G20 is one of those rather mysterious international events that everyone has heard about, but could not really explain what exactly they are about, or how they work or why they would even matter. Nevertheless, several TBEC members from G20 countries in Europe are continuously using G20 and accompanying C20 engagement process as a pathway for country advocacy on TB, specifically for coordinated action on antimicrobial resistance and universal health coverage, of which TB is considered a corner stone.

As the G20 Summit in Tokyo approaches, and several TBEC members are already actively engaging with C20 processes, it seems appropriate explain how the G20 and C20 work and how they impact for global health and TB specifically. Hopefully, it will allow you to see the opportunities for TB advocacy.

Background and structure

The G20 (in short for Group of Twenty) is an international forum for the governments and central bank governors from 19 countries and the European Union. Five of these countries are part of the WHO Europe region, with one being high-burden TB country – the UK, France, Germany, Russia and Italy. Together, G20 countries account for 80% of world trade and two thirds of the world’s population, and, thus are uniquely positioned to address global health threats. G20 countries also account for about half of all TB cases. The majority of issues discussed are financial – national debt, financial markets etc. or “issues of global importance” such as migration, digitalisation, climate change or anti-microbial resistance.

Although the G20 annual Summit (this year to take place in Japan) and resulting leaders’ communiqué is usually the most visible part of G20 process, it is the culmination of many coordination meetings by officials, hours of advocacy from a range of stakeholders including civil society and global debates that takes place throughout the year. Although the G20 processes slightly changes from year to a year, depending on the hosting country, there are some key aspects that remain the same:

  • Each country has a Sherpa – a senior government official, who acts as the key coordination point throughout the year and provides support for the government ahead of the Summit. Usually, the office of Sherpa is one of the advocacy targets for civil society at national level.
  • Numerous high-level meetings at ministerial/central bank governor level take place throughout the year. The most important one for TB community is the annual Health Ministers meeting, which this year will take place in Okayama. This again provides advocacy opportunities through the national Ministry of Health.
  • Numerous groupings also known as Engagement Groups are set up to provide an input ahead of G20 itself, for example, B20 (for businesses), C20 (for representatives of civil society), L20 (for labour movements), and Y20 (for youth).

C20 – what is what

The C20 Engagement Group is where TB activists and civil society organisations can the play the most active role at regional and global level. The C20 is led by the Steering Committee (members of which are decided upon by host country CSOs). The members together with the Steering Committee develop a position paper, which outlines key concerns and recommendations of civil society and aims to influence the content of G20 leaders communiqué. It is published well in advance of G20 Summit. If you are interested in learning about C20 processes, please click here to see more information about last year’s engagement and here to learn and participate in this year’s activities.

In 2019, the C20 initial coordination meeting will take place in mid-February in Osaka, and a representative of a TBEC member organisation will attend it. At the moment, the planned schedule of C20 is following:

  1. January: Drafting process of the global health policy paper;
  2. February 18-19: C20 Preparatory Face to Face Meeting in Tokyo, which includes face to face discussion between C20 and G20 Health Working Group representatives;
  3. March 11: the 1st deadline of the submission of the policy paper to the C20 Steering Committee;
  4. March 31: the policy paper is completed and submitted to the C20 Steering Committee;
  5. April 21-23: C20 Summit in Tokyo (C20 Policy Pack 2019 will be officially submitted to the Prime Minister of Japan);
  6. June 28-29: G20 Osaka Summit;
  7. October 19-20: G20 Health Ministers Meeting;

G20 focus on health

This year, discussions in the G20 Health Working Group will focus under three thematic priorities; universal health coverage, health security (including AMR) and healthy and active ageing. Discussions on the Universal Health Care (UHC) hope to inform the upcoming UN High-Level meeting on UHC, which will take place on 23rd September 2019. UHC will be discussed within 6 key themes at the G20:

  • enhancing primary health care,
  • promoting innovation,
  • fostering collaboration between health and finance authorities,
  • developing human resources for health,
  • enhancing accountability through continuous monitoring,
  • strengthening partnerships.

The G20 Health Working Group has already met for an information session in Geneva at the end of January. The Health working group includes 8 other countries (Spain, Netherlands, Singapore, Vietnam, Thailand, Chile, Senegal and Egypt) and key international organisations such as WHO, OECD, World Bank, Global Fund and Gavi, the Vaccine Alliance. Health working group discussions will feed into the Leaders’ Summit and hopefully are reflected in the leaders communiqué.

In addition to the Health ministers meeting this October, G20 Secretariat is also planning a joint health and finance ministers meeting on UHC on the side lines of the Leaders’ Summit in Osaka in June. This meeting will focus on reaffirming the critical importance of joint efforts towards UHC and agreeing the critical importance of UHC financing.

For more information on engaging, please contact TBEC at coordinator@tbcoalition.eu