Can BRICS fill the void after Trump cuts funding for global health?

During the recent BRICS summit that Brazil hosted, member countries and partners declared their intent to make a collective contribution to promote global health.

The bold initiative spotlights the change in mindset among emerging economies and the Global South—of leading the drive to shoulder global responsibilities, including promoting a healthier planet.

Yet, the new outreach will demand a herculean effort, careful planning and extensive coordination among the member countries so that an exciting moment in human history, which mirrors a tectonic shift in global power and influence, can be realised.

At the Rio summit, the BRICS countries hailed the novel initiative called the Partnership for the Elimination of Socially Determined Diseases.

The out-of-the box approach was unique in several aspects. For instance, the initiative took a holistic view of countering diseases, going far beyond clinical treatments alone. The July 6 Rio de Janeiro Declaration nailed by the leaders of the 11- nation grouping therefore addressed the “root causes” of health crises, tracing them to poverty, social exclusion, housing and environmental conditions. Fully aware that such an ambitious task can only be tackled collectively, the grouping decided to work in lockstep to mobilise resources, and foster innovation to ensure a “healthier future for all”.

The BRICS collective was also laser -focused on benefiting low-income populations that are often neglected by wealthier nations. It specifically identified “diseases of poverty” that included tuberculosis, leprosy, malaria, dengue, and yellow fever as well as Chagas disease for a targeted response.

“We are very pleased with the launch of the Partnership for the Elimination of Socially Determined Diseases, a milestone for advancing health equity that demonstrates our commitment to addressing the root causes of health disparities, such as poverty and social exclusion,” the Rio document read.

The initiative also recognised the importance of leveraging traditional medicine and digital health systems as additional tools to promote global health.

The comprehensive approach to health adopted by BRICS was inspired by Brazil’s Healthy Brazil Programme. This initiative sought to address social and environmental issues, infrastructure iniquities that undermined health of the most socially vulnerable.

Unsurprisingly, during his address to the forum, Brazilian President Lula da Silva attributed the BRICS’ health initiative to the structural injustices that have perpetuated diseases such as tuberculosis, malaria, and other tropical diseases that have been neglected in the Global South.

The global health outreach by the BRICS, with a sharp Global South focus, has a bigger context. It comes at a time when US President Donald Trump has decided to significantly reduce global health funding, leaving a significant gap in international health requirements. Some of the key programmes that are significantly defunded include PEPFAR (President’s Emergency Plan for AIDS Relief), the Global Fund, and Gavi.

PEPFAR has suffered a $ 1.9 billion cut bringing it down to $ 2.9 billion. Gavi, the vaccine alliance has been completely defunded.

This has alarmed many in the Global South. Earlier this month South Africa’s Health Minister Aaron Motsoaledi tried to reassure citizens that the country’s vast HIV/Aids programme “will not collapse” following the withdrawal of US funding for PEPFAR.

”There is no way we are going to allow the world’s biggest HIV/AIDS Programme to collapse – never,” a defiant Motsoaledi said.

In tune with the BRICS’ declaration on health, it is apparent that among the members of the grouping, India will have to step up its game significantly.

Already, India is the largest provider of generic medicines, enjoying a 20 per cent share of the global market. Besides, it produces 60% of the global vaccines, exercising world leadership in the supply of vaccines such as DPT, BCG, and Measles. Consequently, the World Health Organisation sources 65-70 per cent of its requirements from India.

India is a major producer of generic antiretroviral (ARV) drugs, which are widely used in Africa. Indian pharmaceutical companies such as Cipla and Aurobindo have historically supplied affordable ARVs to many African countries through partnerships with organizations like the Global Fund and PEPFAR.

Indian pharmaceutical giants, including Dr. Reddy’s Laboratories and Emcure Pharmaceuticals, are now going to produce generic versions of Lenacapavir, a new injectable HIV prevention drug, following non-exclusive licensing agreements signed with Gilead Sciences, Inc.

These agreements will allow the companies to manufacture and distribute lenacapavir to 120 resource-limited countries, pending regulatory approvals, according to Gilead's official statement.

In addition to HIV prevention, the drug is being explored for treatment in individuals with multi-drug-resistant HIV, adding significantly to its potency.

Aware of India’s growing role as the “pharmacy of the world”, Indian Prime Minister, Narendra Modi, speaking at the Rio BRICS summit went to considerable length sharing his vision about India’s role in health security, with Global South as the focus.

In his speech, Modi pointed to India’s “One Earth, One Health”, doctrine. He stressed that India was ready to share its home-grown digital health initiatives with Global South countries.

This includes the India’s ambitious digital health ecosystem based on provisioning Unique Health IDs, electronic health records and telemedicine services.

These advances are an extension of the  COVID Vaccine Intelligence Network (CoWIN)-- a home grown digital platform that was developed to manage and streamline the COVID-19 vaccination drive. It played a crucial role in making India’s vaccination campaign one of the largest and most efficient in the world.

Modi stressed that India takes over the reins of the BRICS presidency as host for next year’s summit, New Delhi will prioritise the Global South in its agenda, which included that agenda of global health. Specifically, it would focus on people-centric and “humanity first” approach. Under India’s presidency, the India, the BRICS acronym would also stand for – Building Resilience and Innovation for Cooperation and Sustainability. 

However, Modi stressed that without solidarity, BRICS ambitious goals were unlikely to be met.

“The health of our people and planet is interconnected. The COVID-19 pandemic taught us that viruses do not arrive with visas, nor are solutions chosen based on passports! Hence, we have to strengthen our shared efforts to make our planet healthier.”