Editorial

“They came, they met, and nothing happened.” So was the conclusion of James Rubin, former US Assistant Secretary of State. A harsh, but many might say fair, statement about the recent G7 meeting held in Germany. A few days before the start of the Summit, UN Secretary General Ban Ki-moon set the scene for leaders: “When they meet at the Schloss Elmau Summit in Germany on June 7–8, G7 leaders can show they are serious about seizing the moment and protecting people and the planet.” He was right to suggest that as the international community prepares to adopt a new sustainable development agenda in New York in September, together with a new climate treaty in Paris in December, G7 countries have “a special responsibility to lead”. Did they meet expectations? Under the leadership of German Chancellor Angela Merkel, climate change and environmental protection received special attention, in what could be seen as essential steps toward reaching a climate agreement in Paris. In their Declaration, G7 leaders recognised the need for an ambitious solution at the COP21 meeting in Paris, and they reaffirmed that the increase in global temperature must be kept below 2°C, an important red line that seemed in the past to have been sacrificed to the exigencies of politics. As part of a global response, they committed to reduce their greenhouse gas emissions towards the upper end of the 40–70% reductions that the Intergovernmental Panel on Climate Change recommended by the end of the century. They also promised to implement a climate risk insurance initiative to accelerate adaptation, while protecting economic growth and poverty reduction. But climate was not the only global health priority discussed. In the aftermath of the Ebola crisis, G7 leaders reaffirmed “the central role of the WHO for international health security”, while supporting the ongoing process of reform to strengthen WHO’s ability to respond to health emergencies. Leaders began their statement on health by committing to strengthen health systems—so crucial to delivering health security in countries. They also committed themselves to assisting countries in implementing the International Health Regulations. They promised to assist at least 60 countries over the next 5 years, including countries worst hit by Ebola. Those efforts included paying attention to the health-care needs of migrants and refugees—populations rarely receiving attention in high-level political discussions. G7 leaders www.thelancet.com Vol 385 June 20, 2015

endorsed the World Bank’s Pandemic Emergency Facility (although no financial commitments were made) and encouraged G20 nations to take part. They plan to create a common platform for the rapid deployment of multidisciplinary teams to fight future health crises. However, the response from civil society was scathing. Joanne Liu, Médecins Sans Frontières (MSF)’s International President, commented, “Once again entire communities and villages will be left to die until [Ebola] risks spreading to the West and only then will these leaders decide to take action.” She called the G7 statement on health “lip service” to the seriousness of the threats posed by pandemics. Tackling the other major threat to global health security—antimicrobial resistance (AMR)—G7 leaders endorsed WHO’S Global Action Plan and One Health approach. They committed to implement national action plans and to cooperate in a joint effort to combat AMR “by conserving the effectiveness of existing and future antimicrobials and by engaging in research and development for new antimicrobials, vaccines, treatment alternatives, and rapid diagnostic tools”. While G7 nations “take note of the Independent Review on AMR”, no mention was made of the new Global AMR Innovation Fund, which has been proposed by the recent O’Neill Review. Again, non-governmental organisations displayed their frustration. Philipp Frisch (MSF) noted that, “Millions of people suffer from disease…because they don’t represent a lucrative market for the pharmaceutical industry.” If G7 leaders were serious about AMR, they would “put their money where their mouth is”, he added. Leaders also emphasised their commitment to tackle neglected tropical diseases (and achieve the 2020 elimination goal), end preventable child deaths, and improve maternal health. They backed a new Global Financing Facility to support Ban Ki-moon’s signature health initiative, Every Woman, Every Child. They also committed to lift 500 million people out of hunger and malnutrition by 2030. This latest G7 Summit seems to have attracted more criticism than usual. We believe this condemnation is unfair. What was shown in Germany is that G7 leaders can agree on the importance of crucial universal issues— such as protecting health and climate. Although these commitments are welcome proof of political will, actions (not advocacy) must now follow. „ The Lancet

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The G7 and global health: inaction or incisive leadership?

For the G7 Leaders’ Declaration Think Ahead. Act Together see https://www.g7germany.de/ Content/EN/_Anlagen/G7/201506-08-g7-abschluss-eng_ en.pdf?__ blob=publicationFile&v=1 For more on Global health security see David Heymann and colleagues’ Public Policy report http://www.thelancet.com/ journals/lancet/article/ PIIS0140-6736(15)60858-3/ fulltext

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The G7 and global health: inaction or incisive leadership?

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