COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS EU Global Health Strategy Better Health for All in a Changing World
Date: 2022-11-30
Institutions: Directorate-General for International Partnerships, European Commission
Subjects: EU strategy, coronavirus disease, cross-border cooperation, disease prevention, epidemic, health care system, public health, social well-being, universal health coverage

EN 

  EN 

   EUROPEAN COMMISSION  Brussels, 30.11.2022  COM(2022) 675 final  COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS EU Global Health Strategy        Better Health for All in a Changing World  
 
 
1.  Introduction 
The experience of recent years, particularly the COVID-19 pandemic, has highlighted as never before 
that  health  has  no  borders:  it  is  a  global  common  good.  The  well-being  and  lives  of  citizens,  the 
prosperity  and  stability  of  societies  and  economies,  and  sustainable  development  in  general,  all 
depend on addressing health from this perspective. Global health is an essential pillar of EU external 
policy, a critical sector geopolitically and central to the EU’s open strategic autonomy. 

Since the EU’s last 2010 Communication on the EU role in global health1, health challenges are fast 
evolving—in  an  equally  rapidly-changing  geopolitical  environment.  More  than  ever  before  global 
health is being impacted by the triple planetary crisis of climate change, biodiversity and pollution, with a 
particularly  heavy  burden  on  most  vulnerable  countries  and  people.  At  the  same  time,  new 
opportunities  linked  to  areas  like  research  or  digitalisation  have  arisen.  A  robust  Global  Health 
Strategy (“the strategy”) is needed to provide a new, coherent, effective and focused policy world-
wide.  

As the world population has just moved past the 8 billion mark and life expectancy is rising globally, 
we should prioritize health and well-being for all throughout the life course. 

This strategy represents the external dimension of the European Health Union, which protects the 
well-being of Europeans and the resilience of their health systems, and a key component of Global 
Gateway2, which builds partnerships of equals  with  partner  countries based on joint  responsibility 
and co-ownership. 

The  EU’s  leading  role  in  fighting  the  COVID-19  pandemic  has  shown  that  it  can  make  a  major 
contribution to global objectives with the Team Europe approach3 (see box A). The main message of 
this  strategy  is  that  the  EU  intends  to  reassert  its  responsibility  and  deepen  its  leadership  in  the 
interest  of  the  highest  attainable  standards  of  health,  based  on  fundamental  values,  such  as 
solidarity and equity, and the respect of human rights. 

The  challenges  are  significant.  There  is  a  massive  unfinished  agenda  in  global  health,  as  progress 
inter  alia  towards  the  universal  health  targets  enshrined  in  the  2030  Agenda  for  Sustainable 
Development and its Goals (SDGs)4 has reversed in many countries: collectively, countries have only 
achieved  about  a  quarter  of  what  is  needed  to  reach  the  SDG  health  targets  by  2030.  Major 
infectious  diseases  represent  a  heavy  burden  on  many  countries  and  high  infant  and  maternal 
mortality,  and  malnutrition  remain  matters  of  concern  among  others.  At  the  same  time,  it  is 
essential  to  address  global  health  security  swiftly  and  comprehensively,  to  better  prevent  and  be 
more  resilient  to  face  pandemics.  High-quality  risk-preparedness  in  the  health  sector  will  show 
significant positive impacts on the resilience of other key sectors. 

1 COM(2010)128 final -  31.3.2010   
2 https://ec.europa.eu/info/strategy/priorities-2019-2024/stronger-europe-world/global-gateway_en 
3 “Team Europe approach” refers to action by EU institutions and some or all of its Member States, in line with 
respective competences. 
4 https://www.un.org/sustainabledevelopment/development-agenda/ 

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Box A: EU response to COVID-19: leadership through the Team Europe approach 
The EU played a decisive role in the global response to the COVID-19 pandemic providing solidarity and effective 
support by acting in a Team Europe approach to help implement the global vaccination campaign and reaffirm 
the EU’s commitment to multilateralism. 
Leadership: The EU was a driving force behind the adoption of the G20 Rome Declaration5—the internationally 
agreed principles for action to fight, prepare for, prevent, and respond to pandemics. Alongside other key global 
stakeholders, the EU played a leading role in organizing the first Global Pledging Conference against COVID-19, 
and in setting up the Access to COVID-19 Tools Accelerator (ACT-A), a key tool supporting the development and 
equitable  distribution  of  the  tests,  treatments,  and  vaccines  to  lower  income  countries.  Together  with  EU 
Member States, the EU contributed over EUR 7 billion to ACT-A, including its vaccine pillar (COVAX). 
Cooperation: The EU has been stepping up its  cooperation, for example by setting-up the globally pioneering 
solution EU Digital COVID Certificate (EUDCC): by October 2022, 49 countries outside the EU were connected to 
the EUDCC Gateway, including seven from the African continent, making it the largest interconnected system of 
digital COVID certificates in the world. Thanks to EU solidarity, the Union Civil Protection Mechanism put  into 
action several emergency medical teams and provided medical equipment and supplies6 to third countries. The 
EU  was  a  key  founding  member  of  COVAX  and  has  increased  its  efforts  to  collaborate  on  therapeutics, 
diagnostics, through the ACT-Accelerator, international organisations and research institutions.  
Resources: The EU combined its resources to maximise their impact on the COVID-19 pandemic response. Since 
the  outbreak  of  the  COVID-19  pandemic,  the  EU,  EU  Member  States  and  European  financial  institutions,  as 
Team Europe, have so far committed EUR 53.7 billion to support 140 countries, covering emergency response to 
humanitarian  needs,  strengthening  of  health,  water  and  sanitation  systems,  and  mitigation  of  the  social  and 
economic consequences of the pandemic. The Team Europe way of working proved effective and valuable and 
has been rolled out across other global priorities. The EU stepped up research, especially vaccine and medicine 
advancement, and created an enabling environment for manufacturing and distribution of four billion COVID-19 
vaccine  doses  both  in  the  EU  and  globally  and  supported  additional  rollout  of  vaccines7.  The  European 
Commission and EU Member States have also quickly set  up a new European reserve of resources including a 
stockpile of medical items to respond to health emergencies8.  

To  contribute  to  the  delivery  of  better  health  for  all  in  a  changing  world,  a  different  approach  is 
needed, starting with what must be done. To this end, the strategy focuses on three core priorities. 

Going back to fundamentals, the first two essential priorities are: investing in the well-being of all 
people and reaching universal health coverage with stronger health systems. To achieve these two 
goals, we need to shift our focus, as the landscape is very different from 2010: 

- 

In addition to traditional root causes of ill-health such as poverty and social inequalities, other 
drivers  of  ill-health  must  be  addressed  in  an  integrated  manner,  such  as  climate  change, 
environmental  degradation,  humanitarian  crises,  or  food  insecurity,  aggravated  by  crises  like 
the  Russian  war  of  aggression  against  Ukraine.  Therefore,  it  is  essential  to  mobilise  a  wide 
number of policies to work on a global health agenda. 

-  Rising  challenges,  like  antimicrobial  resistance  and  mental  health,  or  evolving  challenges  of 
health  and  care  systems,  including  workforce  imbalances  and  resources  shortages  must  be 
prioritised,  alongside  maximising  new  opportunities  for  health  offered  by  powerful  enablers, 
like research and digitalisation, including the use of artificial intelligence. 

The third core priority is combatting current and future health threats, which also requires a new 
focus. It calls for enhanced equity in the access to vaccines and other countermeasures; for a “One 

facts  and 

5 https://global-health-summit.europa.eu/rome-declaration_en 
6  See  key 
protection/eu-civil-protection-mechanism_en#facts--figures. 
7 See project 11 in Annex 1. 
8 EU develops strategic reserves for chemical, biological and radio-nuclear emergencies (europa.eu) 

figures  under  https://civil-protection-humanitarian-aid.ec.europa.eu/what/civil-

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Health  approach”9,  which  tackles  the  complex  interconnection  between  humanity,  climate, 
environment  and  animals;  for  a  more  effective  disease  surveillance  worldwide;  and  for  stronger 
international rules and cooperation mechanisms on health. 

As we shift the focus on what to do, an equally fundamental shift must occur on how to do it. A new 
global health order is emerging —and the EU must contribute to shaping it through a more strategic 
and effective engagement.  

The  EU  has  a  unique  potential  to  drive  international  cooperation.  Expanding  partnerships  with  a 
wide range of relevant stakeholders is of the utmost importance—promoting health sovereignty for 
more  resilience  and  open  strategic  autonomy  supported  by  partners'  political  commitment  and 
responsibility. Our relationship with international partners must be guided by common priorities in 
line with this strategy. 

To enhance the EU’s role as a strong and effective player, the Commission and Member States will 
ensure  synergy  between  national  and  EU  global  health  strategies  and  work  closer  than  ever  in  a 
Team  Europe  approach,  with  new mechanisms  to  better  coordinate  policies,  actions  and  financial 
efforts to maximise impact—speaking and acting together.  

Global governance will require a new focus to maintain a strong and responsive multilateral system, 
with  a  World  Health  Organization  (WHO)  at  its  core  which  is  as  sustainably  financed  as  it  is 
accountable  and  effective.  Consensus  should  be  built  through  deepened  cooperation  through  G7, 
G20, and other global, regional and bilateral partners. The EU should drive the essential process of 
filling the existing gaps in global governance, avoiding duplication and ensuring coherence of action. 
This will need close cooperation with the private sector, philanthropic organisations, civil society and 
other stakeholders to support this strategy’s objectives.  

Effective  funding  is  another  key  element  of  the  strategy.  The  EU  and  its  Member  States  are 
collectively among the largest funders of global health – whether in terms of global goods (financing 
international  organisations  and  global  health  initiatives),  development  aid,  or  humanitarian 
assistance10. This strategy’s ambitions will require high political commitment globally, as well as an 
important  commitment  of  resources.  The  EU  financial  contribution  will  follow  a  new  approach 
involving  innovative  finance,  co-investment  from  partners  and  pooling  with  other  international 
actors—and  the  EU’s  influence  in  shaping  the  agenda  must  match  its  financing  support  as  a 
champion of global health. 

Success  will  naturally  depend  on  the  contribution  of  our  partners—but  the  EU  will  take  its  full 
responsibility.  This  includes  also  improving  health  preparedness  and  response  at  home  as  part  of 
the European Health Union, as health developments in the EU affect partners across the world and 
vice  versa.  In  the  EU,  universal  health  coverage  and  a  strong  EU  health  security  framework  will 
continue to be developed by taking forward key initiatives under way or under preparation.  These 
include the Europe’s Beating Cancer Plan11 the Pharmaceutical Strategy12, and the planned European 

9  A  full  definition  of  One  Health  is  provided  by  OHHLEP  under  https://www.who.int/news/item/01-12-2021-
tripartite-and-unep-support-ohhlep-s-definition-of-one-health  
In the context of the Consultation on the Future of Europe, citizens proposed a One Health Approach: “Adopt a 
holistic  approach  to  health,  addressing,  beyond  diseases  and  cures,  health  literacy  and  prevention,  and 
fostering a shared understanding of the challenges faced by those who are ill or disabled, in line with the “One 
Health Approach”, which should be emphasized as a horizontal and fundamental principle encompassing all EU 
policies”. 
10 According to data from the OECD Development Assistance Committee: 
https://www.oecd.org/dac/development-assistance-committee/  
11  A  cancer  plan  for  Europe  |  European  Commission  (europa.eu).  This  is  supported  by  the  EU  Mission  on 
Cancer ( EU Mission: Cancer | European Commission (europa.eu)). 
12 https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52020DC0761&from=EN 

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Health  Data  Space13.  Combatting  health  threats  more  comprehensively  will  be  possible  with  the 
implementation of the new cross-border health threats regulation14, the reinforced mandates of the 
European Center for Disease Prevention and Control and the European Medicines Agency, the work 
of the new Health Emergency Preparedness and Response Authority to improve preparedness and 
response  in  medical  countermeasures15,  and  a  One  Health  network  to  act  against  all  pathogenic 
threats with integrated surveillance16. Better healthcare delivery, open strategic autonomy in health-
related  value  chains,  and  strong  action  on  antimicrobial  resistance  will  also  all  act  as  powerful 
foundations  for  a  strong  EU  position  worldwide.  We  will  continue  supporting  Member  States  in 
implementing health reforms and investment under the Recovery and Resilience Facility. And we will 
implement  the  European  Green  Deal17  and  particularly  the  Zero  Pollution  Action  Plan18  and  the 
Chemicals  Strategy  for  Sustainability  to  fight  root  causes  of  ill  health  in  the  EU.  All  this  work, 
together with the new strategy, will form a seamless continuum for health protection in the EU and 
worldwide.  

The strategy offers an agenda leading up to 2030. It sets three policy priorities, provides for twenty 
guiding principles to shape global health, makes concrete lines of action that operationalise those 
principles,  and  creates  a  new  monitoring  framework  to  assess  effectiveness  and  impact  of  EU 
policies and funding. It outlines what the Commission will do and what it invites Member States to 
do,  each  strictly within  their  respective  competences  and  institutional  roles  as  provided  for  in the 
treaties19. To illustrate upcoming actions, Annex 1 lists some of the key projects which underpin this 
strategy at global, regional and national levels.  

The  strategy  builds  on  the  important  contribution  of  the  European  Parliament,  successive 
Presidencies  of  the  Council,  the  civil  society’s  2020  shadow  health  strategy20,  and  other  key 
stakeholders—including the input received during a wide public consultation. This strategy should be 
read together with the first State of Health Preparedness Report, published in parallel with it21. 

2.  The EU’s global health priorities 
The strategy reaffirms the commitment to the SDGs and the European Consensus on Development22, 
and to act particularly in the areas that are cornerstones of good health. To ensure success in this 
endeavour, it suggests a new approach based on key priorities.  
The  Commission  will  therefore  focus  its  efforts  on  three  interrelated  priorities23,  inviting  Member 
States to do the same:  
(1) Deliver better health and well-being of people across the life course; 

(2) Strengthen health systems and advance universal health coverage; and  

(3) Prevent and Combat health threats, including pandemics, applying a One Health approach. 

13 European Health Data Space (europa.eu) 
14  https://www.consilium.europa.eu/en/press/press-releases/2022/06/23/provisional-agreement-on-new-eu-
law-on-serious-cross-border-threats-to-health/ 
15 The Health Emergency Preparedness and Response Authority. 
16 See financial project 2 in Annex 1. 
17 A European Green Deal | European Commission (europa.eu) 
18 Zero pollution action plan (europa.eu) 
19 The relevant references to the EU throughout this document should be understood in this fashion. The same 
applies to the use of the terms “we” and “our”. 
20 https://www.ghadvocates.eu/wp-content/uploads/Global-Health-Strategy.pdf 
21 https://health.ec.europa.eu/health-emergency-preparedness-and-response-hera/key-documents_en  
22 european-consensus-on-development-final-20170626_en.pdf 
23These 
https://www.who.int/about/what-we-do/thirteenth-general-programme-of-work-2019---2023  

correspond  with 

the  WHO’s 

priorities 

agenda: 

largely 

billion 

target 

triple 

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2.1. Deliver better health and well-being of people across the life course 

The EU will concentrate its collective strength and engage with countries to achieve the ambitious 
health-related SDGs globally, in particular Goal 3 (ensure healthy lives and promote well-being for 
all at all ages), Goal 5 (achieve  gender equality)  and Goal 10 (reduce  inequality within and among 
countries).  

To do so, the Commission will follow guiding principles, inviting Member States to do the same:  

Guiding  Principle  1.  Prioritise  tackling  the  root  causes  of  ill  health,  paying  particular 
attention  to  the  rights  of  women  and  girls,  and  to  vulnerable  populations  and 
disadvantaged groups. 

Efforts to deliver better health have traditionally focused on fighting specific diseases—a fight that 
must continue. However, without addressing the root causes of ill health, that make people prone to 
disease in the first place, it will continue to plague wide sections of the population, particularly the 
most  vulnerable.  Hence,  as  a  novelty,  the  strategy  will  prioritise  addressing  the  economic,  social 
and  environmental  root  causes  of  health  and  disease  –including  poverty and  discrimination,  age, 
nutrition  and  healthy  diets,  social  protection,  education,  care,  water,  sanitation  and  hygiene, 
occupational  health–  and  other  areas  such  as  healthy  ecosystems  pollution  or  contact  with 
chemicals  and  waste  and  threats  to  security  of  energy  supply.  This  will  also  require  an  integrated 
“health in all policies” approach (see section 3). 

An  approach  based  on  human  rights  leaving  no  one  behind  will  be  maintained  throughout  the 
implementation  of  this  strategy.  This  also  includes  a  particular  focus  on  sexual  and  reproductive 
health and rights (SRHR).  

Guiding Principle  2. Improve  equitable access  to  a full range of essential  health services 
from  health  promotion 
treatment, 
rehabilitation and palliative care to fight communicable and non-communicable diseases.  

to  disease  prevention  and  affordable  quality 

Resilient  public  health  programmes  are  critical  to  disease  control,  especially  of  infectious  and 
neglected tropical diseases, and in addressing underlying risks of non-communicable diseases. At the 
same time, increased prevention, expanded resources, and intensified research are needed to tackle 
the growing challenge of non-communicable diseases and other health disorders. 

To develop these two guiding principles, the following lines of action will be prioritised: 

  Prioritise addressing the economic, social and environmental root causes of ill-health through a 

“health in all policies” approach. 

  Follow a human-rights based approach throughout the strategy, paying particular attention to 
the needs and the rights of women, children and young people, in line with the Gender Action 
Plan24 III and Youth Action Plan25, persons with disabilities in line with  the UN Convention on the 
Rights  of  Persons  with  Disabilities26,  as  well  as  to  access  to  health  by  other  vulnerable  groups 
such as LGBTIQ people27, older people, migrants, refugees and internally displaced people, also 
in the context of natural or man-made disasters and the impacts of climate change.  

24 EU Gender Action Plan (GAP) III : https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:52020JC0017  
25  EU  Youth  Action  Plan:  https://international-partnerships.ec.europa.eu/document/fe1bcd30-58da-4a37-
ab2a-61848789da60_en 
26 https://ec.europa.eu/social/main.jsp?catId=738&langId=en&pubId=8376&furtherPubs=yes 
27 LGBTIQ Equality Strategy 2020-2025 | European Commission (europa.eu) 

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  Continue  to  lead  the  fight  against  a  range  of  communicable  diseases,  especially  AIDS, 
tuberculosis, malaria, poliomyelitis, Ebola virus disease as well as neglected tropical diseases28. 
This includes investing with partner countries and through research and development alliances 
and global health initiatives, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria29 30. 
  Help  prevent  and  manage  non-communicable  diseases  which  is  increasingly  important  in  an 
ageing world where over 65s and over 80s will represent ever larger proportions of  the global 
population. We will  support this via the WHO’s Universal Health Coverage Partnership31  32 and 
apply  multisectoral  approaches  that  address  major  risk  factors  such  as  substance  abuse,  diet, 
physical inactivity, and air pollution. This applies specially to cancer. 

  Support  the  expanded  uptake  of  vaccines  against  childhood  illnesses  and  increasingly  to 
support adult health including by continuing its strong support to Gavi33 34, the Vaccine Alliance 
that helps increase equitable and sustainable use of vaccines.  

  Ensure that innovative vaccines, treatments, and diagnostics for new, prevalent, or neglected 
infectious and non-communicable diseases, are developed and used, including through funding 
from  Horizon  Europe  and  the  EU-Africa  Global  Health  European  and  Developing  Countries 
Clinical  Trials  Partnership  (EDCTP3)35  for  research,  capacity  building  and  strengthening  of  the 
regulatory environment in sub-Saharan Africa. 

  Strengthen support for universal access to Sexual and Reproductive Health and Rights36 with a 
focus on women, girls, young people and people with disabilities including through designing a 
Team  Europe  initiative  on  SRHR  in  Africa  and  support  to the  United  Nations  Population  Fund 
(UNFPA)  Supplies  Partnership37.  This  includes  addressing  gender-based  violence,  harmful 
practices,  unmet  needs  for  family  planning,  preventable  maternal  mortality  and  gender 
inequalities.  The  work  relies  on  ensuring  equitable  access  to  quality  services,  products  and 
information, including via health systems strengthening  toward  universal health coverage,  and 
youth-friendly services. 

  Support health, nutrition, mental health, and psychosocial support for communities during and 
after  crisis  situations  (natural  or  man-made),  delivered  in  ways  that  limit  mortality,  morbidity, 
disability, and disease associated with humanitarian crises38. 

2.2 Strengthen health systems and advance universal health coverage  

Achieving health systems that are effective, resilient and accessible in all their fundamental aspects 
(service  delivery,  health  workforce,  health  information  systems,  access  to  essential  medicines, 
financing, and leadership/governance) is a core priority of the strategy. Advancing universal health 
coverage  in  an  equitable  way  will  ensure  financial  risk  protection,  access  to  quality  essential 
healthcare services and safe, effective, quality and affordable essential medicines and vaccines.  

28 Neglected tropical diseases are a diverse group of 20 conditions that are mainly prevalent in tropical areas, 
where  they  mostly  affect  more  than  1  billion  people  who  live  mostly  impoverished  communities.  They  are 
‘neglected’ because they are almost absent from the global health agenda.  
29 See project 7 in Annex 1. 
30 https://www.theglobalfund.org/en/  
31 https://extranet.who.int/uhcpartnership/  
32 See project 8 in Annex 1. 
33 See project 9 in Annex 1. 
34 https://www.gavi.org/ 
35 See project 18 in Annex 1. 
36  Considering 
content/EN/TXT/?uri=celex%3A42017Y0630%2801%29 
37 See project 6 in Annex 1. 
38  Directorate-General  for  European  Civil  Protection  and  Humanitarian  Aid  Operations,  Health:  General 
Guidelines, 2014. 

the  European  Consensus  on  Development 

(2017)  https://eur-lex.europa.eu/legal-

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To do so, the Commission will follow guiding principles, inviting Member States to do the same:  

Guiding  principle  3.  Improve  primary  healthcare  with  built-in  surge  capacity39,  and 
enhance core public health capacities to meet the requirements of the International Health 
Regulations40.  

The  pandemic  has  shown  the  importance  of  having  proper  available  medical  capacity  to  evaluate 
and  care  for  a  markedly  increased  volume  of  patients—one  that  challenges  or  exceeds  normal 
operating of health systems. Prioritising this area in our work is a novel approach and will have an 
important  added  value:  it  is  the  first  barrier  against  the  spread  of  pandemics  and  other  health 
threats. Support to primary healthcare will also help ensure the management of non-communicable 
diseases.  

To develop this guiding principle, the following lines of action will be prioritised: 

  Engage with partner countries to expand access to a basic package of health services covering 
prevention  and  care  with  particular  focus  on  poor  and  marginalised  populations  through 
bilateral  and  regional  programmes41.  The  Universal  Health  Coverage  Partnership  under  WHO 
enables  targeted  technical  support  in  119  countries,  taking  leadership  in  harmonising  national 
efforts to achieve the national SDG3 targets. 

  Encourage investments in health systems by implementing targeted incentives and increasing 
accountability42. The EU should consider improvement of health systems and public health as a 
core aspect of international cooperation with partners, including financial support.  

  Strengthen  social  protection  systems  through  bilateral  country  programmes,  particularly  by 
supporting  the  creation  of  minimum  social  protection  rules  that  include  equitable  access  to 
essential healthcare.  

  Foster  international  standards  in  pharmaceutical  medical  devices  and  technologies  through 
the  Commission’s  participation  in  international  organisations  and  bodies,  and  promote  a  high 
level of quality, effectiveness and safety standards, and training in regulatory matters, with the 
support of the European Medicines Agency and in collaboration with the WHO.  

Guiding principle 4. Foster digitalisation as a fundamental enabler.  

To  develop  this  guiding  principle,  a  digital  action  for  global  health  will  display  EU  leadership  and 
shape the ongoing digital transformation in an equitable way43: 

  Address underinvestment in digital health and care in low- and middle-income countries, with 
a Team Europe initiative on digital health, building on the principles underpinning the planned 
European  Health  Data  Space.  This  would  focus  on  achieving  a  transformational  impact  for 
advancing universal health coverage, primary healthcare, pandemic preparedness and response, 

39  This  refers  to  a  health  system’s  ability  to  prepare  for,  and  cope  with,  “surges”  (sudden  large-scale 
escalations) in treatment needs. 
40 These are the internationally accepted characteristics that health systems must meet to “to prevent, protect 
against, control and provide a public health response to the international spread of disease”.  See International 
Health Regulations (2005) Third Edition (who.int) 
41 See project 20 in Annex 1 
42 
et 
content/uploads/2021/12/A-new-understanding-of-global-heath-security-
UPDATED.pdf__;!!DOxrgLBm!FfwKtCBNDEEFdv0Lhhm84mxHTFJ8hsQ0BQMCPJAfrez0deRI_jLni1swaTgq5XZ7EB
HjoJF3f4CdHtU7soD0FII0igpx4g7IYurdHQ$.  Donor  funds  and  technical  assistance  will  always  play  a  role,  but 
structures  (aid,  financial,  political  and  geopolitical)  must 
incentivize  a  clearly  understood  national 
responsibility. 
43 See project 3 in Annex 1. 

https://urldefense.com/v3/__https://globalchallenges.org/wp-

Kickbusch, 

Ilona, 

See 

al., 

7 

 
 
 
                                                           
improved diagnosis and personalised medicine and continuum of care. A specific example is how 
providing  digital  health  and  care  services  may  facilitate  access  to  expertise  even 
in 
geographically  remote  locations  e.g.  through  m-health  (mobile  health)  and  telemedicine.  The 
development  and/or implementation of national and regional strategies  such as the  upcoming 
African Union/African CDC digital health strategies will be supported. 

  Build on the EU being pioneers in regulation of health data, digital certificates, using the cloud 
for data sharing, data protection and privacy. The EU will leverage the potential of health data 
worldwide in line with the principles of the planned European Health Data Space and foster the 
use  of  new  technologies  including  artificial  intelligence  to  boost  their  potential  to  improve 
diagnosis and treatments worldwide.  

  Contribute  to  shaping  the  digital  health  ecosystem  globally  (rules,  norms,  standards, 
interoperability), using European examples and best practice like the EU Digital Covid Certificate 
and supporting international rules that are compatible with the EU framework while facilitating 
person-centred health data governance and protection.  

Guiding  principle  5.  Boost  global  health  research  to  develop  the  technologies  and 
countermeasures which are necessary to improve health.  

Research is also a key enabler of better health. Leveraging  research  efforts worldwide can make a 
step  change  to  advancements  in  diagnostics  and  treatments.  Drawing  on  the  success  of  COVID19 
vaccines,  a  research  action  for  global  health  will  drive  change  to  ensure  research  and  innovation 
benefit people worldwide.  

To develop this guiding principle, the following lines of action will be prioritised: 
  Extend  international  research  and  innovation  cooperation,  making  research  data  as  open, 
standardised and interoperable as possible, and promoting the dissemination and exploitation 
of results as a common good. This is in line with the Commission Communication “The Global 
Approach to Research and Innovation” and the respective Council conclusions.  

  Support  research  end-to-end  by  creating  a  conducive  research  environment,  bolstering  the 
entire value chain from fundamental to preclinical and clinical research, in order to bridge the 
gap between generating and implementing knowledge and evidence. 

  Support  the  design  of  regulation,  production,  procurement,  and  delivery,  so  that  research 
conducted in low- and middle-income economies is relevant for local pharmaceutical and health 
technology production.  

  Contribute to mutual capacity building through Joint Undertakings, such as the Global Health 
European  and  Developing  Countries  Clinical  Trials  Partnership,  to  foster  ever  closer 
collaboration with low- and middle-income countries44.  
Leverage  the  industrial  dimension  to  reinforce  local  production  capacity,  ensuring  effective 
cooperation between public and private actors.  

 

  Boost support of international processes that strengthen the scientific base for policy action, 

including the creation of a Science-Policy Panel on Chemicals, Waste and Pollution.   

Guiding principle 6. Address workforce imbalances and foster skills. 

Through  a  health  workforce  action,  this  strategy  will  address  both  the  necessary  development  of 
right  skills  and  the  challenge  of  personnel  shortages.  It  requires  a  long-term,  integrated  approach 
with  the  involvement  of  social  partners,  collaboration  across  countries,  and  recognition  that 
problems are more acute for the nursing and care segments – and disproportionately affect women:  

44 See projects 12 and 19 in Annex 1. 

8 

 
 
 
 
                                                           
  Strengthen  international  cooperation  and  adherence  to  international  commitments  on 
recruitment, developing reliable monitoring and data collection on workforce and its flows. 
  Foster  mutually  beneficial  mobility  arrangements  with  partners  in  a  context  of  health 
workforce  shortages45  promoting  circular  mobility  and  countering  brain  drain,  including  by 
drawing on the Skills and Talents package, in particular the forthcoming talent partnerships with 
partner countries. 

  Support  partner  countries  in  training,  recruiting  and  putting  into  action  healthcare  workers 
and  ensuring  their  professional  development  through  appropriate  education  as  well  as 
vocational training (VET) programmes for auxiliary staff in partnership with other donors, while 
respecting the need to support retention of skilled healthcare workers. The Opportunity Driven 
Vocational Training Team Europe initiative46 will help analyse the need for technical profiles and 
help deliver the required training.  

  Support  partnerships  working  through  the  Pact  for  Skills  and  Blueprint  for  sectoral  skills  to 
increase understanding of specific skills needs in health and care and develop relevant training 
solutions 

2.3  Prevent  and  combat  health  threats,  including  pandemics,  applying  a  One  Health 
approach  
Combating health threats has become a top priority. The world is entering what may well be an age 
of  pandemics47  due  to  the  interconnectedness  of  today’s  societies  and  our  interplay  with  climate, 
the  environment  and  animals.  Health  threats  can  be  of  different  origins,  including  environmental 
pollution, and chemical, biological, radiological or nuclear (CBRN), which calls for a comprehensive 
all-hazards  approach.  In  July  202248,  the  Commission  established  a  list  of  top  three  cross-border 
health threats (e.g. pathogens with high pandemic potential, CBRN and anti-microbial resistance) to 
prepare against, which should guide both internal and external action.  

The EU drew the early lessons of the pandemic, adopting a new Regulation on serious cross-border 
health  threats  and  improving  preparedness  and  response  in  the  field of  medical  countermeasures 
notably  with  the  creation  of  the  Health  Emergency  Preparedness  and  Response  Authority  (HERA). 
Regarding such countermeasures, the State of Health Preparedness Report presented in parallel to 
the strategy outlines the robust action that has been taken including at the global level.  

Efforts must continue because as stressed by the Independent Panel for Pandemic Preparedness and 
Response  a  lot  of  work  remains  to  be  done  before  the  world  is  collectively  ready  for  this  task.49 
Therefore,  the  strategy  will  continue  to  tackle  the  ongoing  COVID-19  pandemic  and  its  aftermath 
and,  building  on  lessons  from  the  past  three  years,  build  a  comprehensive  approach  to  ensuring 
global health security.  

To lead these global efforts, the Commission will follow guiding principles, inviting Member States to 
do the same:  

Guiding principle 7. Strengthen capacities for prevention, preparedness and response and 
early detection of health threats globally. 

45 Supported by project 4 in Annex 1. 
46 See under https://europa.eu/capacity4dev/tei-jp-tracker/. 
47  Professor  Peter  Piot,  quoted  in  https://ec.europa.eu/research-and-innovation/en/horizon-magazine/how-
we-prepare-age-pandemics. 
48 https://ec.europa.eu/commission/presscorner/detail/en/IP_22_4474 
49 The Independent Panel for Pandemic Preparedness and Response  was established by the Director-General 
of WHO in response to World Health Assembly resolution WHA73.1: https://theindependentpanel.org/ 

9 

 
 
                                                           
COVID-19 has shown the importance of robust preparedness and response capacities and adequate 
funding to save lives. The pandemic has also demonstrated that spending billions would have saved 
trillions.  It  will  be  essential  to  provide  the  WHO  with  sustainable  financing  and  spearheading 
innovative  ways  to  fill  gaps  such  as  the  Pandemic  Fund50,  which  the  Commission  and  some  EU 
Member States co-founded as major contributors.  

The  EU  should  continue  to  focus  on  improving  biosafety  and  biosecurity  measures  in  relevant 
institutions, and on increasing public awareness and training staff.  

To develop these guiding principles, the following lines of action will be prioritised: 

  Prioritise health security on the global health agenda, including by designing and implementing 
the  Team  Europe  initiative  with  Africa51  on  health  security  using  a  One  Health  approach  to 
strengthen  systems  and  capacities 
for  sustainable  and  risk-informed  prevention  of, 
preparedness  for,  and  response  to  infectious  and  non-infectious  threats,  including  those 
stemming  from  environmental  pollution  and  antimicrobial  resistance  (see  below  also  under 
principle 11).   

  Support regional and country efforts to strengthen pharmaceutical systems and manufacturing 
capacity  for  vaccines  and  other  medical  products  and  technologies  to  increase  quality,  safety, 
equitable access, and health sovereignty. To this end, boost the ongoing Team Europe initiative 
on Manufacturing and Access to Vaccines, Medicines and Health Technologies in Africa52 and 
the EU and Latin America and the Caribbean manufacturing and health partnership53. The EU 
will invest in strengthening health commodity markets and supporting end-to-end procurement 
and supply chain management, including transparency and monitoring, using inter alia business 
support  networks  to  favour  matchmaking,  facilitate  marketplace  exchanges  and  dialogue  of 
industrial actors.  

  Diversify and build  EU capacity of supply chains for critical equipment and countermeasures, 
diagnostics  and  therapeutics  with  targeted  action  to  avoid  supply  shortages  and  secure 
worldwide  providers. This will enhance  the EU’s  strategic  resilience  and, crucially,  increase  the 
global supply of countermeasures, thus enhancing access by partners to such goods and opening 
cooperation avenues. 

  Develop  capacities  for  early  detection,  sound  and  sustainable  management  of  hazardous 
waste  and  materials54,  building  on  the  work  under  the  Union  Civil  Protection  Mechanism  and 
strengthening  the  legislative  framework  related  to  biosafety  and  biosecurity  measures  in  all 
relevant  institutions. Awareness  raising and training of staff should  be  helped by the EU CBRN 
Risk Mitigation Centres of Excellence55 and their activities in 63 partner countries. 

  Support  the  development  of  a  comprehensive  disease  outbreak  humanitarian  response 
system that also includes coverage for areas outside the EU, building on Union Civil Protection 
Mechanism (UCPM) and the European Humanitarian Response Capacity (EHRC). 

  Continue to support the implementation of Security Council Resolution 228656 on protection of 
civilians  in  armed  conflict,  by  advocating  respect  for  international  humanitarian  law  and 

50https://www.worldbank.org/en/programs/financial-intermediary-fund-for-pandemic-prevention-
preparedness-and-response-ppr-fif 
51 See project 15 in Annex 1. 
52 https://europa.eu/capacity4dev/tei-jp-tracker/tei/manufacturing-and-access-vaccines-medicines-and-
health-technology-products-africa  
53 https://ec.europa.eu/commission/presscorner/detail/en/ip_22_3890  
54 Including those under waste shipments (europa.eu) 
55 https://cbrn-risk-mitigation.network.europa.eu/index_en  
56 http://unscr.com/en/resolutions/2286 

10 

 
 
                                                           
supporting accountability for attacks against medical workers and infrastructure, and continuity 
of healthcare and access in armed conflicts. 

  Expand  and  strengthen  European  and  global  research  partnerships  including  clinical  trial 
networks  that  can  be  pivoted  to  address  new  and  emerging  pathogens  to  ensure  timely 
availability of effective medical countermeasures. 

Guiding  principle  8.  Work  towards  a  permanent  global  mechanism  that  fosters  the 
development of and equitable access to vaccines and countermeasures for low- and middle-
income countries. 

lessons  of  the  COVID-19  pandemic 

One  of  the  key 
is  that  equitable  access  to  medical 
countermeasures  is  core  to  pandemic  preparedness  and  response.  This  calls  for  a  permanent 
solution,  building  on  the  Access  to  COVID-19  Tools  Accelerator  (ACT-A),  the  Pandemic  Influenza 
Preparedness Framework57 and other relevant experiences.  

For effective medical countermeasures to become available quickly, effective surveillance needs to 
identify  pathogens  early,  and  effective  research  platforms  need  to  be  ready  to  produce  the 
necessary  evidence  for  quick  development  and  rollout,  supported  by  a  conducive  research 
environment  with  clinical  trial  platforms  that  can  be  quickly  pivoted  to  new  diseases,  and  an 
effective regulatory environment for the conduct of clinical trials. 

Guiding principle 9. Negotiate an effective legally binding pandemic agreement with a One 
Health approach and strengthened International Health Regulations. 

This fills the gaps in the international rulebook for pandemic preparedness and response, requiring 
countries  and  empowering  the  WHO  to  report  and  investigate  pandemic  threats  rapidly58.  The 
pandemic agreement should include concrete provisions on anti-microbial resistance59.  

Guiding  principle  10.  Build  a  robust  global  collaborative  surveillance  network  to  better 
detect and act on pathogens  

The strategy supports the creation of a new reliable network that surveys and detects pathogens in 
key hotspots, and not only identifies threats but also advises on action to take. This work would be 
supported by  EU Delegations  on the  ground  and  complement  the  G7  initiative  connecting existing 
networks60.  It  will  include  digitalisation  and  integration  of  surveillance  systems  across  the  human, 
animal  and  environment  spectrum,  strengthening  laboratory  capacities  and  genomic  sequencing 
capabilities, as well as workforce training.  

Guiding principle 11. Apply a comprehensive One Health approach and intensify the fight 
against antimicrobial resistance. 

Two critical challenges have become more urgent in recent years. The first concerns the complexity 
and the consequences of animal, environmental and human interactions calling for a multisectoral, 
integrated  and  transdisciplinary  “One  Health”  approach.  This  includes  the  increased  risk  of major 
pandemic  outbreaks  due  to  in  particular  to  changes  in  land-use,  environmental  degradation, 
complex food production systems and intensified trade and travel, but also the burden in low- and 

57 https://www.who.int/initiatives/pandemic-influenza-preparedness-framework 
58  https://www.consilium.europa.eu/en/press/press-releases/2022/03/03/council-gives-green-light-to-start-
negotiations-on-international-pandemic-treaty/ 
59 See below also under principle 11. 
60 G7 Pact for Pandemic Readiness: 
https://www.g7germany.de/resource/blob/974430/2042052/2d5b55bcdfc0f1aa46b979566288e9a5/2022-05-
20-pact-for-pandemic-readniness-data.pdf?download=1   

11 

 
 
 
                                                           
middle- income economies of neglected pollution-related or endemic diseases, most of which can be 
zoonotic, air-, water or vector-borne.  

The second is the silent pandemic of antimicrobial resistance (AMR), which the WHO has identified 
as  one  of  the  top  10  current  global  health  threats61.  AMR  is  also  an  aggravating  factor  during 
pandemics.  Moreover,  antimicrobials  pollute  the  environment  and  affect  the  biodiversity62. 
Countries, institutions and global stakeholders must collectively and comprehensively address these 
challenges as a priority.  

To develop this guiding principle, the following lines of action will be prioritised: 

  Intensify work with the Quadripartite, including WHO, the Food and Agriculture Organization of 
the  United  Nations  (FAO),  the  World  Organisation  for  Animal  Health  (WOAH),  and  the  United 
Nations Environment Programme (UNEP) to implement its One Health Joint Plan of Action. 
  Seek  ‘deep  prevention’63  –  identifying  and  addressing  threats  before  pathogens  cross  from 
animals  to  humans,  not  after  human  outbreaks  have  occurred  and  strengthen  capacity  to 
prevent pollution related health threats.  

  The  Commission  will  explore  existing  international  conventions  that  affect  the  ‘upstream’ 
course  of  potential  pandemics,  to  examine  whether  their  provisions  or  implementation  plans 
could be strengthened to support a One Health approach64. 

  Work towards the inclusion of concrete provisions on anti-microbial resistance in the pandemic 

agreement. 

  Support  the  development  of  and  access  to  innovative  medical  countermeasures  to  address 

AMR, including antimicrobials, vaccines, and diagnostics65.  

3.  A new internal governance to tackle global health challenges 
Achieving this strategy’s goals requires a more joined-up way of working within the Commission and 
with Member  States  and partners.  This is because  global health is increasingly shaped by  multiple 
policies  (such  as  climate,  environment,  energy,  nutrition,  food  security,  social  protection, 
demography,  education,  research,  humanitarian  assistance,  finance,  trade,  industrial  policy  or 
foreign  and  security  policy)  that  either  affect  health  or  enable  the  solution  to  health  challenges, 
with various agencies and bodies at EU and national levels and different financial institutions actively 
involved.  This  calls  for  reinforced  coordination  to  help  achieve  the  priorities  of  this  strategy  and 
implement a true ‘health in all policies’ governance—a novelty of this strategy. 

Guiding  principle  12.  Link  effectively  all  policies  and  measures  that  have  an  impact  on 
global health within the Commission, EU agencies and EU financing institutions. 

The Commission will fully integrate global health considerations into all EU policy areas that have an 
impact  on  global  health  by  reinforcing  internal  coordination  mapping  roles  and  responsibilities, 
policies and tools, and how they will help achieve the priorities of this strategy.  

61 https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance  
62  See  Biodiversity  Strategy  (COM(2020)  380),  Farm  to  Fork  Strategy    (COM(2020)  381)  and  Zero  Pollution 
Action Plan (COM(2021) 400). 
63 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00948-X/fulltext  
64  Including  the  United  Nations  Framework  Convention  on  Climate  Change;  the  Convention  on  Biological 
Diversity  and  its  Nagoya  Protocol  on  Access  to  Genetic  Resources  and  the  Fair  and  Equitable  Sharing  of 
Benefits  Arising  from  their  Utilization;  the  United  Nations  Convention  to  Combat  Desertification  in  those 
Countries  Experiencing  Serious  Drought  and/or  Desertification,  Particularly  in  Africa;  the  Protocol  on  Water 
and  Health  to  the  Convention  on  the  Protection  and  Use  of  Transboundary  Watercourses  and  International 
Lakes; and the Convention on International Trade in Endangered Species of Wild Fauna and Flora.  
65 See also under principles 7 and 9.  

12 

 
 
 
 
                                                           
This involves lines of action in the following key policy areas: 

  Pursue global climate neutrality by 2050, increasing the capacity to adapt, strengthen resilience 

reducing vulnerability to climate change in accordance with the Paris Agreement.  

  Promote ambitious global action to tackle biodiversity loss, wildlife trafficking, air, water and 
soil  pollution,  exposure  to  toxic  substances.  Fostering  the  One  Health  approach  in  the  future 
Global Biodiversity Framework to be  agreed at  the UN Biodiversity Conference  (COP15),  and in 
global action to tackle wildlife trafficking to reduce the risk of zoonoses. Support soil biodiversity, 
the  international  pursuit  of  air  pollution  reduction  and  mitigation  of  global  emissions,  the 
promotion  of  key  international  instruments  and  a  global  mechanism  for  the  management  of 
chemicals and waste  beyond 2020, the negotiation of a new, legally binding instrument to end 
plastic pollution, and ambitious outcomes on water and health at the upcoming 2023 UN Water 
Conference. 

  Promote  effective  health  and  safety  standards  worldwide,  by  continuing  to  engage  with  the 
International  Labour  Organization  (ILO)  in  supporting  the  integration  of  the  right  to  safe  and 
healthy working conditions into the ILO framework of fundamental principles and rights at work. 
  Step up humanitarian assistance and support to regions and populations most affected by food 
insecurity  and  high  incidence  of  malnutrition,  track  food  prices  and  make  stocks  available  to 
countries in need, as reflected in the March 2022 Commission Communication on Safeguarding 
food  security  and  reinforcing  the  resilience  of  food  systems66  and  the  Communication  on 
fertilisers. Adopt a systemic approach by accelerating the transition to a sustainable food system 
that can bring health, environmental and social benefits.   

  Leverage  investment  in  education  to  support  health  in  the  short  and  long  term,  as  per  the 
commitments  taken  at  the  Transforming  Education  Summit,  while  prioritising  early  childhood 
development,  health  education,  SRHR,  and  school  meals  through  its  programmes  with  partner 
countries. 

  Strengthen humanitarian assistance  and civil protection operations  related to global health in 
emergency  and  crisis  settings  through  increasing  operational,  analytical,  monitoring  and 
communication  capabilities  of  the  Emergency  Response  Coordination  Centre  and  the  European 
Humanitarian  Response  Capacity  –and  placing  more  public  health  experts  into  action  in  crisis 
areas.  Support  disaster  management  capacity  building  with  organisations  such  as  the  ASEAN 
Coordinating  Centre  for  Humanitarian  Assistance.  Reinforce  the  availability  of  health-related 
response  capacities  under  the  Union  Civil  Protection  Mechanism;  develop  new  medical  and 
CBRN  related  capacities  under  the  European  Civil  Protection  Pool  and  RescEU;  and  strengthen 
cooperation with WHO on emergency response and continue to support their work on standards 
development and classification processes for emergency medical teams deployable globally. 
  Make  the  behaviour  of  public  and  private  stakeholders  work  for  global  health  in  a  range  of 
finance-related  measures  by  (i)  promoting  a  pro-health  behaviour  by  domestic  and  foreign 
companies by including health impacts in the EU Non-Financial Reporting Directive67; (ii) working 
with international financial institutions and rating agencies so that they embed the same health 
criteria in their decisions; and (iii) engaging with the International Monetary Fund (IMF) so that it 
includes  health  investment  in  its  regular  assessment  of  countries’  macroeconomic  stability  – 
encouraging investment in public health. 

  Ensure  that 

international 
international  trade  policy  works  for  global  health,  so  that 
pharmaceutical  supply  chains  are  not  broken,  that  partners  benefit  from  medicines,  medical 
devices  and  services  –  strengthening  the  resilience  of  health  systems through  the  World  Trade 

66https://eur-lex.europa.eu/resource.html?uri=cellar:5391557a-aaa2-11ec-83e1-
01aa75ed71a1.0002.02/DOC_1&format=PDF 
67  DIRECTIVE  2014/95/EU  OF  THE  EUROPEAN  PARLIAMENT  AND  OF  THE  COUNCIL  of  22  October  2014 
amending  Directive  2013/34/EU  as  regards  disclosure  of  non-financial  and  diversity  information  by  certain 
large 
(https://eur-lex.europa.eu/legal-
content/EN/TXT/PDF/?uri=CELEX:32014L0095&from=EN). 

undertakings 

groups 

and 

13 

 
 
                                                           
Organization (WTO) Trade and Health Initiative68 and sharing experiences with WTO partners on 
trade facilitation. This includes annual stocktaking with WTO partners of lessons learned from the 
pandemic,  and  monitoring  the  implementation  of  the  Ministerial  Decision  on  the  WTO 
Agreement  on  Trade-Related  Aspects  of  Intellectual  Property  Rights  (TRIPS)69  that  makes  it 
possible to authorise the manufacture and export of COVID-19 vaccines in a fast  and simplified 
manner  without  the  consent  of  the  patent  owner.  We  will  discuss  constructively  whether  to 
extend this mechanism to cover COVID-19 therapeutics and diagnostics, and support the scaling 
up of the production capacity of vaccines and other products in developing countries.  

  In  supporting  the  High  Representative,  shape  the  common  foreign  and  security  policy  and 
promote  the  full  implementation  of  that  policy  by  including  health  in  political  dialogues  with 
partners  to  facilitate  international  cooperation.  External  action  can  serve  as  a  vector  to 
promoting  global  health  by  such  means  as  mapping  external  security  threats.  Global  health 
should  consolidate  with  other  factors  that  affect  health, 
like  environment,  migration, 
demography or food security. Future lines of action should include: (i) supporting the creation of 
pandemic surveillance mechanisms in non-EU countries; (ii) circulating mutual information about 
partners’  plans  to  advance  foreign  policy  and  commercial  goals  through  health;  (iii)  ensure  in 
Geneva,  New  York  and  across  the  world  cooperation  with  like-minded  partners;  and  (iv) 
prevention of and response  to foreign information manipulation and interference  (FIMI), which 
can  weaponise  global  health.  Effective  communication  on  EU  health  action  has  proven  to  be  a 
very useful tool in this regard. 

  Ensure  an  active  role  of  EU  Delegations  in  implementing  this  strategy.  During  the  COVID-19 
pandemic,  the  EU  Delegations  have  proven  to  be  an  effective  source,  gathering  health-related 
intelligence around the globe and communicating and reaching out on EU priorities, while raising 
political  awareness.  The  role of  the  EU  Delegations will  need  to  be  bolstered, ensuring  specific 
expertise  in  health-related  areas  of  geostrategic  importance.  Strengthening  specific  health 
expertise in Delegations, also through the secondment of experts, will be explored.  

Guiding principle 13. Better link and coordinate policies and measures of the EU and its 
Member States to speak with one voice and deliver effective action worldwide. 

EU leadership has played a key role in the fight against the COVID-19 pandemic globally through the 
Team  Europe  approach,  with  the  EU  and  Member  States  acting  within  their  respective 
competences. Strengthening this leadership is essential to boost the impact of the EU contribution 
to global health and to shape a new global health order based on our fundamental values. There is 
wide consensus amongst EU Member States and stakeholders that this calls for closer coordination 
in practical ways, which would not only respect the specific competences, but facilitate the decision 
making that would take place through the established statutory channels.  

Building on ideas from EU Member States, this strategy suggests defining practical ways to enhance 
coordination in 202370, with the following lines of action:  

  Ensure synergy between national and EU global health strategies. 
  Facilitate information and intelligence sharing among the EU and Member States in the many 
focal  points  dealing  with  global  health  (Brussels,  Member  State  capitals,  Geneva  and  New 
York), with increased health capacities and/or expertise in the latter two. This will build on an 
ongoing initiative of the Czech Presidency of the Council to address this need.  

  Collect views from Member States, including by carrying out periodic surveys on specific topics, 

to facilitate the shaping of positions.  

68 WTO | Ministerial conferences - Twelfth WTO Ministerial Conference - Geneva Switzerland 
69 https://www.wto.org/english/tratop_e/trips_e/trips_e.htm  
70 With the support of the EU4Health project 1 in Annex 1. 

14 

 
 
                                                           
  Undertake  permanent  mapping  of  key  measures  and  financing  efforts  of  the  EU  and  its 
Member States to better understand what actions are taking place and to allow for tying means 
to the strategy’s priorities, considering when necessary, the help of joint ministerial meetings in 
the areas of health, finance, foreign affairs and development. 

  Strengthen  upstream  coordination  with  Member  States,  particularly  in  fora  in  which  not  all 
Member  States  are  directly  participating  (e.g.  the  G7,  the  G20  and  the  Organisation  for 
Economic Co-operation and Development (OECD)).  

  Step-up  EU  coordination  and  building  allies  to  ensure  due  EU  presence  and  decision-making 

role in international organizations.  

  Strengthen  external  communication  catered  to  the  strategy,  so  that  efforts  by  the EU  and  its 
Member States receive adequate recognition, with ‘Team Europe approach’ as a trademark for 
EU effective action in health, in line with the Global Gateway strategy. 

4.  A new multilateral governance for the emerging global health order  
Since  the  2010  Communication,  a  new  global  health  order  is  emerging:  an  ever-evolving  system 
with a multiplicity of new stakeholders and initiatives that reshape global health relations against a 
complex geopolitical backdrop. The COVID-19 pandemic has been a litmus test of what is essential, 
what  must  change  and  what  is  missing  to  bring  about  effective  global  health  governance.  The 
Commission will follow guiding principles, inviting Member States to do the same: 

Guiding principle 14. Support a stronger, effective and accountable WHO. 

All EU27 Member States are members of the WHO, and even though the EU is formally not a WHO 
member, the WHO has always received steadfast EU support, including at times when its role was at 
stake. The COVID-19 pandemic has demonstrated that WHO is the indispensable cornerstone of the 
multilateral health system – and at the same time it has also revealed areas of certain shortcomings. 
This  strategy  should  aim  at  ensuring  further  strengthening  of  WHO’s  leadership,  effectiveness, 
efficiency, accountability and align EU and WHO priorities.  

The following lines of action will be prioritised:  

  Seek formal  EU observer status with full participation rights  as a first  step towards full WHO 

membership.  

  Contribute to making the financing of WHO more sustainable in line with the decisions of the 

75th World Health Assembly71 by 2030-2031. 

  Advance  WHO  reform  to  strengthen 

its  governance,  efficiency,  accountability  and 

enforcement of rules, in accordance with its member-driven nature.  

  Strengthen  WHO’s  focus  on  its  normative  role  in  areas  of  global  relevance,  starting  with 
strengthened International Health Regulations and a future pandemic agreement by 2024, and 
explore other areas like health data governance and workforce.  

  Enhance  cooperation  with  the  WHO,  at  central  and  regional  European  level,  using  the 
aforementioned  mapping  mechanisms  to  ensure  greater  alignment  of  EU  and  WHO  priorities. 
These common goals will guide  the EU’s sizeable voluntary contribution to the WHO. In 2020 
and 2021, Commission voluntary contributions were the fourth largest overall, and the EU and 
its  Member  States  accounted  for  more  than  20%  of  the  WHO  budget,  being  the  largest 
contributor72. 

71 WHA75(8): https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75(8)-en.pdf  
72 Source:  WHO | Programme Budget Web Portal. Consulted on 3 November 2022.  

15 

 
 
 
                                                           
Guiding principle 15. Steer the new global health governance by filling gaps and ensuring 
coherence of action  

As shown again during the COVID-19 pandemic, the global health governance (the set of institutions, 
actors,  rules,  and  financing  strands  in  this  field)  needs  strengthening  to  ensure  (i)  the  necessary 
mechanisms are available to address health challenges; and (ii) the plurality of bodies active in global 
health  are  sufficiently  aligned—avoiding  duplication  and  fragmentation  that  make  effective  and 
efficient responses to health challenges more difficult. 

In  the  short  term,  the  United  Nations  system,  the  G7,  the  G20  and  the  OECD  have  provided 
important impetus to global action. The G7 Pact for Pandemic Readiness73 is a good example – in the 
absence  of  a  global  pathogen  surveillance  network,  it  seeks  to  connect  existing  partial  networks. 
Another  good  example  is  the  G20-born  Pandemic  Fund74  that  fills  immediate  financing  gaps  at 
global, regional and national level.  

In  the  longer  term  a  robust  global  health  governance  requires  to  fill  existing  gaps  and  ensure 
coherence.  In  addition  to  seeking  a  pandemic  agreement  (see  section  2.3),  the  following  lines  of 
action will be prioritised: 

  Work towards permanent cooperation and synergies between the health and finance tracks, 
with  a  standing  arrangement  between  health  and  finance  policies  to  deal  effectively  with 
threats to global health and the global economy, building on the work of the G20 Joint Health 
and  Financing  Task  Force.  This  arrangement  would  assess  economic  impacts  of  global  health 
threats  and  vulnerabilities,  identifying  what  governments  would  need  to  do  to  be  better 
prepared for a potential crisis. It would also mobilise the necessary financial resources after the 
WHO declares a pandemic emergency, so countries can better manage the resulting economic 
and social effects. 

  Strengthen alignment and coordination between global health initiatives to ensure maximum 
efficiency and explore permanent solutions75 which may combine or expand the operations of 
several existing health funds and continue to provide important funding to their core work76.  
  Ensure  that  global  health  challenges  stay  at  the  top  of  the  global  agenda  and  that  top 
leadership is structurally involved to provide impetus to global health work, with the WHO at its 
core,  and  to  take  individual  and  collective  responsibility.  Support  a  structure  involving,  where 
required,  heads  of  state  and  government,  to  do  so,  in  the  context  of  on-going  multilateral 
discussions. 

Guiding principle 16. Ensure a stronger EU role in international organisations and bodies. 

The EU and its Member States make sizeable financial contributions in a Team Europe approach to 
all key international institutions and global health initiatives. Therefore, it is key to ensure that these 
financial  contributions  translate  into  commensurate  decision-making  powers  to  achieve  the 
objectives of this strategy.  

The following lines of action will be prioritised: 

73https://www.g7germany.de/resource/blob/974430/2042058/5651daa321517b089cdccfaffd1e37a1/2022-
05-20-g7-health-ministers-communique-data.pdf 
74 See project 10 in Annex 1. 
75  As  suggested  by  the  Lancet  Commission,  see  https://www.thelancet.com/journals/lancet/article/PIIS0140-
6736(22)01585-9/fulltext 
76 For three financing windows: commodities for disease control, pandemic preparedness and response, and 
primary health system strengthening in low and middle income economies. 

16 

 
 
                                                           
  Ensure a level of participation and a decision-making role in all institutions and bodies that is 

commensurate with EU and Member State contributions to increase our impact. 

  Monitor  the  EU  financial  contributions  to  international  organisations  and  agencies  and  to 

initiatives and how they support EU priorities. 

  Develop a plan to further increase the EU’s influence within a reasonable timeframe wherever 
EU impact in institutions and bodies is not commensurate with EU contributions, with the aim of 
ensuring alignment. 

5.  Expand the Union’s strategic partnerships on health and reshape its 

engagement with different stakeholders 

The  wide  challenges  in  global  health  across  the  world  require  an  expansion  of  our  partnerships, 
exploiting the EU’s unique potential to drive international cooperation. 

The Commission will follow guiding principles, inviting Member States to do the same: 

Guiding principle 17. Expand partnerships based on equal footing, co-ownership, mutual 
interest and strategic priorities.  

The  aim  of  the  Global  Gateway  strategy  is  to  deepen  meaningful  and  mutually  beneficial 
partnerships with a wide range of traditional and non-traditional partners and stakeholders. Health 
is  a  key  pillar  of  this.  The  EU  will  continue  developing  partnerships  to  support  improving  health 
across the world, with a particular attention to countries with weaker health systems.  

The EU’s relations with partners must be based on ownership – with the EU and our partners taking 
the responsibility that is key to achieve health sovereignty.   

The EU’s bilateral partnerships will build on the ongoing collaboration with a wide range of partners 
and counterparts including national health authorities, public health institutions, and other relevant 
bodies. In the spirit of meaningful partnership, the EU will encourage partner countries to make and 
meet  ambitious  commitments  to  prevent  health  threats,  improve  health  and  invest  in  health 
services for their whole population, increasing domestic resource commitment to health in the long 
term. This includes for instance advancing in Africa towards the target set in the 2001 African Union 
Abuja  Declaration77  to  allocate  ‘at  least  15%  of  [the]  annual  budget  to  the  improvement  of  the 
health sector while taking account of the necessary fiscal space’. 

The  EU  is  expanding  partnerships  in  health  at  regional  level.  Regionalism  is  important  in  global 
health, and regional stakeholders play an increasingly important role. Deepening health partnerships 
at  regional  level,  including  in  Africa,  Latin  America  and  the  Caribbean,  the  Asia-Pacific  region,  as 
well as supporting South-South cooperation will be essential.  

The February 2022 EU-African Union summit strengthened the health partnership between the EU 
and  Africa,  which  underpins  five  Team  Europe  initiatives  with  African  partners78.  The  EU  is  also 
committed to the EU-Africa Global Health EDCTP3 3 Joint Undertaking that builds on the European 
and Developing Countries Clinical Trials Partnership bringing together 15 members from the EU with 
21 members from Africa and other public and private actors, from industry, philanthropy, or non‑EU, 
non‑African countries.   

A regional Team Europe initiative79 is being developed in Latin America and the Caribbean focusing 
on 1) private sector engagement, 2) improved regional supply chains, trade integration and business 
environment,  3)  regulatory  strengthening,  4)  demand  consolidation  and  pooled  procurement,  5) 
scientific  cooperation,  6)  pandemic  preparedness  and  health  security,  and  7)  other  health-related 

77 https://au.int/sites/default/files/pages/32894-file-2001-abuja-declaration.pdf 
78 See projects 13, 14, 15, 16 and 17 in Annex 1. 
79 See project 19 in Annex 1, https://ec.europa.eu/commission/presscorner/detail/en/ip_22_3890 

17 

 
 
                                                           
areas (health data, digital and emerging technologies, non-communicable diseases, health systems, 
etc.).  The  partnership  will  support  ongoing  regional  efforts,  notably  the  Plan  for  self-sufficiency  in 
health  matters,  endorsed  by  the  Community  of  Latin  American  and  Caribbean  States  (CELAC)  in 
September 2021, which sets out action to strengthen capacities to produce vaccines and medicines 
in the region. A key partner will be the Pan American Health Organization (PAHO/WHO). 

In line with its Strategy for Cooperation in the Indo-Pacific, the EU will continue working with Indo-
Pacific  partners  to  strengthen  their  capacities,  health  sovereignty  and  pandemic  preparedness,  in 
particular for the least-developed countries in the region. The EU will enhance collaborative research 
on communicable diseases in the context of the Horizon Europe research programme. In line with its 
Pharmaceutical Strategy, the EU will strengthen multilateral cooperation to secure safe and diverse 
pharmaceutical and health-related industrial supply chains, to facilitate access to quality medicines 
and  health  products.  The  EU  will  explore  further  EU-ASEAN  cooperation  enshrined  within  a  “One 
health  approach”,  promoting  tighter  connections  between  regional  health  capacities,  such  as  the 
new ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED). 

The EU will further prioritise health resilience in its neighbourhood. The EU is actively assisting its 
partners  in  the  Western  Balkans  and  the  neighbourhood  to  raise  their  healthcare  standards  and 
reduce  the  likelihood  of  future  border  closures  due  to  health  emergencies.  The  EU  supports 
candidate  countries  and  potential  candidates,  including  Ukraine,  Moldova  and  Georgia,  to  align 
their health legislation with EU health law and to be able to implement it. This includes mobilising EU 
Agencies  (ECDC  and  EMA)  to  support  this,  notably  via  the  implementation  of  EU  acquis  on  cross 
border  health  threats  in  line  with  EU  standards,  field  epidemiology  training  programme  for 
strengthening  national  public  health  workforce  capacities  across  the  neighbourhood  and  Western 
Balkans,  advancement  on  One-Health  approaches  on  antimicrobial  resistance,  strengthening 
surveillance systems and public health microbiology capacities, and regional cooperation in the field 
of epidemic intelligence, risk assessment, preparedness, response, and public health emergency.  

The  Western  Balkan  partners  and  Ukraine  were  invited  to  join  the  Health  Security  Committee  as 
observers, and the Western Balkans are all signatories to the EU Joint Procurement Agreement for 
medical countermeasures.  

The United States (US) is a key partner in global health as shown by ‘U.S.-EU Agenda for Beating the 
Global  Pandemic:  Vaccinating  the  World,  Saving  Lives  Now,  and  Building  Back  Better  Health 
Security’,80 the administrative arrangement with the US Department of Health and Human Services 
on public health threats81, the Transatlantic Taskforce on Antimicrobial Resistance82, the EU and US 
joint task force addressing Covid-19 Manufacturing and Supply Chain challenges83 and coordination 
with US Agency for International Development. The EU-US partnership should be expanded to cover 
a  more  comprehensive  set  of  health  issues,  with  an  EU-US  taskforce  on  health  cooperation, 
encompassing health security, cancer policy, and global health governance. 

Close  collaboration  with  like-minded  partners  and  donors  such  as  Canada,  Japan  and  the  United 
Kingdom amongst others on issues such as health system strengthening, equity and universal health 
coverage,  will  continue  to  be  instrumental  in  building  multilateral  approaches  to  solving  global 
challenges. The European Centre for Disease Prevention and Control collaborates with other centres 
for disease control in non-EU countries, including the US Centers for Disease Control and Prevention. 

To develop this guiding principle, the following lines of action will be prioritised: 

80 https://ec.europa.eu/commission/presscorner/detail/en/statement_21_4846  
81 https://ec.europa.eu/commission/presscorner/detail/en/STATEMENT_21_4846 
82 This has subsequently turned into a plurilateral initiative including other partners (Canada, Norway and the 
United Kingdom). 
83 CIPR - USA-EU Joint Statement on Covid-19 Manufacturing and Supply Chain Taskforce (europa.eu) 

18 

 
 
                                                           
  Focus,  in  all  regions,  on  the  partners  most  in  need  and  where  results  on  the  ground  can  be 
achieved,  while  taking  into  account  specific  challenges  such  as  conflict  settings,  promoting 
cooperation where governments take responsibility and facilitate the effectiveness of support. 
  Further  prioritise  health  in  its  neighbourhood  and  in  support  to  candidate  countries  and 
potential  candidates;  and  stand  with  Ukraine  and  Moldova,  whose  health  systems  are  under 
enormous  strain  due  to  Russia’s  war  of  aggression  against  Ukraine  and  give  comprehensive 
support to post-war reconstruction efforts, modernising and re-building their health systems. 
  Deploy  the  EU’s  strengths  with  unique  regional  bodies  (like  the  European  Centre  for  Disease 
Prevention and Control (ECDC) and the European Medicines Agency (EMA)) that can collaborate 
with other regional initiatives worldwide, sharing EU data, science and knowledge, and benefit 
from  non-EU  expertise.  This  would  strengthen  collaboration  with  bodies  such  as  the  Africa 
Centres for Disease Control and Prevention, the African Medicines Agency, and similar entities in 
the neighbourhood and programmes in Latin-America, and the Indo-Pacific (such as the South-
East  Asia  Pandemic  Response  and  Preparedness  programme,  supporting  ASEAN  countries  in 
strengthening national capacity to control COVID-19). 

Guiding principle 18.  Strengthen engagement with key global health stakeholders 

Some  global  civil society  organisations,  philanthropic  organisations, global health initiatives  (such 
as  the  Global  Fund,  Gavi,  CEPI,  and  others),  other  UN  bodies  (including  UNFPA,  UNICEF,  UNAIDS), 
multilateral  development  banks  and  private  stakeholders  have  larger  funding  volumes  than  many 
donor  countries  provide  on  their  own.  Engagement  with  these  stakeholders  is  key  to  ensure 
coordination  and  complementarity  of  efforts.  Cooperation  with  all  types  of  civil  society 
organisations  (including  youth  organisations),  patients’  organisations,  social  partners,  parliaments, 
and  communities  more  broadly,  is  fundamental  in  enabling  the  EU  to  express  its  support  for 
solidarity  and  democracy,  and  its  focus  on  open  and  transparent  governance  and  human  rights. 
Equally 
localisation,  which  may  support 
effectiveness  of  action.  Finally,  the  role  of  the  private  sector  is  key  in  particular  in  the 
pharmaceutical,  biotech  or  med-tech  industries  and  for  digital  solutions,  to  help  improve  self-
sufficiency. 

is  engagement  with  communities  and 

important 

To develop this guiding principle, the following lines of action will be prioritised: 

 

 

 

Continue to build strong partnerships with global health stakeholders (i) advancing common 
priorities;  (ii)  helping  achieve  public  sector  objectives;  (iii)  ensuring  accountability;  and  (iv) 
avoiding fragmentation that may undermine the effectiveness of global health action. The EU 
will support efforts by these organisations to better coordinate their action, avoid duplication 
and  maximise  their  effect  on  the  ground.  The  EU  will  continue  to  advocate  for  strong 
collaboration and setting shared goals, for example under the Global Action Plan for Healthy 
Lives and Well-being for All84. 
Continue support to strengthen civil society as partners of the strategy and the role and voice 
of people in securing their own health including by holding governments and health providers 
accountable.  The  EU  will  extend  this  support  to  cover  community  participation  and 
engagement  across  health  processes.  Communities  are  key  and  localisation  may  support 
effectiveness of action.  
Ensure  that  the  private  sector  and  health  industries  are  appropriately  considered  and 
involved  in  its  various  forms  including  production  of  commodities,  service  delivery  and 
support.  

84 https://www.who.int/initiatives/sdg3-global-action-plan  

19 

 
 
 
                                                           
6.  Finance  

The COVID-19 pandemic made the  risks  related to underfunded health systems more explicit than 
ever. It has led to an unprecedented mobilisation of funding for global health and has increased the 
awareness  on  the  importance  of  preventive  actions  to  fight  pollution  and  protect  nature.  These 
financing  efforts  need  to  be  sustained  and  ensure  they  duly  contribute  to  better  health  and  well-
being of people, to stronger health systems, and to combatting health threats globally. 

The Commission will follow guiding principles, inviting Member States to do the same: 

Guiding principle 19. Enhance EU finance for global health with maximum impact 

The  EU  and  its Member  States  should  invest  in  global  health  in  a  predictable and  sustainable  way 
commensurate with needs and ambitions. Importantly, results will depend not only on how much, 
but  increasingly  on  how  we  finance  so  there  is  a  need  for  closer  monitoring  of  the  impact  of  EU 
financial  contribution  overall.  In  addition,  other  funding  sources  need  to  be  leveraged  including 
partners’ own contributions and also using novel finance instruments to match the high ambition set 
by the strategy.  

To develop this guiding principle, the following lines of action will be prioritised: 

  Prioritise  global  health  across  all  relevant  EU  budget  financing  programmes,  including  the 
EU4Health  programme,  Horizon  Europe,  the  NDICI-Global  Europe,  the  Instrument  for  Pre-
Accession Assistance and the Technical Assistance and Information Exchange instrument. Budget 
support will remain a key method, where appropriate, to steer national policies and reforms and 
ensure strong policy dialogue with partner countries.  

  Fulfil its commitment on financing for global health within the framework of the multi-annual 
financial  framework.  The  EU  has  committed  itself  to  allocating  at  least  20%  of  its  official 
development  assistance 
the 
to  human  development  and  social 
Neighbourhood,  Development  and  International  Cooperation  Instrument  –  Global  Europe 
(NDICI-Global Europe). Under the NDICI-GE, in the 2021-2027 period, the EU has programmed so 
far over EUR 4.4 billion86 in grants for global health at national, regional and global levels, which 
should duly unfold in line with this strategy.  

inclusion85  under 

  Seek new ways to financing with an effective Team Europe approach where EU and Member 
State resources can be pooled to achieve maximum impact. The EU will advocate for EU Member 
States to increase financing for global health in line with the priorities in the strategy. 

  Encourage  the  use  of  innovative  financial  instruments  and  build  on  the  European  Fund  for 
Sustainable Development Plus (EFSD+) that facilitates access to blended finance and budgetary 
guarantees.  A  specific  window  on  human  development  under  the  EFSD+  open  architecture 
provides  opportunities  to  leverage  further  investment  in  health.  Together  with  the  European 
Investment  Bank  and  the  European  Bank  for  Reconstruction  and  Development,  the 
Commission  intends  to  develop  a  framework  for  global  health  financing,  aligned  with  our 
priorities and those of our partner countries and respective mandates of both banks. Encourage 
participation of private investors where relevant and in line with EU priorities. 

  Prioritise  co-investment  initiatives  with  local  partners,  and  pooled  financing  with  other 
international stakeholders. The EU must shape the future of the various funds and initiatives by 
being  at  the  heart  of  their  governance  and  by  influencing  their  priorities,  financial  flows  and 
action. The EU will encourage and help domestic resource mobilisation in partner countries and 
efficiency as the most sustainable source of public financing.  

  Advocate for increased accessible finance for countries through multilateral development bank 
lending  and  for  increased  sustainable  finance,  for  example  through  special  drawing  rights  on 

85 european-consensus-on-development-final-20170626_en (5).pdf 
86 Subject to availability of funds in the annual budget procedures. 

20 

 
 
                                                           
lending to contribute to the International Monetary Fund (IMF) Poverty Reduction and Growth 
Trust and the IMF Resilience and Sustainability Trust.  

  Together  with  Member  States,  the  EU  will  promote  new  financing  methods,  including  debt 
swaps  or  loan  buy-downs  to  convert  debt  into  investment  in  health  system  reforms  and  new 
life-saving  programmes.  Such  transactions  could  be  facilitated  by  concessional  loans  and 
guarantees  in  partnership  with  development  finance  institutions  to  help  make  available 
government money and incentivise  health system reforms.  Increasing the  amount  of revenues 
raised  through  environmental  taxation  has  the  potential  to  reduce  debt  financing,  and  to 
mobilise  resources  for  public  health  services.  Countries  should  be  encouraged  to  ensure 
whenever possible, polluters bear the costs of their pollution. 

  Diversify  domestic  health  financing,  support  health  financing  and  system  reforms  both  in 
countries and across global health initiatives, and strengthen public expenditure management. 
  Monitor  health  expenditures  benefiting  low  and  middle  income  countries  (LMICs),  notably 
Official Development Assistance (ODA), trends in domestic financing and other donors funding.  

7.  Way forward: accountability through monitoring and evaluation 
Achieving  the  priorities  of  this  strategy  will  require  an  inclusive  and  comprehensive  process.  It 
relies  on  sustained  action  carried  out  in  a  Team  Europe  approach  and  strong  interaction  with 
partners  worldwide. Implementation of this strategy  will be  strengthened significantly by effective 
partnerships  with  Member  States,  partner  countries,  civil  society  including  youth  organisations, 
global  and  regional  stakeholders,  international  financing  institutions,  academia,  and  the  private 
sector.  
Guiding  principle  20.  Assess  progress  and  ensure  the  accountability  of  the  EU’s  global 
health action through permanent monitoring and assessment.  

To develop this guiding principle, the following lines of action will be prioritised: 

  Implementation of the strategy will be monitored using metrics and key indicators that will be 
developed in 2023 with the help of an EU4Health project, starting to monitor actions carried out 
as  of  2020.  Metrics  and  indicators  will  be  tied  directly  to  actions  and  health  outcomes  that 
respond to EU priorities, and will be made publicly available87. The aim is to assess the impact of 
our actions and funding and be able to adjust as necessary to achieve the ambition set by the 
strategy and meet EU priorities more widely.  

  The Commission will carry out a mid-term review and also a final evaluation of the strategy’s 

implementation in 2030.  

  The  Commission  will  keep  the  European  Parliament,  the  Council  and  civil  society  closely 
informed  about  financing  and  implementation  progress  by  organising  regular  high-level 
exchanges  and publication of a  report  in principle every two years. The EU will  notably  host  a 
structured dialogue with stakeholders as part of the annual Global Health Policy Forum process, 
to discuss implementation and make necessary adjustments. 

8.  Conclusion  

An ambitious global health strategy is crucial in a world where diseases have no borders – and where 
health  is  essential  to  protect  the  well-being  of  people,  guarantee  the  stability  of  societies,  and 
deliver sustainable development in a complex geopolitical landscape. 
Rooted in equity, solidarity and human rights,  powered by the spirit of partnership and fuelled by 
the  determination  to  strengthen  global  governance,  this  strategy  sets  three  policy  priorities, 

87 See project 5 in Annex 1. 

21 

 
 
 
                                                           
provides 20 guiding principles and defines concrete lines of action to contribute to better health for 
all in a changing world.  

Looking forward to 2030, this Strategy will strive to reverse the tide and regain the lost ground as to 
universal health targets in the 2030 Sustainable Development Goals by focusing our firepower on 
the  fundamental  issues  (health  systems  strengthening,  universal  health  coverage,  primary  health 
care,  public  health,  health  determinants),  tackling  workforce  imbalances  and  paying  particular 
attention to women, girls and vulnerable persons.  

Digitalisation  and research  will be  key enablers  and shape the ongoing digital transformation  and 
innovation potential in an equitable way. 

A  quantum  leap  in  health  security  will  be  achieved  with  a  permanent  mechanism  that  enhances 
equity in development of and access to tools such as vaccines, a global surveillance network which 
fully embodies One Health principles, and robust international rules, including enhanced measures 
to tackle anti-microbial resistance. 

The EU will continue showing leadership in global health and seek to shape the emerging new global 
health  order  with  a  more  effective  and  accountable  WHO  at  its  core  where  the  EU  has  formal 
observer status. Fill existing gaps in global governance with a permanent link between global health 
and  finance  efforts,  sustained  attention  by  top  political  leadership,  and  effective  funding  will  be 
novel  ways  forward.  Harness  the  impetus  of  global  health  stakeholders  and  private  initiatives  to 
advance  common  objectives—fighting  duplication  and  ensuring  coherence  of  action  in  the 
multilateral health system will allow a step change to ensure better health security globally. 

Our international partnerships will be expanded with the new Global Gateway focus based on co-
ownership  and  co-responsibility  by  our  partners  to  promote  health  sovereignty,  more  resilience 
and  autonomy,  allowing to target  those most  in  need  where  our  engagement  can  achieve  highest 
impact, and to deliver on our health priorities, matching broader EU interests. 

We will leverage the Team Europe approach with a genuinely single and powerful  voice, assuring 
synergy  between  national  and  EU  global  health  strategies,  mobilising  all  policies  (internal  and 
external) to work for global health, and ensuring close coordination with Member States so political 
action and financial means are tied to the new priorities. 

We will render our important financial contribution to global health even more impactful, through 
innovative finance, pooling of funding internationally, and co-investing by partner countries. 

The  establishment  of  a  robust  and  transparent  monitoring  system  that  maps  EU  efforts  and 
identifies impacts with the help of stakeholders, will ensure accountability of our action in the crucial 
area of global health and maximise EU support and influence capacity. 

The  Commission  calls  on  Member  States,  the  European  Parliament,  other  European  bodies, 
stakeholders and partners across the globe to join our efforts and turn this ambitious strategy into a 
reality, delivering better health for all in a changing world.  

22 

 
 
 
ANNEX 1: Key projects 

The non-exhaustive list of projects presented in this annex support the lines of action mentioned 
throughout this strategy.  

Projects 

Global projects 

1.  Set up a coordination system with EU Member States to ensure a powerful 
EU voice and leadership in global health in a Team Europe approach. Support 
by EU4Health envisaged. 

2.  Expand  the  existing  European  Antimicrobial  Resistance  Surveillance 
Network  into  an  integrated  surveillance  mechanism  covering  all  pathogens. 
Supported by EU4Health. 

3.  Leverage the potential of health data worldwide. Supported by EU4Health. 
4.  Foster mutually beneficial mobility arrangements with partners, including by 
supporting  partner  countries  in  training,  recruiting,  putting  into  action  and 
retaining  healthcare  workers  and  ensuring  their  professional  development 
through  education  as  well  as  vocational  training  programmes  for  auxiliary 
staff.  Supported  by  the  Neighbourhood,  Development  and  International 
Cooperation 
(NDICI-Global  Europe)  and 
EU4Health. 

Instrument  –  Global  Europe 

5.  Follow  up,  monitoring  and  evaluation  of  the  implementation  of  the  EU 
global  health  strategy,  publishing  a  report  in  principle  every  two  years, 
supporting continuous dialogue and involvement of key stakeholders. Support 
by EU4Health envisaged. 

6.  Support  the  United  Nations  Population  Fund’s  Supplies  Partnership  on 
reproductive  health  commodities,  helping  to  end  unmet  needs  for  family 
planning and preventable maternal mortality. Supported by the NDICI- Global 
Europe (EUR  45 million pledged). 

7.  Support the Global Fund against AIDS, tuberculosis and malaria, and health 
Europe 

the  NDICI-Global 

Supported 

by 

system 
(EUR  715 million pledged). 

strengthening. 

8.  Support  the  Universal  Health  Coverage  Partnership  administered  by  the 
WHO  to  advance  universal  health coverage  and  strengthen  health  systems 
in  partner  countries.  Supported  by  the  NDICI-Global  Europe  and  the 
Emergency Support Instrument (EUR 125  million programmed). 

9.  Support  Gavi,  the  Vaccine  Alliance  to  ensure  the  expanded  uptake  of 
vaccines  against  childhood  illnesses  and  increasingly  to  support  adult  health 
(for example by administering the human papillomavirus vaccine). Supported 
by the NDICI-Global Europe (EUR  300 million pledged). 

Indicative 
timeframe 

Second  half  of 
2023 

2023-2024 

2023-2024 
2023-2025 

2023 

2023-2027 

2023-2025 

2023-2027 

2021-2025 

10. Support  the  Pandemic  Fund.  Supported  by  the  NDICI-Global  Europe 

2023-2027 

(EUR  427 million pledged). 

11. Support the roll-out of COVID-19 vaccines in selected most under-vaccinated 
countries. Supported by the NDICI-Global Europe and the Emergency Support 
Instrument (EUR  375 million pledged). 

2023 

12. Support  research  and  development  of  vaccines  against  emerging 
including  through  the  Coalition  for  Epidemics 

infectious  diseases, 
Preparedness Innovations (CEPI). Supported by Horizon Europe. 

2021-2024 

Regional projects 

13. Team Europe initiative on Manufacturing and Access to Vaccines, Medicines  2021-2027 

23 

 
 
 
 
 
 
and Health Technologies in Africa to strengthen pharmaceutical systems and, 
together  with  health  industries,  the  regional  manufacturing  capacity.  EU 
contribution supported by NDICI-GE and other instruments. 

14. Team Europe initiative to improve sexual and reproductive health and rights 
in sub-Saharan Africa, particularly among adolescent girls and young women. 
EU contribution supported by NDICI-GE. 

15. Team  Europe  initiative  on  sustainable  health  security  using  a  One  Health 
approach in Africa to strengthen systems and capacities for sustainable, risk-
informed  prevention,  preparedness,  and  response  to  infectious  threats  and 
antimicrobial resistance. EU contribution supported by NDICI-GE. 

16. Team  Europe  initiative  for  Africa-based  public  health  capacity  through 
support to public health institutes in Africa, at national and regional levels and 
through partnerships between African Union and EU public health institutes. 
EU contribution supported by NDICI-GE. 

17. Team Europe initiative on digital health for health system strengthening and 
universal  health  coverage  to  support  strong  and  digitally  enabled  health 
systems in Africa. EU contribution supported by NDICI-GE. 

18. Support the Global Health EDCTP3 Joint Undertaking through a Team Europe 
approach and Team Africa coming to drive  forward new solutions to  reduce 
the burden of infectious diseases  in sub-Saharan Africa, also addressing the 
rising threat of  antimicrobial resistance  and climate-crisis-related infectious 
disease  challenges.  Supported  by  Horizon  Europe 
(EUR  800  million 
programmed). 

19. EU-Latin  America  and  Caribbean  Partnership  on  manufacturing  vaccines, 
medicines  and  health  technologies  and  strengthening  health  systems.  EU 
contribution supported by NDICI-GE. 

2022-2027 

2022 

2023 

2023 

2021-2027 

2022 

Bilateral projects   

20. Health system support and health system strengthening in partner countries 
to improve equitable access to essential care. List of countries where health is 
prioritised in the NDICI-GE multiannual indicative programmes: Egypt, Tunisia, 
Libya, Morocco, Democratic Republic of the Congo, Central African Republic, 
Burundi, Kenya, South Sudan, Sudan, Uganda, Madagascar, Ethiopia, Zambia, 
Zimbabwe, Nigeria, Mauritania, Guinea, Guinea-Bissau, Mali, Tajikistan, Laos, 
Afghanistan, Iran, Cuba, Palestine, Lebanon. 

24