The G7 Health Ministers met in Nagasaki, Japan on 13 and 14 May 2023 to strengthen global health architecture and recommit to universal health coverage. They also condemned Russia's war of aggression against Ukraine, which has caused intense suffering, loss of lives and serious damage to the country's infrastructure. They are committed to supporting Ukraine in their continued effort to protect the health of the Ukrainian people and will closely coordinate their respective G7 endeavours. The ongoing fighting between the Sudan Armed Forces and the Rapid Support Forces threatens the security and safety of Sudanese civilians and undermines efforts to restore Sudan’s democratic transition. The COVID-19 pandemic accelerated the development of countermeasures against infectious diseases and led to unprecedented rapid research and development (R&D) and roll out of medical countermeasures (MCMs).

It is necessary to establish an MCM ecosystem that has equity, inclusivity, efficiency, affordability, quality, accountability, agility and speed for pandemic prevention, preparedness and response (PPR), including to accelerate the cycle from the R&D of safe and effective MCMs to their access and cutting time-frames for manufacture, delivery and administration of VTDs. Global health needs to remain at the top of the global agenda. The G7 Health Ministers have committed to working together for a healthier future across three areas: global health architecture, UHC, and health innovation. They emphasize the importance of prevention, solidarity, equity, inclusiveness, multisectoral cooperation, and coordination among national, regional, and global actors. Regional-level efforts are critical to catalysing processes of country-by-country and needs-based actions, while collaborative and interdisciplinary research networks, partnerships, and data modernisation efforts are essential for enabling the rapid sharing of information, data, and samples.

Cooperation among countries and regions is also important to strengthen pandemic PPR and promote timely and equitable access of safe, effective, quality-assured and affordable MCMs for public health emergencies. The G7 Pact for Pandemic Readiness calls for increased networking between countries and regions to strengthen health workforce and early detection, swift containment, and sharing timely research. They also support WHO for its central leadership and coordinating role in global health, and applaud the decision at the 75th WHA to increase the share of assessed contributions to 50% of WHO’s 2022-2023 base budget. They also call for enhancing political engagement towards a more coordinated, sustained and stronger governance at all levels, and acknowledge the leading role of WHO in this regard. Governance, financing, legislation and regulation, production, allocation, supply, and delivery are essential for promoting equitable and rapid access to safe and effective MCMs.

This includes strengthening collaboration between Finance and Health Ministries, the G20 Joint Finance and Health Task Force, the WB, the WHO, and other relevant international organisations. Governance, financing, legislation and regulation, production, allocation, supply, and delivery should be guided by equity, inclusivity, efficiency, affordability, quality, accountability, agility and speed and improved coordination and cooperation among all relevant stakeholders. The World Health Organization (WHO) and other international fora have acknowledged the importance of improved coordination and information sharing in order to prevent, prepare for, and respond to future health emergencies. The Pandemic Fund has been established to catalyse resources for disease surveillance systems, laboratory systems, and strengthening human resources, including emergency health workforce, across human health, animal health, and environmental sectors for better prevention and preparedness for future pandemics. The WHO and other donors have committed to enhancing financial, political, and technical support to ensure the Pandemic Fund’s operational success.

The G7 committed to supporting at least 100 LMICs in implementing the core capacities required in the IHR for another 5 years until 2027. They also committed to strengthening financing for pandemic “response” and to contributing to and sustaining momentum on the ongoing discussions at the Intergovernmental Negotiating Body (INB) to conclude the negotiations on a WHO CA+ by 2024. They also reiterated their firm commitment to contributing to and sustaining momentum on the ongoing discussions at the Intergovernmental Negotiating Body (INB) to conclude the negotiations on a WHO CA+ by 2024. The WHO CA+ needs to cover the full cycle of pandemic PPR, including prompt sharing of pathogens and genetic sequence data in a biosecure, biosafe, and responsible manner. To prevent pandemics, the instrument should tackle AMR in an efficient and effective manner, and strengthen linkages and synergies of health systems across countries.

Additionally, the multisectoral stakeholder participation and collaboration is essential for R&D, manufacturing, equitable access and rapid delivery of MCMs, gaining communities support and trust, and improving health literacy. Rapid, transparent, effective, multisectoral, and cooperative action for collaborative disease surveillance in humans, animals, and the environment and open data sharing are necessary to detect zoonotic spillover and spillback, emerging, and re-emerging diseases and/or variants with epidemic or pandemic potential earlier. Multi-sourced and integrated surveillance systems, including community-based surveillance, are needed to provide continuous comparison and assessment of data and information across the human health, animal health, and environment sectors. The Global Polio Eradication Initiative (GPEI) is an important resource for public health emergencies and to stay on track for polio eradication by 2026. Regional hubs can play an important role as a resource for supporting countries for managing local and regional infectious diseases to prevent them from developing into pandemics.

The WHO has highlighted the importance of understanding the origins of the SARS-CoV-2 and a scientific necessity in order to prevent and prepare for future pandemics. Human resources for health, including the public health and emergency workforce, and community health workers, are the backbone of high-quality and resilient health systems. Lack of investment in health workforce education and training contributes to chronic workforce shortages. The WHO Academy and Gender Equal Health and Care Workforce Initiative are important initiatives to tackle gender inequity and inequality in the health sector. The most important details are that coordination of activities based on global health strategies and relevant policy documents is essential for strengthening GHA and supporting countries in their efforts to achieve UHC, and that the COVID-19 pandemic has demonstrated the critical importance of achieving UHC by strengthening health systems at all levels.

Additionally, research into and management of long-COVID and developing and providing appropriate care are needed to understand its impact on patients. The G7 has recommitted to working alongside global partners to help countries achieve universal health coverage (UHC) by supporting primary health care (PHC) and developing and restoring essential health services, to achieve better than pre-pandemic levels by the end of 2025. Implementation is tailored to each country’s circumstances and capacity to embed health in all policies, taking into account the specific legal, resource, cultural, 10 11 and economic conditions as well as the relevant stakeholders in each country. The G7 Global Plan for UHC Action Agenda outlines these initiatives. The G7 has committed to working together to promote universal health coverage (UHC) and align with national plans to achieve more resilient, equitable, and sustainable UHC in each country.

They will work together to achieve meaningful and impactful outcomes of the UNGA HLMs on UHC, pandemic PPR, tuberculosis (2023), AMR (2024), and NCDs (2025) while ensuring synergy among them. They will also explore innovative approaches such as expanding impact 11 to further harness private capital at scale. 12 investments in global health are being made to contribute to generating positive and measurable social impacts and financial returns. These investments will be funded and partnered with relevant stakeholders, such as WHO, WB, Gavi, Unitaid, the Global Fund, the Global Financing Facility and the Pandemic Fund. They will also work together with relevant stakeholders to make global health partnerships more efficient, effective and resilient.

Additionally, they will mainstream nutrition services within UHC to end malnutrition, which is an underlying cause of almost half of child deaths. The most important details in this text are the importance of addressing gender inequality, the importance of promoting WASH, the role of the UN, Global Health Initiatives and International Financial Institutions in preventing and treating malnutrition, the need to improve access to quality mental health services, and the need to make mental health one of the priorities for achieving UHC. Additionally, the text emphasizes the importance of healthy ageing as one of the most pressing health needs and is a key component for achieving UHC. Community-based comprehensive care is necessary to address the challenges of ageing. It includes medical and mental health services, home care, long-term care, dementia-inclusive communities, health promotion, and disease prevention.

We commit to taking steps to ensure universal access to comprehensive health services, including rights-based family planning, MNCH, menstrual health, STI prevention, sexuality education, mental health, safe and legal abortion, and post-abortion care. We will advocate for the inclusion of comprehensive SRH services as an essential part of UHC at the PHC level. We will contribute to relevant funds and support countries through multilateral regional and bilateral cooperation to deliver equitable and quality essential health services. We will pay close attention to the impact on comprehensive SRHR and accelerate achievement of SDGs 2, 3, 5 and 6. Environmental protection and climate change mitigation and adaptation can improve human and animal health and wellbeing.

The Triple Planet Crisis of climate change, biodiversity loss and pollution are global issues with significant impacts on human and animal health and the environment. To address these issues, the Quadripartite, constituted of WHO, FAO, UNEP and WOAH, will work together to implement the One Health approach, support and accelerate the achievement of the SDGs and UHC for all, and call for urgent strategies and action. To promote health innovation, stakeholders from all sectors should work together, such as through public-private partnerships. The most important details in this text are the importance of an end-to-end MCM ecosystem, the development of an MCM delivery partnership for equitable access, and the need to foster innovation and strengthen R&D through global cooperation and equitable partnerships. Additionally, the importance of building more resilient and sustainable health systems to support equitable access to MCMs for all, and the importance of an MCM ecosystem that is effectively coordinated across stakeholders to promote equitable access to MCM worldwide.

The ACT-A experience has highlighted the importance of creating an enabling environment for equitable, transparent, effective, and affordable access to vaccines and other medical products. This includes collaboration with relevant governments, multilateral partners, regional organisations, multilateral and bilateral development banks and initiatives, civil society and private partners. Low vaccine confidence and hesitancy are major issues that impede high vaccination rates, and we should work collectively to increase vaccine confidence. Innovations in infectious disease prevention and laboratory detection, treatment and control are essential to limiting the emergence and impact of AMR and strengthening UHC and improving pandemic PPR. We support investing in the development and adoption of innovative technologies and practices, including non-pharmaceutical interventions.

The World Health Organization (WHO) is committed to addressing infectious diseases, such as COVID-19, HIV/AIDS, tuberculosis, malaria, and NTDs, as well as AMR. To address AMR, the WHO is exploring and implementing push and pull incentives to promote investment in R&D of antimicrobials. Additionally, the WHO is promoting solutions that address the antimicrobial pipeline, protect and work towards maximising the effectiveness of existing antimicrobials through antimicrobial stewardship, and reduce the need for antimicrobials through infection prevention and control. Additionally, the WHO is promoting national and regional activities, such as information and surveillance data sharing, to tackle AMR. The G7 is committed to incentivising antimicrobial resistance and development (AMR) by supporting the Global Antimicrobial Resistance and Use Surveillance System (GLASS), the Global AMR R&D Hub, and the Quadripartite.

It also encourages member states to develop and implement strategies and action plans to address risk factors and social and environmental determinants of dementia, and to enhance early detection, diagnosis, and interventions. It also encourages the development of potentially disease modifying therapies for various types of dementia, including Alzheimer’s disease. The most important details in this text are that data and cost-effective digital technology are key drivers of innovation in health services, and that international dialogue and collaboration is needed to establish trusted global digital health networks and data modernisation efforts. Additionally, the need for improved multisectoral and transdisciplinary collaboration and links between health of people, animals and ecosystems is highlighted, and that the COVID-19 pandemic has revealed the need for improved multisectoral and transdisciplinary collaboration and links between health of people, animals and ecosystems. Finally, the need for improved multisectoral and transdisciplinary collaboration and links between health of people, animals and ecosystems is highlighted.

The most important details are the importance of implementing the Kunming-Montreal Global Biodiversity Framework, the One Health approach, and the Quadripartite playing a key role at the international level. Additionally, the Quadripartite plays a key role at the international level, and complementary international initiatives such as PREZODE and ZODIAC are welcomed.

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