At the end of June, the European Commission published a public consultation about the renewal of its global health strategy (GHS), which should be adopted by the end of the year. Global Health Advocates, which has been advocating for this process for a long time and had even co-written a shadow GHS in 2020, has submitted its contribution. All ACTION African members, namely ASAPSU, CITAMplus, FENOSCI, Health Promotion Tanzania (HDT), KANCO, Princess of Africa Foundation, and WACI Health, also endorsed our contribution.
For the Global Health Strategy to make a positive impact beyond EU borders, GHA calls on this GHS to be anchored in a vision of equity and of fairness to target systemic inequalities. We thus have shared four main messages to support our vision:
- Improving access to medicines
The GHS should promote improved access and affordability to health services and products, and set clear objectives to improve their coverage. The lack of access to affordable, quality medicines, tools, vaccines, medical technology & diagnostics is a barrier to health for all, which the EU must strive to lift by supporting local manufacturing and technology transfer. We call on the EU to support the development of equitable access to quality, safe, effective, affordable & essential medicines, vaccines, diagnostics and technologies in partner countries.
EU health policies must be needs-driven in partner countries, instead of profit-driven. A bottom-up approach is the privileged way to ensure that the needs are taken into account: we therefore call on the EU to better integrate and support the EU Delegations in coordinating with the local civil societies and communities, including grassroot, youth and women-led organizations.
- Reaffirming health as a public good
The pandemic has highlighted the disparities between countries in terms of access to healthcare, and the global response to the pandemic has excluded vulnerable populations from access to vaccines, tests and treatments – especially in the Global South. The collective failure to safeguard vaccine equity against maximization of profits has challenged our common ability to promote accessible and affordable healthcare for all.
The EU must use the revision of its GHS to reaffirm health as a public good and spur investment in primary healthcare and services. This stance must be accompanied by relevant policies: the EU must systematically promote, support and enforce principles of conditionality, transparency, accountability and access – especially in its relations with its partners. In the field of research in particular, the EU must promote access to countermeasures and attach access conditionalities and open science principles to EU funding for biomedical research and innovation. These measures are fundamental to progress towards UHC and to guarantee that health remains accessible and affordable for all.
- Building self-reliant health systems
Reaching Universal Health Coverage means putting in place solid, efficient and resilient health systems, but the pandemic has evidenced that many of our health systems were weakened from decades of chronic under-financing. Since most epidemics occur in fragile contexts, ensuring access to basic health services and investing further in primary healthcare (PHC), including PHC facilities, is a priority that requires greater attention and coordination with other stakeholders.
The GHS should therefore help build self-reliant systems in all countries, and encourage investments in PHC and basic healthcare services. The EU’s ambition to improve its own health independence is understandable, but this goal should also be reflected in this strategy by supporting and contributing to the building of health sovereignty and autonomy of the EU’s Global South partners. Building public health capacities in partner countries needs to be at the top of the global health agenda through greater financial support.
- Enforcing policy coherence
“Health in all policies” and policy coherence are fundamental to give the GHS a chance to have a meaningful impact and to foster positive change. As we wrote in our contribution, the global health strategy encompasses many policies, including health, development, and R&D: more collaboration between DGs INTPA, SANTE, TRADE, RDT and HERA is thus needed. But despite the EU’s “health in all policies” approach, the EEAS, DG ENV and CLIMA do not seem to prioritize global health: this should be addressed by the GHS. Overall, since promoting global health can create tension across all sectors, the EU should define global health-related roles and responsibilities for each DG in this new GHS to enhance coordination and coherence across EU policies.
It also means that policy areas such as international partnerships, trade, R&I and digitalisation must be informed by health risks and stakes, and must be adequately and sufficiently financed to fit and to respond to the global health needs.
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