Link to downloadable PDF: Working paper on The Institutional Landscape of Global Health Governance: The Role of Team Europe
By Alexandros Kentikelenis (Bocconi), Leonard Seabrooke (CBS)
This working paper examines Europe’s role in global health governance, with a particular focus on how the European Union (EU) and its member states contribute to and engage with key international health organizations. While European countries collectively serve as one of the largest sources of global health funding, the EU itself remains an “actor in construction”—possessing significant potential but lacking a clearly defined mandate to influence global health policy in a coordinated and strategic manner.
Over the past three decades, European countries have been among the most significant funders of international health initiatives. While the United States has remained the largest single contributor, the EU member states collectively provide comparable levels of financial support. Notably, if anticipated cuts in US global health funding materialize, Europe will become the largest funding bloc in global health, filling critical financial gaps. However, despite their financial contributions, EU institutions have historically struggled to translate their economic power into geopolitical influence in shaping global health governance.
The analysis focuses on four major organizations using the NAVIGATOR methodological framework:
- World Health Organization (WHO) – A formal, open organization with a mix of technical and normative functions. The WHO is the primary international body for health governance, setting global health norms and responding to health crises.
- UNAIDS – A formal, open, and strongly normative institution dedicated to coordinating global efforts to combat HIV/AIDS. EU countries are the largest collective donors, yet the EU itself lacks a formalized role within UNAIDS, limiting its policy influence.
- Gavi, the Vaccine Alliance – A formal, closed, and highly technical public-private partnership focused on increasing vaccine access. The EU has played an active role in financing and supporting initiatives such as the COVAX program and African vaccine manufacturing efforts.
- United Nations Population Fund (UNFPA) – A formal, closed, and normative institution focused on sexual and reproductive health. EU member states are its most important funding bloc.
Despite the EU’s significant financial contributions to global health, structural limitations prevent it from exerting strong leadership. The EU lacks a formal mandate in global health policy, leading to fragmented engagement across institutions. Additionally, decision-making power within these organizations often resides with individual member states rather than with EU institutions, making coordinated action challenging.
Nevertheless, the EU has demonstrated its ability to lead in certain areas. The EU Global Health Strategy (2022) aims to consolidate Europe’s role in shaping global health policy by leveraging multilateral structures and expanding bilateral partnerships. However, recent challenges—such as the failure to secure global support for a new pandemic treaty—highlight the EU’s difficulties in translating financial support into geopolitical influence.
