Germany’s Role in Global Health After the 2025 General Election: Are the Aspirations Matching the Needs?

Germany has long played a significant role in global health. As the new government takes charge, will Germany continue its commitment to address global health challenges? In this policy brief we assess Germany’s likely government stance on global health and outline the urgent need for a bold shift in strategic approach. We suggest reorienting Germany’s efforts around the principle of co-development with partner countries, while recognising the interconnectedness of global health issues with geopolitical and economic interests.

Strong Global Health Track-Record of the Incoming Parties

Under Chancellor Angela Merkel, the CDU/CSU and SPD coalition made Germany a champion of global health. During her tenure, Germany played a crucial role in shaping international health policies, advocating for pandemic preparedness, and leading financial contributions to global health initiatives such as Gavi the vaccine alliance, the Global Fund to Fight AIDS, Tuberculosis, and Malaria and initiatives against antimicrobial resistance (AMR). Germany was further instrumental in the global response to COVID-19, financially backing the World Health Organization (WHO), and initiatives such as COVAX, to ensure vaccine distribution worldwide. This strong commitment positioned Germany as a trusted and influential global health actor.

The Possible Policy Shift of the New Government

Germany’s political landscape has shifted following the recent general election, with the CDU/CSU and SPD expected to form a new government under the chancellorship of Friedrich Merz (CDU). While SPD’s manifesto includes references to global health, CDU/CSU’s priorities have undergone a noticeable transformation. The party now places greater emphasis on security, economic growth, and national resilience, moving away from prior broad engagement in global health and development cooperation. This is reflected in key discussion and policy document already in the run-up to the election, where global health either received minimal attention or was omitted entirely. Thus, global health may no longer be viewed as a standalone priority but rather risks being subordinated to broader economic and geopolitical considerations.

The documents on the coalition negotiations leaked by Frag den Staat include a paragraph on global health in the chapter on health and care. It states that global health is understood as a lever for strengthening security, prosperity, and resilience. Additionally, the coalition partners emphasize partnerships with the WHO, UNAIDS, and the Global South. Thus, Germany is unlikely to abandon global health engagement entirely, but a more transactional and selective strategy can be expected based on statements by the designated Chancellor Friedrich Merz on his approach to Official Development Assistance (ODA). This shift aligns with a broader global trend in foreign policy, where national economic and security interests take precedence over humanitarian and health-based diplomacy. In future, the interests of the private sector, particularly in pharmaceuticals and medical technology, are likely to be given higher priority by the new government, thereby shaping a global health approach driven more by economic interests than Universal Health Coverage (designated WHO Sustainable Development Goal 3.8). As a result, Germany’s role in global health may change to a more reactive, self-interest-driven engagement.

Bold and Proactive Measures Required

However, maintaining the status quo or retreating from the current level of engagement would weaken the global health architecture and undermine Germany’s credibility as a key global health actor, especially as global challenges continue to evolve and where the United States (US) now represents an unreliable partner that views global health as a “business” amidst funding cuts. A possible similar transactional approach by the new German government towards lower-middle-income countries (LMICs) not only impedes filling the gap in global health torn by the US, but also prevents Germany from countering the growing influence of actors like Russia and China, who increasingly engage in global health activities, expanding their geopolitical reach and increasing the dependencies of LMICs.

Importantly, rather than retreating from global health engagement, Germany remains in a unique position as a trusted partner for LMICs and high-income countries alike, with a view to changing the status quo of the global health ecosystem towards more equitable and mutually beneficial partnerships-including economic opportunities. Now is the time to co-develop and co-lead on the initiation and implementation of big and novel ideas to co-create a new global health architecture. The guiding principle of this ‘Global Health 2.0’ agenda should be to forge strong, mutually beneficial partnerships that foster self-reliance and give LMICs a stronger voice in shaping global health policy. To achieve this, the new government should seriously consider the insights of the mid-term review of its global health strategy and establish a structured and forward-looking global health action plan. To this end, specific aspects of the strategy should be further developed in order to adapt it to the changed global political environment.

A Co-developed and Integrated Global Health Approach

We recommend that a newly developed action plan should specifically include an integrated, partnership-driven policy approach to global health. Germany should adopt a renewed and holistic vision for global health that integrates geopolitics, economics, and health within a coherent multilateral framework. At the heart of this effort is the promotion of non-transactional cooperation with LMICs, where health investments are framed as long-term partnerships rather than short-term unidirectional financial aid. Partners should be engaged through co-development models that foster mutual benefits, sustainability, increasing self-reliance, and possible joint ownership. A more integrated and equitable approach is not only essential to address global health challenges, but it also advances Germany’s strategic interests by protecting countries from geopolitical and geoeconomic influences, as well as promoting regional stability, opening new markets, and strengthening the resilience of health systems that benefit partner countries and Germany itself.

All countries stand at a crossroads in global health. The era of Global Health 1.0 has ended, and Global Health 2.0 is yet to be developed. Germany’s role and future engagement in this process will depend on whether the new government embraces a visionary and proactive stance on co-developing a more resilient and equitable global health architecture that recognises the reciprocal relationships between geopolitics, economics, and global health. Without clear commitments and a structured as well as forward-looking approach, Germany will miss out on ensuring that its investments align with both national interests and global health needs. Both should not be seen as separate or conflicting priorities, but rather as interdependent goals. Such an approach can ensure that the investments align with both national interests and global health needs and reflect true leadership on both fronts.