EU - Global health

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; European Commission and European Investment Bank, EIB) spent US$959 million in ODA for health in 2019 making it the fifth-largest OECD Development Assistance Committee (DAC) donor to health in absolute terms. This amounts to 5% of its total ODA (DAC average: 8%).  

In 2019, the EUI channeled 75% of its health ODA bilaterally, amounting to US$722 million. This included US$209 million channeled as earmarked funding through multilateral institutions as well as US$56 million from the EUI’s general budget support that benefits the health sector. Overall, bilateral health ODA spending has been fluctuating since 2016 but is expected to increase in response to the COVID-19 crisis. 

In 2019, key sectors receiving bilateral health funding included health policy and administrative management (28%), basic health care (26%), basic health infrastructure (16%), and basic nutrition (16%).

The EUI also contributes 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$236 million (or 25% of total health ODA) in 2019, with the largest contributions going to the Global Fund (US$142 million), Gavi (US$77 million), and the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNWRA) (US$18 million).  

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 2020 and 2021 in response to the COVID-19 crisis. The primary development instrument in the 2021-2027 MFF, the Neighborhood, 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. 

In 2020, in response to the COVID-19 crisis, the EU launched several initiatives aimed at supporting partner countries in responding to the immediate and long-term consequences of the crisis (it is currently unclear how much of this funding will be qualified for ODA reporting). 
These funding initiatives included:

  • The 'Team Europe' support package: In April of 2020, the EU mobilized a global recovery package for addressing COVID-19-induced humanitarian needs in partner countries that has since grown to €46 billion  (US$51.5 billion; as of April of 2021).   
  • 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$448 million) in guarantees on loans. Of this pledge, €100 million (US$112 million) was provided for the Coalition for Epidemic Preparedness Innovations and €158 million (US$177 million) for the World Health Organization.
  • The EU and Global Citizen co-hosted event in June 2020, the EUI committed a further €4.9 billion (US$5.5) for the global COVID-19 response. 
  • The EU has contributed a total of €400 million (US$448 million) in grants and €600 million (US$672 million) in loans to the COVAX Facility, to finance access to COVID-19 vaccines for low-income and upper- and lower-middle-income countries.
  • Contributions to EU4Health: EU4Health the new largely domestic health program in the current MFF, has been allocated €5.1 billion (US$5.7 billion). Within this budget, a maximum of 12.5% of funding will go toward global health initiatives.


EU commitments to health at 6th AU-EU Summit in February 2022

  • The AU-EU Summit declaration includes an Africa-Europe Investment Package of at least €150 billion  (US$168 billion), which will include a health package, although the amount of this is still to be determined. The overall package is the estimated size of the Africa regional program within the EU’s new Global Gateway investment initiative. The declaration also stated that the EU will support African health sovereignty and invest in production capacity for manufacturing health products in Africa. However, However, the EU is yet to address divisions remain on COVID-19 vaccine equity, such as on a potential TRIPS waiver.
  • During the Summit, Team Europe (including EU member states) committed to mobilizing €425 million  (US$476 million) in new funding to ramp up vaccinations and support vaccine delivery, medical teams training, and sequencing capacity in Africa, including €125 million (US$140 million) from the European Commission. 
  • The Bill & Melinda Gates Foundation, the EU and EU member states Belgium, France, and Germany announced ahead of the Summit a commitment of more than €100 million (US$112 million)  for regulatory strengthening for health products in Africa, in partnership with the African Union Development Agency-NEPAD (AUDA-NEPAD). Over the next five years, this partnership will support the first stage of the operationalization of the recently established African Medicines Agency (AMA) and the development of the African regulatory ecosystem at the continental, regional, and national levels.
  • The European Investment Bank (EIB) announced it would make €500 million (US$560 million) in financing available with the aim of mobilizing €1 billion (US$1.1 billion) of investment through a partnership with the WHO and the European Commission to support resilient health systems in Africa. 



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’.