Under Germany’s tightly constrained draft budget proposal for 2027, the government is set to reduce global health funding substantially. While mandatory assessed contributions to the World Health Organization (WHO) will rise slightly, flexible budgets for pandemic preparedness are planned to be cut by 15.3%. 

As part of a broader budget overhaul, the German government is planning drastic cuts to its global health funding. While the overall draft budget for 2027 is set to expand by 5.9% to a total of €555.4 billion, driven by increased defence spending, Finance Minister Lars Klingbeil is enforcing strict fiscal discipline in other policy areas.

Consequently, the government is set to allocate significantly less funding to flexible funds for pandemic prevention than the previous year – a decision arriving in the midst of the fastest-growing Ebola outbreak ever recorded.

At the heart of proposed cuts to the Federal Ministry of Health’s (BMG) budget under the newly appointed Health Minister Carsten Linnemann is a reduction of the international health allocation by around €8.5 million (7.4%) to €106.42 million.

This affects almost exclusively the central operational fund for strengthening international public health, which Berlin is planning to slash by 15.3% to €47.33 million.

This flexible fund supports the fight against antimicrobial resistance (AMR), capacity-building in the Global South and the Joint United Nations Programme on HIV/AIDS (UNAIDS) – which is slated to receive up to €6 million, down from €6.75 million the previous year – as well as voluntary contributions to the WHO, which also support outbreak responses.

But the concrete effects of these cuts on most projects cannot be directly mapped because the majority of Germany’s support to the WHO is provided as unearmarked funding, a BMG spokesperson explained, responding to an enquiry by Health Policy Watch. Despite the cuts, the ministry emphasises that “international health security, pandemic prevention, and resilient health systems remain key priorities.”

Health Ministry defends budget plans

The Health Ministry defended the budget draft against concerns over the funding rollbacks, underscoring that the ministry is “contributing to the demanding fiscal framework.”

A spokesperson emphasised that Germany “remains an important supporter and reliable partner of the WHO and a central actor in global health,” noting that alongside “continuing substantial funds for strengthening international public health,” its assessed contributions to the WHO are being “reliably paid” and funding for the WHO Pandemic Hub in Berlin is maintained at its existing level.

The Pandemic Hub will again receive €15 million after a cut of 50% last year. Germany’s assessed contributions to the WHO in Geneva are planned to gradually rise to around €34.39 million from €34.32 million the previous year.

Since the US’s withdrawal from WHO, the Federal Republic has become the largest government contributor.

Additionally, the draft allocates €298,000 as a mandatory contribution to the new global pandemic agreement. It also channels funds into special WHO agreements such as the Framework Convention on Tobacco Control (FCTC) (€291,000) and the Protocol to Eliminate Illicit Trade in Tobacco Products (€413,000).

The Federal Ministry for the Environment (BMUV) is also maintaining its payments to the WHO European Centre for Environment and Health in Bonn at a constant level of €3.42 million.

Contributions to Global Fund and Gavi drop slightly

Allocated through the Federal Ministry for Economic Cooperation and Development (BMZ), funding for Gavi remains at the previous year’s level of €80 million, leading to a slight decline in real terms due to inflation. Germany’s contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria falls from €288 million to €286 million.

A BMZ spokesperson defended these figures, explaining that Germany remains the second-largest government donor to both organisations. The ministry emphasised that its long-term, multi-year pledges, including €1 billion to the Global Fund for 2026–2028 and €600 million to Gavi for 2026–2030, will be “fully implemented” in 2027 with “no cuts” or changes to the agreed disbursement schedules.

Funding the central pillars of global health across different ministries follows the logic of Germany’s “whole-of-government” approach. This establishes global health as a cross-departmental priority – but in times of budgetary pressure, it leads to simultaneous adjustments across various areas of the federal budget.

Shift in geopolitical realities

The new draft budget cements the shift in political priorities resulting from Russia’s war of aggression in Ukraine. Under Chancellor Friedrich Merz, the federal government is taking out new loans totalling just over €118.7 billion.

However, with the majority of this borrowing headroom – €85.4 billion – earmarked for defence and security, other ministries are being forced to absorb the pressure of Germany’s constitutional debt brake. The Basic Law limits the federal structural deficit to a mere 0.35% of Gross Domestic Product (GDP), which is particularly strict in challenging economic times.

Overall, the draft subordinates international cooperation and multilateral contributions to national interests and measurable geopolitical benefits. New guidelines issued by the Federal Ministry for Economic Cooperation and Development prescribe a clear “strategic orientation towards German interests.”

The Health Ministry takes a similar approach, now strengthening bilateral partnerships abroad only where there is a “clear federal interest,” and gearing its global engagement primarily towards protecting the population in Germany.

Policymakers warn against global health funding cuts

Although leading German global health politicians recognise the need to set budget priorities, they warn against the consequences of the cuts.

Sascha van Beek, a centre-right Christian Democratic Union (CDU) Member of Parliament and the rapporteur responsible for global health, argues that fiscal constraint requires smarter, more effective spending.

“The budget situation forces us to set priorities and also critically review existing expenditures for their effectiveness,” van Beek explains in response to an enquiry from Health Policy Watch.

“At the same time, I consider it wrong to view global health solely as a voluntary international commitment. Pandemic prevention, the fight against infectious diseases and antimicrobial resistance, as well as high-performing health systems in our partner countries, are in Germany’s and Europe’s direct interest.”

While continued support for the Global Fund and Gavi is important, he considers the cuts to flexible funding in particular to be risky: “We must not skimp on prevention if the next health crisis ends up costing us many times over,” van Beek explains.

His colleague on the public health committee, Serdar Yüksel – rapporteur for the centre-left Social Democratic Party (SPD) – echoes this sentiment. “It is precisely these flexible project funds that enable Germany to make a difference where help is needed quickly and in a targeted manner. Anyone who wants to strengthen the WHO must not, of all things, withdraw its flexible funds,” the health policy expert explains.

He also warns of the devastating signal sent by the gradual erosion of global alliances. Freezing contributions to organisations like Gavi or the Global Fund, causing them to lose real-terms value, directly undermines the effectiveness of life-saving partnerships on the ground, he warns.

The battle for scarce resources

Both health policymakers have announced their opposition to the budget plans in the imminent negotiations. Van Beek stresses that every cut must be scrutinised to determine whether it would weaken key structures for pandemic prevention.

Yüksel takes a more uncompromising stance, emphasising that the planned reductions should not be implemented.

As members of the governing parties under the federal government led by Chancellor Merz (CDU) and Finance Minister Klingbeil (SPD), both policymakers will have significant leverage in the budget negotiations.

Whether they can adjust the federal government’s priorities remains to be seen in the coming months. Following the first reading of the draft budget in the Bundestag on September 8, further debates will take place in the plenary session and in the Bundestag’s Budget Committee.

The Bundestag expects to finalise the budget in late autumn.

Image Credits: Claudia Solano via Pexels, Felix Sassmannshausen/HPW, Bundestag/Thomas Imo, Sascha van Beek/Niclas Brosthaus, Photothek Media Lab.