Civil society organisations and the Business 20 Dialogue all put their positions on the table before the opening of the first-ever meeting of G20 Health Ministers tomorrow in Berlin, Germany taking place tomorrow.

The B20 held a full day of workshops today bringing together industry, including big pharma companies, representatives of partnerships and international organisations. Before the workshops the B20 in their recommendations focused on incentives for innovation and R&D, public private partnerships for pandemic preparedness and response and  the big data potential for health care.

The German Platform for Global Health, an alliance of a dozen health and development NGOs, developed recommendations for the ministers during a one-day conference with experts from various countries on 15 May. They called on the G20 countries to  takes steps against the growing commercialization of health, shift the focus in free trade agreements and strengthen the WHO.

Without including political, development and economic factors into their considerations, there is no progress in fighting pandemics, warned Anne Jung from medico international.

Médecins Sans Frontières (MSF, Doctors Without Borders) President Joanne Liu, in an open letter asked to put the fight against antimicrobial (AMR) resistance and drug resistant tuberculosis much more prominently on the agenda and also address the attacks on medical facilities in Syria, Yemen, Sudan and Afghanistan. It is impossible to talk about strengthening health systems and neglect the destruction of these very systems at the same time, Liu said.

The G20 tomorrow and the next day (19-20 May) will engage in a health crisis simulation exercise and also try to iron out open issues for their joint declaration which feeds into the G20 Summit meeting in Hamburg in July.

Interestingly, the very issues that were raised by civil society organisations in their calls this week are still being debated controversially by the government representatives, namely the linking of health issues with broader societal, economic and environmental problems, the need for more financial support for example through an effort of each G20 country adopting one low income country to help build up its AMR capacity.

Also statements on the attacks on health facilities and the need for more and potentially alternative options to fund AMRs are still partly bracketed in the draft text for the final declaration.

One hot issue according to observers close to the process is if the delinkage of cost of investment in research from price and accessibility to the lifesaving drugs and diagnostic tools. While Brazil requests to include this, the US is one of the parties against it.