Amitabh Kant and Helen Clark
Investing in women’s, children’s, and adolescents’ health is critical to sustainable economic growth globally. Every year, across all G20 countries, nearly two million preventable deaths occur among mothers, newborns, children, and adolescents-including stillbirths.(1, 2) In recent years, the key drivers of these negative outcomes have included the “four Cs”: covid-19, conflict, climate change, and the cost of living crisis. These factors have combined to inflict immense damage on the health and wellbeing of women, children, and adolescents. Systemic discrimination and an increase in extreme weather events, food insecurity, and poverty are major causes of the lack of progress in women’s, children’s, and adolescents’ health. In 2000, the climate emergency was already responsible for more than 150 000 deaths worldwide and an increasing global burden of disease, 88% of which fell on children. (3, 4) It is estimated that 80% of people displaced by the climate emergency are women, largely due to economic and social disparities between genders. (5)
Such inequalities, environmental damage, and loss of human life and capital are profoundly distressing. As a result, women are negatively impacted, exacerbating the “feminisation of poverty.” Throughout the world, women continue to earn less than men, even when accounting for similar education levels. (6)
The G20 countries are home to two thirds of the global population and the actions they take collectively have global scale. The G20 must act now to improve the health of women, children, and adolescents and tackle preventable loss of life. India currently holds the G20 presidency and is committed to achieving universal health coverage and improving healthcare service delivery globally. For example, India has proposed several initiatives for digital health solutions as part of a digital strategy launched in 2021. (7) These digital tools enabled the registration of a billion people in order to monitor immunisation coverage, and the administration of more than 1.78 billion doses of the covid-19 vaccine. India has also proposed initiatives on the climate-health nexus, (8) given the ongoing impacts of the climate crisis on public health, and on efforts towards better pandemic preparedness and response. It is important to ensure that these initiatives are gender and age sensitive, for instance through prioritising women-centric digital health services. Cooperation across countries is critical for sharing good practices and addressing shared challenges. For example, effective adaptation to climate change requires both systemic approaches and, for countries to support each other’s efforts in raising financial resources and building technological capacities through South-South and North-South cooperation. G20 countries must also take more substantial action to overcome the health and wellbeing challenges faced by women, children, and adolescents. Firstly, G20 countries must prioritise increased cross-cutting financing to strengthen health systems, enhance access to essential health services, and address the social determinants of health, such as poverty and gender inequality. Investments in physical and digital infrastructure through a gender lens could reduce the burden of unpaid work, improve wellbeing, create jobs, increase labour force participation, reduce the digital gender gap, bolster productivity, and foster economic growth. (9) Secondly, numerous countries are struggling to maintain pre-pandemic levels of health spending. That is affecting women’s, children’s, and adolescents’ health worldwide. Global efforts are required to help countries strengthen their health systems by attracting more development assistance for health, and finding sustainable solutions to alleviate debt burdens. The G20 must advocate for this. Thirdly, we need robust data systems to monitor and implement policies and programmes effectively. Given that G20 countries account for approximately 85% of global GDP, two-thirds of the global population and carry significant political influence, they are well positioned to advance research and the development of new and improved health technologies and vaccines. When investing in these areas and making decisions, it is essential to meaningfully engage women, children, and adolescents. Fourthly, investing in the early years of childhood is vitally important, including in family-friendly policies and universal social protection. Such investments can boost cognitive capital-the complete set of intellectual skills, primarily nurtured prenatally and in early childhood, that determines human capabilities-leading to inclusive economic growth. (10) Tackling youth unemployment across the G20 requires developing adolescents’ skills, such as digital literacy, and building technology-driven and environmentally conscious growth.
The G20 must prioritise the health and wellbeing of women, children, and adolescents by making it a permanent fixture on its agenda for action. That requires dedicated, enhanced, and sustained financing, as well as more global coordination and solidarity so that no woman, child, adolescent, or country is left behind.
The health and wellbeing of women, children and adolescents are essential for sustainable economic growth worldwide. This cannot be optimised without strong G20 leadership.
(The writers Amitabh Kant is India’s G20 Sherpa, representing the country at the G20, and he has previously served as the CEO of NITI Aayog and Helen Clark is the Chair of the PMNCH Board and a former Prime Minister of New Zealand).