in innovation and research, secure supply chains, production of active ingredients, access to health data, competition for health personnel, and investment in digital transformation and artificial intelligence. Brazil’s G20 presidency speaks of promoting the ‘health economic-industrial complex’ – an investment strategy that promotes local production and supply chain autonomy based on health priorities, thereby reducing dependencies. This was achieved in vaccine production during the Covid-19 pandemic. Questions of data infrastructure and data sovereignty are centrally important for the Global South, including in relation to health. China is investing significant resources in the expansion of digital infrastructure, particularly in Africa. In its data sovereignty policy, India consciously draws reference to the colonial past and refuses to allow foreign companies to behave ‘like the East India Company’ and extract valuable health data like raw materials. India’s goal is to be a global digital leader. It used its G20 presidency to this end and launched a new Global Initiative on Digital Health together with the WHO. In this uncertain period, the weaknesses of existing processes and organisations are circumvented and cleverly exploited.
reorganised and redefined very actively with new centres of action and new directions. The new focus combines geopolitical interests with security, competition policy and decolonisation. The hegemony of the Global North has been weakened in global health. This shows itself not only as a political North-South conflict but also as the power to define agendas moving forward. The call for equity and rights is particularly evident in the negotiations for the ‘access and benefit sharing’ provisions in the WHO’s pandemic agreement. New financial initiatives from the Global South – such as the Bridgetown Initiative, which aims to reform the global financial system – have gained traction. Agenda drivers are the declarations and initiatives of the most recent G20 presidencies of Indonesia, India and now Brazil. In parallel comes a new decentralised focus on national sovereignty, bilateralism, minilateralism and regional alliances that are establishing themselves within global meetings, such as the admission of the African Union to the G20. South Africa has already announced close cooperation with the African Union to use its G20 presidency in 2025 to advance the economic development of African countries and the Global South. Health will play an important role. DIGITAL INNOVATION In the emerging economies of the Global South, demographic development – population growth and ageing – and increasing prosperity are leading to a growing demand for health products and services. Consequently, there is an increasing requirement for investment The hegemony of the Global North has been weakened in global health”
Trust in common solutions was destroyed during the Covid-19 pandemic. Yet countries remain highly interdependent. No country can solve pandemics and climate change alone. The complex interrelationships of the multiple existing crises are encountering a tired multilateral system with little money, reduced power to act and increasingly blurred responsibilities and accountability processes. Change is imperative. Multipolarity combined with the increase in power – politically and economically – of the Global South carries the potential for major change, the values, norms and policies of which are only just emerging. The G20 carries a high responsibility here.
ILONA KICKBUSCH Ilona Kickbusch is the founding director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, Switzerland. She is a member of the Global Preparedness Monitoring Board and the WHO Council on the Economics of Health for All, and co-chair of the World Health Summit Council. She has had a distinguished career with the World Health Organization and Yale University, and has published widely on global health governance and global health diplomacy. She directs the Digital Transformations for Health Lab. She and John Kirton are co-editors of, most recently, Health: A Political Choice – Building Resilience and Trust .
@IlonaKickbusch : ilonakickbusch.com
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2024 — G20 BRAZIL: THE RIO SUMMIT
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