- We call for continuity of concerted action towards a whole-of-government and whole-of-society response through good governance of health systems and immediate and medium-to-long term multi-sectoral actions on the social, economic and environmental determinants of health, in every country, to strengthen prevention, detection, preparedness and response capacities, through a health-in-all policies approach. Urgent coordination is needed to strengthen health systems, foster social well-being and community trust by implementing high-impact policies to protect people’s health by working across all sectors for a "transformative resilience" approach. Principles of sustainability, inclusiveness, holistic vision, transparency, accountability, foresight and equality and equity must be at the center of a governance transformation of health. Within this context, linkages between human and animal health, the effects across One Health related to antimicrobial resistance (AMR), food systems, and environmental health, including climate change, ecosystem degradation, increased encroachment into natural systems and loss of biodiversity should be addressed through the One Health approach, leveraging and relying upon the technical leadership and coordinating role of the WHO, FAO, OIE and UNEP. The COVID-19 response and recovery efforts offer an opportunity to move in this direction, in order to ensure healthy lives and promote well-being for all.
- We identified key actions by focusing on the following four priority areas: healthy and sustainable recovery; building One Health resilience; coordinated and collaborative response; and accessible vaccines, therapeutics and diagnostics. HEALTHY AND SUSTAINABLE RECOVERY
- We call for collaborative multisectoral action to increase surveillance, strengthen prevention, preparedness and response for improved health outcomes and enhanced well-being for all, sustainable food systems, water and sanitation, and environmental protection. We highlight the need to build a strong, trans-disciplinary, holistic One Health approach with political commitment for long-term investment. This would enable us to strengthen and support resilient and sustainable health, social protection and food systems, and to address risks emerging from the humananimal-environment interface, leveraging the technical leadership and coordinating role of the WHO, FAO, OIE and UNEP. We will consider identifying key actions and calling upon relevant international organisations, partners in the health and private sectors, civil society, academia, philanthropic and research institutions to follow through on these actions.
- We welcome the role of the WHO and Member States to assist countries to strengthen their core public health capacities for disease surveillance and response; and we take note of creation of the One Health High Level Expert Panel (involving WHO, FAO, OIE, and UNEP); and of the Independent Panel on Evidence for Action against AMR, being established by FAO, OIE, and WHO; the WHO’s Global Hub for Pandemic and Epidemic Intelligence. We welcome the update provided by the WHO on its work to establish an international pathogen surveillance network which, alongside other centres, will enable detection of variants of concern and future pathogen threats. We look forward to the United Nations Food Systems Summit to take place in September 2021, the United Nations Biodiversity Conference 15th meeting of the Conference of the Parties to the Convention on Biological Diversity (COP 15) taking place in October 2021, and the 26th United Nations Climate Change Conference of the Parties (COP 26) taking place in November 2021 as well as the final report of the One Health Initiative Scope Study in March/April 2022.
- We commit to operationalizing the One Health approach at all levels, and collectively supporting the development by the WHO, OIE, FAO and UNEP of a common strategy, including a joint workplan on One Health to improve prevention, monitoring, detection, control and containment of zoonotic disease outbreaks (as in WHA74.7 resolution, 31 May 2021), with a joint vision and commitment to advancing collective action on One Health implementation, linked to related SDG targets; promoting multi-sectoral initiatives at appropriate local, national, regional, and international levels, sharing experiences and lessons learned in One Health implementation; supporting the development of joint capacity building initiatives and tools from international organizations related to One Health; improving preparedness through full IHR implementation and compliance, through cooperation and the development of core capacities, noting the role of relevant international organisations in that regard and encourage new public health guidance on international travel by air or sea, including cruise ships, based on the principles of inclusivity and non-discrimination. We aim to explore solutions, mobilize resources, raise awareness and look to funding from all sources, including existing national and international, to support the implementation of the One Health approach. We take note of the Call to Action on building One Health resilience developed by the Italian Presidency in collaboration with WHO, OIE, FAO and UNEP.
- Noting the significant impact that AMR stands to have on the attainment of the SDGs, there is a need for continued actions to tackle AMR in line with initiatives supported by previous G20 presidencies and consider more strongly the environmental dimensions of AMR. We reaffirm our high-level commitment to build capacities for national, regional and global interoperable early warning information and surveillance of AMR and antimicrobial use, to strengthen the One Health approach, to support the implementation of infection prevention and control (IPC) measures, including through water, sanitation and hygiene (WASH), as well as the prudent use of antimicrobials in humans, animals and plants through multilateral initiatives such as the Multi-Partner Trust Fund on AMR. Effective new technologies addressing AMR, including treatments, diagnostics and vaccines, as well as promoting access to existing, quality assured, essential antimicrobials, will be a central component in securing a resilient future, for our communities, human, animal health systems, the environment and economies. We therefore commit to continue our support for the development of new safe and effective antimicrobials, in particular antibiotics, and strive for sustained and reliable of supply and sustainable production of existing antimicrobials, by incentivizing the production of affordable generic antimicrobials and advancing appropriate usage/antimicrobial stewardship principles, to fight infections and preserve antimicrobial efficacy, strongly endorsed by the G20. As multidrug-resistant tuberculosis (MDR-TB) is estimated to account for one-third of all AMR-related deaths globally, sustainable and robust resources for TB R&D are needed in order to address the challenges of developing new tools and delivering on previous commitments from the G20 and the UN HLM on TB, AMR and UHC. We highlight the necessity for a rapid, articulated, multisectoral response, and the need to strengthen national TB strategies, as appropriate, with robust funding and technical cooperation, including to achieve the global goal of ending TB.
- We will continue to encourage strong collaboration between the members of the Tripartite and UNEP as well as the implementation of the Global Action Plan on Antimicrobial Resistance, FAO Action Plan on AMR, and the OIE Strategy on AMR and the Prudent Use of Antimicrobials, as well as the work of the Codex Alimentarius Intergovernmental Task Force on AMR, recognizing the different contexts and realities of countries, to accelerate actions against AMR at all levels. We also aim to promote collaboration on research and development, which may include through the work started under the German G20 Presidency, by strengthening the engagement with the Global AMR R&D Hub and leveraging its expertise across the One Health. We welcome the establishment of the Global Leaders Group on AMR to strengthen accountability and international cooperation structures and the Call to Action on Antimicrobial Resistance put forward at the United Nations High Level Interactive Dialogue on AMR in April - 2021.
COORDINATED AND COLLABORATIVE RESPONSE
- In line with the resolutions adopted by the 74th World Health Assembly on ‘Strengthening WHO preparedness for and response to health emergencies’ (WHA74.7) and ‘Protecting, safeguarding and investing in the health and care workforce’ (WHA74.14), G20 members should expand and transform the recruitment, development, education, training, distribution, retention and financing of the health and care workforce. We will invest in human resources for health and in health and care workforce readiness, education, training, skills and competencies, and build capacities for health preparedness and response, including through WHO’s Global Outbreak Alert and Response Network (GOARN), pre-service education and lifelong learning. We will work in partnership with WHO and the crucial role of the WHO Academy, which is also committed to develop One Health learning opportunities in conjunction with the OIE Training Platform and other potential partners, as well as other relevant training centres. In addition, we will contribute to the Member State led process to shape the 2022-2030 action plan for the ILO/OECD/WHO Working for Health programme and, as appropriate, work to ensure it is adequately resourced through its UN multi-partner trust fund. We recognize the importance of a pool of multi-disciplinary teams to facilitate assistance and response capacities nationally, regionally and internationally by expanding and strengthening national training programmes, with initiatives such as the Public Health Workforce Laboratorium for improving training in prevention, preparedness, and response to health - proposed by the G20 Italian Presidency.