G7 Health Ministers’ Communiqué
20 May 2022, Berlin
1. We, the G7 Health Ministers, met in Berlin, Germany, on 19 and 20 May 2022, at an
extraordinary time of multiple, acute crises. We affirm our common values as a strong
basis of collaboration and responsibility in challenging times like these: We have a special
responsibility to foster better health solutions for the G7, as well as for all people. We arecommitted to work in multilateral cooperation and partnership with other countries andstakeholders based on our shared values, as laid out in the G7 Leaders’ Communiqué 2021
and other relevant G7 declarations. Participatory processes, including a whole-ofgovernment and whole-of-society approach, in strong cooperation with civil society, arecentral to our work and to delivering improved health outcomes for all.
2. We condemn, in the strongest possible terms, Russia’s unjustifiable, unprovoked andillegal war of aggression against Ukraine. Russia has blatantly violated the rules-based
international order, international law and humanitarian principles and it has breached
universally agreed and legally binding fundamental principles such as peacefulcooperation, sovereignty, self-determination and territorial integrity. We reiterate ourconstant call on Russia to put an end to the war it started and to end the suffering andloss of life it continues to cause. We underscore the significant disruptions of the
Ukrainian health system caused by the Russian war of aggression, with hundreds of
hospitals and health facilities damaged and destroyed by attacks, with thousands ofhealth workers being displaced. Millions of displaced people currently have limited or noaccess to health services, and people are dying because of disrupted life-saving
treatments. We are committed to supporting the government of Ukraine in theircontinued effort to protect the health of the Ukrainian people from public health threats.
We will continue to support Ukraine with a view to strengthen the operation and therebuilding of the health system now and in future and will closely coordinate ourrespective G7 endeavours as a central part of the G7 work in the second half of 2022. The
COVID-19 pandemic is in its third year, and new variants and sub-variants continue tothreaten progress we have made. The silent pandemic of antimicrobial resistance, anddisruptions to routine health services, have set us further back from achieving universal
health coverage (UHC) and the Sustainable Development Goals (SDGs), in particular SDG
3 on health and well-being. Climate change detrimentally impacts the health of all
people, and our common future.
3. The multiple crises affect certain populations such as women and girls and thosealready experiencing health inequities based on race, culture, gender, age, socioeconomic status, ability, and geographic location as well as those living with chronic

G7 Health Ministers’ Communiqué | page 1physical or mental illness. We will pay special attention to those groups and regions,develop gender-, age-, and culturally sensitive responses, and reduce health inequalities
within and between communities, regions and countries. We need to strengthen healthsystems to restore essential health services for women and girls, including to address the
COVID-19 pandemic’s negative impacts on sexual and reproductive health and rights for
all, including access to comprehensive sexuality education, contraception, and safe
abortion and post-abortion care.
4. We commit to transparent decision-making and clear communication that is based on
scientific evidence. The multiple crises that impact health require strategic foresight,
connecting data from the human, animal and environmental sectors, and harnessing thestrengths of digitalisation, which allows for new forms of analysis and more inclusive,
agile cooperation. Therefore, we will improve the generation, exchange and application ofscientific evidence, integrating the One Health approach, placing a special focus on
surveillance, early detection and warning based on a specifically educated and trained
pandemic workforce to strengthen the global network approach.
5. We recognise that the G7 plays an important role in taking forward lessons learned
from COVID-19 and strengthening the global health architecture. We must strengthen
our capacity to prevent, prepare for and respond to future global health emergencies andmake further efforts to achieve universal health coverage. G7 Health Ministers discussed
the important issue of vaccine equity in a joint session with G7 Development Ministers.
We will continue our support for international organisations, and will increase our focus
on the human-animal-climate-environment nexus through the One Health approach. We
will continuously strive to close financing gaps recognised inter alia by the G20 Joint
Finance-Health Taskforce, in part through a new financial intermediary fund for
pandemic preparedness and response, and will continue to work in close collaboration
with Finance Ministers. G7 Health Ministers welcomed having a discussion on global
health issues in a joint session with G7 Finance Ministers and key internationalorganisations.
6. We fully support the World Health Organiziation (WHO) and the crucial leadership,
convening and coordination role it plays in global health, to strengthen multilateral
cooperation and guide the world’s prevention, preparation, detection and response to
public health emergencies. We recognise that improving the way WHO is financed isessential if the organisation is to play the leadership role we all want to see. Therefore, westrongly support the recommendations of the WHO Working Group on Sustainable
Financing that call for the development of budget proposals for an increase in flexible
funding for WHO’s base budget by raising the assessed contributions by WHO Member
States. This is with the aspiration to reach the level of financing 50 % of WHO’s 20222023 base budget through assessed contributions, by 2030-2031, while aiming to achieve

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this by the biennium 2028-2029 concurrently with further reforms to strengthen theagility of WHO, and call on all other countries to support these recommendations at theWorld Health Assembly (WHA).
7. We have to ensure a more effective, better coordinated, inclusive, gender-responsive
and age-sensitive, equity-driven and less fragmented global governance for pandemic
prevention, preparedness and response, guided and coordinated by a strengthened WHO.
Sustainable and reliable funding, as well as international cooperation and politicalcommitment, are crucial to help prevent and prepare for future pandemics. To strengthen
global cooperation on issues of concern to all we refer to the Foreign Ministers’Communiqué dated 14 May 2022 including Taiwan and believe it is vital to ensure
inclusive processes in international organisations. The international community should be
able to benefit from the experience of all partners.

Protecting all people from new variants and further outbreaks – G7
Pact for Pandemic Readiness8. We underline the need for the G7 to advance and optimise coordinated and targeted
support and partnerships to strengthen global health security. We therefore support a G7
Pact for Pandemic Readiness. The Pact is a coordinated approach – building upon pastand current initiatives and experiences – to strengthen and to align our efforts forworldwide pandemic readiness in close cooperation with WHO, supported by its partnerorganisations following the One Health approach. The Pact will support the advancementof a global network, based on local, national and regional proven structures, to enhancecollaborative surveillance to detect emerging threats and predictable rapid response
capabilities and capacities. We aim for a strengthened, highly qualified and trained publichealth workforce at all levels. In this regard, we will consider the white paper by WHO on
strengthening the global architecture for health emergency preparedness, response andresilience.
9. As part of the G7 Pact for Pandemic Readiness, we commit to strengthening andsupporting the development of integrated, interoperable and interdisciplinary
surveillance and cross-sectoral surveillance capabilities that aim to cover all countries,
multiple pathogens, antimicrobial resistance and human, animal, environmental, andclimate-related inputs, as part of the One Health approach, to reduce the risk of future
cross-sector health threats.
10. As part of the G7 Pact for Pandemic Readiness, we commit to continue building andstrengthening cross-sectoral genomic sequencing networks and capabilities including forsurveillance to detect new variants and pathogens as they arise in people, animals, both
domesticated and wild, and environmental samples. By doing so we support WHO’s 10-

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year strategy for genomic surveillance of pathogens with pandemic and epidemic
potential. Further, we commit to explore options to support national authorities in theefforts to implement non-invasive methods such as national wastewater surveillancesystems, utilising the rapid improvements in the infrastructure for wastewater screeningthat has developed during the COVID-19 pandemic to support the detection of outbreaks
as early as possible, screen for new SARS-CoV-2-variants and monitor the spread of
infectious agents, such as SARS-CoV-2, poliovirus, influenza virus and drug resistantpathogens by 2024.
11. As part of the G7 Pact for Pandemic Readiness, we support the WHO Hub for
Pandemic and Epidemic Intelligence and its innovations that will drive improved analytics
and a linkage of data systems to predict, detect and address worldwide health threats.
This will be done including by advancing efforts to strengthening surveillance andanalysing data on potential outbreaks, including rapid and transparent cross-sectoral
information and data-sharing also in relation to medical countermeasures, following the
One Health approach. In this context, we also recognise the crucial and central
importance of multi-stakeholder bodies such as the International Pathogen Surveillance
Network (IPSN) and the Global Influenza Surveillance and Response System (GISRS) andcollaboration among them and the WHO Hub.
12. We also welcome the recently announced operational definition of One Health by thework of the One Health High Level Expert Panel, endorsed by WHO, FAO, OIE and
UNEP, and its forthcoming gap analysis and recommendations on monitoring andsurveillance of emerging zoonotic diseases and priority activities, looking forward toconsidering the results of the One Health Intelligence Scoping Study as we agreed lastyear, as G7 Health Ministers, and we support the consideration of the inclusion of the
One Health dimension in the new WHO convention, agreement or other international
instrument on pandemic prevention, preparedness and response. We encourage otherinitiatives aiming at strengthening the implementation of the One Health approach such
as Zoonotic Disease Integrated Action (ZODIAC) and Preventing Zoonotic Disease
Emergence (PREZODE).
13. While strengthening surveillance and intelligence systems for emerging infectious
disease threats, we recognise the crucial importance of transparent global cooperationand national capacity building to assess outbreaks and risks more quickly and to respondto them in a concerted and more predictable manner as part of the G7 Pact for Pandemic
Readiness. We stress our commitment to cooperate with WHO-led international expertdriven, timely, transparent and independent missions to investigate potential outbreaks orhealth emergencies of international concern. We aim at strengthening and fostering
structures, including technologies and other tools, people and training programmes with
up-to-date curricular, processes for public health risk assessment and rapid response to

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support public health capacities and always-ready health emergency workforce, familiar
with and trusted by the communities they serve. As part of the G7 Pact for Pandemic
Readiness, we want to support the further enhancement of a global network of experts
and trainings, including among others the further development of WHO’s Global
Outbreak Alert and Response Network (GOARN) and WHO’s Academy and the related
G20 Public Health Workforce Laboratorium. We also acknowledge the role of the WHO
Scientific Advisory Group for the Origins on Novel Pathogens (SAGO). We underline thata highly qualified workforce is central for successful implementation of the International
Health Regulations (IHR).
14. As the COVID-19 pandemic has demonstrated, we need to continue our efforts.
Within the framework of the G7 Pact for Pandemic Readiness, we will build on thecommitments made in the Leaders’ Declaration at Elmau in 2015, and reiterated insubsequent years, to continue our support for low- and middle-income countries (LMICs)
in implementing the core capacities required in the International Health Regulations(IHR) for another 5 years until 2027 toward our collective goal to assist at least one
hundred countries implementing the IHR core capacities. This can be done throughcoordinated bilateral and multilateral work, including through existing initiatives such as
the Global Health Security Agenda (GHSA), while recognizing the work of the Global
Strategic Preparedness Network (GSPN) to emphasise, bridge, and match efforts for IHR
implementation.
15. We underline the need to strengthen the monitoring of IHR implementation and IHR
compliance. In this regard, we acknowledge the recent update of the State Party SelfAssessment Annual Report (SPAR) framework and welcome the upcoming 3rd edition of
the WHO Joint External Evaluation IHR monitoring tool. We look forward to reviewing
the findings of the first WHO pilot stage of the Universal Health and Preparedness
Review (UHPR) which will be presented at the 75 th WHA as a potential new whole-ofgovernment and whole-of-society-based mechanism that could complement the existing
IHR Monitoring and Evaluation Framework (MEF).
16. To implement the G7 Pact for Pandemic Readiness, we will follow up with theguidance of WHO and key stakeholders on these aforementioned initiatives in threemeetings in the second half of 2022 in order to compile a general roadmap for G7
coordinated action, deciding on major principles for further practical cooperation.
17. Global health security must also be ensured through country and international
capacity building in biosafety and biosecurity to protect from pathogen- and toxin-relatedrisks. We reiterate the importance of using and further strengthening existing networks,
such as the Global Health Security Initiative (GHSI) and the Global Partnership Against
the Spread of Weapons and Materials of Mass Destruction, to jointly analyse, assess andG7 Health Ministers’ Communiqué | page 5

counter further chemical, biological, radiological and nuclear (CBRN) threats in order toreinforce health emergency preparedness and response beyond pandemics.
18. We reiterate our support of the decision of the World Health Assembly Special
Session in 2021 (SSA2(5)) to establish an intergovernmental negotiating body (INB) to
draft and negotiate a WHO convention, agreement or other international instrument on
pandemic prevention, preparedness and response with a view to adopt under Article 19,or under other provisions of the WHO Constitution as may be deemed appropriate by the
INB. We commit to supporting this global process to achieve its overall objective. In
addition, we recognise the value of the IHR as a legal framework for global healthsecurity. In particular, the IHR underscores the role that country-level preparedness andresponse capacities can have in the world’s ability to effectively respond to healthemergencies that transcend borders. We therefore support strengthening the IHR
through targeted amendments in an inclusive process as recommended by the report of
the Working Group on Strengthening WHO Preparedness and Response to Health
Emergencies (WGPR) to be considered at the 75 th WHA.

Overcoming the COVID-19 pandemic in 2022
19. To overcome the COVID-19 pandemic now, coordinated action and substantial
acceleration is still needed in order to ensure global equitable access to safe, effective,
quality-assured and affordable vaccines, therapeutics and diagnostics (VTD), and advancetowards the WHO COVID-19 target of vaccinating at least 70 % of the population in all
countries while adapting to local contexts and needs, focusing on reaching the mostvulnerable. G7 members have so far pledged 18.3 billion USD to Access to COVID-19
Tools Accelerator (ACT-A), of which 12.36 billion USD has been pledged to COVAX. G7
members at Carbis Bay furthermore pledged 870 million vaccine doses, mostly to COVAX.
We underline our support for all four pillars of the Access to COVID-19 Tools Accelerator(ACT-A), including its COVAX facility and recognise that supporting ACT-A by all means,including with adequate funding, is central to end the acute pandemic, as laid out in theG7 Foreign Ministers’ Action Plan. We will step up our support to address the barriers tovaccine rollout, including by supporting logistics and delivery, strengthening healthsystems and by supporting health care workers especially in Africa and in low- andmiddle-income countries (LMICs), where vaccination rates are still low. As multiple
variants have shown, the pandemic is far from being over anywhere until it is overeverywhere.
20. Local and regional research, development and manufacturing capacities need to bescaled up along with more sustainable supply and distribution mechanisms in order tosupport faster, equitable, global access to safe and effective medical countermeasures.
We stress the importance of expanding sustainable vaccine, therapeutic and diagnostic

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manufacturing production in LMICs, in close cooperation with industry and in a mannerthat ensures sustainability between emergencies. Considering the importance of ensuring
the quality, safety and effectiveness of vaccines, therapeutics and diagnostics, which aremost sensitive with regards to their production, it must be accompanied by corresponding
capacity building to ensure appropriate regulatory systems and quality control
mechanisms. We are willing to support this endeavour through sharing of regulatory
expertise and best practices. We welcome and support the work of WHO, the Medicines
Patent Pool, the private sector, and others to establish the mRNA vaccine technology
transfer hub in South Africa and extend its spokes globally.
21. We acknowledge that increased investments are required to develop new vaccines
faster, while ensuring their safety, effectiveness and quality. Building upon the 100 Days
Mission – supporting science in a mission to develop safe and effective vaccines,
therapeutics and diagnostics within 100 days of a declaration of a public healthemergency of international concern (PHEIC) – we therefore support initiatives aiming tofacilitate the deployment of such instruments, such as the 100 Days Mission, to supportscience and innovation. We support the role of organisations contributing to develop safeand effective vaccines, such as the Coalition for Epidemic Preparedness Innovations(CEPI), alongside our relevant authorities such as the US Biomedical Advanced Researchand Development Authority (BARDA) and the EU Health Emergency Preparedness andResponse Authority (HERA). We welcome the discussions and lessons learned from thetabletop exercise “Every Day Counts” hosted by the German Federal Ministry of
Education and Research, CEPI, and Johns Hopkins Center for Health Security, which wasa side event of the Munich Security Conference and focused on accelerating thedevelopment and worldwide availability of safe and effective vaccines. We will continue
working to achieve this goal and make the necessary investments.
22. We note that mid- and longer-term health impacts of COVID-19 are increasingly
evident, both within the G7 and around the world, and are widening inequities. We willcontinue our work on understanding post COVID-19 symptoms and to address negative
mental health impacts and substance-use-related harms, including on health and care
workers, as well as to take strong action against the increases in domestic and genderbased violence, which disproportionately affects women and children. We are concerned
about the detrimental impact of COVID-19 on routine health services such as
postponement of surgical interventions, a decline in preventive medical check-ups,
interrupted routine vaccination campaigns, and setbacks in the fight against otherinfectious and non-communicable diseases and endemic and emerging AMR, all of which
demonstrate the need for continued focus on building sustainable, resilient and inclusive
health systems.

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23. We recognise challenges regarding vaccine confidence and uptake, the use of nonpharmaceutical protection measures and mis- and disinformation. We, as G7, commit totackling these challenges by better informing and supporting all parts of society,especially where inequalities may exist, including through supporting context-adapted,
science-based information campaigns and strategies to improve vaccine confidence andaddress access barriers.

Tackling the “silent pandemic” of antimicrobial resistance
24. Antimicrobial resistance (AMR), and in particular resistance of bacteria to antibiotics(antibiotic resistance), is an urgent public health and socio-economic problem that has a
profound effect on the world causing an estimated 1.27 million deaths attributable toantibiotic resistance in 2019. Modern medicine depends on effective antibiotics. The
impact of drug resistance could affect people anywhere. Moreover, inappropriate use ofantibiotics further exacerbates AMR. The World Bank estimates that up to 3.8 % of global
GDP could be lost due to AMR by 2050. Although the risks of AMR are shared by all
countries globally, low- and middle-income countries bear a more significant burden of
infectious disease and will be most adversely affected by AMR. Building on previous G7
commitments, alongside those in the WHO AMR Global Action Plan, we acknowledge
AMR as a shared responsibility and we commit to intensifying our activities and to takefurther urgent and tangible action in order to address AMR. We are convinced that thetime to act is now.
25. We acknowledge that AMR further emerges and spreads at the human, animal, plantand environment interface and requires an integrated One Health approach. We will leadby example and commit to contributing to establishing new and/or improving existing
national integrated surveillance systems on AMR and antibiotic use in the human, animaland plant production and environmental sectors, in cooperation with WHO, FAO, OIE
and UNEP, enhancing the scientific basis to inform risk assessments and identify
opportunities for mitigation. This data will form the basis for further targeted measuresand evidence-based information campaigns at national level that follow the One Healthapproach. We welcome Germany’s proposal to host an expert meeting of the G7 on how
best to establish such surveillance systems in autumn 2022.
26. We commit to continue our contribution to and collaboration through the WHO’s
Global Antimicrobial Resistance and Use Surveillance System (GLASS). We recognise theimportance of antimicrobial stewardship in the food chain as a fundamental part ofsafeguarding human, animal and environmental health. We welcome the Codex
Alimentarius “Guidelines on Integrated Monitoring and Surveillance of Foodborne
Antimicrobial Resistance” (CXG 94-2021) and the “Code of Practice to Minimise andG7 Health Ministers’ Communiqué | page 8

Contain Foodborne Antimicrobial Resistance” (CXC 61-2005) as important steps towards
reducing AMR in line with the One Health approach.
27. We reiterate our commitment to promote the prudent and appropriate use of
antimicrobials (i. e. antimicrobial stewardship) and access to new and existing
antimicrobials under the One Health approach in order to preserve effective treatment for
current and future generations. To promote the prudent and appropriate use of
antimicrobials, we will encourage antimicrobial stewardship, including strengtheningprescription practices in line with appropriate use, their availability by prescription only,and education across all relevant human health sectors, and with a focus on equity andsocio-behavioural evidence to encourage prudent use practices. To be able to assess the
progress of our efforts, we will define national measurable targets on AMR in line withdomestic authorities, including antibiotic usage in human health (both volume andappropriateness, whenever possible), with the aim of having them in place preferably by
the end of 2023.
28. We commit to strengthening and assessment of the implementation of Infection
Prevention and Control (IPC) programs across the One Health spectrum, in particular for
health care facilities in line with the IPC minimum requirements identified by WHO,taking into account the learnings from and response investments during the COVID-19
pandemic, and recognise the importance of water, sanitation and hygiene (WASH) as a
key element in AMR prevention and response. We will support other countries within theframework of existing programs, (e.g., through the exchange of best practice examples) tostrengthen IPC capacity in health care facilities. We welcome the recently published first
WHO Global Report on Infection Prevention and Control. WHO’s new report shows that
where good hand hygiene and other cost-effective practices are followed, 70 % of
healthcare-associated infections during hospital stays can be prevented. We note ongoingwork by WHO and OECD to prepare the upcoming report on IPC and present it at theWorld Health Summit in Berlin in October.
29. We note with concern that delayed diagnosis and management and/or ineffective or
unavailable antibiotic treatment leading to sepsis is killing an estimated 11 million people
per year globally. We will intensify our efforts to strengthen early detection, diagnosis
and therapy of sepsis and ensure synergy with antimicrobial stewardship and IPC
programmes, e.g., through national educational campaigns, and boost theimplementation of the WHA Resolution “Improving the Prevention, Diagnosis andClinical Management of Sepsis” (WHA Res. 70.7). We are committed to supporting LMICs
to strengthen prevention through capacity building where appropriate, and access todiagnosis and treatment for resistant infections.
30. We recognise the urgent need to foster innovation and to strengthen the research anddevelopment (R&D) pipeline. We therefore highlight the importance of accelerating theG7 Health Ministers’ Communiqué | page 9early and late-stage development of urgently needed new antimicrobial drugs, vaccines,
alternative therapeutics and diagnostics. We value and support initiatives such as the
Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) and the
Global Antibiotic Research and Development Partnership (GARDP) and will continue
national and international efforts on AMR research and development for new
therapeutics, vaccines and diagnostics. We underline the importance of closing GARDP’sfunding gap to facilitate GARDP’s “5 by 25”-Initiative for the delivery of five newtreatments by 2025.
31. We acknowledge that it is essential to ensure a sustainable market for existing as well
as new antibiotics. This includes appropriate steps to address antibiotic market failure andto ensure the commercialisation and provision of existing and new antibiotics for unmet
public health needs while taking into account stewardship and equitable access. Buildingon the G7 Finance Ministers’ Statement of 2021 on Action to Support Antibiotic
Development, we commit to expedite implementation of existing strategies and to takeadditional specific and appropriate steps in our domestic markets and health systems,
underpinned by the 2021 G7 Shared Principles for the Valuation of Antimicrobial
Therapeutics. Recognising country-specific circumstances and member statecompetences, we will explore a range of market incentive options, with a particularemphasis on supporting relevant pull incentives. We welcome the progress update by the
Global AMR R&D Hub and the WHO to support and strengthen the work on pullincentives. We welcome the SECURE initiative’s pilot project to overcome critical accesslimitations to essential old and new antibiotics in low- and middle-income countries andto promote stewardship and improve their market situation alike.
32. We recognise that nearly 90 % of countries have developed a multi-sectoral national
action plan on AMR. However, only 20 % have identified funding for implementing andmonitoring these plans. To address this main challenge at country level and to facilitate
the mobilisation of domestic and external financing, we support the development of
national investment cases on AMR response across all sectors in LMICs. We call upon the
Quadripartite (FAO, OIE, WHO, and UNEP) to facilitate these investment cases incollaboration with relevant stakeholders. We call on WHO to develop guidance on acosted core package of AMR interventions that all countries, and especially LMICs could
include within their primary health care (PHC) strengthening initiatives. We welcome thework of the AMR Multi-Partner Trust Fund, which focuses on development financing tosupport implementation of One Health National Action Plans, and support to this Fundon a voluntary basis. Finally, we look forward to the launch by the Quadripartite Allianceof the AMR multi-stakeholder partnership platform, which will mobilise all stakeholders
in an inclusive manner. Assessment is critical for ensuring that resources are effectively
targeted. We commit to annual assessment using the Tripartite AMR Country SelfAssessment Survey (TrACSS) tool.

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Climate-resilient and sustainable, climate-neutral health systems
33. As the G7 Health Ministers, we acknowledge the importance of combating climatechange to protect health: climate protection equals health protection. Climate change isalready affecting the health of people, animals and ecosystems globally, and robust
projections indicate increasingly negative health impacts. Climate change exacerbates
both directly and indirectly heat-related illnesses and premature deaths and can increase
the burden of disease from infectious and non-communicable diseases. We acknowledge
that the impacts of climate change may also increase risks to mental health and wellbeing. Higher frequency and intensity of extreme weather events such as heatwaves,wildfires and floods, as experienced by many of our countries as well as other,s place
additional stress on populations, the capacity of the health systems and criticalinfrastructures of public health. Further, climate change and the related biodiversity loss
are some of the drivers increasing the risk of zoonoses, and therefore increasing the risk
of future pandemics. Land degradation and desertification also challenge the resilience of
health systems.
34. We recognise that climate action aligned with the goals and targets of the Paris
Agreement including the goal of keeping 1.5°C within reach could save millions of lives
and lead to improvements in air quality, positive impacts on ecosystems and biodiversity.
We encourage climate decision-making processes to account for direct health effects andhealth co-benefits connected especially with clean air, healthy diets and physical activity,
and advance their socio-economic evaluation. It is critical that health expertise iscentrally involved in climate decision-making processes at all levels, taking a One Healthapproach, to ensure that health and equity considerations are well understood andaccounted for when developing climate policies.
35. We acknowledge the key role of the health sector for climate adaptation, the need formore climate-aware health sector planning, and the need for health systems worldwide
to become more environmentally sustainable, better prepared for and more resilient tomultiple concurrent threats such as climate change, pandemics, and other risks in orderto protect populations from environmental threats and respond to and prevent adverse
health effects alongside mitigating indirect socio-economic impacts. We recognise thedisproportionate effects on marginalised and vulnerable groups and the importance of
reducing health inequalities. As climate change impacts can vary greatly at the local level,
we also recognise and support locally and community-driven actions to protect health.
36. To strengthen the climate resilience, sustainability and to achieve climate neutrality of
our health systems, we commit to generating, harnessing and pooling scientific evidence,monitoring of both impacts and effectiveness of solutions, and increasing informationand knowledge sharing. We will also provide support for the development and exchange

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of evidence-based, efficient, effective and inclusive resilience measures at local andnational levels. We will also encourage other countries to develop climate-resilient healthsystems through actions such as the expansion of international dialogue, cooperation in
research, and capacity building to support climate adaptation. By achieving climateresilient health systems, the health sector will be in a stronger position to advocate forother sectors to pursue the same goal.
37. We aim to build climate-informed health systems and surveillance systems that
integrate socio-demographic, climate, environmental and animal and human health data
as well as early warning systems, foresight modelling, and risk assessments to enable
early detection and responses to climate-sensitive health risks and disease outbreaks
nationally and globally. We will promote the development and dissemination of data andevidence.
38. We commit to advancing the integration of adaptation to climate change andenvironment-related health impacts into care and the expansion of prevention efforts.
We aim to include climate change-related aspects into the education and training ofhealth care and public health professionals. We promote the planning and conducting ofclimate change, health vulnerability and adaptation assessments, sharing best practices,building capacity and specifying interventions to increase resilience and protect
population health. Additionally, as national public health institutes are key players instrengthening environmental health protection, we will promote the collaboration of theG7 public health institutes on climate and environmental health impacts. We also support
the Roadmap for Action on Health and Climate Change of the International Associationof National Public Health Institutes (IANPHI).
39. We acknowledge that mitigating the effects of climate change by reducing
greenhouse gas emissions can have significant health co-benefits. As such, health caresystems need to be part of climate change mitigation and nature-positive transition
efforts. We acknowledge the unsustainable footprint health care systems including
medical supply chains can have and commit to supporting more sustainable supply chainsfrom production to end of life. We welcome with strong appreciation the joint initiative of
WHO and the UK Presidency of COP26 on climate-resilient and sustainable low-carbon
health systems. We aim to build environmentally sustainable and climate-neutral healthsystems at the latest by 2050 and to support other countries in this effort. This can besupported through the use of emissions accounting systems for the health care sector,
which can serve as a basis for developing roadmaps to achieve climate-neutral health caresystems. We will also support other countries to develop their climate neutral healthsystems by enhancing dialogue, knowledge sharing and capacity building. We welcome
the important work of WHO and other agencies in providing guidance and expertise tocountries for the development of climate-neutral health systems.

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