In June, Italy hosted the annual Group of Seven (G7) summit. The Apulia G7 Leaders' Communiqué acknowledged that the group confronted "global challenges" in a world beset by "multiple interconnected crises." The communiqué spelled out the G7's plans for tackling the challenges and crises. The scale of the challenges and severity of the crises, however, raise questions about the G7's influence in geopolitics and global governance.
Those questions are particularly sharp concerning global health. The G7 and its members have played seminal roles in supporting and funding global health activities. Yet numerous global challenges threaten health, and crises associated with geopolitical competition worsen those threats and damage the prospects for collective action against them.
As commentators noted, the summit's importance centered on the G7's response to geopolitical threats created by Russia's invasion of Ukraine, China's behavior in and beyond the Indo-Pacific region, and the potential for Iran and its proxies (for example, Hezbollah in Lebanon and the Houthis in Yemen) to expand the Hamas-Israel war into a regional conflict. Geopolitics also informed the G7's desire to improve relations with African nations to counter Chinese and Russian influence on the continent.
Those priorities overshadowed the parts of the Apulia communiqué that touched on health. The communiqué identified many health-related challenges, but its handling of them involved inadequate responses and recycled rhetoric. The communiqué leaves the impression that global health is in trouble but that G7 members are neither able nor willing to make that crisis a strategic priority.
Transnational Problems, Zero-Sum Politics
During the COVID-19 pandemic, Thomas Wright argued that the United States needed a "strategy to address transnational threats under the conditions of great-power competition." That objective requires U.S.-led "coalitions of the willing" to shoulder a "greater share of the burden of providing global public goods." Wright identified the G7 as such a coalition. Given the G7 members' collective economic clout and experience with global problems, the G7 makes sense to use in addressing transnational threats amid geopolitical competition.
It reads more like a recitation of global health boilerplate from more benign times than a blueprint for progress in a more difficult, dangerous world
In many ways, the Apulia communiqué reflects that strategy. It addresses great-power politics and lays out G7 commitments against transnational problems, such as climate change and pandemics. That approach, however, strains under three sources of mounting pressure.
Geopolitical threats have grown in the early 2020s, forcing G7 members to spend more political and economic capital countering them. Prioritizing responses to worsening geopolitical conditions pushes transnational problems down the foreign policy agenda. Arguments that bearing greater burdens to address transnational problems produces geopolitical benefits lack persuasiveness given that G7 nations face hard-power dangers in Europe, the Indo-Pacific region, and the Middle East.
The second source of pressure is global anger about the failures of G7 nations on transnational problems. The COVID-19 pandemic was a disaster for G7 members' credibility as global health leaders, especially the United States. The decades-long struggles of G7 governments to mitigate greenhouse gas emissions sufficiently and provide meaningful adaptation assistance for low-income countries have tarnished the notion that U.S.-led coalitions are willing to bear escalating burdens in managing transnational problems.
The third source arises from disagreements within G7 countries about geopolitical and transnational threats. Consensus in the United States does not exist, for example, on assistance for Ukraine, policy on the Hamas-Israel war, pandemic preparedness, or climate change. Support for nationalist, populist, and isolationist parties has grown in several G7 nations, and those parties often oppose the internationalist policies required to counter geopolitical and transnational challenges. For such parties, immigration is a greater threat, and, tellingly, the Apulia communiqué contains a lengthy section on migration.
Global Health in the Service of Geopolitics
The G7's credibility as a coalition willing to accept ever greater burdens in handling transnational problems amid great-power competition is in question. That reality makes the Apulia communiqué's identification of global health problems more a concern than a vote of confidence. The communiqué mentions, among other issues relevant to health, air and plastic pollution, antimicrobial resistance, biodiversity loss, climate change, drug trafficking, food insecurity, HIV/AIDS, malaria, neglected tropical diseases, pandemics, sanitation, supply chains, tuberculosis, and safe water.
On the one hand, that parade of problems reflects the fact that high-level diplomatic statements often read like a laundry list of aspirations written in politically correct rhetoric. On the other, the plethora of issues suggests that global health governance faces a proliferation of daunting problems amid weakened multilateralism.
The Apulia communiqué supported strengthening the "Global Health Architecture" with the World Health Organization (WHO) "at its core." Yet it does not mention the most important reform efforts in decades—the amendments to the International Health Regulations that the WHO adopted in early June or the negotiations on a WHO pandemic agreement that restarted the day after the G7 summit ended.
The Apulia communiqué's health section also reprises oft-made commitments on, for example, access to medical countermeasures, antimicrobial resistance, climate adaptation, ending HIV/AIDS as a public health threat, the One Health approach, the Pandemic Fund, and universal health coverage. The section does not grapple with how recycled G7 commitments operate in a context marked by increased geopolitical competition and fractured multilateralism. It reads more like a recitation of global health boilerplate from more benign times than a blueprint for progress in a more difficult, dangerous world. The section reinforces the sense that, in a troubled world, global health struggles for top-tier policy attention.
The Apulia communiqué's section on fostering partnerships with African countries helps illustrate that struggle. Despite spending billions of dollars on global health initiatives in Africa over decades, G7 governments realized that China and Russia had made geopolitical inroads across the continent with their economic and security assistance. In 2022, the group launched the G7 Partnership for Global Infrastructure and Investment (PGII) to compete with its rivals in Africa, particularly with China's Belt and Road Initiative. The PGII included some health-related objectives, such as pandemic preparedness and climate change resilience, in its strategy.
The Apulia communiqué continues that approach. It emphasizes the PGII's strategic importance and nests health issues within it. In particular, the communiqué highlights a new food security project, the G7 Apulia Food Systems Initiative. The initiative seeks to help low-income countries, with "special attention" on Africa, to achieve food security through resilient agriculture and food systems. That objective requires addressing climate adaptation given the threats that global warming poses to agriculture, food systems, and health.
Domestic politics within G7 countries threaten the group's ability to catalyze collective action
The G7's food system initiative constitutes an effort to build a coalition of the willing across high- and low-income countries to address health threats associated with agricultural and food systems' vulnerabilities, including climate change. Connecting the initiative to the PGII indicates that G7 countries intend the endeavor to provide geopolitical benefits for them, particularly in Africa—benefits that earlier G7-supported global health activities did not deliver when balance-of-power politics returned to international relations.
Coalitions of the Conflicting
Sustaining the kind of coalition of the willing envisaged in the G7's food system initiative will be difficult. According to the Apulia communiqué, the desire to improve relations with African countries includes the G7's geopolitical interests in those countries strengthening democratic governance, contributing to global stability, and protecting the rule-based international order.
G7 governments, however, are still concerned about democratic backsliding in Africa, the refusal of many African leaders to condemn Russia's invasion of Ukraine, and the threat Moscow's aggression has created for global stability and a rule-based international order. How new G7 initiatives that link health and geopolitics change those phenomena is not apparent.
In addition, low-income countries in Africa and elsewhere have few incentives to join the G7's geopolitical camp by participating in G7-supported activities. Many countries in the so-called Global South are trying to exploit the advantages associated with nonalignment. To date, G7 nations have not pulled back global health commitments because recipient governments have or want good relations with China and Russia. Whether G7 members would start conditioning health assistance on recipient countries abandoning nonalignment is not clear.
Low-income countries pursuing nonalignment might also sense that they have a strong hand on global health problems given G7 nations' poor performance during COVID-19 and culpability on the climate crisis. The Apulia communiqué's discussion of climate mitigation and adaptation, particularly its silence on how G7 members will help mobilize the UN-estimated need of nearly $400 billion annually for the adaptation needs of low-income countries, is unlikely to impress low-income countries.
Coalitions that do not produce geopolitical benefits but increase national burdens are vulnerable to domestic political forces in G7 countries hostile to internationalism. For example, little in the Apulia communiqué on climate change, including the new food system initiative, would survive if former president Donald Trump wins in November and implements his anti-climate change policies. Support for nationalist and populist parties and policies could also constrain what other G7 governments can accomplish concerning geopolitical threats and transnational problems.
The Apulia summit suggests that the strategy of using the G7 to build coalitions of the willing to address transnational challenges amid geopolitical competition remains salient. The strategy, however, is vulnerable. Geopolitics buffet the G7 and the coalitions it fosters in ways that expose the divergent interests of nations. Domestic politics within G7 countries threaten the group's ability to catalyze collective action. The G7, and the cooperative efforts it supports, could in short order become coalitions of conflicting countries unable to navigate geopolitical competition and mitigate shared risks that transnational problems create.
