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A Fundamental Gap: Why China's G20 Must Address Health Security

Marissa J. Young, G20 Research Group
September 4, 2016

In the 2015 G20 summit in Antalya, Turkey, the leaders' communiqué identified health as an issue for further action at the summit the following year. The leaders concluded that "we agree that attention should be given to global health risks, such as antimicrobial resistance (AMR), infectious disease threats and weak health systems." The onus was placed on China to take global health as a primary concern.

However, in the months since China assumed G20 presidency on December 1, 2015, there has been a noticeable omission of health-specific issues and goals on the summit agenda and in the official pre-Summit publications.

In Chinese president Xi Jinping's statement when China assumed the G20 presidency on December 1, 2015, health was not included as a theme or key agenda item for the summit. Closest to health was Xi's focus on development, and implementing the United Nations Sustainable Development Goals (SDGs). Although "good health and well-being" is the third SDG, global health governance must not be dealt with generally or tangentially. It must be addressed directly as a vital issue in its own right.

Foreign Minister Wang Li, in a speech on May 26, 2016, also failed to mention health. Like Xi, Wang included health security only under the SDGs.

Again, health was noticeably absent in Xi's exclusive article in the G20 China: The Hangzhou Summit. It was again simply alluded to by stressing China's overall support for the SDGs.

The G20 does not have a long history of pursuing health as a major concern. Only at the 2014 Brisbane Summit did both Ebola and AMR push health security into the forefront of the G20 communiqués. There were high levels of compliance with the commitments on both these health subjects, with a score of 68% for Ebola, and 98% for AMR. These trends continued into the 2015 Antalya Summit.

Zika is the Ebola of 2016, as an acute outbreak epidemic is now rapidly spreading throughout the world. With recent estimations of Zika's spread throughout Asia and Africa, reports suggest that upwards of 2 million people are at risk of contracting the virus. With next year's G20 host Germany already pledging to make health a primary concern, will China take a leading role in covering global health governance at the Hangzhou Summit to provide a firm foundation for the 2017 Hamburg Summit, or leave it to be dealt with a year later in Europe?

As John Kirton explained in his most recent book, China's G20 Leadership, Xi's presidency has focused on innovation, rather than implementing and strengthening the broader social development commitments made in Antalya, notably those for gender and health. This pivot suggests that China will not assume accountability for ensuring that past G20 health commitments are kept and improved. For Hangzhou to be successful in G20 health governance, however, the Chinese presidency must build upon Antalya's direction and create and implement the health-specific commitments needed to address modern health security concerns.

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Marissa YoungMarissa J. Young is a research assistant at the University of Toronto's G7 and 20 Research Groups. She is entering her fourth year of her honours BA in political studies and history at Queen's University in Kingston, Ontario. She is the former program editor for women in security with the NATO Association of Canada. At Queen's, Marissa has been actively involved with the Queen's International Affairs Association as their Chief Financial Officer, and has travelled across North America on their competitive Model United Nations team. Her research interests focus on women in security and global health, where she hopes to specialize in gender integration efforts within the armed forces.

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