Health as an economic priority – building on the momentum of the G20 South Africa presidency

South Africa leads the G20 this year at a moment of profound global shifts. In an era of competing priorities and geopolitical tensions, the fact that the South African presidency has placed health and financing as one of its central tracks deserves recognition. It reflects the understanding that health is not just a cost, but a strategic economic investment that drives growth and resilience. 

Building on this momentum throughout the next G20 Presidencies has the potential to embed health as a foundational pillar of the global economic agenda. By looking at health as a foundation, rather than a sectoral issue, future G20 presidencies can send a clear signal that investments in disease prevention, health innovation, and universal health coverage (UHC) play a key role in strengthening economies and reducing inequalities. 

Prevention as the first line of growth, with immunisation as
a multiplier

At the core of the South African G20 health agenda is UHC, with a focus on primary health care. This approach is inclusive and cost-effective in improving health while preparing for future emergencies. The World Health Organization (WHO) estimates that 4.5 billion people worldwide were not fully covered by essential health services in 2021. 

According to WHO modelling, scaling up primary health care interventions in low- and middle-income countries could save some 60 million lives and add almost four years of life expectancy on average by 2030. These are the kinds of gains that the G20 can help unlock, by elevating health at a higher level. 

One critical pillar of this is embedding immunisation throughout the life-course. Robust national immunisation programmes, reaching people of all ages and across the life-course, are key as they help reduce the burden of preventable diseases, protecting people and societies. A 2024 analysis by the Office of Health Economics showed that adult immunisation programmes in 10 countries yielded returns of up to 19 times their initial investment when broader social and economic benefits were considered. Similarly, WHO estimates that every $1 spent on immunisation generates $26 in economic returns. This kind of multiplier effect is difficult to overlook. 

The South African presidency has also rightly emphasised the need to tackle non-communicable diseases (NCDs). These account for 74% of global deaths and are among the most pressing health and economic challenges of our time. In low- and middle-income countries, nearly half of NCD deaths occur before the age of 70, cutting lives short and undermining productivity.

The most effective way forward is prevention—reducing risk factors, strengthening early detection, and ensuring timely access to care. Building on momentum created by the recent Political Declaration on NCDs, there’s a chance for G20 members to align global commitments with national action. The Political Declaration can play an important role in rallying collective, global efforts to ensure there is the right political commitment and investment to tackle the growing global burden of NCDs which impacts individuals, health systems, economies, but also economies and societies at large. 

Evidence underscores the need to act. Research we conducted shows that, by investing an additional 1% of GDP in public healthcare spending, where at least 40% of this is aimed at preventing and treating NCDs, close to five million lives could be saved each year in low- and middle-income countries.

Unlocking the benefits of health innovation 

Health advances do not happen without scientific progress and innovation. Achieving meaningful progress on UHC, strengthening the health workforce, and preparing to respond to health emergencies all require sustained commitment to R&D. 

Africa’s story reflects both challenges and opportunities. Two decades ago, African Union member states committed to spending 1% of GDP on R&D–yet no country has reached that target. According to UNESCO, Africa accounts for 16% of the world’s population but only 1.3% of its researchers, highlighting the need to further invest in scientific capacity and African talent. Encouragingly, initiatives such as the S20 and Y20 under the South African Presidency have sought to engage scientists and youth in shaping innovative solutions.

At the same time, Africa is showing inspiring leadership. South Africa is setting an example through centres of research excellence such as the H3D Centre for Drug Discovery, and through advanced surveillance laboratories that help detect infectious diseases. It was, after all, South African scientists who first identified the Omicron variant.

This ingenuity needs to be supported by the right policies. Strong intellectual property (IP) frameworks provide the stability needed to incentivise long-term, high-risk R&D. Intellectual property is really the foundation that sustains this cycle of innovation. IP is also a great catalyst for partnerships, and not just for the innovative pharmaceutical industry that we represent. Small biotechnology firms rely on IP to attract investment and establish voluntary partnerships. It also facilitates cross-border cooperation, bringing together academia, start-ups, and industry to accelerate progress.

Health as growth: A call to the G20

The return on health investment is undeniable. But to sustain this virtuous cycle, leaders must prioritise targeted investments in health. 

The G20 faces a choice: to treat health as a cost to be contained, or as the most powerful investment in growth, equity, and security.