India's G-20 Health Agenda Needs SAHAYTA

India has taken over the rotating presidency of the G-20 grouping of nations in December 2022.

With it, the government laid out its priorities during its presidency which include green development; climate finance and LiFE; accelerated, inclusive and resilient growth; accelerating progress on SDGs; technological transformation and digital public infrastructure; multilateral institutions for the 21st century and women-led development.

This ambitious agenda has been put to work through the two formal modalities of the Finance Track and the Sherpa Track, which will culminate in the plenary session in September, with the heads of state in attendance in New Delhi. 

While laying out the agenda, the government has been very vocal in projecting it as one of shared ideals, the successful attainment of which will impact all of humanity.

Along with this, India has also spoken of the desire for its presidency to be seen as a voice for the global South. This ambition builds on the work India has done around health, education, infrastructure, and capacity building in the developing world and Low- and Middle-Income Countries over the past many decades.

As opposed to China, perceptions of Indian support in varied geographies—whether in Africa, the South Asian neighbourhood or even in the developed world—with our global contribution during Covid, has been largely positive. 

In light of this, it is only natural that India anchors its G-20 presidency with a focus on the global South and to address issues that are most material to this cohort.

Climate change, climate financing and accelerating a move towards net-zero economies have all become centrestage in global multilateral forums. Along with this, the need to strengthen economies post-Covid, especially given the geopolitical and inflationary shocks are equally important to help countries from slipping into recessions and thereby, further widening the gap to attain the agreed upon Sustainable Development Goals by 2030.

Central to these challenges is the role of equitable health services for countries of the global South, which are struggling with the worst impacts of climate change, under-investment in health services and lagging in progress on SDGs. 

One solution to these myriad issues—one which to some extent addresses at least four of India’s objectives—could be through Project Sahayta. Under Project Sahayta—Sustained Assistance on Healthcare Access, Technology and Aid—the G20 must explore mechanisms to finance and support critical and vulnerable health infrastructure in developing countries bearing the brunt of climate change.

Providing specific and targeted support for healthcare infrastructure and technologies, within the paradigm of climate impact, makes for strategic and humanitarian importance. Support for health services in the developing world and capacity building for disaster management have hitherto been operating in distinct silos. The devastating impact of climate change-induced disasters on the continuity of health services have adequately underlined the need for the meeting of these parallel tracks. 

Public policy towards health services have traditionally approached the subject through the lens of access, equity, affordability, and quality. However, skewing this approach has been the climate challenge necessitating a modification of this vocabulary.

Continued accessibility, resiliency during disasters and continuum of care have become some of the necessary components that must find representation when devising future health policy. In line with the traditional policy frameworks, financing of health services has also followed the more traditional felt needs within healthcare.

India is presented with a unique opportunity to make this paradigm shift in our approach towards health policy, especially for the global South. 

Under Project Sahayta, vulnerable countries can identify centres of excellence and critical health infrastructure projects that can access funds to strengthen climate and disaster adaptation. This should include building islanding and passive resiliency in case of extreme climate events, installation of capacities for utility generation and storage, ability to harness renewable energy through newly installed technologies, critical inventory maintenance of life saving medications, medical gases and other supplies, development of health IT systems that can enable telemedicine facilities in case of an identified health centre going off-grid in a climate emergency, etc. 

Through the project, health centres will be able to build resiliency that can withstand extreme events that are localised to their areas of operations. Additionally, the project can enable active resiliency planning with national emergency response organisations that can first assess current state capabilities, vulnerabilities and hazards, ensure capacity building and design response measures to ensure critical health infrastructure is capable of continuing services during extreme climate events. 

Funding for vulnerable countries—especially on climate risks, mitigation and adaptation—has been regrettably contentious. The establishment of the Loss and Damage Fund at the COP27 summit in Egypt marked progress, but its operationalisation remains undefined. Other mechanisms, like direct transfers from the developed world to vulnerable nations has also left much to be desired.

However, funding through multilateral organisations, like the World Bank, does offer a glimmer of hope. In 2021, the World Bank provided $33 billion of funding for climate change mitigation and $17 billion for climate change adaptation. The G20 could look at such sources of funding and look for specific assignments for financial support for health infrastructure.

An agreement on such a mechanism will help formalise and codify support for vulnerable health systems that invariably struggle to provide health services and face a double whammy of climate-induced health infrastructure challenges. 

As the Sherpas gather in Thiruvananthapuram for the first Health Working Group meeting, the need to amplify the voice of vulnerable health systems that need the G20 sahayta must find their way via media through India.

Dr Karan Thakur is a healthcare administrator and heads sustainability initiatives at Apollo Hospitals. He tweets @karanthakur.

The views expressed here are those of the author, and do not necessarily represent the views of BQ Prime or its editorial team.