Civil 7 Communique (Whole text is provided here)
Global Health
The G7 Japanese Presidency has identified health and human security as the forefront ofits 2023 agenda focusing on i) global health architecture for public health emergencies, ii)
Universal Health Coverage (UHC), and iii) the promotion of health technology innovation,
including digital health transformation. Across our global community, the effects of theCOVID-19 pandemic continue to impact on health and community systems and services,
further exacerbating existing inequalities within and between countries and contributing topressure on national economies.. Despite this, international attention appears long gone.
Our G7 recommendations underscore the protection and advancement of health equity andglobal solidarity to guarantee the rights of everyone to the highest attainable standard ofphysical and mental health. We advocate for gender equality, people-centered health andcommunity systems and responses, localization/decolonization and country ownership,equal access to scientific evidence and innovation, multilateralism, and balancing the One
Health concept of people, animals and ecosystems. We firmly commit to ensuring thatwomen and girls in all their diversity, vulnerable groups (children, youth, persons withdisabilities, people living with HIV, people living with non-communicable diseases, olderpersons, Indigenous Peoples, refugees, internally displaced persons, migrants) and key
populations (people who use drugs, men who have sex with men, transgender people, sex
workers, and people in prisons and other closed settings) are at the centre of global healthstrategies and responses so as to Leave No One Behind. International human rights
standards must translate to urgent action with G7 leaders accountable for their commitments
to deliver health for all.
G7 Commitments and Plans
The G7 has repeatedly reaffirmed commitment to achieving UHC as a SDG. In 2022, it
declared renewed focus on people affected by multiple crises, particularly women and girls.
The Japanese G7 Presidency commits to progress by strengthening health and community
systems to overcome multiple health challenges, emphasizing the importance of the lifecycle approach. While gender equality and the needs of marginalized groups are widely
recognised as key to improved global health outcomes, neither are effectively linked toprimary health care or UHC.
In 2022, G7 Germany incorporated “climate-resilient and sustainable, climate-neutral healthsystems” targeting the impact of climate change on health, and pressed health systems tobecome more sustainable and carbon neutral.
Japan's commitment to strengthening the global health architecture comes at a crucial time
as world leaders discuss how to improve global and regional capacities to prevent, prepare,and respond to public health threats and emergencies.
The Japanese G7 Presidency seeks further political efforts for the “100 Days Mission
Initiative”, which was launched at the G7 in 2021. As a donor-driven initiative, civil society isintensely concerned about the lack of involvement of LMICs and civil society, and insufficientmechanisms to ensure universal access to tools for pandemic prevention, preparedness,and response (PPPR). We urge G7 leaders to strengthen global solidarity, collective actionand accountability with global health initiatives and recommit to the SDG agenda, including
highest political presence at the 2023 UN HLMs.
G7 2017 (Italy) gave attention to the health impacts of environmental factors, aligning withthe planetary health agenda. With the COVID-19 pandemic, healthy people on a healthyplanet became a significant focus while acknowledging other health threats caused byclimate change, pollution and other environmental factors.
Current Situation, Challenges and Policy Asks
UHC. With nearly two billion people facing catastrophic health spending, living with anddying from preventable and treatable illnesses, UHC is far from reality. Weak health systems,
a lack of effective health investments, and insufficient efforts to address social determinantsof health remain the culprit. Neither the SDG UHC targets nor the 2019 UHC Political
Declaration are on track due to insufficient political leadership and financial commitment,
coupled with the impact of COVID-19 and multiple humanitarian crises. Urgent investment
is critical to implement equitable, resilient, sustainable health and community-based/led
systems with an empowered workforce. Health policies and services must be accountable
and target under-served, under-resourced people and communities to reduce inequalities
and achieve UHC.
We urge the G7 to: Increase resources and investments in LMIC towards UHC, based on primary healthcare (PHC). Support should be provided to remove out-of-pocket payments.
 Re-commit to ending HIV, TB and malaria as well as non-communicable diseases(NCDs) and neglected tropical diseases (NTDs) as critical pathways to achieving
UHC.
 Engage people, in particular vulnerable and marginalized populations and with lived
experiences, physical and mental health conditions; aging, dementia, NCDs, NTDs,to ensure the delivery of people-centered, community-led, gender-transformative
UHC. Addressing the social determinants of health is crucial to ensuring UHC isachieved in underserved communities. National governments and internationalorganizations must develop inclusive governance to ensure the engagement of civilsociety organizations and communities. Guarantee sexual and reproductive healthand rights (SRHR) under the umbrella of essential PHC services as an integral partof UHC.
 Ensure gender responsive health systems that prioritize investments in Sexual,
Reproductive, Maternal, Newborn, Child and Adolescent Health (SRMNCAH).
 Invest in and strengthen equitable, rights-based, life-cycle and person-centeredapproaches by integrating healthy aging and dementia, preventive measures,medicines, and psychosocial services into PHC.
 Ensure equitable access to medical countermeasures, and essential medical devices,and promote and support country utilization of TRIPS flexibilities. Invest in water,
sanitation and hygiene (WASH) to ensure safe, dignified health care delivery as wellas essential nutrition services within and beyond emergencies.
 G7 efforts must be coordinated with other multilateral policy processes e.g., UN HLMs,and recognize UHC and PPPR as two intertwined goals that must be planned andimplemented together through health and community system strengthening and PHC.
Gender and Health. Integrating a gender perspective in health policies at a global levelremains a significant challenge. Currently, girls, women, and LGBTQIA+ populations

encounter numerous obstacles that limit their ability to achieve optimal physical, mental, andsocial well-being, and equitable access to health services. Current challenges are rooted in
the continued feminization of pandemics; the lack of capacity building in women’s education,
empowerment, economic inclusion, agriculture, and leadership; the lack of leadership andpolitical will in commitments to include of SRHR in PHC services; and the lack of genderinclusive medicine and research, despite recent advances in science and medicine.
We urge the G7 to: Enact past international agreements on women’s health and rights and the CEDAW
by ensuring the participation of women in all decision-making processes, including
policymaking, monitoring and evaluation.
 Continue championing of SDG 5 and other gender specific targets and indicators
across the SDGs related to gender and health, such as target 3.7 and 5.6, being
mindful that SDG 5 is one of the most off tracks.
 Ensure adequate resources for gender mainstreaming and addressing the needs ofwomen as vulnerable and marginalised groups.
 Accelerate women’s overall multisectoral empowerment, especially for healthpractitioners and community health workers.
 Enact health policies through a gender transformative approach.
 Create safe, enabling environments to increase access to health services for womenand girls and reduce unpaid care work.
 Address Gender Based Violence and guarantee access to justice.
Planetary Health. Planetary boundaries are thresholds of environmental stability beyond
which abrupt and irreversible changes may occur. Crossing them risks catastrophic
consequences for humanity's ability to thrive on Earth. Therefore, we highlight current
challenges such as climate crisis, food security, and environmental pollution.
We urge the G7 to: Strengthen inclusive and accountable climate finance, prioritizing planetary health inhealth policies, and prioritizing co-beneficial policies of the environment and health totackle climate change.
 Pursue food security and nutrition and shift to sustainable food systems throughintersectoral collaboration across health and agricultural sectors while respectfully
incorporating Indigenous perspectives.
 Reduce environmental pollution, reduce reliance on fossil fuels, promote clean andenvironmentally friendly transportation systems, and regulate pollutants in urbanareas.
 Accelerate contributions through global partners and invest in climate and disasterresilient sustainable quality infrastructure as necessary to achieving climate
commitments and the SDGs.
Global Health Architecture. A new approach is vital to avoid further global healthfragmentation and to increase focus on the most vulnerable, marginalised and underserved.
We urge the G7 to: Recognise the WHO as the coordinating entity for global health. Strengthen it throughsustainable financing; foster integration and convergence across different efforts andprocesses, building on synergies among health initiatives at global and regional levels
with ample resourcing to organizations that continue to play crucial roles inresponding to COVID-19 and PPPR, such as GAVI, the Global Fund to Fight AIDS,

TB and Malaria, UNAIDS, UNITAID, FINDx, CEPI, the Global Financing Facility,
among others. G7 commitments should align with the WHO conventions, agreements
or other international instruments on PPPR and not develop separate structures orparallel pathways.
Accelerate agreements and mechanisms that ensure inclusive and equal
representation of LMICs and CSOs in reforming the global health architecture.
Ensure meaningful and inclusive participation of communities, civil society andwomen at all levels of decision-making, implementation and monitoring, and prioritize
actions that strengthen health and community systems to achieve UHC.
Expand ODA and identify new revenue generators e.g., financial transaction tax andother tax policies. Leverage significant new resources through regional andmultilateral development banks to unlock financing that enhances country capabilities
to respond to public health emergencies.

PPPR. The lessons of COVID-19 have not been acted upon. ACT-A and COVAX failed toanswer vaccine nationalism, supply restrictions or to include LMICs and communities ingovernance structures from the beginning. PPPR is a global task.
We urge the G7 to: Ensure the G7 100 Days Mission Initiative and agreements for publicly funded PPPR
tools are clear and firmly embedded as preconditions for equitable access,accountability and transparency, and facilitate technology transfers, surmounting IP
barriers, and encourage geographically diversified manufacturing capacity.
 Recognise the fundamentality of manufacturing capacity in the Global South,
additional and sustainable ODA, innovative non-ODA global financing as well as
domestic resources in LMICs as quintessential to ensuring equitable access tolifesaving medical systems and products as global public goods, so that they areaccessible for all.
 Accelerate the meaningful inclusion of planetary/One Health, AMR, and secondary
pandemic effects such as hunger and supply chain at each stage and level of PPPR.