This one-day roundtable event involved opening and closing speeches, two sessions of moderated roundtable discussions, presentations on the G20 priority foci of Antimicrobial Resistance (AMR) and pandemic preparedness, the B20 and its health initiative as well as the current project, its Call to Action (CTA) output document and discussions on how to carry it forward. The stated objective was to create a platform for cooperation and policy advocacy for an open and unique coalition of organizations leading up to and following the Berlin declaration of the G20 Health Ministers and the Hamburg Summit.
Report
Jeremy Lefroy opened the event saying there were five key political challenges to global health and sustainable development:
1) long-term approach needed but if not pursued by parliaments it won’t be done – parliaments need to be interested;
2) close collaborations
3) better communication, especially of the good news
4) encourage young people to get involved in areas of research, development and politics
5) link national with international interests & issues.
Bernhard Schnittger from the European Commission (EC) highlighted the role and interest of the EC in global health, saying that it was the second largest funder of this area in the world and that global health is no different to things like terror, hacking – it can affect us everywhere, anywhere and anytime. He also said the “divide and conquer” approach was inappropriate to address global health, since diseases did not respect any borders.
Important aspects that were raised during session one “How global health partnerships changed the research and development landscape for neglected diseases” included:
- More flexible funding is needed for vaccine development for infectious diseases as well as more funding models are required generally combining private and public funding
- What does it take to get the product to where they need to go: talk to many stakeholders to establish volume, price, maintenance of manufacturing
- Important to involve ministers of health, finance & communities in order to ensure the uptake of the product
- Important to strengthen regulatory systems, which are part of health systems
- Funding is needed throughout the process: idea – development – market
- This is the role for PDPs, they have to step in here
- PDPs: to not just look at one product at a time but take several at once and test them together
- PATH – they have more than 100 products in their portfolio
- Julie Archer from FIND emphasised the role of diagnostics:
- There are big challenges in access
- Diagnostics are neglected / orphaned
- There is focus on vaccines and other drug developments but we need diagnostics to provide the right treatment
- Talent & capacity is there, what is needed is money and enabling policies, such as regulatory tools and guidelines
- Mr. Alsdurf (previously with TB Alliance): there is a need for a policy debate that does not create siloes between global health conditions and those more directly related to health security, citing the exclusion of TB from the WHO Priority Pathogens under the AMR agenda.
- The G20 and the policy response is important to avoid artificial distinctions on what an AMR pathogen is as, for a lot of the developing world - including in G20 countries - drug resistant malaria and drug resistant TB are the face of AMR, so including those in the same policy framework is important.
- Mr Lefroy pointed out that politicians tend to act in silos – we have to use the current advocates but increase the base of advocates of this field significantly and this has to be continued during the Argentinian presidency – politicians can be won over by providing compelling packs of information that are more frequent and smaller
- We need financial incentives to work on NTDs and should not let funding dictate research but research dictate funding
Prof. Richard Feiner, Columbia University, concluded session one with his comments on the importance he gave to teaching about cross-sectorial partnerships in the global health space and that he highlighted both CARB-X and CEPI in class as new financing mechanisms. He commented that the philanthropic focus was missing from the conversation and said that some of Dr. Hatchett’s earlier comments in particular would have a strong philanthropic pull as there was a wealth of invested philanthropists and social impact investors that would welcome entry into this space. He also mentioned that the non-profit sector in the US had no idea of all these initiatives
Session two then looked at “Looking Ahead: “Improving Global Health Cooperation to meet the Sustainable Development Goals” and important aspects included:
- Prof Helen Rees: When thinking about partnership, it is not just about G20 countries giving but ownership by receiving countries – own government money needs to be invested
- CEPI: how do they see themselves in 10 years? What is their vision
- Hatchett says it also depends on the visions of the partners
- It may be 3-5 years until some funded vaccines reach the mature point
- In 10 years they are hoping to be making investments in platforms – they would like the coalition to be enlarged, more inclusive with more international partners
- Looking for portfolio partnerships with partners
- Carb X – they have funding for 5 years so a 10 year vision is tricky
- It would be nice to not be needed in 5 years’ time
- It would be good not to have a model that is broken
- Transparency & value for money is something people, funders etc. are increasingly looking for
- Public sentiment is very critical and more justifications are needed
- G20 global Health is very focused on one part of the continuum – product development
- Implementation is equally important and must not be neglected
- Funding is not long-term and preventative
- Demand is high for funding but budgets are being tightened
- There are needs for open access, data sharing, communication, M&E increasingly needed, diagnostic
- An appeal was made for better coordination to avoid duplication
Overall, it can be said that maintaining a focus on the political - in addition to the scientific - aspects of global health was emphasized with the political figures present highlighting the need to embed government involvement in global health and innovation into the domestic political discourse. Related to this were the exchanges and comments on improving communication and significantly broadening the base of advocates (including global parliamentary champions) outside of the traditional areas of operation, using smaller - but more regular - conduits of information and facts on impact that are compelling and show value for money. These political and communicative aspects, combined with the need to embrace long-term approaches were reflected in broad support for the current dialogue and its continuation as a way of stimulating a broader multi-stakeholder coalition of advocates and a platform for creating innovative partnerships.
The group was introduced to a “Call to action” that had been drafted in preparation of this meeting by the event’s sponsors and hosts and that should be communicated to the G20 community to demonstrate the group’s stance and the needed action for global health. The final Call to Action can be accessed using the following link: http://sovereignstrategy.com/g20calltoaction/
Peter Hotez, via Skype, then gave a closing speech, stating that there was a shifting landscape in global health that calls for an increasing involvement of G20 countries. There are new challenges in terms of vector and airborne diseases, with NTDs emerging or re-emerging in a way that had not been envisaged by the MDGs. He highlighted that the poor in the G20 countries plus Nigeria accounted for most poverty-related diseases, and that this was not a resource problem but one of advocacy.
The overall sentiment at this event can be summarised by words spoken by Schultz-Asche in the morning, “there is a lot to do, so let’s do it”.