Minister Aaron Motsoaledi: G20 Health Working Group Meeting

Premier of KZN, Honourable Thamsanqa Ntuli
MEC of Health in the Province, Honourable Nomagugu Simelani Mayor of Ilembe District, Honourable Thobani Shandu
Distinguished delegates from G20 Members states and invited countries Representatives of International Organisations and Regional Economic Communities
Heads of Delegations, Distinguished guests, Ladies and gentlemen,

It is a privilege to welcome you to South Africa for the 2nd Health Working Group meeting under our G20 Presidency.

Our theme for the G20 presidency, "Building a Sustainable and Inclusive Future," is not just a slogan; it's a call to action. This theme takes forward the Brazilian Presidency Health Ministers Declaration of 2024, as we continue to build sustainable health systems with the view to addressing and reducing health inequalities. This gathering provides a crucial opportunity for us to reaffirm our dedication to promoting solidarity, equality, and sustainable development. Our focus is clear: to advance global health equity and resilience in a world facing unprecedented challenges through Universal Health Coverage and stemming the tide of non-communicable diseases.

Our work is inextricably linked to the Sustainable Development Goals (SDGs), particularly SDG 3, which focuses on ensuring healthy lives and promoting well-being for all. We remain now, with just five years before the 2030 deadline, a stark reminder of the urgency required to fulfil the

2030 Agenda for Sustainable Development. This agenda calls for a world where no one is left behind, and with such limited time, our actions must be accelerated and impactful and sustainable.

The UN High-Level Meetings (HLMs) on Universal Health Coverage in 2019 and 2023 were pivotal moments in reaffirming our commitment to UHC. The 2019 HLM emphasized the need for strong primary health care systems and sustainable financing. The 2023 HLM further reinforced the urgency of addressing health inequities and ensuring financial protection, especially in the context of global crises.

However, the reality on the ground is deeply concerning. The World Health Organization (WHO) has reported a significant regression in Universal Health Coverage (UHC) indices. Specifically, UHC service coverage, measured by indicator 3.8.2, has seen a decline, with global averages stalling and, in some regions, even regressing from previous levels. Similarly, financial protection, measured by indicator 3.8.1, has also been compromised, with millions more facing catastrophic health expenditures.

For example, recent WHO data suggests that the number of people protected from catastrophic health spending increased steadily before the COVID-19 pandemic, but since then, that number has been reduced by an estimated 100 million people falling back into financial hardship due to health expenses. "The COVID-19 pandemic, coupled with economic downturns and conflicts, has disrupted essential health services and pushed millions further into poverty." This regression across both indicators underscores the fragility of our health systems and the urgent need for renewed action. We must reverse this trend and accelerate progress towards UHC.

A strong primary health care system is the cornerstone of universal health coverage. It's where prevention meets early intervention, where communities are empowered, and where the social determinants of health need to be addressed. We must invest in accessible, affordable, and comprehensive primary health care for all.

However, our ambitions are threatened by the harsh realities of global economic constraints. We are witnessing a concerning trend: declining global health budgets simultaneously with rising costs. This is particularly acute in the Global South, where many nations are burdened by unsustainable debt servicing. These debt repayments are effectively cannibalizing vital health budgets, leaving millions without access to essential health services.

We must acknowledge that spending on health is not a cost, but an investment. A healthy population is a productive population. We need innovative financing mechanisms that prioritize health, even in challenging economic times. In 2009 the G8 already coined the slogan that we “need more money for health and more health for the money that we spend”. This includes:

• Increased Domestic Resource Mobilization: We must advocate for greater allocation of national budgets to health, ensuring efficient and equitable spending.
• Debt Relief and Restructuring: For many nations, debt relief is not a luxury, but a necessity. We must explore mechanisms that allow countries to reallocate resources towards health.
• International Partnerships and Innovative Financing: We need to strengthen global health partnerships and explore innovative financing mechanisms, to bridge the funding gap.
• Efficiency and Transparency: We must ensure that every dollar spent on health is used effectively and transparently.

In South Africa, we are actively pursuing a transformative strategy to achieve Universal Health Coverage through our National Health Insurance (NHI) system. The NHI is designed to provide financial protection for all, ensuring that access to quality healthcare is not dependent on one's ability to pay. It will also assist in the efficient utilization of available resources by pooling funds and strategically purchasing services. The NHI is a concrete demonstration of our commitment to leaving no one behind, fostering equity and strengthening our health system's resilience.

Crucially, we implore all G20 members to champion increased public financing of health systems. This is not merely a budgetary issue; it is a fundamental investment in our collective future. We must prioritize public health over other competing interests, ensuring that adequate resources are allocated to meet the health needs of our populations. Furthermore, we must all align our efforts with the provisions of the Lusaka Agreement, which emphasizes the importance of strengthening health systems and promoting equitable access to healthcare. By adhering to these principles, we can build more resilient and equitable health systems for all.

Beyond financing, we must address the persistent health inequities that plague our world. Non-communicable diseases are a growing burden, particularly in low- and middle-income countries. We must accelerate efforts in prevention and control, focusing on multisectoral approaches.

Specifically, we must:

• Alleviate Financial Burdens
• Restrict Unhealthy Food Marketing
• Finance Emergency Health Services
• Accelerate Cervical Cancer Elimination, the only cancer which is preventable.

As we look ahead to the upcoming UN High-Level Meeting on Non- Communicable Diseases (NCDs), the urgency to stem the rising tide of these preventable conditions cannot be overstated. This meeting presents a crucial opportunity to galvanize global action and reaffirm commitments.

The discussions within this G20 Health Working Group, particularly regarding health financing, multisectoral approaches, and the social determinants of health, can directly inform and strengthen the outcomes of the Ministerial Declaration expected to be adopted in November 2025 during the G20 Heath Minister’s meeting.

By sharing best practices, advocating for policy changes, and committing to concrete actions on issues like regulating unhealthy food marketing and promoting healthy lifestyles, the G20 can play a pivotal role in shaping a robust global response to NCDs and ensuring that the UNHLM delivers tangible results.

Ladies and gentlemen, the time for action is now. We must move beyond dialogue and commit to concrete steps. We must prioritize health financing, address inequities, and work together to build resilient health systems.

South Africa is committed to collaborating with all G20 members to achieve our shared goals. Let us work together to ensure that health remains a priority, not a commodity especially during these unstable economic times..

I wish you a productive and successful meeting, and look forward to getting succinct recommendations from these critical deliberations.

Thank you.

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