Germany's expanding role in global health

Germany has become a visible actor in global health in the past 10 years. In this Series paper, we describe how this development complements a broad change in perspective in German foreign policy. Catalysts for this shift have been strong governmental leadership, opportunities through G7 and G20 presidencies, and Germany's involvement in managing the Ebola virus disease outbreak. German global health engagement has four main characteristics that are congruent with the health agenda of the Sustainable Development Goals; it is rooted in human rights, multilateralism, the Bismarck model of social protection, and a link between development and investment on the basis of its own development trajectory after World War 2. The combination of momentum and specific characteristics makes Germany well equipped to become a leader in global health, yet the country needs to accept additional financial responsibility for global health, expand its domestic global health competencies, reduce fragmentation of global health policy making, and solve major incoherencies in its policies both nationally and internationally. (...)

So far, Germany has failed to live up to its aspirations as an innovator and global health leader in relation to migration and refugee health. Germany delayed addressing migrant health in policy-making efforts for a long time. Consequently, Germany ranks only 22 out of 38 countries in the MIPEX health score (a summary indicator for entitlement and access to health services),78 below average when compared with countries with comparable migrant populations and GDP, making the country “just halfway favourable from an integration perspective”.