The G8 and global health: What now? What next?

The policies of the G8 countries (the G7 industrialized countries plus Russia) matter for population health and the determinants of health worldwide. In the years before the 2005 Summit, relevant G7 commitments were more often broken than kept, representing an inadequate response to the scale of health crises in countries outside the industrialized world. The commitments made in 2005 by some G7 countries to increase development assistance to the longstanding target of 0.7% of Gross National Income, and by the G7 as a whole to additional debt cancellation for some developing countries, were welcome and overdue. However, Canada and the United States did not state timetables for reaching the development assistance target, and new conditionalities attached to debt relief may undermine the benefits for population health. Lack of adequate funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria, even after the September 2005 replenishment meeting, is unconscionable; yet even if those funds were provided, additional resources for developing country health systems would be needed. Similarly, widespread agreement on the need for improving market access for developing country exports was not met with any concrete policy response to the "asymmetrical" nature of recent trade liberalization; neither was the need to control the deadly trade in small arms. To respond adequately to global health needs, the G8 will need to adopt an agenda that more fundamentally alters the distribution of economic and political power, within and among nations.