Key Takeaways
| Foster genuine cooperation with Global South countries: Germany must move from outdated donor-recipient models towards equitable cooperation. Co-managed health funds and stronger local agency will restore trust and ensure sustainable capacity building. |
| Promote fair access through flexible policies on intellectual property (IP): Germany should push for patent waivers and fair licensing in health emergencies, ensuring equitable access to life-saving treatments while maintaining incentives for innovation. |
| Europeanize Germany’s Global Health Strategy: The new German government should use the upcoming review of its Global Health Strategy to align the country’s efforts with EU priorities, improve coordination, and enhance impact. |
The online version of this Policy Brief does not contain footnotes. To view the footnotes please download the pdf version here.
Global Health in an Era of Geopolitical Shifts
Health, despite being a fundamental global common, has fallen off the international agenda. Under President Donald Trump, the United States is once again withdrawing from the World Health Organization. Lessons to be learnt from COVID-19, once an urgent priority, remain more theoretical than practical. Negotiations for a Pandemic Treaty, which was meant to unify the world in preventing future crises, are stalling, and rifts between the Global North and South have emerged. Instead of demonstrating collective resolve, the struggle to reach a consensus signals the opposite. Yet it is clear that ignoring the far-reaching consequences of the pandemic and the links between health, security, and economic stability will undermine long-term resilience.
In a world marked by geopolitical shifts, crises, and distrust, Germany maintains a strategic interest in safeguarding global governance structures. Global health can serve as a bridge for fostering trust and international cooperation – particularly with the Global South – across governance fields. Germany should leverage is commitment to an effective global health system to rebuild trust, foster equitable partnerships with the Global South, and align its national interests with global responsibility, thereby contributing to a more stable and cooperative world order.
Global Health Matters for Germany
Health is a global common that transcends political divisions, ideological boundaries, and geopolitical rivalries. As health crises do not respect borders, every nation, regardless of its political system or ongoing conflicts, has a vested interest in a resilient global health architecture. This shared imperative offers a platform for cooperation even at a time of strained international relations. At the same time, collaborative efforts to prevent pandemics, improve disease surveillance, and secure equitable access to treatments foster trust and open communication. Such trust, initially built around health, has the potential to carry over into other policy areas, creating pathways for renewed global engagement. As a result, engagement in health cooperation can help build the foundations for greater global cooperation and solidarity.
A Moral and Strategic Imperative
Germany should prioritize support for global health efforts. From a moral perspective, health is a global common that transcends borders. Diseases do not respect political divisions; equitable access to healthcare is a fundamental right. Germany and Europe, committed to values of solidarity and fairness, have a responsibility to act. Moral engagement in health cooperation can build the foundations for greater global solidarity, fostering goodwill that may carry over into other policy areas.
Beyond the moral aspect, Germany also has a political self-interest in promoting multilateral cooperation in health issues and beyond: As a middle power with limited military capabilities, the country’s global influence depends on the respect given to the rules-based international order. Unlike great powers that can unilaterally project force to secure their interests, Germany depends on multilateral institutions, international law, and economic power to resolve conflicts and maintain its strategic position. At the same time, Germany’s strong commitment to international norms reinforces its credibility as a diplomatic actor, allowing it to shape global governance in ways that align with its interests and values.
Beyond diplomatic and security considerations, Germany’s prosperity is at stake. As an export-driven and resource-scarce country, Germany depends on an open global economy, stable trade relationships, reliable supply chains, and fair access to global markets. A functioning multilateral system reduces economic volatility and mitigates risks associated with protectionism, unilateralism, and geopolitical fragmentation.
Against this backdrop, global health has the potential to emerge as a key instrument for strengthening multilateral cooperation. Health initiatives provide a platform for fostering trust, reinforcing international institutions, and demonstrating the tangible benefits of collective action. By investing in global health governance, Germany can contribute to the stability of the broader international system – one that is essential for its own security, economic resilience, and global standing.
Engaging with the Global South
Germany’s relations with the Global South are of growing strategic importance. With growing populations, expanding economies, and greater political agency, the Global South is emerging as a key sphere for global political and economic cooperation. Its countries are no longer passive recipients of aid but active players in global governance. For Germany, maintaining strong ties with the Global South is essential to safeguarding its economic interests, securing reliable supply chains, and sustaining its position as a leading voice in international diplomacy.
Germany’s engagement should be based on genuine, equitable partnerships
Global health partnerships can play a crucial role in shaping Germany’s engagement with the Global South. As emerging nations gain influence in international politics, equitable and trust-based cooperation on health issues can serve as a foundation for deeper political and economic partnerships. A sustainable and inclusive global order requires cooperation that is not merely transactional but built on mutual benefit.
Germany’s engagement with the Global South should be based on genuine, equitable partnerships that reflect shared values and global responsibilities. It should also be framed within a broader commitment to global stability and collective prosperity. This aligns with Germany’s self-perception as a value-driven actor and its historical commitment to multilateralism.
At the same time, it is crucial to acknowledge the vast diversity within the Global South. Emerging economies such as India, Indonesia, and South Africa are increasingly influential players in global governance, capable of shaping international norms and policies. By contrast, many smaller, low-income nations continue to face structural challenges, including deepening economic disparities and limited political leverage on the global stage. Germany must therefore adopt a differentiated approach, tailoring its multilateral engagement to the specific needs and capacities of each partner. This means recognizing the agency of emerging powers while ensuring that more vulnerable nations are not left behind in global decision-making processes.
A History of Strained Relationships
Historically, promoting global health has been framed as a form of soft power. Humanitarian aid for Global South countries has often been perceived as a charitable endeavor by wealthier nations rather than as a strategic, mutually beneficial partnership. This has reinforced a donor-recipient model, creating a system of dependency and mistrust, thereby undermining efforts to establish equitable, long-term collaborations that prioritize capacity-building and local ownership.
The COVID-19 pandemic dramatically exacerbated these challenges. The Global North’s approach to vaccine distribution was starkly unjust, with wealthier nations stockpiling life-saving doses while countries in the Global South faced prolonged shortages. This phenomenon, which WHO Director-General Tedros Adhanom Ghebreyesus referred to as “vaccine apartheid,” became a defining symbol of broken global solidarity. Germany, despite its reputation as a value-driven donor, was perceived as complicit in these inequities. The prioritization of booster campaigns in Europe over equitable vaccine access for developing nations further eroded trust in North-South relations.
In the light of these challenges and the global shift towards more nationalistic approaches, it is essential to weigh the potential short-term costs of a fair and equitable engagement against the long-term strategic benefits: A balanced approach recognizes that credibility and influence in the Global South enhance Germany’s ability to shape international norms, secure reliable partnerships, and safeguard economic and political stability.
In addition to these long-term advantages, there are also significant short-term benefits. Strengthened health cooperation reduces the risk of infectious disease outbreaks reaching Germany, ensures public health security, and minimizes economic disruptions. A well-functioning global health system also prevents supply chain breakdowns which would directly impact German industries.
Addressing the Global South‘s Priorities
To effectively utilize global health as a bridge for strengthening international partnerships, Germany must align its efforts with the priorities of the Global South. Building on strategic commitments such as the Global Health Strategy 2020-2030 and Germany’s Africa Strategy 2023, Germany has already taken concrete steps to support health partnerships with countries on the African continent. Beyond the moral argument, their regional proximity as well as their resource richness and growing economic importance make them ideal partners for Germany. However, to maximize impact, Germany must expand partnerships beyond Africa to include other emerging economies in the Global South, such as India, Brazil, and Indonesia. These nations, given their well-developed healthcare systems and increasing political influence, present opportunities for mutually beneficial cooperation.
By moving beyond traditional donor-recipient dynamics and engaging in co-managed health projects, joint research, and knowledge exchange, Germany can foster stronger and more sustainable partnerships. These efforts align with the African Union’s Africa Health Strategy (AHS) 2016–2030, which emphasizes pan-African, locally driven health solutions. Given that African countries currently produce only three percent of global medicines, African nations are seeking to enhance self-reliance. They are looking for stable, long-term partnerships focused on technology transfer, research collaboration, and financial support from high-income countries.
Rebuilding trust with the Global South is key to transforming global health
Some of that is already happening. Germany is collaborating with the European Union and other partners to establish an mRNA vaccine production facility in Rwanda. German and European support has also been important for the efforts made by the Africa Centres for Disease Control and Prevention (Africa CDC) to enhance health security across the continent.
These initiatives highlight Germany’s and Europe’s commitment to equitable health partnerships in Africa through a multifaceted approach, including institutional support, infrastructure investment, and research collaboration. However, they are only part of the broader challenge. Germany must go beyond these initial steps and address structural imbalances, ensure sustainability, and reinforce multilateral frameworks.
Recommendations
The following recommendations can help Germany solidify its role as a trusted global health partner:
1. Foster Equitable Partnerships
Rebuilding trust with the Global South is key to transforming global health from a donor-driven model into a true and equitable partnership. Germany – and the EU – must reframe their engagement through mutual respect, shared decision-making, and a “listening-first” approach. Institutionalizing high-level dialogues with the African Union and other key actors will align initiatives with local priorities, thereby ensuring relevance and impact. Integrating global health objectives into broader European strategies on trade, digital innovation, and sustainable development will further reinforce the EU’s commitment to long-term, trust-based cooperation in a multipolar world.
2. Set up a Joint Health Fund
Germany’s current portfolio in global health investments already includes projects such as the mRNA vaccine production facility in Rwanda and robust support for the Africa CDC. These initiatives show that technology transfer and local capacity building are essential to reduce dependency on external supplies. However, to move from short-term interventions to sustainable, long-term capacity building, Germany and its European partners should establish joint health funds co-managed with Global South partners. Such funds would focus on technology transfer, research collaboration, and infrastructure development, thereby ensuring that African stakeholders have equal influence over project design and implementation.
The Gavi model offers a powerful example. Gavi’s approach is built on empowering developing countries to identify their immunization needs and implement and co-finance vaccine programs. By including representatives from developing countries on its board, Gavi has successfully shifted the dynamic from a donor-recipient-relationship to a partnership. Germany should adopt similar governance mechanisms for its global health initiatives. The proposed health funds could, for instance, mirror Gavi’s co-governance model, ensuring that African partners set the priorities and oversee the implementation of projects. This approach would not only increase local ownership and accountability but also foster trust and ensure that initiatives are responsive to local needs and sustainable in the long term.
3. Address Intellectual Property Barriers
For such partnerships to be truly effective, the structural barriers must be addressed. A major obstacle in global health cooperation and the North-South relationship is the rigid intellectual property (IP) framework that limits access to essential medicines. The case of sofosbuvir illustrates how prohibitive licensing fees and strict patent regimes prevent life-saving treatments from reaching those who need them. Germany, as a leader in pharmaceuticals and innovation, has the means to bridge this divide. By promoting flexible IP arrangements both within the EU and for the Pandemic Treaty, such as temporary patent waivers or compulsory licensing schemes during health crises, Germany can establish itself as a reliable partner for the Global South. India and Brazil have shown that such measures can work.
To satisfy industry concerns, Germany should engage with pharmaceutical stakeholders to develop incentive-based solutions, such as tax benefits, co-investment opportunities, and technology transfer commitments linking financial gains to global health responsibility. Public-private partnerships can also play a role in making essential medicines more affordable, as the case of Gavi proves. By championing a more adaptable IP framework, Germany can reduce structural health barriers, strengthen diplomatic ties with the Global South, and reinforce its leadership in responsible innovation.
4. Leverage Multilateralism and Strengthen European Coordination
In today’s multipolar world, unilateral action is no longer effective. Germany’s strategic interests are best served through robust multilateral engagement and close coordination with its European partners. Germany’s global health strategy review in 2025 presents an opportunity for the new German government to better align its approach with European partners and the EU. Currently, the health strategies of EU member states and the EU’s global health strategy reflect different priorities and operate in isolation, which limits their impact. To improve coherence, Germany should push for stronger EU coordination and a structured division of responsibilities among member states. Integrating the strategic priorities of key European partners into Germany’s approach would create synergies, while structured diplomatic and technical exchanges would strengthen Europe’s collective health leadership.
