EU - Global health

EUI’s ODA to health is characterized by strong budget support and contributions to multilateral organizations   

According to OECD data, the European Union Institutions (EUI; which indicates financing from both the European Commission (EC) and the European Investment Bank (EIB)) spent US$1.1 billion in ODA on health in 2020 making them the fifth-largest Organisation for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC) funder of health in absolute terms. This amounts to 5% of their total ODA (DAC average: 10%).  
In 2020, the EUI channeled 87% of their health ODA as bilateral ODA, amounting to US$986 million. This included US$608 million which was channeled bilaterally, as well as US$378 million which was channeled as earmarked funding through multilateral institutions. Overall, bilateral health ODA spending on health has been increasing since 2018 and peaked in 2020 due to the response to the COVID-19 crisis. 
In 2020, key sectors receiving bilateral health funding included COVID-19 control (25%), health policy and administrative management (24%), and basic health care (22%).
Along with the health ODA it delivers bilaterally, the EUI contribute to key multilateral organizations working in health. Based on the OECD DAC methodology for calculating imputed multilateral contributions to the health sector, the EUI’s core contributions to multilateral organizations within the health sector amounted to US$153 million (13% of total health ODA) in 2020, with the largest contributions going to the Gavi, the Vaccine Alliance (Gavi; US$123 million), the Global Fund (US$15 million),  and the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNWRA; US$15 million).
In response to the COVID-19 crisis, the EU launched several initiatives aimed at supporting partner countries in responding to immediate and long-term consequences (it is currently unclear how much of this funding will be qualified for ODA reporting). 
These funding initiatives included:

  • In 2022, at the second Global COVID-19 summit, European Commission President Ursula von der Leyen announced €300 million (US$342 million) for vaccine support via COVAX, €100 million (US$114 million) for ACT-A initiatives, and US$450 million for the pandemic preparedness and global health security Financial Intermediary Fund (FIF) at the World Bank. The funding for these commitments comes out of the €1.3 billion (US$1.5 billion) the Commission had previously set aside to purchase 200 million vaccines for donating to low- and middle-income countries; 
  • During the 2022 'Break COVID Now Summit', an event hosted by Gavi, the European Commission pledged €75 million (US$86 million) in grants, and the European Investment Bank (EIB) committed €1.0 billion (US$1.2 billion) in front-loaded financing for the COVAX AMC;
  • At the World Health Assembly in 2021, the European Commission pledged to share at least 700 million COVID-19 vaccine doses by mid-2022 with lower- and middle-income countries;
  • The 'Team Europe' support package: In April 2020, the EU mobilized a global recovery package for addressing the socio-economic impacts of the COVID-19 pandemic in partner countries that has since grown to €46.0 billion (US$52.0 billion; as of April 2021). This included contributions from EU Member States. The EUI’s contribution to this package included €14.9 billion (US$17.0 million) from the European Commission and €11.4 billion (US$13.0 million) from the European Investment Bank; 
  • During the EU-hosted 'Coronavirus Global Response' pledging event in May 2020, the EUI committed a total of €1.0 billion (US$1.1 billion) in grants and €400 million (US$456 million) in guarantees on loans. Of this pledge, which mostly consisted of funding for research, €100 million (US$114 million) was provided for the Coalition for Epidemic Preparedness Innovations (CEPI) and €158 million (US$180 million) for the WHO;
  • At an EU and Global Citizen co-hosted event in June 2020, the EIB committed an additional €4.9 billion (US$5.6 billion) in financing for the global COVID-19 response in partnership with the European Commission; and  
  • The EU contributed a total of €400 million (US$456 million) in grants and €600 million (US$684 million) in loans to the COVAX Facility in 2020, to finance access to COVID-19 vaccines for low-income and upper- and lower-middle-income countries.
  • 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 rarely met this target during the 2014-2020 Multiannual Financial Framework (MFF). However, health ODA allocations are likely to increase in 2022 and 2023  in response to the COVID-19 crisis. The primary development instrument in the 2021-2027 MFF, the Neighbourhood, Development, and International Cooperation Instrument – Global Europe (NDICI – Global Europe), includes a target of 20% of NDICI - Global Europe to human development, with 10% of NDICI - Global Europe (half of the 20% human development target) going to education. This leaves approximately 10% for other components of human development, including health and social protection. The EU also created a new, largely domestic health program in the current MFF, EU4Health, which has been allocated €5.1 billion (US$5.8 billion)  for 2021-2027. Within this budget, a maximum of 12.5% of funding will go toward global health initiatives.


DG INTPA’s Human Development, Migration, Governance & Peace Directorate leads on health policy development

The Council defines overall priorities within global health, but the European Commission’s Directorate-General for International Partnerships (DG INTPA) oversees developing the EU’s policies and thematic programs around global health. Within DG INTPA, global health is covered by Unit G.4 ‘Social Inclusion & Protection, Health & Demography’, within DG INTPA’s Directorate G, ‘Human Development, Migration, Governance & Peace’.