Germany’s contribution to global health has been transformative – and as its new coalition government takes shape, now is not the time for it to weaken this commitment

Germany has long stood as a global leader, not just in public health but also in shaping international cooperation on health through platforms like the G7 and G20. 

With a deep-rooted commitment to strengthening global health security, combating antimicrobial resistance, and advancing universal health coverage, Germany has consistently prioritized health interventions that have transformed health systems and saved countless lives. 

It remains one of the most influential contributors to the World Health Organization (WHO), providing both expertise and funding, and hosts the WHO Hub for Pandemic and Epidemic Intelligence in Berlin, an initiative critical to enhancing global preparedness for future health threats.

As the fourth-largest donor to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and the third-largest contributor to the Pandemic Fund, Germany’s influence in global health is unmatched. 

According to the Organization for Economic Cooperation and Development (OECD), Germany ranks second globally in disbursements for global health, only behind the United States. 

In 2023 alone, Germany’s total disbursement for development assistance for health was $5.29 billion. Yet, despite these significant achievements, the work is far from over. Strengthening resilient health systems, particularly in vulnerable regions like sub-Saharan Africa, requires sustained commitment and leadership.

Concerning coalition talks

At a time when many nations are retreating from international cooperation in favor of domestic priorities, Germany’s unwavering commitment to global health has been particularly commendable. 

However, the coalition talks for a new federal government have been deeply concerning. Proposals to cut development spending – specifically the idea to eliminate the Development Ministry – would severely undermine Germany’s pivotal role in global health. 

Such cuts would disproportionately affect funding for critical health programs, particularly those addressing poverty, food security, climate change, and access to clean water–factors essential for improving health outcomes and building pandemic resilience in vulnerable regions like sub-Saharan Africa.

Beyond immediate health impacts, these cuts would exacerbate existing inequities, particularly among marginalized communities, reversing hard-won gains in economic empowerment and self-reliance. By increasing the number of people pushed into poverty due to health-related expenses and weakening progress in health outcomes, such a move would stall the momentum of economies that were beginning to make meaningful strides toward sustainable development.

It is no surprise that even senior politicians from the parties negotiating to form a new coalition government were raising alarms. 

Severely diminish influence

Reducing Germany’s development budget would not only jeopardize critical partnerships with non-governmental organizations (NGOs), which are vital in addressing the socio-ecological drivers of health, but would also severely diminish Germany’s influence in global health leadership. 

Weakening support for these initiatives poses a direct threat to public health efforts worldwide, at a time when global solidarity is more crucial than ever.

It seems like the alarm bells were heard, at least partially. The fact that the Development Ministry will not be folded into the Foreign Office is an encouraging development. However, it will require an adequate budget.

If cuts to development spending were to be implemented, this would leave a lasting impact–weakening Germany’s leadership in global health and ultimately putting public health efforts worldwide at risk. 

Health threats do not respect borders; a localized outbreak can quickly escalate into a global pandemic, as the world witnessed with COVID-19. Weakening health systems in one region endangers everyone, everywhere. 

Cutting health aid to Africa would not only compromise the continent’s ability to tackle diseases such as mpox, Ebola, and Marburg, but would also erode the resilience of health systems and weaken global health security.

Cost of cutting aid

Cutting aid to global health now is not a sustainable savings strategy – it is a recipe for future disaster at a much greater cost. Development assistance funds some of the most cost-effective health interventions in the world, including vaccinations, maternal and child health services, and malaria prevention. 

A single dollar invested in primary health care in Africa often yields disproportionately high returns in lives saved and economic productivity. Without this investment, the consequences are dire: medicine stockouts, disruption of lifesaving services, and the resurgence of preventable diseases.

Foreign aid has already been instrumental in significantly reducing child mortality, controlling HIV/AIDS, and improving maternal health across sub-Saharan Africa. Rolling back this support now risks undoing decades of progress. What took years to build through public-private partnerships, local capacity building, and health systems strengthening could unravel in mere months.

Africa’s health financing gap

While Germany’s leadership in global health is evident, the reality of Africa’s health financing gap is staggering. The continent faces a $66 billion annual health funding shortfall, which has been exacerbated by the recent USAID funding terminations and stop work orders. 

Even with the Abuja Declaration, which calls for African countries to allocate 15% of their budgets to health, it is still insufficient. 

Sub-Saharan Africa’s combined GDP stands at about $2 trillion, with an average tax revenue of 15% of GDP, amounting to roughly $45 billion for healthcare spending for a population of 1.2 billion people. This works out to about $40 per capita – which pales in comparison to the $4,000 spent per capita in Europe.

Germany’s potential cuts would exacerbate this gap, leading to greater vulnerability, particularly in the face of pandemics. This underscores the need for sustained investment in global health. 

At the recent Africa Health Agenda International Conference (AHAIC) 2025 in Kigali, stakeholders from across the globe emphasized the importance of reframing health as an investment, not a cost. Strengthening health systems through cross-sectoral partnerships is crucial to building self-sustaining and resilient systems across Africa. 

Equally important, these systems must be intentionally redesigned to foster equity, promote respectful collaboration, and prioritize the creation of genuine, inclusive partnerships.

Call for continued commitment

Germany’s contributions to global health have been transformative, and its leadership has set a strong foundation for resilient health systems worldwide. 

However, the work is not yet complete. Addressing today’s global health challenges requires open, collaborative partnerships – not solitary efforts – and shared responsibility for designing impactful programs. 

While economic pressures understandably require difficult choices, cutting development funding now would risk reversing decades of progress, putting both African and global populations at greater risk.
The lessons from COVID-19 are clear: global solidarity and preemptive investment are non-negotiable in preventing future health crises.

Germany must maintain its leadership and reaffirm development finance as a vital pillar of its foreign policy. Now is the time for the incoming government coalition to strengthen – not weaken – Germany’s commitment to global health, ensuring that the mistakes of the past are not repeated.

Dr Githinji Gitahi is the Group CEO of Amref Health Africa.

Ralph Achenbach is the  Executive Director of Amref Health Africa Deutschland