Border closures, lockdowns, competition for medical equipment, export bans – at the beginning of the crisis, states in Europe and around the world were primarily concerned with implementing national measures and interests to contain Covid-19. This discernible lack of solidarity and commitment to international cooperation among key actors exacerbates the crisis of multilateralism and increases the uncertainty of global networking. This highlights the need, especially now, to create productive multilateral framework conditions that will be valid beyond the Covid-19 pandemic and permanently transform the global order. Without global governance, there will be no sustainable successes in health policy and beyond.
What makes the Covid-19 crisis so unique?
With regard to health crises, especially infectious diseases with global dimensions, a policy is needed that simultaneously overcomes the acute crisis, maintains regular health care services, promotes resilient and needs-based health systems, and creates conditions for cushioning the social and economic damage caused by the crises – in local, national, regional, and global contexts. An inner-European perspective is therefore not sufficient to overcome the Covid-19 crisis. Globally coordinated cross-policy initiatives are needed, and Germany should actively seek to shape these on the international stage (the "Health in all Policies" approach). This will involve short-, medium-, and long-term planning approaches.
Three time horizons for international cooperation
In the short term, the top priority is to successfully slow down and control the pandemic. In this context, German and European policy-makers should make financial, material, and human resources available for countries and regions that are particularly affected. This involves access to health services for all people and a social safety net. Efforts in this direction should be promoted in equal partnerships – and on an equal footing – with international organizations such as the World Health Organization (WHO), regional organizations such as the African Union and the Association of Southeast Asian Nations, as well as with development banks and civil society actors.
In the medium term, the crisis and the systemic competition between the United States and China will increase the level of pressure on the European Union (EU) and Germany to act autonomously in a proactive and strategic way. For the EU, it is a matter of creating new productive, multilateral framework conditions for global health (and beyond), in which central elements of European values are embedded. Specifically, the aim should be to establish an international and independent mechanism for monitoring the functioning of comprehensive health systems. Furthermore, it should be ensured that research and development activities in the field of vaccines and therapeutics are globally coordinated, and that the WHO is strengthened financially and in terms of personnel.
For global health, this means in the long term establishing the promotion of robust, needs-based health systems as a guiding principle, and underpinning them with financial and political resources. Germany, in particular, is called upon here, as it is foreseeable that the country will emerge from this crisis better than others. German global health policy focuses on principles such as social security, sustainable development, and international solidarity, which are comparable with the values of the EU. With its Global Health Strategy, the EU, too, is pursuing the goal of ensuring the human right to health, also by interlinking it with other policy areas. In its latest strategic agenda, as well as in its plans to develop EU connectivity partnerships with Asia, the EU is committed to helping shape the global order and bringing its interests and values onto the international stage. This must now be demonstrated.
Showing foresight and shaping policy internationally
With a view to short-, medium-, and long-term initiatives, Germany should play a shaping role in several political forums. Until the end of 2020, the Federal Government is a non-permanent member of the United Nations (UN) Security Council. Germany could make public health, the health of the health workforce, and the role of non-state actors in health care provision in conflict areas an issue. At the same time, Covid-19 is having an impact on UN missions and the deployment of troops. Mandates could therefore be extended to include a health component. Moreover, Germany has a seat on the UN Human Rights Council until 2022, and this could be used to promote the right to health. The forthcoming German EU Council Presidency is already being described as a "Corona Presidency" and can lay the foundations for anchoring values such as partnership, sustainability, and social security in strategies and international initiatives beyond this health crisis. The G20 and G7 have been discussing global health issues for several years. Attention must be taken here to make better use of the levers between health, development, and finance policy. All efforts in international forums should take into account the future of the WHO and multilateral partnerships such as the Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria. In the long term, synergies need to be exploited and public health systems strengthened.
The time horizon of internationally coordinated measures must not be limited to acute crisis management, but must also include recovery, impact assessment, and prevention in order to establish health policy as a global policy in the long term. The field of global health – in all of its complexity – reveals the possibility of developing concrete global solutions for this crisis and beyond, and these can also help shape the framework conditions of the future global order.
This text was also published on fairobserver.com.
