European support for improving global health systems and policies [Internet]

The EU has huge impact – and huge potential impact – on global health. It is one of the world’s largest markets, aid donors, health care innovators and trading powers. It influences global health and health policy directly and indirectly, through its explicit global health policies and through the effect of its other policies on global health.

There is growing recognition that a more coherent EU approach to global health could strengthen its governance and improve global health policies, due in part to the momentum created by COVID-19.

The 2022 EU Global Health Strategy and 2024 Council conclusions EU global health strategy – better health in a changing world set out principles for the future that reflect EU values and a commitment to: better health and well-being across the life course; stronger health systems; and action to prevent and combat health threats.

There is scope for more purposeful efforts to create synergies between EU policy instruments and global health. This means aligning policies that were deliberately designed to address global health and those with unintended (spillover) impacts. It also means coordinating diverse Commission directorates and agencies and other EU actors such as the External Action Service and European Investment Bank.

There are five ‘obvious’ EU policy areas where instruments could be aligned with global health goals: trade in goods and services; public investment and fiscal instruments; official development assistance and humanitarian aid; solidarity, voice and multilateralism; and research and training. There are other important areas that could also be aligned, such as climate change policy.

Repurposing existing policy instruments in areas such as those to advance global health is not straightforward because:

1. ◦

   the instruments were typically developed to meet specific (non-health) needs and are ‘owned’ by teams who are not primarily focused on global health

2. ◦

   adjusting instruments to encompass global health objectives can imply some pooling of sovereignty, which Member States may be reluctant to endorse

3. ◦

   EU policy action on global health takes place in a crowded arena with multilateral organizations, non-governmental actors, and private and philanthropic institutions, and can unintentionally cut across other initiatives.

Collective and careful work with EU policy communities can help integrate new, global health-focused, approaches into ‘non-health’ areas despite their established legal and political frameworks.

Building consensus around a vision of global health with national governments across the EU can address concerns about sovereignty and foster commitment.

EU coordination across agencies and engagement with multilateral forums can help harmonize global health approaches and reduce duplication and fragmentation.

EU global health tools need to be ‘managed’ in context and this means being clear about:

1. ◦

   which of the four types of instrument they involve: policy; funding; information; or technical support

2. ◦

   the geographical context in which the instrument will be used and whether or not this categorization is relevant to the coherence of the global health policies.