Readout of Secretary Azar’s Meetings at the G20 Health Ministerial Meeting

Today, Health and Human Services (HHS) Secretary Alex Azar attended the G20 Health Ministerial Meeting in Mar del Plata, Argentina. Secretary Azar delivered the following remarks at the plenary session on antimicrobial resistance (AMR):

“Thank you Argentina and Minister Rubinstein for your leadership of this important meeting and for your hospitality. The United States is committed to engaging on the issue of antimicrobial resistance, and considers it a top priority for global health engagement and hope G20 countries will continue to advocate for high level focus on AMR at the World Health Organization and other One Health multilateral organizations.  First, we believe that it is productive to consider the role that the private sector can play in addressing this challenge.

“There is no doubt that more must be done to incentivize increased R&D for new antibiotics and diagnostics. Governments must work with companies, and not against them, to encourage innovation in this space…Our health department and the whole U.S. government strongly believe in following the best science we have in formulating policies on issues like AMR. Often the science points to very specific interventions that target certain antimicrobials, certain pathogens, and certain uses, rather than blanket rules or arbitrary thresholds…The United States has made and is making great strides in improved stewardship of the use of antimicrobials: In the agricultural sector, our government has worked collaboratively with our industries to remove any use of antibiotics for growth promotion and to provide greater oversight over the use of antibiotics for treating diseases in livestock…A One Health approach to AMR that incorporates this work is important. It helps us to gain a better understanding of where and how resistance arises and to better confront the transfer of resistance across human health, agriculture, and environment sectors….In the human health sector, we are undertaking initiatives to better educate providers and patients on the prudent uses of antibiotics and to encourage more in-depth consideration of how and when to use antibiotics in hospital settings…”

“A further challenge is substandard or falsified, SF, antibiotics, which greatly increase the risk of resistance, due to decreased effectiveness of the drugs and the uncertainty of proper dosing. At this year’s meeting, the U.S. would like to encourage a special focus on this issue, which is also a key part of health systems strengthening. When SF medicines do not work as expected when compared with genuine medicines, the health of patients suffers and they lose confidence in the healthcare system. The issue of SF medicines is also relevant to this year’s third G20 issue, pandemic preparedness and global health security, where the reliable efficacy of medical countermeasures is critical to controlling major outbreaks.”

And on the topic of strengthening health systems, Secretary Azar said:

“The United States strongly supports efforts to strengthen health security, and believes that action by the G20 is important to improve preparedness across all regions. One crucial aspect of effective pandemic preparedness is building resilient health systems.

“An important tool in this effort is transparency. External evaluations utilizing broad expertise can help identify gaps in preparedness, and published national action plans can help potential donors see opportunities for collaboration. Multi-sectoral partnerships and cross-sectoral coordination, especially engaging the private sector, are critical to fill in the identified gaps in our systems’ capacities to prevent, detect, and respond to infectious disease threats….in the United States, we are now working to advance our health system from one that pays for procedures and sickness to one that pays for outcomes and health—in other words, a value-based system.

“Health system transformation to people-centered and value based health care should be tailored to the needs of the local contexts, and allow for a basket of options to enable the broadest access to care. Nearly all healthcare delivery systems utilize a range of resources, including from non-governmental sources, to provide the most effective care for their citizens. In the United States in particular, we provide broad access to very high quality care by engaging the private sector, both private systems and community- and faith-based groups. .. We do believe that there is value in the extensive research and findings of the Organisation for Economic Co-operation and Development on healthcare systems and care delivery. As the G20, we could be leveraging their work to assist countries at different stages in the improvement of their healthcare systems.

Next, Secretary Azar delivered the following remarks at the plenary session on childhood obesity:

“We all recognize the burgeoning problem of childhood obesity around the world. These challenges demand a comprehensive and cooperative strategy. Examples of successful, voluntary collaborations with private-sector companies to address obesity and its related diseases abound in many countries around the world. In the U.S., for example, the Healthy Weight Commitment Foundation’s Trillion Calorie Pledge was a voluntary ingredient reformulation initiative launched in 2010 by 16 of the nation’s leading food and beverage companies. The aim was to reduce 1 trillion cumulative calories from U.S. diets by 2012 and 1.5 trillion calories by 2015. The initiative actually led to reducing 6.4 trillion calories—400 percent more than the pledged amount. Governments also can collaborate with companies on initiatives to better inform consumers about nutrition and healthy diets, empowering consumers to take control of tackling obesity at the individual level. Voluntary food packaging information or school- and community-based educational initiatives can go a long way towards enabling and encouraging healthy behaviors. Responding to it effectively, however, demands the kind of innovation and commitment that can only come from engaging the private sector, communities, families, and individuals themselves. When our countries do that effectively, we believe we can finally make lasting progress on this challenge.”

“A problem this significant and complex also does not have a single solution, and must be tackled by all sectors. Childhood obesity is a challenge just about everywhere, but approaches to addressing it must be tailored to national contexts and driven by national initiatives. What works for one country will not always work in another. In fact, the issue can even be differentiated across regions within a country—within the United States, different areas have different challenges. For these reasons, local, community and regional initiatives often are the most effective ways to approach the issue. Complex issues like food systems do not lend themselves to an easy, one-size-fits-all approach.  Rather, they demand a comprehensive and cooperative strategy…Responding to it effectively, however, demands the kind of innovation and commitment that can only come from engaging the private sector, communities, families, and individuals themselves. When our countries do that effectively, we believe we can finally make lasting progress on this challenge.”

In the afternoon, Secretary Azar participated in the One Health AMR Simulation Exercise. The purpose of this targeted exercise was to raise awareness and understanding of the key challenges raised by AMR across a variety of sectors.

Throughout the day, Secretary Azar attended bilateral meetings with Dr. Thomas Gebhart, the Parliamentary State Secretary to the Federal Ministry of Health of Germany; Gan Kim Yong, the Health Minister of the Republic of Singapore; Bruno Bruins, the Minister for Medical Care and Sport of the Netherlands; and Steve Brine, the Parliamentary Under Secretary of State for Public Health and Primary Care of the United Kingdom. In these conversations, Secretary Azar focused on U.S. health priorities including drug pricing, health system transformation, and global health security.

Additional information regarding the Secretary’s meetings and schedule will be forthcoming in news releases and social media posts.