Context

• India’s assumption of the presidency of the G20 in 2023 forming the G20 troika with Indonesia and Brazil, marks the first time that the troika has been constituted solely by members from Low and Middle-Income Countries (LMICs).
• It is an opportunity to shape action, particularly in health care, toward their needs.

About G20 and its significance

• Founded in 1999, the Group of Twenty (G20) is the premier forum for its members’ international economic cooperation and decision-making.
• It is an international forum, made up of 19 countries and the European Union, representing the world’s major developed and emerging economies.
• The G20 comprises Argentina, Australia, Brazil, Canada, China, European Union, France, Germany, India, Indonesia, Italy, Japan, Mexico, Russia, Saudi Arabia, South Africa, South Korea, Turkey, UK and USA. 
• It works to address major issues related to the global economy, such as international financial stability, climate change mitigation, and sustainable development
• The G20 Summit is held annually, under the leadership of a rotating Presidency. 
• Troika refers to the top grouping within the G20 that consists of the current, previous and the upcoming presidencies.
• Together, the G20 members represent 85% of global GDP, 75% of international trade and two-thirds of the world’s population.

India’s priorities

• In health, India has identified the following priorities: 
  • Health emergency prevention, preparedness, and response, with a special focus on One Health and antimicrobial resistance; 
  • The strengthening of cooperation in the pharmaceutical sector with a focus on access to safe, effective, and affordable medical countermeasures.
  • Digital health innovations and solutions to aid universal health coverage and the improvement of healthcare service delivery.

Why should health be a priority?

• Lessons from COVID-19
  • The Covid-19 pandemic exposed deep vulnerabilities in the capacity of countries to deliver health services in a pandemic situation. 
  • Covid-19 has illustrated how gaps in vaccine distribution, exacerbated by hoarding, place an undue burden on poorer countries.
• Impacts of future climate change
  • Risk of spread of infectious diseases is very high, given the consequences of climate change. (climate refugees migrating to overpopulation area)
  • Predicted increase in frequencies of extreme events, with droughts, wildfires, and storms may result in adverse consequences for mental and physical health.
• Need for One-Health perspective 
  • As most of the emerging infectious diseases are ‘zoonotic’, the health of entire ecosystems is to be given importance.
• Increasing Antimicrobial resistance
  • Increasing ability of the bacteria that cause disease to evade antibiotics is a cause of concern.

Recommendations

• Dealing with anti-microbial resistance requires a better understanding of those social determinants of disease that contribute to antibiotic misuse.
• Developing nudges that encourage more rational use of antibiotics at the individual level, as well as shifts in government policy to penalize indiscriminate antibiotic use, is an area where G20 countries could share lessons.
• Multilateral initiatives that address the interests of LMICs in accessing health care services would contribute to greater equity. This may include
  • Diversifying locations where vaccines and drugs are made
  • Enabling the transfer of the appropriate technology. 
• The ability to maintain a long-term, accessible record of the trajectory, medical reports, and treatment regimes of individual patients in digital format which is transferable across states and possibly across countries, will be an increasingly important dimension of health in the future.
  • India’s Ayushman Bharat Digital Mission, launched in 2020 in digitizing the health ecosystem could serve as a model to other LMICs.
• Ensuring privacy and security of health data, the elimination of the digital divide, as well as the requirement of balancing public good with privacy should form part of the G20 deliberations. 

Conclusion

India should reminisce the quote said by Mahatma Gandhi, “Recall the face of the poorest and weakest man you have seen, and ask yourself if this step you contemplate is going to be of any use to him” and make use of the opportunity to table effective policy decisions regarding health in its G20 deliberations.