Germany has shown strong leadership on global health through its G7 and G20 presidencies
Germany was the third-largest donor to health in 2015 among the donors of the Development Assistance Committee (DAC) of the Organisation for Economic Co-operation and Development (OECD), spending US$967 million on ODA for health. This corresponds to 5% of its total ODA, which is below the DAC average of 9% for health. The government identified health as a priority sector in its 2017-2021 coalition treaty, specifically health systems, health R&D, poverty-related and neglected diseases, and international partnerships such as the Global Fund and Gavi. Within health, Germany takes a rights-based approach and focuses on health systems strengthening (HSS). Other priority areas include infectious-disease control and reproductive health .
In 2018, Germany will develop a new government-wide global health strategy.
Germany has continuously made global health a priority at both its G7 and G20 presidency in 2015 and 2017 respectively. Pandemic preparedness, antimicrobial resistance, and neglected diseases were identified as priority areas in the G7 communiqué, albeit without specific resource commitments. Germany also champions the Roadmap ‘Healthy Systems – Healthy Lives,’ a global initiative to strengthen health systems that was launched at the Sustainable Development Goals (SDG) summit in September 2015. The Roadmap was further supported by a declaration on health system strengthening at the World Health Assembly in Geneva in May 2016. This initiative translated into a joint vision for health systems strengthening for UHC at WHA in May 2017. Under the German G20 Presidency, the health ministers of the G20 countries met for the first time to discuss global health issues such as pandemic preparedness, health systems, and antimicrobial resistance (AMR). As an immediate outcome, an interational AMR R&D Collaboration Hub, which seeks to better coordinate and foster R&D on AMR, will be located in Berlin. Further, in 2018, Germany will develop a new government-wide global health strategy. The process is led by the Ministry of Health, integrates input from various ministries, and is supported by a high-level advisory board.
In 2015 (latest year for which full data is available), Germany channeled US$445 million (46%) of its health ODA multilaterally, which is lower than the DAC average of 55%. Key recipients of multilateral health ODA in 2015 were the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the EU Institutions, and Gavi, the Vaccine Alliance (Gavi). Germany is the fourth-largest government donor to the Global Fund and the fifth-largest to Gavi. Germany announced at the Fifth Global Fund Replenishment Conference in Montreal (September 2016) that it will contribute €800 million to the Global Fund for the 2017-2019 funding period. (US$998 million as converted by the Global Fund). This is a substantial increase relative to the €655 million (US$725 million) pledge Germany made in 2014. Germany hosted a successful Gavi replenishment in January 2015 and pledged US$720 million direct funding for 2016 to 2020, a significant increase from its previous pledge (US$208 million between 2006 and 2015).
Overall, Germany provided US$610 million as bilateral health ODA in 2016, corresponding to 3% of Germany’s total bilateral ODA (see figure). This is a significant increase of 17% compared to US$523 million in 2015. Priority areas were basic health infrastructure (26%), infectious disease control (20%), reproductive health care (19%), and health policy and administrative management (12%). It committed US$152 million to the Global Polio Eradication Initiative (GPEI) for 2013 to 2017. Funding for GPEI is bilaterally channeled to Afghanistan and Nigeria (both receive US$15 million annually). The Federal Ministry for Economic Development and Cooperation (BMZ) topped up this pledge with US$15 million for Pakistan for 2016 to 2018. Through the ‘Health in Africa’ special program announced in 2015, Germany will spend an additional €600 million (US$664 million) between 2016 and 2019 for bilateral HSS programs in Africa, with this almost doubling its annual bilateral health spending in Africa. Health is currently a priority sector of German bilateral cooperation in 12 countries, five of which are in sub-Saharan Africa.
Priority countries for bilateral cooperation on health:
- Kyrgyz Republic
- South Africa
BMZ’s health division leads on policy development
BMZ drives the development of strategies for German development policy, including on global health. Within BMZ, the division on ‘Health and Population Policy’ is responsible and is led by Heiko Warnken. It is part of the Directorate-General ‘Global Issues – Sector Policies and Programmes’, led by Ingrid-Gabriela Hoven.
- BMF; Bundeshaushaltsplan 2017 - Einzelplan 23; 2017 (in German)
- BMZ; Development Policy as Future-Oriented Peace Policy - The German Government's 15th Development Policy Report; 2017
- BMZ; BMZ's Africa Policy; 2016
- BMZ; Table of Cooperation Countries; 2017
- BMZ; Development policy-related results of the G20 Summit; 2017
- BMZ; Sector Strategy: German Development Policy in the Health Sector; 2013
- Federal Government; Shaping Global Health Taking Joint Action Embracing Responsibility - The Federal Government's Strategy Paper; 2013
- UHC 2030; Healthy Systems for Universal Health Coverage; 2017