Germany Has to Invest Even More in Global Health

Over the last ten years, Germany has played an active role and positioned itself well in the area of Global Health. This became clear from the prioritisation of health during the 2015 German G7 presidency in the aftermath of the Ebola epidemic in West Africa, and during the 2017 German G20 presidency, which witnessed the first meeting of the G20 health ministers. Since then, German assistance to the World Health Organi­zation (WHO), the Global Fund to Fight AIDS, tuberculosis, and malaria, the Gavi Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and new investments in combatting antimicrobial resistance (AMR) has garnered international recognition and support. These efforts and strong dedication to health as a human right, to environmental protection, education of girls and women, and thanks to its long tradition in the area of social security and enhancing health systems, Germany is already playing an important role in expanding Global Health with a ­number of international initiatives.

Germany has had a decisive influence on improving health security on a global scale. It is one of the main donors to the WHO Contingency Fund for Emergencies, which was set up to react quickly to health crises. Less well known but just as meaningful is the German contribution to Global Health in the humanitarian area. As a member of the UN Security Council, Germany draws attention to humanitarian health concerns, attacks on medical facilities and medical personnel, and rape in conflict situations. Germany is an important host country for refugees and one of the most important donors to the UN Refugee Agency.

In its coalition agreement, Germany set itself the ambitious goal of ratifying a new strategy for Global Health policy. An international advisory body was established for this purpose and has now (June 2019) presented its recommendations. Over the past few years, Germany has assumed a strong leadership role in Global Health policy. This is crucial at a time when obligations to multilateralism and joint action at a global level are being called into question. The strategic focus should be on forward-looking issues and is to be implemented in a government-wide, multi-sector, interdisciplinary manner. Promoting innovation is especially important, especially with respect to digital transformation and the correlations between the environment, climate, and health (planetary health). In Germany, there is still no recognised specialist discipline or career structure in the area of Global Health. Investment in the expansion of global health research is needed in Germany, especially at universities. A Global Health Innovation Institute, connected to existing German centres of excellence at universities or establishments, such as the Leibniz Association, would send a clear signal.

To maintain and expand its leadership role, Germany must complement its policy ventures with significant investments if it is to establish sustainable, effective, excellence-based infrastructures for Global Health. Responsibility for this lies not only with the government, but also with many other players in Germany, such as the German federal states and German foundations and institutions for funding research. While German funds for financing Global Health abroad and for international organisations have greatly increased in recent years, it is important to continue to fulfil international obligations such as achieving an ODA/BNE rate of 0.7 per cent, of which at least 0.1 per cent must be allocated to the area of health. The Federal Republic should also commit itself to significantly increasing mandatory WHO contributions.

Germany has initiated a number of important steps for placing Global Health on the political agenda over the long-term. Much has been done, but what has been achieved must be buttressed with sustainable structures and mechanisms. The creation of a parliamentary sub-committee for Global Health, budget increases for Global Health in the Federal Ministries of Health, Economic Cooperation and Development, and Education and Research, and the establishment of the Global Health Hub Germany, are examples of growing commitment to Global Health and a willingness to anchor that commitment in the German policy landscape. The World Health Summit continuously offers an important, well-respected, international platform for networking.

Coordination and coherence continue to pose a major challenge, and the advisory body report contains several proposals on that score. A new strategic coordinating body for Global Health could contribute to ensuring transparency and responsibility. Appointing a Global Health ambassador for Africa might secure the coordination of various Africa strategies relating to Global Health on the part of the German federal government. The body recommends that Germany should continue to consolidate its leadership role in the area of Global Health. A special opportunity to do so is afforded by the upcoming Presidency of the European Union in 2020.

– translated from German –

Dr. Ilona Kickbusch is a professor at the Graduate Institute of International and Development Studies in Geneva, where she serves as Director of the Global Health Centre.