted WHO Pandemic Agreement presents an opportunity to strengthen PPPR with equity at its centre and in line with the principles of sovereignty, solidarity, respect for human rights and inclusivity,” according to the draft Outcome and Chair’s statement, seen by Health Policy Watch. The statement had not yet been published on the Health Track of the G-20 website, at the time of this publication. 

At the same time that the United States withdrew from the WHO, US officials also  repudiated the Pandemic Agreement, framing it as an assault on nations’ sovereignty. The agreement, which took over two years to negotiate, was finally approved by WHO member states in May.

The Outcome statement also stresses the importance of a “timely conclusion of the negotiations on the Pathogen Access and Benefit Sharing System Annex (PABS Annex).” 

The US is reportedly planning to actively circumvent any PABS agreement with bilateral deals with countries that would condition global health aid they received to their bilateral sharing of data on pathogens with “epidemic potential.”  See related Health Policy Watch exclusive:

EXCLUSIVE: US Ties Global Health Aid to Data Sharing on Pathogens – Undermining WHO Talks

Environmental and climatic impacts on health and health systems 

The Outcome and Chair’s statement  also calls attention to the impacts of “environmental and climate change on global health and health systems, including human and environmental health, and its impact especially on those in vulnerable situations and developing countries.” 

It warns, in particular, of the “impact on health of harmful human activities including land-use change, pollution of air, soils and water, on ecosystems and biodiversity loss which undermine health systems’ ability to adapt and promote health resilience, these heighten the risk of zoonotic diseases and their spillovers.”

The statement also recognizes “the critical need for a coordinated, integrated, and well-resourced global response that encourages health within relevant climate action frameworks,” citing a long list of multilateral conventions and environmental agreements, beginning with the 1992 Rio Declaration, and also including the 2015 Paris Climate agreement; the 2024 G20 Health Ministerial Declaration on Climate Change, Health and Equity adopted in 2024 in Rio de Janiero, Brazil; and the 2024 WHO Climate Change and Health Resolution. A follow-up Climate Change and Health Action Plan was adopted at the May 2025 World Health Assembly after a Saudi-led effort to shelve it failed. 

Donald Trump says he won’t attend G20 Summit 

Friday’s Health Ministers’ meeting comes against the background of statements yesterday by US President Donald Trump saying that he would not attend the G20 Summit, scheduled for 23-24 November in Johannesburg. 

On Wednesday, Trump even called for the removal of South Africa from the group of economic leaders.

Speaking at an America Business Forum in Miami, Trump said South Africa shouldn’t be in the G20 – while seeming to confound South Africa with South America – saying that “for generations Miami has been a haven for those fleeing communist tyranny in South Africa.”  

President Trump, speaking at the America Business Forum in Miami, appears to make a mistaken reference to South Africa in relation to people fleeing communism (to Miami, Florida?). And then double’s down by attacking South Africa, including its hosting of the G20, reasserts that… pic.twitter.com/j2Vi7ls4PQ

— Sherwin Bryce-Pease (@sherwiebp) November 5, 2025

Image Credits: G20.org, Health Policy Watch .