Germany has shown strong leadership on global health with a particular focus on health systems strengthening
Germany was the third-largest donor to health in 2015 among the donors of the Development Assistance Committee (DAC) of the OECD, spending US$957 million 1 billion on ODA for health. This corresponds to 5% of its total ODA, which is below the DAC average of 9% for health. The government identified health as a priority sector in its coalition treaty (along with agriculture, education, climate change, and crisis prevention). Within health, it takes a rights-based approach and focuses on health systems strengthening (HSS). Other priority areas include infectious disease control and reproductive health.
Germany has continuously made global health a priority at both its G7 and G20 presidency in 2015 and 2017. Pandemic preparedness, antimicrobial resistance, and neglected diseases were identified as priority areas in the G7 communiqué, albeit without specific resource commitments. Germany also champions the Roadmap ‘Healthy Systems – Healthy Lives,’ a global initiative to strengthen health systems that was launched at the Sustainable Development Goals (SDG) summit in September 2015 ending with a declaration on health system strengthening at the World Health Assembly in Geneva in May 2016. Under the German G20 Presidency, the health ministers of the G20 countries will meet for the first time to discuss pandemic preparedness and antimicrobial resistance.
In 2015, Germany channeled US$440 million (46%) of its health ODA multilaterally, which is lower than the DAC average of 55%. Key recipients of multilateral health ODA in 2015 were the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the EU Institutions, and Gavi, the Vaccine Alliance (Gavi). Germany is the fourth-largest government donor to the Global Fund and the fifth-largest to Gavi. Germany announced at the Fifth Global Fund Replenishment Conference in Montreal (September 2016) that it will contribute €800 million to the Global Fund for the 2017-2019 funding period. This is a substantial increase relative to the €655 million pledge Germany made in 2014. Germany hosted a successful Gavi replenishment in January 2015 and pledged US$720 million direct funding for 2016 to 2020, which was a significant increase from its previous pledge (US$208 million between 2006 and 2015).
Overall, Germany provided US$517 million (54% of its total health ODA) as bilateral health ODA in 2015, corresponding to 3% of Germany’s total bilateral ODA (see figure). Priority areas were health systems strengthening (HSS; 30%), infectious disease control (19%), reproductive health care (18%), and basic nutrition (10%). It committed US$152 million to the Global Polio Eradication Initiative (GPEI) for 2013 to 2017. Funding for GPEI is bilaterally channeled to Afghanistan and Nigeria (both receive US$15 million annually). The Federal Ministry for Economic Development and Cooperation (BMZ) topped up this pledge with US$15 million for Pakistan for 2016 to 2018. Through the ‘Health in Africa’ special program announced in 2015, Germany will spend an additional €600 million (US$665 million) between 2016 and 2019 for bilateral HSS programs in Africa, with this almost doubling its annual bilateral health spending in Africa. Health is currently a priority sector of German bilateral cooperation in 12 countries, five of which are in sub-Saharan Africa.
Priority countries for bilateral cooperation on health:
- Kyrgyz Republic
- South Africa
BMZ’s health division leads on policy development
BMZ drives the development of strategies for German development policy, including on global health. Within BMZ, the division on ‘Health and Population Policy’ is responsible, and as of September 2016 is led by Heiko Warnken. It is part of the Directorate-General ‘Global Issues – Sector Policies and Programmes’, led by Ingrid-Gabriela Hoven.