Evaluating the Progress: One Year into the New EU Global Health Strategy
Article written by Maxime Aubert, Kerstin Klipstein-Grobusch & Alberto Rocamora
A year after the European Commission presented its new EU Global Health Strategy, this plenary session, “The New EU Global Health Strategy: implications for research” moderated by Dr. Anna Vassal (Amsterdam Institute for Global Health and Development) Dr. Antoni Plasència (IS Global)', offered the possibility to evaluate the initial progress of the strategy, the seal of approval of the member states, and most importantly to pinpoint and discuss the opportunities and challenges that are attached to it.
The New EU Global Health Strategy
Dr Jan Paehler, from the EU Commission, initiated the session with a brief introduction of the new strategy and commented on the major adaptations in comparison with the previous 2010 Global Health Strategy. The new version was developed through an extensive consultation process in which many countries, not only within Europe but also worldwide, could provide inputs and make recommendations. The Sustainable Development Goals and the external dimension of the European Health Union were given particular attention in the design of the New EU Global Health Strategy. The strategy is constructed around three objectives that align with those of the World Health Organization and 20 key principles.
On the regional aspect, there is the new Africa-EU Partnership between the European Union and the African Union. The main features of this program include the implementation and support of COVID-19 vaccination and the reinforcement of local manufacturing and access to vaccines, medicines, diagnostics, therapeutics and health products in Africa.
From the global perspective of the strategy, strong commitments have been made by the EU to the Global Fund to fight AIDS, Tuberculosis and Malaria since €750 million have been invested in the current three-year cycle from 2023-2025. Additionally, more than €400 million have been allocated by the EU Commission to the Pandemic Fund.
A Post-Pandemic Revision of the Strategy: Reflections and Criticism
The conversation began with a question regarding the key takeaways of the new strategy in comparison with its 2010 predecessor.
Lisa Goerlitz, Head of the EU Advocacy Unit of the Deutsche Stiftung Weltbevoelkerung (DSW), an international NGO, launched the debate by strongly criticizing the previous strategy which she qualified as “out of date” and overlooking several major global health challenges such as antimicrobial resistance to sexual and reproductive rights.
Now that the new strategy finally considers major issues, it is time to focus on its implementation. For this, it is important to look at where the funding comes from and most importantly that when it comes to research and innovation there are no “strings attached” and that partnerships between the EU, member-states, and sub-Saharan Africa have the principle of equity at their core.
Dr. Kerstin Klipstein-Grobusch expressed the need to have a stable framework with sufficient resources to be able to promote research and development in the areas covered by the Strategy, which at the moment of the session was pending for the Council Conclusions and subsequent Member States contributions via Team Europe.
Are EU Policies Adapted to “African Realities”?
The discussion then continued on the overall shape of the European strategy and whether or not it meets the needs of policymakers in low and middle-income countries. In broader terms, is the strategy aligned with certain African national and regional needs and interests?
Dr. Irene A. Agyepong, a Public Health Physician with the Dodowa Health Research Center of the Research and Development Directorate of the Ghana Health Service, provided very insightful remarks on the matter. At first, she recognized that the strategy was well-aligned with the SDGs and WHO efforts; and that in this sense there is a lot of space for harmony and collaboration.
Nevertheless, she identified a significant challenge with such an all-encompassing strategy that tries to cover all and every single component. “In a world of finite resources, the crunch is going to come in implementation,” she said. It is unrealistic to do it all and in this sense, once funding has been collected, where specifically it is directed is of crucial importance.
There is no global aggregate “African reality” rather there are many different realities and it is therefore important to consider first the local realities. In this sense, bilateral talks based on openness, trust, and transparency are thus extremely important to identify the basic needs and interests in every one of those regions, countries, and communities.
Dr. Constance Assohou-Lutty highlighted the importance of coordination between the implementation of the Strategy and the work the African Union is already doing to better in areas such as investment in production capacities. This framework also interacts directly with the work the WHO is doing, where she would like to see how to engage with the European Commission.
Challenges, Reflections, and Recommendations to the New Strategy
At the core of the conversation, various key takeaways are worth mentioning. At first, as highlighted by Lisa, there is a need to make sure that the EU continues to consider preventing and treating diseases that suffer from market failure and mainly affect low and middle-income countries without “falling into the trap of being only focused on pandemic preparedness.” In addition, she recommended that more recommendations and counter-proposals on Global Health issues coming from the national research community should be voiced during consultations taking place on the work program at the national level.
Irene then made a reflection on health security and health systems in Western Africa in which she emphasized the shocking disparities in health outcomes between certain communities. She pointed out that usually epidemics and pandemics do not start in well-resourced environments and she added the local context, realities, and capacities are usually the reason why worst-health outcomes are rising.
Her overall message was the following: “If you don’t move the poorer countries closer to universal health coverage we are all going to continue to be at risk”. The best way to take the first steps in this direction is to stop thinking in silos and try to place oneself in the other person's shoes, she said.
Furthermore, the panel acknowledged that the EU was giving little attention to workforce issues. This issue will be highly dependent on the commitments made by the member states and the way training and formation will be increased according to Jan. Irene spoke about her experience in Ghana in which hospitals are closing due to the lack of workforce. She said that we need to agree on a “fairer exchange system” and how the needs of different national health systems could be solved. To avoid this “brain drain” taking place in poorer parts of the world, we need to pay greater attention to the basic human rights of health workers and the sometimes unbearable conditions and environment they work in.
Anna finished the panel by highlighting the need to continue advocating for global health, integrated health research, and integrated development investment in health systems.
