G7 performance on health

Health has long featured on the G7’s agenda and compliance has been higher than average – but there is still room for improvement, and there are several ways in which the group can increase momentum in this area

Health has featured on the G7’s agenda almost since the leaders first met. They made their first health commitment in 1979 when the G7 committed to working with developing countries on hunger and malnutrition. Since then, the G7 has played a leadership role by working to improve infant, child and maternal health, and addressing infectious diseases including HIV/AIDS, malaria and Covid-19. 

Recognising that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are intertwined and interdependent, the G7 recently adopted the One Health approach in its commitments. This integrated, unifying approach aims to sustainably balance and optimise the health of people, animals and ecosystems.

Conclusions

Since the first summit in 1975, G7 leaders have dedicated 63,798 words to health, averaging 1,302 (9%) per summit. They have produced many stand-alone documents on health.

Although health first appeared in G7 discussions in 1979, it was not until 1996 that it began appearing at every summit. The highest number of words dedicated to health was in 2016 at 6,087 (for 26% of the communiqué). Between 2001 and 2016, health peaked in the 20–30% range: 2001 had 24%, 2003 had 22%, 2006 had 23%, and 2010 and 2016 had 26% each. The focus on health then decreased, with health accounting for only 10% of words in 2017, 6% in 2018 and 16% in 2019.

The Covid-19 pandemic renewed the G7’s attention on health, with the number of words achieving a high of 72% in 2020, decreasing to 24% in 2021, rising to 36% in 2022 and then decreasing to 17% in 2023. 

Commitments

G7 leaders have made 588 core collective, politically binding, future-oriented health commitments. These cover, among other issues, strengthening the global health architecture, addressing malnutrition, supporting health research and achieving universal health coverage. 

Between 1979 and 1999, health commitments represented less than 10% of the total commitments per summit. This rose to 13% in 2000, dropped to 5% in 2001, increased to 10% in 2002 and dipped below 10% for the next three summits before it reached a new peak of 18% in 2006. Other peaks came in 2010 with 17%, 2015 with 16% and 2016 with 24%. 

In response to the pandemic, 2020 produced the highest peak, with 44%. It then decreased to 21% in 2021, 7% in 2022 and 5% in 2023. 

Compliance

The G7 Research Group has assessed 96 of the 588 health commitments for members’ compliance. Overall, health compliance averages 78%, slightly above the 77% overall average. 

G7 compliance on health is inconsistent, subject to several peaks and dips. The first commitments assessed in 1983 and 1997 received full 100% compliance. Compliance for 1998 was 68% but dropped to 50% for 1999. It rose to 91% for 2000 and 94% for 2001. Other peaks came for 2003 with 90%, 2007 with 86%, 2012 with 100%, 2013 with 86%, 2014 with 92% and 2015 with 86%. The G7’s lowest compliance score came for 2017, with just 25%. It then increased but remained low at 53% for 2018. It rose to 72% for 2019 and again to 98% for 2020. It declined a little but stayed high at 92% for 2021, and dipped to 84% in 2022. Halfway between the 2023 and 2024 summits, G7 members had achieved 94% compliance. 

Causes and corrections

How can the G7 maintain its momentum or improve its compliance? 

First, analysis reveals that commitments that refer to the responsible core international organisation – the World Health Organization – average 83% and those that refer to the United Nations average 91%, well above the 78% average for health commitments and 77% overall average. 

Second, commitments made at the seven summits where there were pre-summit health ministerial meetings (2006, 2015, 2016, 2017, 2020, 2021, 2022, 2023) averaged 83% compliance, higher than the 76% average for health commitments made at summits without health ministerials. In 2020 G7 health ministers began meeting multiple times, supporting consistently high compliance in those years: they met four times in 2020, five times in 2021, four times in 2022 and twice in 2023. The combined average of these four summits (including interim compliance from 2023) is 92%. 

Thus, the G7 should always hold a pre-summit meeting of health ministers to harness the momentum produced by the G7’s high performance in 2023 and in recent years. The G7 should also find synergies with the UN and the WHO, including by including the WHO director-general and the UN secretary-general at the leaders’ meeting.