As many of you know, global health is riding high on the G20 agenda. As Ilona Kickbusch notes this is largely thanks to Germany so it is no surprise then that the first ever G20 Health Ministers meeting is being hosted by Germany on 19, 20 May. At the meeting in Berlin, themed “Promoting Health”, G20 Health Ministers will tackle antimicrobial resistance and engage in a pandemic preparedness exercise “to improve the resilience of health systems” (i.e. global health crisis management & HSS all in one, if you want).
To provide input into this, albeit limited, remit the the German Platform for Global Health convened an international symposium entitled “Control or Prevention – the G20 Summit and Global Health” in Berlin on 15 May. Thomas Gebauer of the German based NGO Medico International challenged symposium participants to question the tension between the global health security focus of the G20 Health Ministers and universalism – asking if global health security is simply about protecting “us” (people lucky enough to have access to quality UHC or wealthy enough to afford quality health care) from “them” (those lacking access to affordable, quality health care). The responses from the speakers were surprisingly similar for a geographically and professionally diverse group. Amit Sengupta (People’s Health Movement) and Anne Roemer-Mahler (University of Sussex) highlighted the tension between the health security agenda and health for all noting that focusing on technological solutions often circumvents important political discussions about who sets global health priorities and the need to address the social and economic determinants of health. Others speakers, like Odile Frank of the NGO Forum for Health, highlighted the importance of reconfiguring the deeply inequitable status quo by looking beyond health institutions, to other key players like the International Labor Organization.
For me, the audience’s contributions were as interesting as the speakers’ messages. The audience of approximately 100, was largely comprised of students under the age of 30 – and the speakers, were, well, all past that age. On average I would say there was a generation between the two groups. In their interventions audience members emphasized the importance of the environment to global health and wanted to know more about concepts like planetary health. They fully understood the One Health link between AMR and farming discussed by Christian Wagner-Ahifs of BUKP Pharma Kampagne and the importance of a multi-pronged strategy. Many audience members pointed out that the links between global health security, development, migration and planetary health require the political engagement of Health Ministers beyond the traditional health field. The discussions also explored the tensions between national solidarity, advocated by trade unions, and global solidarity and the importance of acknowledging this challenge.
I took away three main messages from the day. First, progress in global health requires engaging with big picture influences on health, like the planetary boundaries we hurtle towards. Second, a response to global health threats that focuses on “medical countermeasures ” (that wonderful American term for e.g. drugs, devices, …), while necessary, is certainly not sufficient for advancing global health goals like the SDGs or health for all, which require social counter measures (perhaps even more), like globalized social protection and an international tax body. Finally, all present noted that this systemic change will take time and commitment and that garnering support for hard to measure objectives is difficult. This is why engaging young people in this struggle is vital. Their active political engagement and challenging of a global health agenda rooted in health security is the only way we will get real change. This requires a long term commitment to education and activism for global health justice, like that shown by the Emerging Voices. So, while the first ever G20 Health Ministers meeting is a welcome development its value can be judged by whether discussions and commitments move beyond the limited health security agenda to include prevention.