Health Ministers from the powerful G20 nations have resolved to set up a “Global Coalition” to strengthen local and regional production to promote more equitable access to “safe, affordable, quality and effective health products and technologies”.

The primary focus of the coalition will be to strengthen the manufacturing capacities of countries to deal with “neglected diseases and persons in vulnerable situations”, according to a declaration adopted by the health ministers of the powerful group at their meeting in Rio de Janeiro last week.

It will start by identifying two or three projects to test approaches that could include “technical cooperation, advanced market commitments, voluntary technology transfer on mutually agreed terms, existing funding sources, regulatory cooperation and strengthening, and developing, regional environments that stimulate investments”. 

Two criteria will guide the selection of projects: the diseases they target and the technological platforms and capabilities they will use to promote more equitable access .

Brazil, the current head of the G20, is the key driver of the coalition and will serve as its the executive secretariat and presidency for the first two years. 

Membership will be voluntary and financed through projects by the involved participants and with no mandatory or fixed contribution from members or other institutions involved. 

It is “intended to promote synergies with existing and potential future initiatives, funding channels and philanthropic organisations,” according to the declaration.

The G20 stretches from the US to China, and also counts the African Union and the European Union as members. But non-G20 countries and international organisations that contribute to its objectives can join the coalition if approved by G20 members.

The World Health Organization (WHO) has already been invited to support the coalition by providing scientific and technical support, and help map existing projects to avoid duplication.

Praise for ‘visionary’ coalition 

The Global Council on Inequality, AIDS, and Pandemics, which is convened by UNAIDS  welcomed the establishment of the coalition to stimulate local production.

UNAIDS Executive Director Winnie Byanyima described the coalition as a “visionary, politically feasible solution [that] could transform global health for as long as it remains bold in vision and wide in scope.” 

Nobel Prize-winning economist Joseph Stiglitz, co-chair of the Global Council, said: “Reforms in both the developed and developing countries and in international agreements and institutions, and investments which help broaden the production of medical products and reduce prices are vital to address market failures and accelerate access to medicines for the people in greatest need.”

Brazilian Health Minister Nísia Trindade, who is also a member of the Global Council, said: “By building production capacity in every region, we can learn from past mistakes by ensuring that medicines for neglected and socially determined diseases are made around the world and that capacity is available to respond swiftly to future outbreaks.”

The health ministers also discussed the pandemic agreement negotiations, which re-convened in Geneva on Monday.

Brazil’s representative at the negotiations described the G20’s decision to establish the coalition as “particularly timely” for occurring shortly before the 12th meeting of the intergovernmental negotiating body (INB).

The G20 health ministers’ declaration also expressed their support for the conclusion of the INB process, reiterating their “commitment to an instrument that is ambitious, balanced, effective and fit-for-purpose, including equitable access to medical countermeasures during pandemics”.

Finance and health ministers

Health has been a central concern of Brazil’s G20 Presidency, and the country also hosted the joint meeting of G20 Finance and Health Ministers last week, which focused on addressing the social determinants of health, debt-for-health measures to bolster countries’ investment in health and pandemic prevention, preparedness, and response (PPR)

“Ministers underscored the need to enhance investments in health systems to bolster resilience, safeguard the global economy, and mitigate disruptions, particularly in anticipation of future pandemics,” according to a statement from the meeting.

“Health equity is one of our priorities and a transversal principle in all the discussions we are promoting,” Brazilian Health Minister Trindade told the meeting.

 “From climate change and its impacts on health to the health workforce and the One Health approach, we need to tackle inequalities and protect our most vulnerable populations,” she said.

Trindade also stressed the importance of the “debt-to-health swap” instrument, which allows part of the debts to be converted into investments for the sector, but warned that such instruments should complement rather than replace the efforts to restructure debt.

 “There is consensus on the importance of maintaining a voluntary basis for participation in debt-for-health swaps and aligning them with larger international health and development financing structures to maximise their impact,” she explained.