G7 Carbis Bay Health Declaration

1. We, the G7 Leaders, commit to work expeditiously and collectively toward the goal of ending the COVID-19 pandemic, while also recognising that the next one could come at any time. This declaration sets out our commitment to take action to strengthen our collective defences to better prevent, detect, respond to, and recover from, future pandemics through effective multilateral action and a strengthened global health system, with the World Health Organization (WHO) at its centre.

2. Global solutions are needed. We welcome the strides we have already taken with our partners across the international health system, including the Rome Declaration adopted at the G20 Global Health Summit and the steps taken at the 74th World Health Assembly (WHA). We acknowledge the bold recommendations of the Independent Panel for Pandemic Preparedness and Response (IPPPR) and the other review committees. Building on these recommendations, we will continue to work with the G20, United Nations(UN), WHO, and other relevant international organisations and stakeholders to seek the necessary multilateral consensus and take concrete action this year to strengthen the global health and health security architecture. We note the IPPPR’s many recommendations, including for a potential treaty under the framework of the WHO. We welcome the WHA’s decision to set up a Member States Working Group on Strengthening WHO Preparedness and Response to Health Emergencies. We look forward to considering their report at the Special Session of the WHA in November.

3. Through this declaration, we acknowledge our particular roles and responsibilities in international efforts to strengthen the global health and health security architecture, and commit to harnessing our shared democratic values and unique strengths as leaders in science, research and public health to support this.

4. We pledge to lead the way in building a resilient, integrated and inclusive global health system prepared and equipped to prevent the causes and escalation of disease, and to detect emerging health threats quickly. We need to have multilateral mechanisms in place to transparently report and respond collectively to pandemics and mitigate their impact including on essential services; and take concrete steps to recover once immediate health threats have passed. Consequently, we commit to take action across each stage of the prevent, detect, respond and recover cycle.

Prevent

i. We will uphold a strengthened global health system, premised on transparency, collaboration and accountability.^. Building on the recommendations of the IPPPR and other relevant reviews, we fully support working to strengthen the WHO, which has a crucial role to perform at international, regional and country level. We welcome the measures set out within the ‘Strengthening WHO preparedness for and response to health emergencies’ Resolution, as adopted at the 74th WHA, including the call for increased core and more flexible contributions, and we strongly underscore the need to establish an expert-driven, transparent, and independent process, to expeditiously investigate outbreaks of unknown origin.

ii. We will invest in our own human, animal and environmental health systems and in domestic preparedness to foster resilient populations. We will support vulnerable countries to do the same and encourage others to join us. We will strive for fairness, inclusion and equity, and address the links between health crises, the wider social determinants of health and non-communicable disease. We recognise the importance of access to health services, leaving no one behind by advancing the achievement of Universal Health Coverage and the Sustainable Development Goals. Global health and pandemic preparedness, as well as resilience to other health threats like antimicrobial resistance and climate change, rests on strong health systems and institutions that are responsive to the needs of the populations they serve.

iii. We will lead the way in reaffirming our commitment to the International Health Regulations (IHR 2005), improving implementation and compliance, and determining how to better hold ourselves and each other to account. We will work together with others to proactively demonstrate transparency and accountability on our pandemic preparedness, including through compliance with the IHR monitoring and evaluation framework, such as Joint External Evaluations (JEE). To this end, we support the recommendation of the IHR Review Committee and IPPPR to develop proposals for a renewed periodic review mechanism for IHR compliance. Through the work of our Health and Foreign and Development Ministers, we will support vulnerable countries to improve implementation of the IHR and strengthen health systems, including through coordination of G7 financial investments, promotion of country ownership, and collaboration with regional public health institutions and leadership networks in Africa, Asia and beyond. We will continue to support and advance efforts to accelerate building core capacities, including through the Global Health Security Agenda (GHSA) and the WHO Academy.

iv. We will champion an integrated and systems-based One Health approach across all aspects of pandemic prevention, preparedness, detection and response and work to foster a healthier planet. We support a stronger, expanded ‘Tripartite Plus’ alliance of World Organisation for Animal Health (OIE), the Food and Agriculture Organization (FAO) of the UN, and the WHO, bringing in the United Nations Environment Programme (UNEP) as an equal partner. We invite their leaders to work together, with the guidance of the One Health High-Level Expert Panel and including by conducting a One Health intelligence scoping study, to strengthen collaboration and coordination and align with other One Health initiatives such as PREZODE. Building on past G7 and G20 commitments, we call on our Health, Finance, Environment and Foreign and Development Ministers to continue to take action to tackle antimicrobial resistance. Recognising the links between biodiversity loss, environmental degradation and risks of zoonotic disease, we commit to play our part to halt and reverse global biodiversity loss, including through our G7 2030 Nature Compact.

Detect

v. We will harness the power and potential of data, digital technologies, science and research to improve prevention, detection and response to future pandemic threats. We support the establishment of a stronger international pathogen surveillance network, and welcome the WHO’s commitment to work with expert partners and countries to help achieve this. Such a network should build on existing structures, including the recently announced WHO Hub for Pandemic and Epidemic Intelligence, and ensure a One Health approach to support effective early warning and rapid response and inform vaccine, therapeutic and diagnostic development. To achieve the goal of global coverage, we also urge countries to increase their surveillance and genomic sequencing capacities and will offer capacity building to those who cannot. We commit to supporting the development of common approaches and norms for rapidly sharing information, data, and samples necessary to prepare for monitoring and reporting on the emergence and spread of threats under the auspices of the WHO, IHR and OIE notification requirements while complying with data protection standards. We thank the Science Academies of the Group of 7 and take note of their recommendations on the use of health data for emergencies.

vi. We support the WHO to take concrete steps towards establishing a more nuanced and effective global early warning system, with clear triggers for collective action, and welcome the recommendations from the IPPPR and other reviews in this regard.  Surveillance needs to enable rapid risk assessment and feed into an effective end-to-end global infrastructure, ready to raise the alarm and facilitate timely, evidence-based and coordinated responses to health threats.

Respond

vii. We will adopt mutually determined ‘no regrets’ actions in response to WHO triggered alerts and in line with evidence-based global protocols, including on travel and trade. We look forward to work by G7 Transport Ministers to support safe and sustainable international travel during pandemics while aligning with the work of the relevant multilateral organisations. To enable equitable access to and affordability of essential products to protect the health of all, we commit to support trade in and exports of critical healthcare products and vaccines, and will continue to work in partnership with other World Trade Organisation (WTO) members to formulate longer term pragmatic, effective and holistic solutions for trade in health. We recognise the importance of open, diversified, secure and resilient supply chains in this context, to support global availability of health products. This will increase global access to critical healthcare products and vaccines in the short term, and support future pandemic preparedness and long-term recovery.

viii. We will work together to invest in innovation now with the aim of making safe and effective vaccines, therapeutics and diagnostics available within 100 days of a Public Health Emergency of International Concern (PHEIC) being declared, consistent with our core principles of equitable access and high regulatory standards, and noting the unpredictable nature of future health emergencies. The rapid development of safe and effective vaccines, therapeutics and diagnostics for COVID-19 has shown the power of science, collaboration and innovation across the public and private sectors. We thank the UK’s Chief Scientific Adviser and his G7 counterparts, the international organisations, industry representatives and expert advisers involved in the partnership on pandemic preparedness convened by the UK Presidency and note their practical proposals. We welcome the 100 Days Mission, and recognise that this will require continued, concerted collaboration between the public and private sectors, and the leadership of international health organisations, to make what has been exceptional during this crisis become routine in the future. We invite G7 Chief Scientific Advisers or equivalents to review progress and report to Leaders before the end of the year.

ix. We recognise the value of having a rapid response framework for pandemic tools ready to deploy in the event of a pandemic, such as the Access to COVID Tools Accelerator (ACT-A) and its COVAX facility which have played an essential role in the ongoing pandemic response. As we review the existing response mechanisms and capture learning from the current crisis, we will consider lessons learned from ACT-A to explore potential future solutions for a sustainable network of international health organisations, with the WHO coordinating, poised to kick-start global collaboration, such as advance commitment facilities for vaccines, therapeutics and diagnostics, when faced with another pandemic. We will also support and strengthen rapid response networks and mechanisms, where needed, such as the Global Outbreak Alert and Response Network (GOARN). We will explore the establishment of regional hubs for manufacturing vaccines, therapeutics, diagnostics and personal protective equipment to strengthen resilience in the face of the next threat.

Recover

x. We agree to enhance and further develop medium- and long-term global health financing mechanisms for pandemic preparedness, prevention, detection and response. To be sustainable these will need to leverage funding in a predictable, transparent, coordinated, and collaborative manner, with robust oversight and drawing from a wide range of sources including public, private, philanthropic and international financial institutions. We underline the need for countries to finance their national capacities, primarily through domestic resources in line with their national circumstances, and mustering support for those unable to do so. Through the joint work of our G7 Finance Ministers and other related fora, we will pursue solutions for the financing of the current pandemic response, and the medium- and longer-term, in order to facilitate recovery and build back better resilient, inclusive health security and sustainable health systems.

xi. We endorse better coordination and cooperation between the International Finance Institutions (IFIs) and the global health system, ensuring that post-pandemic economic recovery packages promote investment in health systems and facilitate improved global economic risk monitoring in the context of future health threats. We call on the WHO to work with the International Financial Institutions to explore ways to ensure that countries are not disadvantaged economically by reporting potential pandemic threats faster and earlier, and are integrating health and health security in long-term national security and economic strategies.

xii. We agree to support a robust global recovery from COVID-19, ensuring that countries are able to effectively address the indirect impacts on physical and mental health and broader socio-economic consequences of the pandemic. As we support global economic recovery, we must also recognise the significant impacts of the pandemic, notably the devastating and disproportionate impact on women and girls and on vulnerable and marginalised populations. We call on multilateral institutions, governments and the private sector to work together to mitigate further strain on systems and communities, as well as to regain development losses.