The European Global Health Strategy: key points for an effective and realistic initiative

The European Alliance for Responsible R&D and Affordable Medicines (henceforth, the Alliance) welcomed the initiative of the European Commission to renew the European Global Health Strategy, and the opportunity to provide feedback on the public consultation.

The current EU Global Health Strategy from 2010 has shown deficiencies when responding to the major recent challenges (COVID-19 pandemic, antimicrobial resistance (AMR), and Monkeypox, among others), underlining the urgent need for improvement. Within this context, and from the broad area of expertise of its members, the Alliance highlighted the following key points in its response to the public consultation:

• A successful and comprehensive strategy should prioritise global health research and development (R&D), which would include more investments in need-driven R&D, with attached binding conditions to guarantee transparency and the rapid publication of research results in openly accessible formats, to ensure access to affordable medicines. Improved alignment and coordination of European research opportunities with global health policy objectives would also ensure greater effectiveness and impact of EU research spending.
• Intellectual Property (IP) incentives are also crucial to have policies which include access to provisions, public return on public investment, fair prices, and transparency. The EU should increase collaboration with Medicines Patent Pool to ensure its licenses truly lead to global access to medical tools by equally benefiting all countries and supporting universal health coverage by limiting monopoly abuses.
• The current Global Health Strategy calls for more effective use of existing flexibilities for Trade-Related aspects of Intellectual Property Rights (TRIPS) provisions in support of global health, which could improve affordable access to life-saving medical tools. However, DG TRADE has pushed for free trade agreements (i.e. South Korea) that undermine equitable access to life-saving medicines. The EU needs to provide a clear vision on how more coherent action across EU policies could be monitored, starting by defining global health’s related roles and responsibilities for each DG.
• The lack of balance between corporate power and public interest should be urgently tackled since it often tends to prioritise profits over societal impacts. The pharmaceutical, alcohol, tobacco, and some food industries have the power to set the public agenda, undermining health policies with, for example, monopolies on the most advanced tools and technologies (artificial intelligence, mRNA technology, blockchain, etc.). The new strategy needs to set healthy governance structures within EU global health instruments including R&I in order to address this imbalance of power and ultimately serve the general interest.
• The EU should strengthen bilateral partnerships that support the creation of sustainable systems for health with African countries and African Union bodies & agencies. It should support partners, as and when requested by them, in line with their human rights obligations. Central to this support should be measures that strengthen health systems and primary health care, the regulatory framework for medicine approval, the expansion and empowerment of health R&I networks, technology transfer and local production of health products. The EU must commit to the principles of ownership and solidarity.
• The European Health Emergency Preparedness and Response Authority (HERA), should lead by example in supporting low and middle-income countries by building expertise, developing manufacturing capacities, and facilitating technology transfer. Furthermore, HERA has the potential to become a truly global project, and as such the new authority should set high standards of transparency and accountability, and when performing joint/advance purchase agreements, it must ensure access conditions are attached so that medical tools funded with public investments become global public goods.
• The World Health Organization (WHO) and other global initiatives should be further strengthened by more effective governance and adequate financing. This includes a binding pandemic instrument and reinforced International Health Regulations (IHR). The EU should increase its political and financial support to the WHO to enable it to fulfil its mandate, including strengthening its role as a normative leader, expanding the WHO-UHC Partnership (Universal Health Coverage), strengthening the WHO mRNA vaccine technology transfer hub, and Global R&D initiatives. Furthermore, the EU should champion the implementation of the WHO 2019 transparency resolution through the revision of its pharma legislation and be an active player in the Fair Pricing Forum.
• Annual engagement in the Global Health Policy Forum, together with structural and effective channels of dialogues between policymakers, national and European authorities, and civil society organizations (CSO) would lead to further inclusion, integration and implementation of this new strategy. Support to Civil Society Organizations, meaningful engagement with CSO as well as sufficient and reliable financial aid (i.e., operating grants by the European Commission) to ensure their independence and contribution to the policymaking process.

The Alliance celebrates the EU approach, Health In All Policies, and appreciates the efforts of European policymakers in fostering global health. With the spirit of collaboration and mutual support, we encourage the European Commission to double their efforts and political will towards an effective, realistic and ambitious new Global Health Strategy which offers solutions and tools to tackle not only the current challenges but also the potential ones.