G8 presents united front on global health issues: The fight against infectious diseases has helped summit leaders find common ground but expectations remain low
As the Group of Eight leaders prepare to gather in Vladimir Putin's home town for a summit next weekend, the world's health problems provide one rare patch of common ground, even if expectations of tangible gains are scant.
The fight against infectious diseases may have seemed an after-thought last year when Russia's G8 planners penned their list of summit themes, far behind global energy security and education, but there was a logic that has since been enhanced by fears on bird flu.
Gennady Onishchenko, Russia's surgeon-general, says: "There were two fundamental aspects to the choice of the topic: it should be something that affects all humanity and to which the host country can bring its experience."
After the focus at last year's Gleneagles G8 on Africa, and a declaration to attempt to offer global HIV treatment to all by 2010, the theme of infectious diseases provided continuity with the St Petersburg summit.
Given the sharp growth to dangerously high levels in HIV infection especially among drug users in the former Soviet states - notably in Ukraine, Central Asia and Russia - there is a particular expertise.
Another of the world's leading killers that remains "neglected" is tuberculosis, and Russia also presents a particularity that deserves greater attention: the collapse of the Soviet health system and the maintenance of older approaches to treatment has helped foster the development of drug resistant TB strains.
Historically, the Soviet Union championed the cause of smallpox eradication that was successfully co-ordinated by the World Health Organisation, so there is a logic to fresh support in St Petersburg for the follow-up campaign to free the world of polio.
But it is bird flu that may prove the most uniting force. Since infectious diseases were identified as a Russian theme, awareness of a pandemic risk has grown sharply. That has triggered political commitment by the leaders of G8 nations, which as likely to be affected as the developing world.
"There is no room for bilateralism on flu", says David Heymann, a senior World Health Organisation executive who will attend the G8. "A global disease problem has to be handled by a global response."
While the rhetoric on infectious diseases in the G8 final declaration is likely to be positive, expectations remain low. Early attempts by international officials to introduce intermediate targets on the scaling up of HIV treatment towards the 2010 Gleneagles' goal met with resistance and have been abandoned.
On new mechanisms to help global health, expectations for St Petersburg are also slipping, in line with a dispute that has little to do with Russia. Launch of a first "International Finance Facility", championed by Gordon Brown, the UK chancellor, and designed to "frontload" future aid flows to boost immunisation rapidly in the developing world, was set to be launched in June but has now been stalled till September.
A separate initiative has also stalled. Pushed by the Italians, "Advance Market Commitments" are government pledges to guarantee to purchase innovative drugs and vaccines if they are successfully developed by pharmaceutical companies.
Discussion for the first pilot scheme, a pneumococcal vaccine for the developing world, was deferred this spring, and few expect more than a commitment in principle at best in St Petersburg.
Insiders say both instruments have been held up by disagreements over financing, notably from Germany and Japan.