[Title] G7 Hiroshima Vision for Equitable Access to Medical Countermeasures

The G7 members confirm their commitment to work towards equitable access to medical countermeasures (MCMs) for health emergencies. We recall that our joint efforts toward this positive vision arose out of the global tragedy of the COVID-19 pandemic. While recognizing the great strides made in developing MCMs, we also note the importance of identifying opportunities for coordination and investment by the global community for improved equitable access to safe, effective, quality-assured and affordable MCMs, particularly for countries and regions that have experienced inequitable access in the past, also recognizing their leading role in designing their own national responses.

On the basis of lessons from the COVID-19 pandemic, to tackle future pandemics and public health emergencies, the world needs a strengthened sustainable, equitable, effective and efficient "end-to-end" MCM global ecosystem that is based on voluntary cooperation. Such an ecosystem should enable the relevant functions from research and development to financing, regulatory approval, distributed manufacturing including regional diversification, market-shaping, procurement, in-country delivery including last mile distribution logistics and actual administration to people in need, particularly in Low and Middle Income Countries and in fragile and humanitarian settings. These efforts should be aligned with and coherent to ongoing discussions on the broader pandemic preparedness and response processes of strengthening global health architecture. In that regard, we note the ongoing work to negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response (WHO CA+), the Pandemic Fund, and relevant regional efforts and processes, as well as domestic/national measures to achieve and sustain Universal Health Coverage as an enabler of stronger pandemic PPR, including strengthening a resilient primary health care system and health workforce. The strengthened ecosystem should feature enhanced coordination among implementing entities and other relevant actors with defined leads and responsibilities, and surge and contingent funding for rapid scale-up of essential MCMs, including delivery, from the start of the next emerging pandemic.

The G7 members support further discussions at the World Health Assembly, United Nations General Assembly, G20, WHO CA+, among other relevant forums, leading to concrete actions to facilitate equitable access to MCMs through strengthening the end-to-end global ecosystem. Drawing on relevant discussions and consultations with multiple stakeholders*1*, we strive to promote guiding principles that should include:

1. Equity

2. Inclusivity

3. Efficiency

4. Affordability

5. Quality

6. Accountability

7. Agility

8. Speed

Together, we support a sustainable and equitable future, and commit to work together and with a range of partners to realize this vision for equitable access to MCMs in pandemics. Building on past progress achieved in improving equitable access to COVID-19 medical countermeasures, we recognize the need to join forces for safe, effective, quality-assured and affordable regional production and equitable access to MCMs, to save lives, reduce social and economic impacts, speed and sustain economic recovery and benefit global health.

With steadfast commitment to the health and safety of our respective people, we also recognize that none of us can be safe until all of us are safe. To advance these goals and others, we will redouble our commitment to seeking a solution to strengthen the MCM ecosystem so it is fit to serve all of humanity in future pandemics and other public health emergencies.

{*1* Such consultations include but are not limited to Senior-Level Technical Meeting on building consensus on a medical countermeasures platform for the next pandemic: Governance and financing of an equitable and sustainable medical countermeasures platform, Johannesburg, South Africa, February 23&24, 2023, post the Access to COVID-19 Tools (ACT) Accelerator discussion and G20 Health Working Group.}