Komisjoni teatis - COM(2026) 197

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EUROPEAN COMMISSION

Brussels, 13.5.2026

COM(2026) 197 final

COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN

PARLIAMENT AND THE COUNCIL

Reinforcing global health resilience amidst geopolitical change

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Introduction

Over the last quarter-century, health outcomes have improved significantly in most countries.

Global life expectancy has increased by more than five years; the child mortality rate has halved

and maternal mortality fell by around 40% between 2000 and 2023 (1). This progress has been

driven by economic growth, innovation and sustained global health financing. It has been the

result of political leadership, of the work to consolidate national health strategies and

institutions, and of the rise of influential and effective global health institutions. The progress

has been substantial, but in recent years it has slowed and remains insufficient to meet

global targets (2),andpersistent gender inequalities in health outcomes remain.

Health is increasingly instrumentalised in the pursuit of geopolitical and geoeconomic

interests. Global health governance is shifting away from multilateral cooperation and

humanitarian principles towards at times overtly transactional bilateral approaches.This

challenges the provision of global public goods for health, a need that transcends national

borders and requires global-level dialogue, coordination and predictable financing. Health is

increasingly strategic for industrialand security policies. Societies also face a rise in health-

related disinformation, misinformation and Foreign Information Manipulation and

Interference (FIMI) that go against scientific evidence, erode public trust in science and

undermine evidence-based public health measures.

At the same time, global health financing is fragmented and declining sharply in real terms.

Development assistance for health fell by 21% between 2024 and 2025, from approximately

EUR 45.8 to EUR 36.1 billion, with further declines projected through 2030 (3). This situation

exposes gaps in health systems worldwide, particularly in low-income countries and fragile

contexts (4). Long-standing calls to create a more efficient health architecture at national,

regional and global levels are increasingly gaining momentum. This includes a model that

empowers communities, boosts self-resilience, enhances country ownership and promotes

greater financial and policy responsibility (health sovereignty), while supporting effective

multilateral cooperation and humanitarian assistance.

From a public health perspective, the frequency and intensity of disease outbreaks are

increasing globally. This trend is driven by changing epidemiological patterns, climate change,

environmental degradation, biodiversity loss and pollution, antimicrobial resistance, food

insecurity or insufficient access to clean water and sanitation and clean and affordable energy.

As health threats transcend borders, shortcomings in health systems in one part of the world

heighten risks to the well-being and lives of people in the EU and across the entire world,

particularly the most vulnerable. The risk is also that essential health services, critical to

preventing avoidable mortality and morbidity, are disrupted. Ultimately, all this undermines

sustainable development, the prosperity of our societies today and the well-being of our future

generations.

It is therefore crucial to close the emerging gaps in global health resilience (5). The EU

remains committed to continue contributing to stability and collective action on global health.

This Communication sets out the EU’s vision on how to work with countries worldwide to

tackle the above challenges together with EU Member States, multilateral institutions, civil

society and partners. It sets out proven solutions from the EU healthcare model, while

(1) WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division, 2025.

(2) Such as the health-related targets of the Sustainable Development Goals.

(3) IHME, 2025.

(4) OECD, 2026. (5) Health systems resilience is understood as the ability of systems, communities and institutions to prevent, prepare for, absorb, and adapt

to a wide variety of shocks and stressors, while ensuring the continued provision of quality essential health services (WHO, 2024).

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maintaining strong multilateral engagement. Coordinated and impactful EU action, with

the support of EU delegations and other partners such as the European financial institutions

and national development agencies, will continue in support of health priorities of partner

countries in areas ofmutual interest and in full respect of international rules, humanitarian

principles, intellectual property and the principle of voluntary technology transfer on mutually

agreed terms, while promoting the provision of global public goods for health. Partnerships are

inherently reciprocal and bring opportunities to collectively learn from partners’ experiences,

exchange on research, adopt innovative approaches and strengthen global health resilience and

the EU’s own health resilience. These partnerships also contribute to advancing the EU’s

strategic autonomy, competitiveness and economic security in line with several key policies

such as the EU Competitiveness Compass (6). They benefit from a strengthened industrial base

in the EU and provide opportunities for the EU private sector, while supporting partners to

develop resilient, sustainable and inclusive health systems. A vibrant, competitive and

innovative EU health industry is a core pillar of EU and global health resilience.

This Communication builds on a range of established policies and initiatives. The European

Health Union aims to better protect the health of EU citizens, prevent and manage future health

crises, and improve the resilience of EU health systems. The EU has put in place a

comprehensive framework to tackle infectious diseases prone to causing epidemics and

pandemics, as well as additional health threats. Complementing this, the Preparedness Union

Strategy (7)strengthens the EU’s capacity to anticipate, prevent, detect, and respond to cross-

border health threats, fostering a more coordinated and resilient approach to crisis

preparedness. The EU Global Health Strategy (8) sets out a comprehensive vision for the

EU’s role in global health, anchored in universal health coverage, equity, strengthening health

systems and global health security, and promoting a One Health approach, which recognises

the intrinsic connection between human health, animal health and healthy resilient nature.

Complementing this framework, the Global Gateway is the EU’s strategic external investment

policy. It enables the practical delivery of this vision by mobilising high-standard, sustainable

investments in health in partner countries. The EU is also actively involved in the negotiation

of the Pandemic Agreement.

The initiative puts forward five key priority areas and nine flagship initiatives that focus EU

action on the areas where it can add most value, all to start between 2026 and 2027 (9).

1. Contribute to a more effective and less fragmented global health architecture

The global health initiatives launched around the turn of the millennium have been crucial in

tackling HIV/AIDS, tuberculosis, malaria and other communicable diseases. Nevertheless, the

architecture that delivered past gains now requires substantial reform to remain effective and

fit for purpose. Today’s global health architecture is marked by shortfalls and fragmentation,

including in some instances drifts from core mandates, overlaps and insufficient coordination

among health actors, both across and within regions. Moreover, disease-specific fragmentation

sometimes impedes the efforts to strengthen and integrate national health systems.

Global cooperation is indispensable to protect the health of everyone across the world. It is

urgent to seize the momentumfor reform to increase efficiency and to gradually transition to

the goal of country health sovereignty. The Commission will fully support and participate

(6) COM(2025) 30 final

(7) JOIN(2025) 130 final (8) EU Global Health Strategy: Better Health for All in a Changing World - Public Health. The first implementation report of the strategy

was published on 10 July 2025: Report on the implementation of the EU Global Health Strategy - Public Health.

(9) Corresponding work programmes are still to be adopted.

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in the World Health Organization (WHO) hosted process (10), to facilitate convergence on

the transformation of the global health architecture.

The Commission will promote a global health architecture that strengthens national

ownership and supports partner countries in their goal to reach health sovereignty. The

Commission will support reforms that prioritise the most at-risk and affected populations,

directing resources to contexts where the impact will be greatest. Reforms must ensure global

health architecture adheres to commonly agreed humanitarian standards and should

systematically address gender‑related barriers to health.

The EU values-based approach to global health

EU global health action is guided by fundamental values of equality, non-discrimination

and the right of all people to exercise their human rights and fundamental freedoms. Our

human rights-based approach ensures equal access to health services for all – including

young people, older people, girls and women, people with disabilities and LGBTIQ+ people.

It protects people in disadvantaged and vulnerable situations, for example by ensuring they

have access to sexual and reproductive health and rights (11) and mental health and

psychosocial support.

In a rapidly evolving geopolitical context, the EU continues to be a reliable and predictable

partner. The reform must support multilateralism, having at its centre the WHO focused on

its core normative, standard-setting, global health security, and coordination and

convening mandates, while fostering the role of regional institutions as appropriate.

All actors must work in a coordinated manner. They must aim to eliminate duplication and

increase transparency and accountability to foster a more streamlined and less fragmented

global health architecture that is effective, equitable and sustainable. A strong and well-

coordinated presence of the EU and its Member States on the governing boards of the main

global health initiatives, namely The Global Fund to Fight AIDS, Tuberculosis and Malaria,

Gavi, the Vaccine Alliance and The Pandemic Fund, is essential to ensure that these initiatives

complement each other and play their full role in helping countries transition towards full

health sovereignty. Disease-specific initiatives, the Global Fund and Gavi in particular, should

continue to play a critical role in expanding equitable access to quality, affordable products,

and contributing to diversify supply chains. These should help shape demand in a manner that

supports global health resilience, while ensuring fair, predictable and sustainable market

conditions, including for European and emerging manufacturers. At the same time, it is

essential that the Pandemic Fund continues to play its role to address key gaps in pandemic

prevention, preparedness and response.

➢ Flagship initiative 1. Enhance coordination within the EU on global health

Building on the Team Europe approach (12) and to underscore the impact of global

health action by the EU and its Member States, the Commission will further step up

coordination with and between EU Member States prior to replenishments of

international initiatives and key financing milestones. It will further refine mapping

of EU and Member States global health investment and actions and update this on a

(10) As agreed at the 158th session of the WHO Executive Board and complementing current UN80 Initiative discussions. (11) The EU remains committed to the promotion, protection and fulfilment of all human rights and to the full and effective implementation

of the Beijing Platform for Action and the Programme of Action of the International Conference on Population and Development (ICPD)

and the outcomes of their review conferences and remains committed to sexual and reproductive health and rights (SRHR), in this context.

(12) JOIN(2024) 25 final

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regular and comprehensive basis to improve coherence, transparency and

accountability, and facilitate synergies and complementarity amongst donors.

2. Support resilient country-led health systems

Country-led health systems that deliver accessible and quality essential services and protect

people’s health are the backbone of global health resilience. Ensuring the continuity of

integrated primary healthcare services – including maternal and infant health and sexual and

reproductive health services – is critical to prevent avoidable morbidity and mortality and

maintain resilient systems during crises and shocks. This requires gender‑responsive primary

healthcare and health systems capable of addressing key public health challenges such as

vaccine-preventable diseases, malnutrition, sexually transmitted infections, mental health and

non-communicable diseases. Digitalisation and innovation are key enablers of health

sovereignty, allowing countries to improve fair access and deliver more effective,

interoperable, scalable and cost-efficient health services, empowering patients, including

through data systems, telemedicine and AI-supported tools, where they are safe and

trustworthy. Health policies must factor in root causes of ill-health such as poverty and social

inequalities, and environmental causes, through an integrated One Health approach.

Strengthening health systems is particularly crucial in fragile contexts and in more advanced

systems when faced with massive health crises, such as large-scale epidemics or pandemics.

Vulnerable populations and humanitarian settings deserve particular attention.Global

displacement and food insecurity, climate change and extreme natural hazards, lack of clean

and affordable energy, violence and conflict, social inequalities and recurrent epidemic

outbreaks have further reduced the capacities of already constrained national health

systems in many fragile, conflict- and crisis-affected countries worldwide. This results in a

reduced availability of essential primary healthcare services, and limited progress towards

universal health coverage.

Health sovereignty requires sufficient and efficient domestic health funding. Out-of-pocket

payments are the primary source of financing in 30 low-income countries (13), pushing

millions of people into poverty. Moreover, external aid provides an estimated 30-45% of total

health spending in some economies (14). Dependency on external funding in the long-term risks

undermining country ownership and the ability of individual countries to guarantee health

outcomes. Especially in the current context of declining official development assistance, a

more efficient and effective fragility approach should encompass the coordinated cooperation

between humanitarian aid, development aid and national capacities. Robust public financial

management, economic policies that support long-term growth and solid domestic institutions

are indispensable to improve health outcomes and ensure sustainable long-term health

financing. Ultimately, change can only be driven by countries themselves, through

accountability, dignified care, accessibility and national ownership, complemented by

international support at global and regional level, including through the G7 and G20.

The EU experience in health systems resilience

The EU can draw on the experience of its Member States in building inclusive and resilient

health systems. EU Member States have a diverse range of health systems. They face different

challenges and levels of resources. Yet they all share a strong commitment to universal health

coverage, to delivering both primary healthcare and more advanced healthcare services. They

(13) WHO, 2024.

(14) IHME, Our World in Data.

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also rely on vibrant research and innovation, regulatory certainty, cross-country collaboration

and a strong health industry and business sector.

Complementary to this, the EU has a unique capacity to act as an advanced regional integration

framework. The EU has adopted models for preventing and combating major non-

communicable diseases, but also rare, low prevalence and complex diseases (15).

The EU has proposed and developed strong regulatory frameworks to improve access to

pharmaceuticals and medical devices, strengthen the security of supply and tackle public health

challenges such as antimicrobial resistance, notably through initiatives such as the

Pharmaceutical Strategy for Europe (16), the proposed Critical Medicines Act (17), and the

Council recommendation on stepping up EU actions to combat antimicrobial resistance in a

One Health approach (18), encouraging the prudent use of anti-microbials with concrete

targets to reduce antimicrobial use, stronger national action plans, better surveillance, and

enhanced awareness.

The European Health Data Space will harness the power of digitalisation, empowers patients

to better control and share their health data, and improves healthcare delivery. It enables the

secure and trustworthy reuse of health data for research, innovation, and policymaking. EU

frameworks emphasise openness, ethical use, and shared standards, ensuring that digital

transformation benefits all stakeholders in a fair and equitable way.

In addition, robust social protection systems prove crucial in cushioning the socio-economic

impact of shocks.

Supporting collectively health systems towards a more effective, resilient and accessible

model, across all their fundamental building blocks (19), has been a core priority of the EU

Global Health Strategy and will remain a cornerstone of EU action on global health.

Overall, the EU with its Member States and European financial institutions, in a Team Europe

approach, are among the leading donors to global health. For example, the EU and its

Member States together contribute the highest share of funding contributor to the WHO (20).

Between 2021-2025, the Commission committed around EUR 6 billion in official development

assistance for global health. Approximately half of the contributions have been directed

towards regional institutions and countries, while the other half at global level (21). This

contribution is complemented by additional EU funding streams supporting global health

objectives across research, innovation, and investment instruments.

At regional level, the Commission has fostered partnerships with key regional institutions such

as the Africa Centres for Disease Control and Prevention, the African Medicines Agency, the

Pan American Health Organization and the Caribbean Public Health Agency, promoting the

(15) These include the prevention of non-communicable diseases (Healthier Together – EU Non-Communicable Diseases Initiative, fighting

cancer (Europe’s Beating Cancer Plan), tackling mental health challenges (Comprehensive Approach to Mental Health), addressing

cardiovascular disease (EU cardiovascular health plan: the Safe Hearts Plan), enabling cross-border networks (European Reference

Networks, ERNs) or dealing with health-related issues linked to climate change (EU Strategy on Adaptation to Climate Change).

(16) COM(2020) 761 final

(17) COM(2025) 102 final

(18) ST/9581/2023/INIT (19) Service delivery, health workforce, health information systems, access to key medicines, financing, and leadership/governance.

(20) The direct contribution was over USD 1.7 billion to the 2024-2025 WHO budget – 22% of the total and more than twice larger than the next largest contributors.

(21) During 2021-2025, the EU has directly supported 49 countries with health-related actions across different regions, including Sub-Saharan

Africa (Benin, Burkina Faso, Burundi, Central African Republic, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea,

Guinea-Bissau, Kenya, Madagascar, Mauritania, Mozambique, Niger, Nigeria, Rwanda, Senegal, Somalia, South Africa, South Sudan,

Sudan, Uganda, Zambia and Zimbabwe), North Africa (Egypt, Libya, Morocco and Tunisia), the Middle East (Jordan, Lebanon, Syria

and the West Bank and Gaza Strip), Eastern Europe, the Neighbourhood and the Western Balkans (Armenia, Azerbaijan, Bosnia and Herzegovina, Moldova, North Macedonia, Serbia, Türkiye and Ukraine), Central and South Asia (Afghanistan, Lao People’s Democratic

Republic and Uzbekistan), Latin America (Costa Rica, El Salvador and Mexico), and the Caribbean (Barbados, Cuba and Guyana).

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cross-sharing of expertise and information in the area of health systems strengthening. The

Commission will step up this collaboration in areas of mutual interest, recognising the key

role these regional institutions play in supporting countries, and building on the expertise of

EU agencies such as the European Medicines Agency, the European Centre for Disease

Prevention and Control and the European Food Safety Authority, as appropriate and while

fulfilling their mandate in the EU.

Particular attention will be paid to Ukraine and the EU neighbourhood, building on the

extensive work done to help partners prepare for accession. Joint efforts, continued investments

and reforms are vital to meet the EU’s public health standards and protect EU citizens in a

larger Union. Therefore, the Commission is supporting candidate countries on their path to

accession by providing expertise and technical assistance to ensure alignment with the EU

public health acquis and effective implementation on all fronts. For example, the Commission

through WHO is supporting the recovery and transformation of the health system in Ukraine.

This involves establishing national authorities, laboratories, databases, ensuring necessary

staffing, and providing comprehensive training, among other critical components. The EU

provides funding to deliver further tangible support in areas of health security, management of

communicable diseases, tackling antimicrobial resistance as well as training of experts from

authorities. Furthermore, as part of the gradual integration process, participation as observers

in the European Medicines Agency working groups and the European Centre for Disease

Prevention and Control disease networks builds capacity in the area of health and strengthens

technical expertise. Also, access to the Early Warning and Response System for serious cross-

border threats to health can be granted to candidate countries, once they comply with EU data

protections rules, to ensure that high quality and safety health standards are in place on day one

of enlargement.

Through the Antimicrobial Resistance Multi-Partner Trust Fund, the EU, together with several

Member States support low- and middle-income countries as they implement national action

plans to combat anti-microbial resistance and strengthen its surveillance in a One Health

approach.

Under the Global Gateway strategy, the Global Gateway Investment Hub and the roll-out of

innovative financial instruments, such as guarantees (e.g. the Human Development

Accelerator) and blended finance, the Commission will seek to encourage mutually beneficial

investments by the European private sector in global health.

➢ Flagship initiative 2. Support partner countries’ transition to health sovereignty by

providing sustainable financing and sharing expertise

Building on existing EU support, the Commission will work with partner countries

in accelerating their transition to health sovereignty and achieving universal health

coverage, addressing gender gaps in access, affordability and quality of care, with a

major focus on primary healthcare and in line with the One Health approach.

Beyond disease-specific approaches, the Commission will propose an integrated offer

that can include: a) support to the design of robust health policies and comprehensive

strategies, b) enhanced domestic resource mobilisation and public financing

management to free fiscal space for health and social protection policies, c)

innovative financial instruments that respond to public sectors’ needs, while

supporting the uptake of relevant EU private sector solutions based on voluntary and

mutually agreed terms, including in digital health, under Global Gateway. EU

delegations will play a central role in implementation, ensuring coordination with

EU Member States, alignment with countries’ priorities and effective coordinated

delivery.

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Cooperation will be fostered between EU agencies and regional agencies, where

relevant and respecting the EU agencies’ mandates within the EU, in the

neighbourhood and between EU networks and public health institutes in partner

countries and regions, to share the breadth of EU experience in tackling public

health challenges. The EU will pay particular attention to Ukraine and partners in

our neighbourhood and seek new partnerships with like-minded regions.

3. Reinforce prevention, preparedness and response to global health threats and

crises

The world faces major global health threats and the spread of infectious diseases, with

influenza and respiratory diseases remaining a major source of concern. In view of current

geopolitical shifts, global health networks are increasingly hindered by gaps in basic clinical

and epidemiological surveillance systems, insufficient laboratory and treatment capacities and

gaps in the availability of medical countermeasures and emergency health workforce readiness.

This requires integrated action at global, regional and country levels to feed into and support

effective global networks and help close gaps in expertise, resources and information sharing.

In this context, due attention should be given to the countries and regional organisations that

border the EU’s outermost regions.

At the same time, modern technologies, like sequencing, or AI-supported intelligence

systems, can be further developed and deployed to fill gaps and provide more real time

surveillance, and faster identification of threats and responses. Furthermore, wastewater

and environmental surveillance capabilities should be strengthened as they are capable of

detecting pathogen signals ahead of clinical reporting systems.

Speed is decisive in outbreak response(22). Early warning systems must include trusted local

networks. The 2024 mpox outbreak on the African continent demonstrated how coordinated

action can accelerate the development, authorisation, and deployment of medical expertise and

countermeasures. But it also exposed gaps in threat detection that must be closed if we are to

contain future outbreaks. Pathogen-agnostic platforms, embedded within routine surveillance

systems, offer a promising path forward. By building surge readiness into everyday

infrastructure, countries can be better positioned to respond swiftly when the next threat

emerges.

Surveillance data, including pathogen data, should feed promptly into globally accessible

systems, thereby enabling rapid development of medical countermeasures, in the spirit of

global responsibility and solidarity, building on multilateral and international achievements.

The roles played by the WHO and by the Pandemic Fund in this regard are fundamental.

Global health resilience requires health services that can prevent, prepare for and respond

to shocks, while maintaining their capacity to deliver essential healthcare to populations. This

requires sustained investment in prevention, preparedness, and response capacities, especially

in lower and middle-income countries, which are often most at risk of global health threats

such as pandemics.

Effective pandemic response also depends on the availability of and access to medical

countermeasures, including for most at-risk populations, including groups facing

gender‑related barriers. At the international level, the EU has fostered partnerships on medical

countermeasures with the Africa Centres for Disease Control and Prevention, the Pan American

(22) Principles such as the 7:1:7 model (7 days to detect a suspected disease outbreak; 1 day to notify relevant public health authorities; 7

days to complete early response actions) are used to convey the urgency in times of crisis.

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Health Organization, Canada, Japan and the Republic of Korea. Looking forward, the

Commission will also seek to strengthen collaboration in the field of medical countermeasures

with other relevant regional bodies, such as the Association of Southeast Asian Nations.

The EU’s health security framework

The EU’s health security framework, which was reinforced in the aftermath of COVID-19,

is a strong basis for our cooperation with partners and our contribution to global health

security. It is based on a strengthened regulation covering prevention, preparedness and

response to serious cross-border health threats (23). Under this Regulation, the Union

prevention, preparedness and response plan (24) describes effective governance and

coordination mechanisms within the EU, its agencies, bodies and Member States, as well as

with international organisations such as the WHO and other international partners, which are

crucial for ensuring effective readiness and response to serious cross-border threats to health.

Furthermore, the EU Health Emergency Regulation (25) creates an emergency framework

for securing crisis-relevant medical countermeasures during a public health emergency at

Union level.

In addition, the new framework foresees greater roles for the European Centre for Disease

Prevention and Control and the European Medicines Agency. In 2021, a dedicated

Commission Health Emergency Preparedness and Response Authority was established with

a focus on medical countermeasures. On this specific aspect, the Medical

Countermeasures strategy (26) provides that the Commission will continue to team up with

international partners, thereby enhancing synergies and alignment between EU and global

initiatives for the development of medical countermeasures. This framework also ensures

increased international cooperation on health threat intelligence, ensuring data feeds into

global surveillance systems. It strongly relies on EU Member States, neighbourhood and

EEA countries’ capacity to feed into regional and global levels.

Regulation (EU) 2022/2371 is relevant to EEA countries and they are fully implementing it.

In addition, an agreement on health security has been signed with Switzerland. Negotiations

with EEA EFTA states on an international agreement to associate Iceland, Liechtenstein and

Norway to the Union’s health emergency measures in the area of medical countermeasures

are ongoing to further strengthen global health resilience.

Under the Union Civil Protection Mechanism, the Commission facilitates rapid

coordination of mutual assistance to deploy medical teams, equipment and emergency

assistance when countries face major health emergencies. Complementing this mechanism,

rescEU provides a centrally managed European reserve of critical capacities (such as

medical stockpiles, field hospitals, and medical evacuation assets) to provide swift support

when national resources are overwhelmed. The Commission also responds to humanitarian

emergencies by mobilising funding or delivering life-saving medical supplies, logistics and

assistance and expertise through ReliefEU.

➢ Flagship initiative 3. Strengthen global networks for enhanced detection,

preparedness and response

(23) Regulation (EU) 2022/2371 on serious cross-border threats to health

(24) COM(2025) 745 final (25) Council Regulation (EU) 2022/2372 on a framework of measures for ensuring the supply of crisis-relevant medical countermeasures in

the event of a public health emergency at Union level

(26) COM(2025) 529 final

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The Commission will help detect epidemic and pandemic threats earlier, by

strengthening global surveillance and laboratory networks. In particular,

cooperation with the WHO and other global and regional partners will foster

additional sources of epidemic intelligence including through environmental

surveillance (27). In addition, the European Centre for Disease Prevention and

Control will step up training for surveillance and laboratory experts, including

through collaboration with EU Reference Laboratories. Finally, the Commission will

support better surveillance and laboratory infrastructures in low and priority middle-

income countries through the Pandemic Fund and dedicated support action with

WHO or other relevant global and regional partners, avoiding duplication and

parallel networks.

The Commission will expand cooperation of the European Centre for Disease

Prevention and Control with national and regional centres for disease control to

facilitate the flow of information on pathogens and with the WHO’s Global Outbreak

Alert and Response Network to support rapid international interventions.

Finally, the Commission will help strengthen prevention by carrying out more

effective vaccination campaigns and preparedness in the EU and in neighbouring

regions.

➢ Flagship initiative 4. Strengthen response capacity through the availability of

medical countermeasures

Therapeutics: the Commission will support the establishment of the Global

Therapeutics Development Coalition and set up the EU Therapeutics Hub, which will

address the chronically underdeveloped pipeline of therapeutics. Alongside this, the

Commission will mobilise innovative financial instruments to provide support for the

development of new therapeutics, in particular of broad-spectrum nature.

Vaccines: to operationalise the ambition of a safe and effective vaccine within 100

days of a pandemic declaration for all priority viral families and unknown pathogens

(Disease X scenarios (28)), the Commission will step up its commitment to the

Coalition for Epidemic Preparedness Innovations and ensure continued investment

in the European Vaccines Hub to support new vaccines.

Diagnostics: the Commission will support the establishment of an EU diagnostics

Hub, which will promote the development and market deployment of novel

diagnostics tests and technologies that can be easily repurposed and/or scaled-up

when a pandemic hits. By leveraging existing and new technologies for testing, the

Commission expects to contribute to a wider and more equitable access to diagnostics

in general and, in particular, by vulnerable or minority populations, in collaboration

with other existing initiatives.

➢ Flagship initiative 5. Support a global health and resilience tracker

The global health and resilience tracker aims to ensure a consistent approach is taken

to routinely track global health expenditure and complement ongoing efforts to

strengthen national funding data to ensure more coherent and effective financing.

(27) Examples include the Epidemic intelligence from open source initiative (EIOS), the International pathogen surveillance network (IPSN),

the Pathogen genomic initiative (PGI) and the Global consortium for wastewater and environmental surveillance for public health (Glowacon).

(28) Unknown pathogen that has not yet emerged but could cause a significant threat to public health.

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The tracker will be developed in collaboration with the OECD, the WHO and the

World Bank.

The tracker will initially focus on pandemic preparedness, prevention and response

by mapping the domestic spending of partners and the international support they

receive in this area, to avoid duplication and increase the transparency,

accountability, and effectiveness of global health security financing. Where data

allow, the tracker will promote the use of sex‑disaggregated and, where relevant,

gender‑sensitive expenditure and results indicators. Additional areas of global health

expenditure should progressively be added to cover broader global health priorities.

4. Diversify global supply chains and support development and manufacturing of

key health products in partner countries, based on mutual interests

Cooperation with the EU industry has been part and parcel of the EU offer for global health

partnerships, with EU investments promoting mutual interests adding to EU capacity and

expanding the manufacturing base for complementary health products, leading to more

diversified and secure global health supply chains. It is therefore essential that the EU maintains

and further strengthens a solid pharmaceutical industrial base in support of EU strategic

autonomy and competitiveness and as an important contribution to global manufacturing

capacity.

Disruptions in global supply chains can affect the strategic autonomy of both the EU and our

partner countries. These disruptions are becoming more frequent and more severe, driven by a

growing number of global shocks, such as pandemics and geopolitical tensions. Their impact

exposes shared vulnerabilities and interdependencies (29). At the same time, the global supplier

base for key health products, such as vaccines, active pharmaceutical ingredients and

antibiotics, where concentrated in a limited number of manufacturers, sites and geographies,

increases exposure to external shocks and supply bottlenecks.

Therefore, diversified and well-integrated global supply chains help build health resilience

against shocks and geopolitical uncertainty, operating within open, rules-based

international trade and partnership frameworks that ensure no region is structurally

excluded from access to the means of its own health security.

Likewise, EU companies can draw benefits from easier access to new, expanding and rules-

based markets supportive of legal certainty and innovation, through partnerships with local

businesses and authorities, underpinned, where appropriate, by voluntary technology transfers

on mutually agreed terms and targeted investment. This can offer EU companies a

complementary route to the market than exports alone. This is especially the case for products

designed to tackle persistent, unmet or poorly met health needs, including cancer, sexual and

reproductive health, malaria, HIV, tuberculosis, as well as epidemic potential diseases such as

respiratory viruses, mpox or vector-borne fevers.

The EU manufacturing and innovation model

Regulatory maturity promotes prompt access to quality-assured medicines and vaccines,

robust pharmacovigilance, emergency authorisation procedures, and predictable market

conditions for sustainable manufacturing. Rules to increase the security of supply and access

(29) For example, Africa imports 99% of its vaccines and 70-90% of its medicines (WHO, 2024), while in Latin America local production

was estimated at around 15% of COVID-19 vaccine supply (PATH, 2024).

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to pharmaceuticals, critical medicines, and medical devices (30) can offer useful elements for

partners’ health system resilience.

The EU brings regulatory certainty as well as strong pharmaceutical systems and

manufacturing capacity. The EU draws on expertise from the European Medicines Agency,

responsible for the scientific evaluation, supervision, and safety monitoring of medicines,

which can share expertise with counterparts in other regions of the world.

The EU also fosters research and innovation through a wealth of initiatives, including the

European & Developing Countries Clinical Trials Partnership (EDCTP) (31), which spends

up to EUR 910 million from Horizon Europe leveraging at least the same amount from

European, African, and international partners to support clinical research to accelerate the

development of new or improved drugs, vaccines, microbicides and diagnostics against

poverty-related and emerging infectious diseases, with a focus on sub-Saharan Africa. It funds

multi-country clinical trials and implementation research, while strengthening national

research capacity, ethical review, and regulatory systems, in strong partnership with African

institutions.

Responding to the call by African leaders, in May 2021 the EU launched the Team Europe

Initiative on manufacturing and access to vaccines, medicines and health technologies in

Africa, known as MAV+ (32). To date, MAV+ has invested around EUR 2 billion notably in

South Africa, Senegal, Ghana, Nigeria, Rwanda and Egypt, and has partnered at continental

level with the Africa Centres for Disease Control and Prevention, the African Medicines

Agency and the African Union Development Agency – Partnership for Africa’s Development,

as well as with WHO. The MAV+ framework addresses supply, demand and the enabling

environment in a complementary way (33).

The Commission will step up efforts to diversify global supply chains and strengthen

manufacturing capacities for key health products and support security of supply in areas of

mutual interest for the EU and its partner countries, while ensuring the continued

competitiveness of the EU industry. This can include key vulnerabilities in supply chains (such

as specific vaccines, antibiotics, active pharmaceutical ingredients and other key health

products, for which access for populations in need should be enhanced, like maternal and

reproductive health commodities) where concentration of production and limited geographic

diversification or other bottlenecks, such as fragmented demand, create systemic risks.

➢ Flagship initiative 6. Advance EU support for global supply chains diversification

and the development and manufacturing of key health products based on mutual

interest

The Commission will accelerate the deployment of EU investment tools such as

guarantees (e.g. the Human Development Accelerator (34)) or blending grants and

loans and will seek to advance cooperation with the financial sector and

philanthropic organisations, and with the private sector, based on mutual interests to

support joint investments by EU and local companies in partner countries.

(30) Through e.g. pharmaceutical reform, the revision of medical devices’ rules and the proposed Critical Medicines Act. (31) https://www.global-health-edctp3.europa.eu/index_en

(32) https://international-partnerships.ec.europa.eu/policies/team-europe-initiatives/team-europe-initiative-manufacturing-and-access-

vaccines-medicines-and-health-technologies-africa_en

(33) The MAV+ framework covers six key workstreams: (i) industrial development and supply chains, including private sector engagement;

(ii) market shaping, demand consolidation and trade facilitation; (iii) regulatory strengthening; (iv) voluntary technology transfer on

mutually agreed terms and in respect of intellectual property; (v) access to finance; and (vi) research, higher education and skills development

(34) Accelerating Human Development - International Partnerships

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To ensure the effectiveness and sustainability of these investments, the Commission

will continue to strengthen the enabling environment for industrial development,

including through support to research, gender‑responsive skills and workforce

development, innovation and barrier-free markets. Where relevant, the Commission

will mobilise its network of EU academic institutions and public-private partnerships.

It will also continue to mobilise the European Medicines Agency and the network of

EU National Regulatory Authorities to support collaborative regulatory pathways.

➢ Flagship initiative 7. Promote a global partnership for knowledge exchange on

medical countermeasures and surge capacity

To strengthen demand, the Commission aims to step up its collaboration with partner

regions, global health initiatives and international financing institutions on

procurement frameworks and advance purchase commitments to justify sustained

investment by diversified manufacturers. Joint and pooled procurement should be

explored for this purpose (35), while reinforcing partnerships built on mutual

benefits. Looking forward, the Commission will also seek new partnerships with like-

minded regions. Together with the WHO, the Commission will increase its

cooperation to agree on common principles with regional procurement partners in

Africa, Latin America, Asia and the Middle East.

Building on the success of EU FAB (36), the Commission will share its know-how on

surge capacity production with international partners, who can then adapt it to their

own contexts.

➢ Flagship initiative 8: Support clinical research networks for end-to-end clinical

development of health products

The Commission intends to expand its support to end-to-end clinical research and

multinational clinical trials, with robust safeguards for data protection (37), through

dedicated networks based on the experience of the Global Health EDCTP3 clinical

trial partnership with Africa.

5. Strengthen societal resilience by fostering trust in science and countering

disinformation, misinformation and FIMI

Tackling common health challenges means enabling researchers and professionals worldwide

to collaborate seamlessly: ensuring that knowledge knows no borders is what drives scientific

progress and solutions to some of the world’s most pressing issues including on public health.

In that respect, open databases have democratised access to knowledge, increased research

visibility, and facilitated interdisciplinary collaboration and are key to develop artificial

intelligence tools and medicines and medical technologies.

The growing spread of health disinformation and misinformation (38) and FIMI poses

significant challenges to health research and global health resilience, as it erodes trust in public

health authorities, science and medicine, and hampers people’s ability to make informed

decisions. During major health crises, there is a higher risk of health disinformation,

misinformation and FIMI. Malicious actors disseminating misinterpreted or false healthcare

(35) The Joint Procurement Agreement to procure medical countermeasures has been signed by 39 countries, including all enlargement

countries, Norway, Iceland and Liechtenstein.

(36) https://health.ec.europa.eu/latest-updates/new-pandemic-preparedness-facilities-inaugurated-under-heras-eufab-network-2025-02-

03_en (37) https://www.edpb.europa.eu/news/news/2026/edpb-brings-clarity-data-processing-scientific-research-speeds-finalisation_en

(38) See definitions of misinformation and disinformation in European Democracy Action Plan communication: COM(2020) 790 final

13

information during the COVID-19 pandemic gave a stark example of science being

weaponised, with serious consequences such as vaccine hesitancy or public resistance to

necessary public health measures (e.g. mask use and social distancing). This undermines the

effectiveness of public health risk communication, community engagement and other

measures. It also weakens the ability to prevent, prepare and respond to health emergencies

worldwide. FIMI reported during the pandemic also included the promotion and organisation

of physical threats and intimidation of researchers and practitioners involved in the response.

In addition to directly obstructing public health measures, this had a chilling and polarising

effect more generally (39).

Countering FIMI, disinformation and misinformation in the domain of health requires greater

monitoring, prompt community engagement, pro-active and factual information, tailored to the

specific culture and context.The growing use of artificial intelligence tools in the health space

makes digital and media literacy and accessible digital tools essential, enabling individuals to

critically assess online content and understand how it is generated and targeted. To ensure

effective public health communication, authorities should work in cooperation with health

professionals, local communities and stakeholders, including trusted intermediaries such as

professional networks, community leaders and faith-based organisations. In this context, EU

delegations are instrumental to mobilise Team Europe on the ground and support authorities in

partner countries.

In parallel, the fight against counterfeit and substandard medicines needs to be stepped up,

drawing on the EU experience and expertise in the sector and leveraging opportunities offered

by new technologies. Addressing the risks posed by such products is essential to ensure high

global standards and in order to address specific threats such as the growth of antimicrobial

resistance.

The EU approach to ensure trust in science and counter health disinformation,

misinformation and FIMI

Public trust in scientific research is a necessary precondition for the acceptance and uptake of

scientific and technological innovations that can increase public health and boost individual

and social wellbeing. The EU offers top-tier research and education opportunities, with a

steadfast commitment to academic freedom, diversity and inclusion, as the Choose Europe

initiative emphasises. The Erasmus+ programme, through its international dimension aligned

with Global Gateway priorities, builds resilience against disinformation in partner countries by

strengthening health-related education systems. EU-supported global health research,

including peer reviews, meets the highest scientific standards and isin line with the new WHO

Guidance for Best Practices for Clinical Trials (40).

The Commission is currently working to develop and provide guidance to EU Member States

on preventing, detecting, and responding to misinformation and disinformation in the area of

medical countermeasures. The Digital Services Act provides a safe, predictable and

trustworthy online environment in the EU, and its associated Code of Conduct on

Disinformation sets out a comprehensive range of commitments and measures to address the

phenomenon of online disinformation, including in the field of public health. The European

Digital Media Observatory monitors the spread of health disifinformation and

misinformation and FIMI in the EU, including in the health domain. The EU supports the vital

work of fact-checking organisations (for example, the European Network of Fact-Checkers

has started its operations). Actions announced under the European Democracy Shield

(39) JOIN(2020) 8 final

(40) https://www.who.int/news/item/25-09-2025-core-funders-of-medical-research-commit-to-strengthening-clinical-trials-worldwide

14

contribute tosafeguarding the integrity of the information space by helping build societal

resilience against health disinformation and misinformation and FIMI.

The EU FIMI toolbox, which provides a set of possible EU responses to FIMI activities, can

also be mobilised to support EU delegations’ efforts to counter and debunk manipulative

narratives, as was the case during the 2024 mpox outbreak on the African continent.

➢ Flagship initiative 9: Ensure global access to key health science, genome, and

biodata repositories and strengthen international cooperation

Countering misinformation necessitates also access to robust scientific data. The

Commission will ensure open access to repositories and key databases on science,

genome and biodata hosted in the EU that are critical to research and development

of medicines and medical technologies (41).

The Commission, with the support of EU delegations, will seek to strengthen

cooperation with partner countries both on regulatory and scientific aspects, building

on a repository of best practices on responsible research and innovation and science

communication.

Conclusions

The EU remains unwavering in its determination to be a principled, reliable and forward-

looking global health partner in a rapidly evolving geopolitical context. Building on our unique

strengths, the EU brings a proven, inclusive and rights-based health model that delivers

universal health coverage and equitable access to healthcare, combined with world-class

research, innovation, regulatory capacity and industrial strength. This is supported by the EU’s

unique experience as a regional integration project, supporting partnerships within and across

regionsand its strong support to multilateral engagement.

The Commission invites the other EU institutions and Member States to unite under a

reinforced Team Europe approach to further our goal to boost both global health resilience, in

partnership with countries, regions and multilateral institutions, and our own resilience,

competitiveness and economic security. Together, we must bridge the gap between

humanitarian response and long-term resilience, strengthen local and regional health systems,

and deliver measurable impact – because our collective security depends on the health of all

people. No one is protected until everyone is.

(41) In particular, the Commission intends to provide adequate financing to GENCODE, UniProt, Europe PMC.