Issue Deep Dive: Germany/Global Health

Last updated: January 2, 2023

ODA Spending

ODA in Context

Germany was the third-largest OECD DAC donor to global health in absolute terms in 2020, but only the 12th among DAC donors in terms of its prioritization of global health.

Germany’s ODA to health grew by 150% in absolute terms from 2016 to 2020, especially between 2019 and 2020 (112% growth), due to Germany’s response to the COVID-19 pandemic.

According to the BMZ’s ‘Agenda 2030 thematic model’, ‘health, social security, and population policy’ is one of six core themes, which means that the topic should transcend legislative periods. In reaction to the COVID-19 crisis, the BMZ has also established a new subdivision titled ‘Global Health: pandemic prevention, One Health’.

ODA Breakdown

Bilateral Spending

Germany channeled more than half of its health ODA (68% or US$2.1 billion) bilaterally in 2020 including 31% of [earmarked funding through multilaterals. This is above the DAC average of 56% bilateral spending (including earmarked funding to multilateral organizations).

Bilateral health ODA focused mainly on COVID-19 response and infectious disease control. Smaller shares went to health policy and administrative management, basic nutrition, and reproductive health care. Funding for all these areas increased in 2020 compared to 2019.

Multilateral Spending and Commitments

In addition to its bilateral funding to health, Germany channeled 32% of its health ODA to multilaterals, which is below the DAC average of 44%, but higher than Germany’s contributions to multilaterals in other sectors. The largest recipients in 2020 were the Global Fund and Gavi, which are both priority multilaterals for the BMZ. Germany has a seat on the Global Fund Board and is a member of the Board’s Strategy Committee. Germany hosted Gavi’s replenishment conference in 2015 and co-hosted its COVAX AMC Summit in 2022.

Germany pledged €1.3 billion to the Global Fund (US$1.5 billion) in September 2022, for its 2023-2025 funding period. This represents an increase of 30% compared to Germany’s previous pledge. For Gavi’s strategic period of 2021-2025, Germany pledged US$721 million in direct funding.

In May 2022, Germany pledged €1.3 billion (US$1.5 billion) to ACT-A in 2022, exceeding its ‘fair share’ for 2022 of US$1.2 billion. As of November 2022, Germany had contributed a total of US$3.9 billion to ACT-A, making it the second-largest donor to the global initiative.

More recent pledges to multilateral organizations include:

Funding and Policy Outlook

Marking global health as a priority sector: The German government identified health as a priority sector in its 2021-2025 ‘Coalition Agreement’, specifically strengthening global health architecture under the One Health approach, health R&D, especially in biotechnology, PRNDs, and WASH. Some of these issues are also included in the BMZ’s priority topic ‘Fighting the COVID-19 pandemic and its effects, preparing for future pandemics’, which is one of four priorities.

Leveraging G7 and G20 presidencies to sharpen leadership in global health: Under former Chancellor Angela Merkel, Germany came forward as a leader in global health, especially since 2015. Germany prioritized global health during both its previous G7 and G20 presidencies in 2015 and 2017, respectively. Pandemic preparedness, AMR, and neglected diseases were identified as priority areas its G7 communiqué in 2015. Under the German G20 presidency in 2017, the health ministers of:abbrG20 countries met for the first time to discuss global health issues such as pandemic preparedness, health system strengthening, and AMR. Research on AMR and pandemic preparedness are also among Germany’s key priorities for its G7 Presidency in 2022.

Advancing SDG 3: In April 2018, the former Chancellor Merkel, together with her Ghanaian and Norwegian counterparts, suggested that the World Health Organization (WHO) should convene global health actors to develop a ‘Global Action Plan’ with interim milestones toward reaching SDG 3: Healthy Lives and Well-being for All, by 2030. That same year, Germany was the first country to establish a formal parliamentary sub-committee on global health. At the beginning of 2019, the ‘Global Health Hub Germany’ was launched to strengthen the link between national research institutions and domestic mechanisms to enhance the country’s capacity and expertise in global health matters.

New global health strategy: In October 2020, the German Federal Cabinet also adopted a new cross-ministerial global health strategy for 2020-2030, entitled ‘Responsibility – Innovation – Partnership: Shaping global health together’ to serve as the basis for Germany’s engagement in global health and to ensure Germany’s contribution to SDG 3: Ensure healthy lives and promote well-being for all at all ages. The strategy outlines five strategic priorities in global health:

  • Promoting health and preventing diseases;
  • Mitigating the health effects of climate change;
  • Health systems strengthening and UHC;
  • Strengthening the global health architecture for epidemic and pandemic preparedness; and
  • Advancing research and innovation for global health.

Launching a Global Hub for Pandemics and Epidemics: In September 2021 WHO and the German government launched a new 'Global Hub for Pandemic and Epidemic Intelligence' based in Berlin to strengthen cooperation between countries and scientific institutions worldwide to enhance global capacity for pandemics and epidemic forecasting. Germany contributed US$100 million in initial investment to the Hub.

BMZ taking a One Health approach: In response to the COVID-19 pandemic, the BMZ established a new division focusing on global health, pandemic response, and One Health. In November 2020, the BMZ also published its first One Health strategy, anchoring the climate-health-environment nexus in German development cooperation. The strategy gives special attention to the prevention and containment of infectious diseases, including NTDs , zoonotic infections, and WHO

Key Bodies

Global health R&D is also important to addressing many of the global health challenges that disproportionately affect the world’s most disadvantaged people. For more information on how donor countries are supporting global health R&D across three main areas — 1) EIDs; 2) PRNDs; and 3) SRH — read the excellent G-Finder reports and explore the interactive data portal created by Policy Cures Research. Not all funding mentioned in these analyses qualifies as ODA.

Kristin Laub

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