EU - Global health
At a glance
EUI’s ODA to health is characterized by strong budget support and contributions to multilateral organizations
According to Organisation for Economic Co-operation and Development (OECD) data, the European Union Institutions (EUI; EU and European Investment Bank, EIB) spent US$1.2 billion on ODA (both bilateral and multilateral) to health in 2016 (the latest year for which multilateral and bilateral OECD data is available), making the EU the fourth-largest OECD Development Assistance Committee (DAC) funder for health in absolute terms in 2016. Funding for health accounted for 6% of EUI’s total ODA in that year. In 2016, the EUI channeled 75% of its health ODA as bilateral ODA and the remaining 25% as multilateral ODA.
The EU’s bilateral ODA to health has been steadily increasing in recent years reaching US$1.1 billion in 2017, although, in 2018, funding decreased by 43% to US$601 million. The increase in funding prior to 2018 is largely due to increased investments in basic health infrastructure, which tripled between 2016 and 2017 (rising from US$81 million to US$243 million) and investments in health policy and administrative management (which rose from US$120 million to US$176 million). The funding decrease in 2018 can be attributed to reduced spending in basic health infrastructure: funding to this subsector declined by 69% in 2018 compared to 2017 (falling from US$243 million to US$76 million).
In addition to funding that is reported to the OECD as health ODA, the EUI provide partner countries with general budget support that indirectly benefits the health sector. In 2018, benefits for health are estimated at around US$57 million (based on the Muskoka methodology, approximately 10% of general budget support goes to the health sector). The EUI’s health ODA channeled as bilateral funding also includes US$202 million spent as earmarked funding to multilaterals, which is counted under total bilateral support by the OECD.
The EUI also contribute to key multilateral organizations working in health; the EUI are key supporters of global health initiatives. In recent years, key recipients of EUI’s multilateral funding to health have included the Global Fund to Fight AIDS, Tuberculosis and Malaria (contributed US$649 for the 2020-2022 period) and Gavi, the Vaccine Alliance (US$354million for the 2021-2025 period). The EUI have also supported the Global Polio Eradication Initiative (GPEI), pledging €55 million (US$65 million) in 2017, and the Global Financing Facility, pledging US$30 million in 2018.
EUI’s development assistance to partner countries is aimed at reducing health inequalities, improving social cohesion, and increasing equitable and universal access to quality health services. According to information from the European Commission (EC), bilateral assistance to partner countries is aimed at strengthening health systems and facilitating access to quality basic health services in partner countries. In 2018, key sectors receiving bilateral health funding included basic health care (33%), health policy and administrative management (21%), basic nutrition (17%), and basic health infrastructure (14%).
The European Consensus on Development, signed in 2017, commits the EUI to a spending target of at least 20% of its ODA on human development and social inclusion, which includes health; the EUI has yet to meet this target during the current Multiannual Financial Framework (MFF). However, health ODA allocations are likely to increase in 2020 in response to the COVID-19 crisis.
In 2020, the EU launched several response packages and initiatives aimed at supporting partner countries in responding to the immediate and long-term consequences of the COVID-19 health crisis. These include:
The 'Team Europe' support package for partner countries provides funding to address the immediate implications of the COVID-19 crisis and resulting humanitarian needs in partner countries. Because it is the last year of the current MFF, the 2020 budget cannot be increased, so the EC’s contribution to this package will be financed through funds reallocated from the current budget. The total ‘Team Europe’ package, worth €38.5 billion (US$45.4 billion, as of October 2020), draws on contributions from EUI totaling €21 billion (US$24.7 billion) combined with resources mobilized by EU Member States and the European Bank for Reconstruction and Development (EBRD)
The EU-hosted 'Coronavirus Global Response' pledging event in May 2020, during which the EUI committed a total of €1.0 billion (US$1.2 billion) in grants and €400 million (US$472 million) in guarantees on loans. The funding is being channeled for 1) developing scientific solutions for testing, treating, and preventing COVID-19, 2) financing pre-commercial stage investments in COVID-19 research and development, and 3) funding new proposals and innovations for tackling COVID-19. Of this pledge, €100 million (US$118 million) will be provided for the Coalition for Epidemic Preparedness Innovations (CEPI) and €158 million (US$186 million) for the World Health Organization (WHO). This pledge too will be financed through reallocated funding.
The EU and Global Citizen co-hosted event in June 2020, during which the EUI committed a further €4.9 billion (US$5.8 billion) for the global COVID-19 response.
In November 2020, the EU contributed an additional €100 million (US$118 million) to the COVAX Facility, a global mechanism to equitably source and distribute COVID-19 vaccines. This is on top of a previous €400 million (US$472 million) in guarantees made by the EU in August 2020. The EU’s contributions will help to finance access to COVID-19 vaccines for lower- and middle-income countries that are unable to self-finance. The funding will come from the European Development Fund’s reserves and will go directly to Gavi, the Vaccine Alliance.
In November 2020, the EC published a Communication on its plans to build a European Health Union, alongside three legislative proposals to address cross-border health threats, strengthen the European Center for Disease Prevention and Control (ECDC), and extend the mandate of the European Medicines Agency (EMA). The plans to build a 'European Health Union' were developed based on the early lessons learned from the COVID-19 crisis and is expected to include ECDC support to build more resilient health systems for sustainable health security preparedness in EU partner countries.
DG DEVCO’s Directorate on People and Peace leads policy development on health
The Council defines overall priorities within global health, while the EC’s Directorate-General for International Cooperation and Development (DG DEVCO) oversees developing the EU’s policies and thematic programs around global health. Within DG DEVCO, global health is covered by Unit B4, ’Culture, Education and Health’, within DG DEVCO’s Directorate B, ’People and Peace’. In the 2014-2020 MFF, the Global Public Goods and Challenges program allocated €5.1 billion (US$6.0 billion) for Human Development. Funding for health – alongside other issues such as education and social protection – comes out of this budget.