Professor Hacker – I am also including all of your colleagues from the G20 nations or their representatives,
Minister-President, my dear Reiner Haseloff,
Ladies and gentlemen,
First of all, I would like to thank you for the work that you have done. Science depends on curiosity, a thirst for knowledge, and the joy of discovery. In science, one person builds on the insights of another. It is precisely this that makes it different from politics. In politics, one can feel comfortable saying the same thing two or three times because the audience is always different. In science, however, there is the expectation that you won’t repeat what a predecessor has already said. In politics, one is sometimes pleased when two people in a party say the same thing. Reiner Haseloff knows what I am talking about.
In science, interaction and cooperation are very important. Openness and interconnectedness are virtually taken for granted as part of life. This is also why science presents itself as a driver of globalisation on the one hand, and benefits from globalisation on the other. The fact that globalisation exists also makes scientific activity simpler and more normal.
Three hundred and sixty five years ago, four doctors laid the foundation for the Leopoldina in order to promote the exchange of ideas in the medical and natural sciences. Back in the era of stagecoaches, it was still somewhat more complex to communicate with each other than it is today in the digital age. But the urge for knowledge and understanding, the urge to learn from and with one another, already existed back then. The same rule that applied in those days still does today: Only those who demonstrate an openness to the world, and engage in cooperation beyond professional and physical boundaries, can fully benefit from it.
This is basically true for science, as it is for the economy. In both areas, we increasingly face the same challenges through the growing interconnectedness worldwide. Developments on one side of the globe have more and more impact on the other side of the globe. This applies in a positive sense, just as it does in a negative sense. One of the most concrete examples was surely the international financial and economic crisis at the end of the last decade.
Globalisation is taking place. Whoever tries to evade it, whoever focuses on isolation and protectionism, may perhaps expect to gain some advantages in the short term. However, it is clear to me that this will cause one’s own innovative capabilities and competitiveness to weaken in the medium and long term. After all, we find a great many examples of this in history.
In a closely networked world, we need – more than ever – answers that are consistent and don’t undermine each other in their effects. Therefore, global questions also require global answers. The G20 at the heads of state and government level – I wish to repeat this – was the result of the financial and economic crisis in the years 2007 and 2008. It was then that the heads of state and government met for the first time at G20 level. Previously, this was a forum for finance ministers. We saw back then that our joint action – concerning bank regulation as well as efforts to stimulate the world economy – actually made it more possible to deal with this global crisis.
At the beginning of July, the heads of state and government of the G20 member nations will meet for a summit in Hamburg. On this occasion, too, we will have guests in attendance. They are the representatives of regional organisations as well as representatives of international organisations, such as the United Nations, the IMF, the OECD, the World Bank, the World Trade Organization and the International Labour Organisation. For this reason, too, G20 summits are always global meetings, as it were. We have now included the scientific community, as well as other areas of civil society, in the summit process. Civil-society groups will be present from the very start this time – such as representatives of the business community as well as the trade unions. Also because of the good experiences from the G7 or G8 process, we had decided to expand the group of participants this year at the G20 level as well.
Therefore, this is a world premiere today, so to speak: the first meeting of science academies in the G20 format. I thank you for making the journey, which involved very long distances and travel times in some cases. I would also like to express my gratitude to Professor Hacker and his team, as well as all other participants, for deciding to convene here, for preparing the meeting, for thinking about the topics, for making a note of the conclusions, and all of this – I’ll come back to it later – in sensible language that we, as politicians, can understand.
Apart from business and trade-union representatives, the other groups we will meet with include non governmental organisations, think tanks, women and young people. As a result, this G20 process also has an impact on society.
In reference to science, it is clear that responsible policy depends on scientific recommendation. This is self evident for us in national politics. For this reason, we time and again seek the advice of scientists. This is enriching for policymakers, I would say.
Naturally, I am also pleased that Minister-President Reiner Haseloff is here and has said that his daily work routine is also enriched by this. I also thank the state of Saxony-Anhalt for being such a good host state for the German National Academy of Sciences. If the budget is already secured for the next two years, then that is much more than I can predict for our budgetary commitments. So, congratulations.
I mentioned earlier that you have developed a policy brief. It is important that the language of science is translated in such a way that it can also be comprehended by non scientists. In this sense, as presidents and representatives of your national academies, you are the builders of bridges into society. Because when it comes to the many problems that we have to solve, we can only benefit from scientific knowledge. This applies to the topic of health just as much as it does to other subjects, such as digitalisation, climate and environmental protection, poverty reduction, the empowerment of women, and the G20 partnership with Africa. All of this is crucial for the shaping of sustainable development.
We have adopted the 2030 United Nations Sustainable Development Agenda. A topic that plays a central role in the 2030 Agenda is health. The United Nations says in this sustainability charter that every person in the world is entitled to reasonable health care. Of course, serious illnesses are a bitter stroke of fate for those affected and their relatives, first of all. Many diseases also lead to life threatening situations or even to death. But as Professor Hacker already said: There aren’t just individual repercussions; illnesses can also devastate entire regions economically. They can cause social tensions and they can lead to violent conflicts. Therefore, it’s not for nothing that the 2030 Agenda gives a great deal of recognition to the topic of health.
As I have said, we have already had the scientific academies present in the G7 process and focused on health issues. We know – most notably from the Ebola crisis – that health issues can become a global topic very quickly and unexpectedly. People travel today, in times of globalisation, from one place to another – and the pathogens travel with them. The president of the World Bank, himself a physician, repeatedly points out the following: If we were to get another pandemic like the Spanish flu, as we had at the start of the 20th century, then the world – with the intense interconnectedness that we have today – would very quickly find itself in a very, very difficult state.
For this reason, a topic like health belongs on the G20 agenda. Perhaps the related organisational efforts sometimes can be quite burdensome. But I hope that you have also enjoyed getting to know each other. Of course, I also express my gratitude for the communiqué, in which you deal with the issues that particularly concern us.
Professor Hacker, I agree with you: It is essential to have strong health systems on the ground in order to prevent the outbreak of epidemics. Many epidemics could be confined locally if the health systems were sustainable and stable. This is a problem that affects many poorer countries, in particular. If you take one look at the African continent, you will know what a huge amount of work is ahead of us.
Therefore, German development cooperation has been drawing on exactly this point for years now. In Africa alone, we will make available about 600 million euros by 2020 in order to improve health systems. However, I would also add that good government leadership should always go with it – particularly in the cooperation with Africa – so that the funds don’t get stuck somewhere “unsustainably,” as it were, but rather that sustainable structures emerge out of this financial support.
With the World Health Organization, we have also started the “Healthy Systems – Healthy Lives” initiative, which serves to develop a common understanding of how we can strengthen health systems in a sustainable way. The goal is an action framework with specific agreements, with which we support countries in their efforts to provide better medical care. I promote this project among the G20 partners as well.
Within the G7, we spoke on several occasions – including when Germany held the presidency – about strong health systems. In 2015, when we hosted the summit, the G7 countries committed themselves to providing aid for at least 60 nations, in order to truly implement the international health regulations of the WHO. We have clear guidelines from the World Health Organization, but we haven’t introduced them everywhere. At the summit that followed last year in Japan, we broadened this goal. On the list, there are now 76 countries that we want to support in the development of an efficient health system. The G7 nations are doing this. Of course, we also need the governments concerned to have their own initiatives. Naturally, this process always involves evaluating the implementation of measures. I may say that we have completed such an evaluation in 30 countries. This is also planned for 30 more countries.
Strengthening national health systems is one aspect. The other one is to be prepared for emergencies at an international level as well, if diseases were to spread internationally in spite of preventive measures. In this case, the main issue is speed. A rapid response is critical. Medical staff, materials and mobile laboratories must be on the spot quickly in a crisis. Sufficient money must also be available.
I would like to add one more point because it is very sensitive. The World Health Organization is structured in such a way that it has regional offices. These regional offices have a relatively autonomous status. That means there is no chain of command from the head of the World Health Organization and no clear reporting obligation when something happens in a region. Instead, it is largely at the discretion of the regional offices to report on it.
Naturally, there is then something similar to shame: If I identify a looming pandemic in my region, should I report it and thereby trigger an alarm worldwide, so to speak, with all the consequences that this could involve – a collapse of tourism, economic repercussions? Should I have the courage to make myself heard in order to prevent major damage? There has been much discussion about this at the World Health Organization. The voluntary commitments – shall we say – were reinforced. I am relatively optimistic that it will work better in future. But this is, of course, a very important point. Because in order to trigger an alarm and to start a chain of action, I naturally need someone to tell me that something is going on somewhere – and, if possible, at a point in time when the spread of the disease isn’t that far advanced yet.
We must also ensure effective coordination. Therefore, the World Health Organization is of great importance in two respects. It must be the organisation from which we get the information and the assessment. It can employ the help of specialists for this purpose. There must also be the capability of triggering a chain of action for the international community.
The World Bank also plays an important role in this context. In particular, it has established the basis for poorer countries to be able to insure themselves against pandemic risks. This means it’s no longer necessary to just sit there alone with a huge burden in one’s hour of need because such insurance makes it possible to put to use the chain of action that we are still building up. For example, Japan and Germany are participating in this emergency programme. Naturally, there are huge debates, as there always are in science: Can one be insured against pandemics? Who wants to calculate and assess the risk? How long could it take for me to ever get into such a situation? It can take a very long time for the damaging event to occur. But it can then become very expensive once the damage has been done. These are all wonderful topics and they are all being dealt with.
A broad field of research opens up when it involves developing effective means to prevent, diagnose and treat diseases. In relation to potential pandemics in regions that may not have received the full focus of our attention so far, there should also be diagnostic and treatment options. You know how long it took with the Ebola vaccination. If it had involved measles, then perhaps we would have had it a lot sooner. Therefore, it is also important to be fair and to create similar treatment options for the different risks in the world.
In Germany – which I want to mention at this point – we have made great efforts to attend to health research, particularly in the past few years. I recently opened a health-research centre for neurodegenerative illnesses in Bonn. We have created a framework programme for health research in order to be well equipped to deal with the most diverse illnesses and to be a good partner in international collaborative arrangements.
However, we see that the incentive to go into certain fields of research also has to be kindled. In this regard, a global view is of great importance to all of us in order to concentrate not just on the diseases that we deal with in industrialised countries, but also to take into consideration other illnesses. At this point, I would like to mention the so called neglected, often tropical, diseases that were already a topic of interest during our G7 presidency. The research commitment for this doesn’t seem to be paying off at all in some cases. But if you consider that up to 1 billion people could be affected by such illnesses, you realise that it is a huge issue.
Therefore, I also expressly welcome an initiative that was launched at the beginning of this year – it was given the go ahead in Davos – and is called the Coalition for Epidemic Preparedness Innovations, abbreviated as CEPI. This will promote the research and development of new vaccines. Various countries, foundations and companies are participating in the initiative. Germany is also joining this public private partnership with a contribution of 10 million euros.
Professor Hacker has already pointed out that the development of new antibiotics and antibiotic resistance are also huge issues. We risk falling behind again in some areas because antibiotics that we had once researched no longer have the desired effect due to antimicrobial resistance. Therefore, the topic is one of the pillars of our health commitment in the G20.
In the G7, we reached agreement that we should rely on the so called One Health approach. That means there is just one health that applies to humans and animals in equal measure. That is to say, we carefully examine the food products that we humans ingest, looking at how the food came about and what types of antibiotics were used on the animals that we consume.
The G20 agriculture ministers have already held a meeting and committed themselves to the goal of allowing the use of antibiotics in veterinary medicine exclusively for therapeutic purposes and no longer for the purpose of promoting animal growth. But one must say that the definition of therapeutic purpose is an intriguing matter because the question of how much room hens and chicks have in their coops, for example, plays a part in deciding whether antibiotics must be used in order to prevent diseases, or whether one can forgo antibiotics because there is enough space for the poultry. We should give very good consideration to how high a price we are paying when there is resistance to an antibiotic and we aren’t finding new antibiotics so easily. Achieving success in antibiotic research in the pharmaceutical industry – I am no specialist, of course, but I’ve taken a look at it; indeed, all of you here are experts – is like getting five numbers right, or probably six, in Lotto. You can’t plan this easily. Success doesn’t grow on trees.
This year, not only you from the science academies have met, but we also have a conference of health ministers at the G20 level for the first time in order to once again make a good professional evaluation of what you tell us here. We have also asked the health ministers to carry out the simulation of a pandemic outbreak – a kind of dry run – for the first time and to describe action plans. At a national level, we conduct regular training exercises for anything and everything back in our home country in order to practice how we should act in the event of a catastrophe. But on a global level, we aren’t familiar with such exercises, which led to a situation in which the most efficient helpers in the fight against Ebola were military units because they were able to act with clear chains of command and clear capabilities, while the civilian structures were not prepared for it: Who will do the transporting? Who will procure the medicines? What does the chain of command look like? Who will boost hospital capacity? There were quite different approaches. In this respect, we want to be better prepared for crisis situations.
The state and government heads are supposed to be presented with a short version – so to speak – of the simulation exercise. I’m still not quite sure how theoretical or how clear the thing will be. I always look at my summit Sherpa quite eagerly when something is being presented to me. But it should be the case that we, as state and government heads, are also able to understand what is being presented to us. Because such presentations then lead to action recommendations, which we can prepare in our governments.
I really consider this topic to be extraordinarily important. For this reason, I would like to once again sincerely thank you for facing this joint undertaking. I hope that it was rewarding for you as well. It certainly is for us. Many thanks, Professor Hacker, and to your colleagues as well.
I have forgotten one other thing. We saw how poorly things worked when handling the Ebola crisis. We then considered what lessons were to be learned from Ebola. We thought that was something only the United Nations could carry forward – the World Health Organization indeed belongs to the United Nations system. Then three countries initially – Germany, Ghana and Norway – formulated an appeal to the UN Secretary-General to address the issue. The UN Secretary-General then commissioned three other countries to prepare recommendations for action. That was somewhat strange. I said: I haven’t heard anything more about it because three other countries are now dealing with it. The international community is large, but we were allowed to again bring in our experts in the second panel. The action recommendations were then delivered to the UN Secretary-General. After that, he named a special officer to oversee it further in cooperation with the WHO. It finally found a way, so to speak, into the mechanism of the United Nations. As a result, the issue was formalised and therefore has relevance at the United Nations as well. Now they should just make sure not to lose sight of it.