High-level Meeting on One Health – 30 October 2024
DNDi welcomes the G20’s commitment to adopting a One Health approach and its application to diseases such as NTDs.
I want to highlight an issue often not discussed: the worsening global health threat of fungal diseases, which particularly impact vulnerable populations. One Health helps explain how fungal diseases emerge and spread, as fungi that cause human diseases live in the environment and are affected by climate change.
We are seeing the emergence of antifungal resistance and limited access to existing diagnostics and treatments, especially in low- and middle-income countries. Take cryptococcal meningitis for example. The common opportunistic infection in people living with advanced HIV is difficult to diagnose and requires three separate drugs for treatment: liposomal amphotericin B, which is prohibitively expensive; flucytosine, which is not registered in many African countries where it is most needed; and fluconazole, which is more widely available, but resistance to it is beginning to emerge. As a result, cryptococcal meningitis remains the second leading cause of death among people with HIV.
Another example is eumycetoma, a very neglected disease. Advanced eumycetoma usually leads to amputation. Treatments are unaffordable and inaccessible, and their long duration leads to frequent treatment failure.
Action is needed to close knowledge gaps related to the burden of disease and antifungal resistance. Coordinated investment in laboratory-based and clinical surveillance at national, regional, and international levels is essential, as is investment in R&D for new and improved diagnostics and treatments.
High-level Meeting on Climate Change, Health, and Equity – 30 October 2024
DNDi welcomes the G20’s commitment to putting equity at the core of climate and health initiatives. Developing and ensuring equitable access to vaccines, diagnostics, and medicines for climate-sensitive diseases that affect vulnerable communities are a crucial element of building resilient communities and health systems.
This commitment can be further reinforced by focusing a pilot project of the G20 Coalition for Local and Regional Production, Innovation and Equitable Access on developing new treatments for dengue, a neglected climate-sensitive disease.
The control and elimination of climate-sensitive diseases is essential to curtailing the health impacts of climate change. A recent scoping review led by WHO with co-authors including DNDi found that a range of NTDs are sensitive to climate change. Of course, additional research will help to fully understand the links.
The G20 can build on commitments in the Declaration by supporting research to clarify these links and the influence of climate change on pathogen survival and disease virulence, transmission, and spread. It can also build on the UAE-Belem work programme on indicators by supporting the inclusion of indicators related to climate-sensitive diseases in the Global Goal on Adaptation.
Finally, we congratulate Brazil on assuming the COP30 Presidency and urge continued focus on embedding equity in climate change responses. Countries and neglected populations facing disproportionate impacts must be positioned at the centre of climate action.
Health Ministerial Meeting – 31 October 2024
Thank you, Chair, Ministers, and distinguished delegates.
We congratulate the G20 on approving the Rio de Janeiro Declaration and Health Ministerial Declaration on Climate Change, Health and Equity, and One Health, particularly for their focus on health equity for the most vulnerable.
At DNDi, we aim to bring the best science to the most neglected. No single organization or country can achieve this alone. We therefore strongly support the establishment of the G20 Coalition for Local and Regional Production, Innovation, and Equitable Access. It is a key deliverable of this meeting. The Coalition can increase the partnerships, capacities, and resources needed to develop health tools for poor and marginalized populations at the local and regional level.
We applaud the Brazilian Presidency for prioritizing this Coalition and for its ongoing commitment to serve as the Coalition’s first President and Executive Secretariat.
Other G20 countries can now demonstrate their shared commitment to addressing health inequities and help meet the SDGs by supporting the launch of two to three pilot projects. These projects should deliver tangible results, build on existing initiatives, and ensure that knowledge-sharing and equitable access are central to their design.
One example could be developing new therapeutics for dengue, a neglected and climate-sensitive disease with no current treatments that affects many G20 countries. This approach also aligns with the G20’s commitment to equity in climate and health responses.
As a global not-for-profit R&D organization that develops treatments with and for neglected communities, DNDi stands ready to support the Coalition’s development and launch in an operational or advisory capacity.
