G20: A New Vision for Global Health, or Just Another False Dawn?

Last week, the G20 Health Ministers met in Polokwane, South Africa, and delivered a clear message: if we want better global health, we must tackle inequality head-on.

Their Ministerial Statement sets out concrete actions to protect public health and prevent future pandemics by confronting the root causes that make people vulnerable in the first place. It’s an approach that aligns strongly with the findings of the Global Council on Inequality, AIDS, and Pandemics and their new report, Breaking the inequality–pandemic cycle.

At The Eddystone Trust, we know that inequality is at the heart of many health challenges. We see it every day in our communities. So it's encouraging to see world leaders taking this seriously.

What the G20 Said

Experts including Joseph Stiglitz, Sir Michael Marmot and Monica Geingos praised South Africa’s leadership for pushing global health in a fairer direction. The G20 statement recognises that:

• Inequality fuels pandemics, and pandemics make inequality worse.

• Access to medicines must be fairer and faster.

• High national debt traps countries, preventing them investing in the health of their people.

• Global health security can only exist when everyone has access to tools that keep them safe.

UNAIDS Executive Director Winnie Byanyima put it simply: “Inequality is bad for public health.” There could not be a clearer and truer word said!!!

The G20 Action Plan

The G20 has outlined several key actions aligned with the Global Council’s recommendations:

1. Expanding access to pandemic medicines

Ensuring treatments- like long-acting HIV medicines - are affordable and available to all, not just those in wealthy nations.

2. Addressing global debt

Acknowledging that crushing national debt undermines health systems and calling for fairer financial structures so countries can invest in care, prevention, and preparedness.

3. Tackling the social determinants of health

Shifting away from austerity and towards investment in housing, income security, education, gender equality, and the environments people live in.

4. Strengthening global health security

Recognising that pandemics don’t respect borders and that true security only comes through equitable access to technologies and medicines.

5. Promoting universal health coverage

Following South Africa’s example of national health insurance to ensure people get the care they need without falling into poverty.

These commitments reflect a move towards a more compassionate, realistic approach to global health-one that understands that we only get to improved health outcomes and security by taking everyone with us.

But Here’s the Tension…

While global leaders are calling for action, the financial reality is moving in the opposite direction.

Aid budgets around the worldchave been cut significantly in recent years. The global HIV response has already suffered deeply from reduced funding, and these cuts threaten progress that communities, organisations and activists have fought for over decades.

On top of that, UNAIDS-one of the key global bodies coordinating the HIV response-is now due to shut down five years earlier than originally planned, following sustained financial pressures.

So we’re hearing ambitious commitments at the highest levels… but we’re also watching the resources needed to make them happen slip away.

Local Realities: Still Showing Up, Despite the Cuts

Here in our local communities, agencies, councils and frontline organisations continue to do everything they can to protect public health and support those most affected by inequality. Despite significant financial pressure and reduced international funding, local partners remain committed to delivering services that make a real difference. Their determination shows that while resources may be shrinking, the will to support people is still strong.

This resilience at local level is a reminder that the work never stops - even when global systems wobble.

Where Does That Leave Us?

The G20’s message is powerful: inequality is at the heart of pandemics, and we know what needs to be done to break the cycle.

But without the investment to match the vision, can these commitments become reality or are they yet more hollow promises?