That’s the title of an editorial in this week’s Nature looking at the shift in balance of governance in global health away from the World Health Organization, prompted by the plethora of new actors, including the G8 (see the Saint Petersburg communiquÃ© on infectious diseases) the Global Fund to fight AIDS, Tuberculosis and Malaria and the Bill & Melinda Gates Foundation.
Infectious diseases were one of the G8’s top three declared priorities, alongside energy security and education, and the summit featured the first preparatory meeting of health ministers in the forum’s thirty-year history.
Prompted by the world’s failure to stop the spread of H5N1 avian flu, the meeting attempted to address the neglect of disease surveillance and emerging diseases (see Nature 440, 6â€“7; 2006). The spread of avian flu has exposed both the vulnerability of rich countries to diseases that emerge outside their own borders, and their lack of the vaccines or infrastructure needed to resist a human pandemic. In response, a G8 communiquÃ© calls for better international cooperation on surveillance and monitoring, building infrastructure in affected countries, “full transparency by nations in sharing, on a timely basis, virus samples and other relevant information about the outbreaks of diseases” and “encouraging development of next generation influenza vaccines”.
But this is just a wish-list, with no roadmap or funds â€” although the G8 reminded the world’s countries that they should pay up the $1.9 billion they pledged to the United Nations’ avian-flu effort last January in Beijing, something most of them have yet to do.
Re sharing on avian flu; the G8 countries themselves pledged with this wording: ” to comply with the provisions [of the revised International Health Regulations], including those related to rapid and transparent notification, and to provision of essential information.”
The editorial continues:
But the shift away from the WHO and other multilateral UN agencies carries risks. The G8 does not represent the world’s people, and its members’ national interests, including commercial ones, are not always aligned with global public health.
Future summits need to confront two major questions: how funding can be increased to levels that can do the job, and how, 58 years after the WHO’s creation, the international community intends to agree and fund a coherent set of research and control priorities for global health.
I’ve a related quick Q&A on email@example.com — “Watchdog at the G8” — where I talk to John Kirton, director of the G8 Research Group at the University of Toronto, Canada, about this year’s ‘Group of 8’ meeting in Russia.