EU Global Health Research and Development

How does the EU channel its global health R&D?

The EU’s global health R&D funding is channeled through two main funding programs: Horizon Europe and EU4Health.

Horizon Europe is the EUI’s key funding program for research and innovation and includes a health cluster covering global health R&D. The 2021 MFF and subsequent FY2023/24 MFF midterm review has set Horizon Europe’s total budget across the MFF period at approximately EUR93.4 billion ( US$88 billion) (originally EUR95.5 billion ( US$101.6 billion) with EUR2.1 billion ( US$2.2 billion) being redeployed within the MFF midterm review).

EU4Health is the EU’s first standalone internal health program, with a total budget over the 2021 to 2027 MFF period of approximately EUR4.3 billion ( US$4.5 billion) (originally EUR5.3 billion ( US$5.6 billion)) with EUR1 billion ( US$1.1 billion) being redeployed within the MFF midterm review), of which a maximum of 12.5% can be used for global commitments and health initiatives, with a maximum of EUR538 million ( US$567 million) across the MFF period, to include both global health R&D and pandemic preparedness and response.

How is the EU’s global health R&D funding changing?

The EUI spent US$312 million on global health R&D in 2022.

In 2020, EUI funding for global health R&D increased by 90%, driven primarily by substantial investments in combatting the COVID-19 pandemic. However, this increase in funding has not been maintained. Funding allocated to COVID-19 decreased by 37% between 2020 and 2022, and overall funding declined by 15% over the same period. The surge in COVID-19 funding from 2020-2022 likely reflects a front-loading strategy, in which funds from the total budget of this MFF have been moved up in response to the urgent demands posed by the pandemic. Unspent funds from Horizon 2020 may also have been reallocated to the health cluster and global health R&D funding during this time.

Excluding allocations for COVID-19, EUI's global health R&D funding was higher in the period between 2020 and 2022 than in previous years. This can in part be attributed to the commencement of the latest MFF in 2021, as expenditure tends to be elevated during the initial years of the framework. It is therefore not expected that this higher level will be maintained across this MFF period.

How does the EU allocate global health R&D?

Disease priorities

The EU does not have any disease-specific strategies, but rather allocates funds through calls for proposals, resulting in a broad demand-driven approach to funding. It is therefore difficult to predict how priority areas will evolve over time.

Over the period 2018 to 2022, EUI global health R&D funding focused on a range of disease priority areas including NDs, AMR, and pandemic preparedness. A large share of global health R&D targets more than one ND.

Recipient types

EUI global health R&D funding is allocated via open calls for proposals, wherein the allocation of funds to various recipients reflects the capacity of the recipients to effectively address these calls. The recipient type does not constitute a component of the evaluation criteria within this process; instead, emphasis is placed on factors such as scientific excellence and the use of innovative research.

The EDCTP, a public-public partnership between the EU and Sub-Saharan African countries for poverty-related and neglected infectious diseases, is by far the largest recipient of EUIGH R&D funding, receiving 45% of all EUI global health R&D funding in 2022.

Excluding EDCTP and COVID-19 spending, approximately 56% of EUI global health R&D funding is directed to academics and research institutions, indicative of their scientific expertise and responsiveness to proposals. A further 12% is allocated to industry, aligning with the EU’s strategy emphasizing health research as a driver for economic growth and industrial competitiveness. Other intermediaries, excluding EDCTP, also receive approximately 12% of the EUI’s global health R&D funding; within this group CEPI is the largest recipient.

R&D stages

EUI funding allocated to each R&D stage has fluctuated between 2018 and 2022, reflecting the demand-driven funding landscape within the EU. On average during this period, tuberculosis received the largest share of discovery and pre-clinical R&D, followed by malaria and kinetoplastid diseases.

Between 2018 and 2022, the proportion of funding directed towards discovery and pre-clinical stages decreased as a result of large reductions of later-stage innovations for HIV/AIDS (US$3 million decrease since 2018), Zika (US$1 million decrease since 2020) and malaria (US$5 million decrease since 2022). Additionally, the EU call for proposals system makes it more challenging for later stages to be funded.

The largest share of the EUI’s clinical and field development global health R&D was invested in R&D for tuberculosis and filoviral diseases, including Ebola and Marburg, across the same period.

Funding and Policy Outlook

What is the current outlook on public global health R&D?

The EU approaches innovation from a competitiveness perspective. Its focus on R&D is economic, and its interpretation of the health agenda is rather narrow, as health research is seen as a lever for economic growth. The EU does not have a global health R&D strategy, nor disease-specific strategies.

The EU's Global Health Strategy includes a commitment to boost global health research to develop the technologies necessary to improve health. Research and innovation are also part of the EU- AU partnership, with a specific focus on public health.

The budget allocated to health within the EUI has fallen in recent years, partly following the de-prioritization of health after the COVID-19 pandemic. During the 2023/24 MFF midterm review, EUR2.1 billion ( US$2.2 billion) was reallocated from Horizon Europe and EUR1 billion ( US$1.1 billion) from EU4Health to fund other priorities, including support to Ukraine.

Key Stakeholders and Budgets

The EUI’s annual budgets are derived from the MFF, in which total budgets for programs are set for a seven-year period (currently 2021 - 2027), and then revised during the MFF midterm review (2023/24).