Moscow Declaration Of The XIV BRICS Health Ministers: Can Sustainable Development Goal 3 Be (SDG3) Achievable? – Analysis

The 14^th BRICS Ministerial Meeting took place in Moscow from October 10 to 11, 2024, bringing together health ministers from the BRICS to discuss global health challenges and promote enhanced cooperation among member states. The ministers reiterated their commitment to the fundamental principles of BRICS, encompassing mutual respect, sovereign equality, solidarity, democracy, openness, inclusiveness, and enhanced collaboration.

The meeting underscored the imperative of a unified strategy for the management and control of infectious diseases, acknowledging that viruses transcend national boundaries. This encompasses the enhancement of capacities, the fortification of health systems, and the establishment of resilient and sustainable supply chains. The ministers recognized the essential role of disseminating technology and knowledge to guarantee equitable access to medical countermeasures, thus preserving the quality, affordability, and availability of healthcare services.

The persistent public health crises, notably Mpox, have been identified as considerable barriers to the realization of Sustainable Development Goal 3 (SDG3), which is focused on promoting good health and well-being. In response to this situation, the BRICS members have pledged to enhance their collaborative efforts to address these challenges and achieve the SDG3 targets by the year 2030. Moreover, they articulated a dedication to advancing Universal Health Coverage (UHC) and underscored the significance of protecting populations that have been negatively impacted by the COVID-19 pandemic and other health crises. 

The recognition of each individual’s right to achieve the highest attainable standard of physical and mental health is paramount, alongside the imperative for accessible and quality healthcare services that do not impose financial burdens. The ministers recognized the imperative to enhance the global health framework, emphasizing the necessity for transparency, sustainability, and equity, with the World Health Organization (WHO) positioned as a pivotal coordinating entity.
The advancements achieved in the negotiations of the Intergovernmental Negotiating Body (INB) concerning a pandemic preparedness instrument were acknowledged, alongside a pledge to persist in deliberations on this vital matter. Furthermore, the BRICS nations committed to endorsing the World Health Organization in its efforts to obtain reliable and adaptable resources crucial for the execution of its 14th General Programme of Work (GPW-14). 

The ministers underscored the significance of establishing joint mechanisms to facilitate collaborative healthcare initiatives among BRICS nations, reiterating their dedication to the agreements formulated during the 2023 Summit held in Durban, South Africa. This meeting functioned as an essential forum for health ministers to devise strategies aimed at addressing both present and prospective health challenges. It underscored their dedication to collaboration, equitable access to healthcare, and preparedness for pandemics, with the overarching objective of bolstering resilience against global health crises and advancing the comprehensive aim of sustainable health for all individuals. 

Sustainable Development Goal 3 (SDG 3): Good Health and Well-being (2022-2024)

Sustainable Development Goal 3 (SDG 3) is designed to guarantee the attainment of healthy lives and the promotion of well-being for individuals across all age groups. This objective encompasses a comprehensive array of health-related aims, addressing both communicable and non-communicable diseases, as well as mental health, reproductive health, and the pursuit of universal health coverage (UHC). 

Current reports indicate that SDG 3 continues to hold significant importance within the global health framework, particularly in light of persistent public health challenges.

A significant aspect of SDG 3 is the dedication to Universal Health Coverage (UHC), aimed at guaranteeing that all individuals can access essential health services without experiencing financial distress. The World Health Organization (WHO) indicates that as the global community approaches the midpoint of the 2030 Sustainable Development Goal aimed at achieving universal health coverage, it becomes increasingly apparent that more than half of the world’s population continues to lack adequate protection from essential health services. Moreover, a considerable segment of the global population experiences economic hardship due to out-of-pocket costs associated with health care. A further critical objective encompasses the reduction of the global maternal mortality ratio to fewer than 70 per 100,000 live births by the year 2030. The World Health Organization indicated that in the year 2022, approximately 287,000 women succumbed to complications related to pregnancy, with a striking 94% of these fatalities occurring in low- and middle-income nations. 

Furthermore, SDG 3 seeks to eradicate communicative diseases by 2030, so aiming at the end of AIDS, tuberculosis, malaria, and neglected tropical diseases. The WHO estimates that 1.6 million deaths from tuberculosis has been recorded in 2022, underscoring the ongoing difficulties in tackling infectious diseases especially in view of the COVID-19 epidemic. With the emphasis on the promotion of mental health and well-being, mental health has also grown in importance. According to a WHO estimate from 2022, one in eight people globally suffer with mental diseases; yet, treatment availability is still rather limited, particularly in low- and middle-income countries. The aim also addresses the need to one-third by 2030 lower premature death from non-communicable diseases (NCDs). With cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes leading causes, the WHO projects that NCDs account for 74% of all worldwide deaths annually. Another important component of SDG 3 is guaranteeing worldwide access to vaccines and basic medications. A major obstacle to reaching health targets, the Global Health Observatory noted that over one in five people lack access to basic medications. 

Achieving SDG 3 also depends on health financing; the WHO advises nations to set aside at least 5% of their GDP for this purpose in order to meet UHC targets. Many nations still fall short of this benchmark, though, and the COVID-19 epidemic has caused budgetary restrictions in many more in 2022. Tracking progress towards health targets depends on strengthening health information systems; yet, the WHO observed that over 80 countries lacked consistent health data in 2022, so compromising the ability of effective policymaking. 

The situation of SDG 3 has shown varied improvement depending on the area. Regarding mother and child health, several nations have made great progress toward lowering death rates. With almost 551 deaths per 100,000 live births as of 2022, the mother death ratio is still shockingly high in Sub-Saharan Africa though. Although diseases like HIV/AIDS and malaria have made great strides toward eradication, the current COVID-19 epidemic has exposed weaknesses in world health systems, so upsetting vital medical services in 90 countries and raising morbidity and death from other diseases. Thanks to urbanization and lifestyle changes, the load of NCDs keeps growing especially in developing countries. Reflecting the critical need for preventative actions, NCDs are expected to kill 1.5 billion people in 2022. With only 35% of nations having included mental health into their main healthcare systems as of 2022, mental health is still a neglected area.

Still there are several difficulties, especially in the Global South. Many nations have poor healthcare systems that cause restricted access to basic medical treatments. With much of this disparity found in developing countries, the WHO estimates that half of the world’s population lacks access to basic health services. Another major obstacle are financial ones since low-income groups cannot get required treatment due to high out-of-pocket healthcare costs. Health costs, according to the World Bank, force 100 million people annually into extreme poverty. Furthermore, still unresolved for the Global South are high rates of infectious diseases combined with poor sanitation, health system flaws, and poverty. Africa accounts for over 90% of malaria cases, and the health system finds great difficulty handling the disease load. 

With the WHO approximating that over 75% of individuals with mental diseases in low-income countries receive no treatment, mental health stigma adds to neglect and underfunding of mental health services. Climate change aggravates health conditions, which increases vector-borne diseases and heat-related illnesses. Based on malnutrition, malaria, diarrhoea, and heat stress, the WHO projects that between 2030 and 2050 climate change will cause an extra 250,000 deaths. 

Through cooperation, resource mobilization, and creative health solutions, the BRICS countries are particularly suited to meet these obstacles. Using their combined power, the BRICS nations can carry out group health projects and distribute best practices. For example, other members might profit from Brazil’s experience addressing HIV/AIDS. As India’s Ayushman Bharat program shows, BRICS can also support policies that forward UHC in member nations, so guaranteeing fair access to healthcare services.
            

Through programs like the BRICS Vaccine Research and Development Center, which seeks to increase vaccine availability and solve inequalities, BRICS can also stimulate innovation in health technologies and drugs. Investing in healthcare workforce development is crucial; BRICS can set training courses and exchanges to improve the health workforce in underprivileged regions. Especially in response to world health crises like COVID-19, BRICS countries can cooperate to mobilize resources for health systems; advocacy for more public health funding is absolutely vital. At last, BRICS can be very important in influencing global health governance by helping WHO projects to solve health disparities and encourage cooperative responses to world health challenges.

In essence, SDG 3 is essential for attaining world health and well-being; nevertheless, there are still major obstacles especially in the Global South. By means of cooperation and creative ideas, the BRICS countries have the potential to solve these issues, so ensuring that none is left behind in the quest of health equity and so advancing progress toward SDG 3 and contributing to better health outcomes for all. 

Healthcare Cooperation in BRICS

The BRICS has been working together to address emerging health threats and the ongoing challenges posed by diseases. They have taken several key actions to foster cooperation in healthcare, with a particular focus on nuclear medicine, tuberculosis (TB) research, vaccine development, infectious disease prevention, and regulation of health products. The XV BRICS Summit in Johannesburg highlighted the establishment of a dialogue on nuclear medicine, focusing on innovative approaches in diagnostics and treatment. The International BRICS Expert Forum on Nuclear Medicine held in Saint Petersburg facilitated discussions on education, training, and advancements in radiopharmaceuticals, addressing its potential in various health sectors. The BRICS Nuclear Medicine Working Group has initiated collaborative efforts to advance the field of nuclear medicine and radio pharmacy.

TB is a significant health challenge for achieving various Sustainable Development Goals (SDGs), and member states support the targets of the 2023 political declaration of the UN General Assembly’s High-Level Meeting on TB, which includes enhancing research capacity, collaboration through TB research platforms, and accelerating vaccine development. The XV BRICS TB Network Meeting in Moscow underlined the necessity for additional resource mobilization through the New Development Bank to support joint research initiatives on TB prevention, diagnosis, and treatment. In vaccine research and development, the BRICS Vaccine R&D Centre aims to strengthen international collaboration to respond to emerging health threats, including potential diseases like Disease X. Member states are committed to stimulating technology transfer to enhance regional vaccine production, addressing the needs of developing countries. A proposal from the Russian Federation aims to establish a platform connecting participants of the Vaccine R&D Center and other interested organizations to enhance cooperative efforts in vaccine research and development.

Conclusion

By means of their cooperative efforts in healthcare, the BRICS countries have shown a strong will to reach Sustainable Development Goal 3 (SDG3). BRICS is positioned to meet important health challenges and enhance health outcomes for their populations by concentrating on vital areas including nuclear medicine, tuberculosis research, vaccine development, and the control of health products. The continuous projects and systems developed during different summits underline the need of group effort in reducing health inequalities and improving access to high-quality healthcare. BRICS can efficiently coordinate initiatives to address public health crises, support universal health coverage, and guarantee fair access to medical services by means of their combined resources and experience. Thus, the current cooperation among BRICS member states is a necessary route towards realizing SDG3 and promoting a better future for all.

About the authors:

• Prof. (Dr.) Bawa Singh, Department of South and Central Asian Studies, School of International Studies, Central University of Punjab.
• Sonal Meena, PhD Scholar, Department of South and Central Asian Studies, School of International Studies, Central University of Punjab.
• Dr. Jaspal Kaur, Department of Sociology, School of Social Science and Humanities, Lovely Professional University, Phagwara (Punjab)-India.