The Group of Twenty (G20) convenes the world’s major economies to influence international policies on key issues such as trade, health, climate, and more. Led by Brazil this year, and within the G20 framework, specialized Working Groups made up of experts and officials from relevant ministries facilitate discussions on these topics as part of the collective decision-making process. The G20 health working group focuses on pressing global health issues and fosters international collaboration and collective action. Unitaid actively participates in the G20 Health Working Group, contributing expertise and resources to help shape effective health strategies and policies. 

Discussions at this year’s G20 health working group meetings are focused on innovative approaches to today’s global health challenges while charting a path toward more resilient health systems. Under its G20 presidency, Brazil is steering the health agenda toward expansive and inclusive policies with an emphasis on four key priorities:

• Pandemic prevention, preparedness and response with a focus on local and regional production of medicines, vaccines and strategic health supplies
• The expansion of digital health technologies
• Equitable access to health innovations
• The integration of climate considerations into health policies

These four priority areas for the G20 come at a crucial moment, as the global health infrastructure buckles under post-pandemic realities on top of emerging threats like climate change and antimicrobial and insecticide resistance. Unitaid’s core work—with support from many G20 countries and observers—aligns well with Brazil’s key priority areas in addressing today’s challenges. By accelerating access to innovative health products in low- and middle-income countries, Unitaid is helping to create a more resilient global health system and stands ready to work with G20 members and the broader international community to advance these vital health priorities.

Concrete results expected of the G20 health working group this year include establishing a multilateral alliance for access, innovation and regional production. Unitaid welcomes the initiative of the Brazilian presidency to emphasize health equity in this proposal, recognizing that access is not an afterthought and that the needs of patients must be addressed from the research and development phase to product delivery. Equitable access to health innovation is the cornerstone of the Unitaid strategy and is a founding principle. Without specific intervention to ensure access, medical innovations typically take 10 years to reach the most vulnerable people. By the time key health products and medicines arrive in low- and middle-income countries, they lack market incentives and are maladapted to the needs of the population.

Equitable access to a lifesaving product requires that the product is developed in the first place, and collaborative research and development with a targeted agenda can address gaps in the public health response against key diseases where the market fails. As Brazil’s G20 presidency prioritizes local and regional production in pandemic prevention, preparedness, and response, Unitaid reiterates its dedication to supporting an equitable innovation agenda that can fast-track the development of new treatments and diagnostic tools that are fit to serve the populations in need. Likewise, dedicated efforts are ongoing at Unitaid to accelerate access to transformative new technologies, such as long-acting injectables and monoclonal antibodies, which may enable access to much-needed products today while equipping us for new threats in the future, including pandemics or climate-induced health crises.

Unitaid’s strategy extends to boosting regional production capabilities to ensure these vital resources are available to respond to major persistent health issues and crises, especially in low—and middle-income countries. We have seen that sustainable and competitive production of key quality-assured and price-competitive products at the regional level is viable.  For example, with Unitaid support, the first African manufacturer attained the required WHO prequalification status to become a global supplier of lifesaving antimalarial medication. Thanks to a technology transfer from the UK and the Republc of Korea – facilitated by Unitaid and partners – regional production for COVID-19 rapid tests began in Senegal during the pandemic, and shifted to produce tests for other diseases beyond the crisis phase. There is now an opportunity to embrace dual-purpose investments that have a viable demand during inter-crisis periods and can pivot to producing pandemic products during health emergencies.

Regional manufacturing has been one of the tools in Unitaid’s market-shaping toolbox for access. To succeed, the following four elements must be met:

• First is the financial viability of regional production, which hinges on market prospects and sufficiently funded demand. Sustained efforts and collaboration are needed to foster demand aggregation and build regional markets large enough to benefit from economies of scale. G20 countries’ purchasing power is a key element to render such efforts viable, as very few countries are large enough to do this independently.
• Second, attaining global quality-assurance standards will enable regional manufacturers to rise as global and regional suppliers. There is a limited pool of manufacturers with sufficient production capacity and experience to meet the requisite quality assurance standards requested by domestic regulations and large purchase funds, undermining market viability.
• Third, creating more efficient regulatory processes across regional and global levels, particularly for new technologies. The complexity of overlapping and often conflicting regulatory processes across multiple mechanisms at the regional and global levels is a barrier.
• Fourth, building strategic plans built on robust analyses to ensure end-to-end viability of value chains, from the synthesis of active pharmaceutical ingredients and other critical inputs, to the final formulation of finished pharmaceutical products(or diagnostic tests).

Regional manufacturing can also enable regions to customize and adapt health products to local contexts where global innovation is not adapted or insufficient; it can enhance local expertise, support knowledge transfer and capacity building, bridge the gap between innovation and manufacturing capacity, and strengthen regional regulation.

Embracing regional manufacturing also has the potential to support another priority under Brazil’s G20 presidency: the adoption of climate-resilient value chains. As an organization focused on access to optimized health products for LMICs, Unitaid already works with a wide range of partners who develop, manufacture, procure, and promote the use of key health products, and has a strategy in place to advance “climate-smart” healthcare solutions that are more resilient to climate change and involve green manufacturing and distribution models.

Supporting equitable access and boosting innovation targeting patients’ needs is also key when addressing antimicrobial resistance. Resistance to critical medicines and insecticides threatens to stall – or reverse – progress in the fight against infectious disease. Unitaid welcomes the reinforced efforts under this presidency to advance the pipeline of tools to improve the AMR fight, given the widening gaps in innovation, market entry, country adoption, and adequate use of new regimens for antimicrobial resistance. Through a diverse portfolio, Unitaid addresses current market failures by supporting access to adapted therapeutics and diagnostics to prevent, monitor, and contain resistance. This includes better formulations and new-drug delivery technologies that can help promote adherence and protect existing therapeutics for infectious diseases.

Finally, and in line with Brazil’s emphasis on digital health, Unitaid actively supports optimizing the integration of digital technologies in healthcare. Our projects leverage digital technology like smart pillboxes, video-supported treatments, and medication labels to support adherence and referral to care in tuberculosis, using artificial intelligence for diagnostics in tuberculosis or cervical cancer, and digital innovations in maternal and child health. These efforts are essential in enhancing data integration within national health systems and expanding telehealth services in low- and middle-income countries.

Unitaid’s alignment with Brazil’s G20 health priorities underscores our shared commitment to enhancing global health security and equity. Our efforts to support equitable innovation, facilitate regional production capabilities, integrate climate-resilient solutions, expand digital health innovations, and prevent antimicrobial resistance are well-positioned to help G20 countries build a more robust global health system. As we continue to support these initiatives, Unitaid remains dedicated to advancing collaborative solutions that respond to today’s urgent health needs while preparing for tomorrow’s challenges.

Media Contact

Kyle Wilkinson, Media Officer, Unitaid

wilkinsonk@unitaid.who.int

+41 79 445 1745