G7 performance on health

The Hiroshima Summit is an opportunity to move beyond reacting to the emergency of Covid-19 and shift focus to tackling long-term health challenges – but only if G7 leaders can harness the momentum driven by the pandemic

Although health has featured at the top of the G7’s agenda in the past few years due to Covid-19, the G7 has a long history of acting on health. The G7 first addressed the issue in 1979 when it committed to working with developing countries on hunger and malnutrition. Since then, the G7 has played a leadership role by working to improve infant, child and maternal mortality, and by collaborating on preventing and responding to infectious diseases.

Conclusions

Since the G7’s 1975 creation, leaders have dedicated 55,921 words in their regular summit communiqués to health, averaging 1,165 words, or 9%, per summit. They have produced 88 stand-alone documents on health.

Health first appeared in G7 communiqués in 1979. But only since 1996 has it appeared at every summit. It received the highest number of words in 2016 at 6,087, for 26%. Between 2001 and 2016, peaks for health were in the 20% range: 2001 had 24%, 2003 had 22%, 2006 had 23%, and 2010 and 2016 had 26% each. Health has been a significant focus since the Covid-19 pandemic struck. It peaked at 72% of the total words in 2020. In 2021 it decreased to 24% and fell to 17% in 2022.

Commitments

G7 leaders have made 687 collective, politically binding, future-oriented, core commitments on health. These cover malnutrition, health research, ageing, illicit drugs, Covid-19 and more.

Between 1975 and 1999, health commitments represented less than 10% of the total across all subjects. This portion rose to 13% in 2000. It dropped to 5% in 2001 before increasing to 10% in 2002 and dipping below 10% for the next several summits. It reached a new peak of 18% at the 2006 summit. Other peaks came in 2010 with 17%, 2015 with 16% and 2016 with 24%.

In response to the pandemic, the virtual summit in 2020 produced the highest peak, with 44%. Health remained a major focus in 2021 with 21%. It decreased to 7% in 2022.

Compliance

Commitments are important but are effective only if G7 members comply with them. The G7 Research Group has assessed 91 of the 687 health commitments for compliance. Overall, compliance averages 78%, slightly above the 76% average across all subjects.

Compliance with commitments is inconsistent, subject to many peaks and dips. The first commitments assessed, in 1983 and 1997, received full compliance. Compliance from 1998 was 68% and from 1999 was 50%. This rose to 91% from 2000 and 94% from 2001. Other peaks came in 2003 with 90%, 2007 with 86%, 2012 with 100%, 2013 with 95%, 2014 with 92% and 2015 with 86%. The G7’s lowest compliance ever came from 2017, with just 25%. But compliance has risen since then to 71% from both 2018 and 2019, 95% from 2020 and 91% from 2021. Halfway between the 2022 and 2023 summits, compliance was already 75%.

Causes and corrections

G7 leaders can do three things to sustain and improve the G7’s already significant compliance with its health commitments.

First, they can ensure that these commitments refer to core and related international health organisations, specifically the World Health Organization and the United Nations. Indeed, commitments that reference the WHO average 83% and those referring to the UN average 91% – both well above the 78% average for all health commitments and the 76% overall average.

Second, commitments that include mobilising money, such as pledging financial support to the Global Fund to Fight HIV/AIDS, Malaria and Tuberculosis, average 76% compliance, close to the 78% average for health.

Third, commitments made at the five summits with pre-summit health ministerial meetings (2006, 2015, 2016, 2020, 2021) averaged 82% compliance. Those without such a ministerial averaged 76%. Japan’s 2023 presidency, with its pre-summit health ministerial meeting in May, bodes well for compliance with its summit health commitments. For 2024, Italy’s G7 presidency should maintain this trend.

At Hiroshima, G7 leaders can move beyond reacting to the emergency of Covid-19 and focus on effectively addressing long-term health challenges, if they can harness the momentum and urgency caused by the pandemic to make more health commitments that refer to the WHO and UN, mobilise money, and build on the meeting of their health ministers.