Leveraging Germany’s Role in Global Health: View from an Outsider

Establishing a national Center for Global Public Health in Berlin is critical. [Photo: Lothar Drechsel/Getty Images]
In the past decade, Germany has caught the attention of the world for the high-profile moves it has made in the field of global public health. While the country’s contributions to social medicine date back two hundred years to the birth of Rudolf Virchow, the waves it has made in global health are more recent. A 2017 article in the Lancet argued that Germany “has become a visible actor in global health [only] in the past ten years.” The WZB Berlin Social Science Center has been at the center of some of these developments.

While a Global Health (formerly Public Health) Institute in the Faculty of Medicine at Heidelberg University – Germany’s oldest university – was founded in 1962, the country struggled to institutionalize schools of public health after World War II. It was only in 1994 that the University of Bielefeld founded a School of Public Health within the interdisciplinary Faculty of Health Sciences. From 1995 to 2012, Dr. Rolf Rosenbrock headed the Research Group on Public Health at the WZB Berlin Social Science Center. Two subsequent global health focused research groups at WZB – the Research Group on Governance for Global Health led by Anna Holzscheiter and the Research Group on Global Humanitarian Medicine led by Tine Hanrieder – were respectively founded in 2015 and 2017. Since 2005, global and public health programs and centers have sprung up at other universities around Germany, including the University of Bremen, Technical University of Munich, and University of Giessen.

Germany’s growing visibility in global health

2007 was a key moment in which Germany began to put its stamp on global health. Chancellor Angela Merkel sought to make the country’s imprint felt that year through a global health funding commitment of four billion Euros at the G8 Summit in Heiligendamm. 2009 saw Germany launch the World Health Summit, the brainchild of Dr. Detlev Ganten – Chairman of the Board of the Charite Foundation and a research scientist working on hypertension. What started as a small meeting space between government and industry in the natural sciences and medicine has grown into one of the premier global health conferences in the world, hosting an annual attendance of more than 2,500 decision makers. That same year began Germany’s three-year term on the WHO Executive Board through to 2012.

2013 was an important year in that Germany released a concept note for global health politics that sought to put Germany on the same path as some of its peer nations in Europe that had already implemented global health strategies through the release of its own global health strategy. Chancellor Merkel built on this at the Munich Security Conference in 2015 in pointing to the importance of thinking about Ebola along the same lines as forced migration and terrorism and in calling for increased funding of the WHO at the 68th World Health Summit. The G20 Summit in Hamburg in 2017 marked the first ever meeting of Health Ministers.

In the wake of Brexit, 2018 became the year in which high-profile educational institutions and funding agencies began flocking to Berlin. The London School of Hygiene and Tropical Medicine opened an office at Charité Universitätsmedizin in Berlin with the aim of enhancing cooperation in global health. The largest funder in global health – the Bill and Melinda Gates Foundation – opened an office in Berlin, with the UK-based Wellcome Trust opening an office in Berlin in early 2019. For the 2020-21 biennium, Germany became the largest donor to the WHO, providing more than one billion dollars in funding. In 2021, the WHO chose Berlin as the site for the new WHO Hub for Pandemic and Epidemic Intelligence.

While this parade of new commitments and institutions may lead some to imagine that Germany’s growing visibility in global health has unfolded as part of a grand strategy, the reality is that many developments took place wholly independently of one another. The significance that some initiatives now hold globally could not have been foreseen initially (see the World Health Summit). And other developments, like Berlin recently becoming the institutional home for global health in Europe, are in no small part owed to the historical accident of Brexit.

This does not mean that Germany does not have an opportunity to consolidate these gains and make these changes permanent and durable. Former Chancellor Merkel obviously began to realize the opportunity Germany had and sought to make something of it. However, the enactment of an actual strategy remains a relatively new phenomenon, and even as it exists today, many of the country’s global health initiatives are not systematically considered in relation to one another.

Consolidating gains made by Germany in global health

A 2013 Letter to the Editor from researchers at Heidelberg University in the Lancet argued that Germany’s potential in global health will remain unfulfilled until it invests in a Center for Global Health Research and Global Health Fund to finance engagement abroad. That was true then and remains so today, though today the stakes are even larger.

Establishing a national Center for Global Public Health in Berlin is critical for a number of reasons. First, Germany does not have a long tradition of interdisciplinary schools of public health. To the extent global health exists as a program of study in universities, it has a hard science emphasis and operates mainly within the context of medical schools and does not include faculty trained in social science disciplines. It is therefore unsurprising that Christian Drosten, a virologist, dominates the news cycles’ discussions of the coronavirus.

The WZB Berlin Social Science Center – with its location in Berlin, its prominence as a Leibniz Institute, its long-standing history of work in this area, and highly visible researchers in the media – offers one potential site for such a Center. An alternative would be to create a new Leibniz Institute altogether dedicated specifically to global health. In whatever form it takes, one of the most exciting aspects of such a center is that it could be woman-led, as many of the country’s most high-profile global health researchers are women. A recent list of rankings found that just 28% of researchers in Germany are female, placing the country near the bottom of all countries in Europe.

This would therefore break important new ground in a policy area that is critical to human life and public health and complement recent global health initiatives, based in medical schools, like the German Alliance for Global Health Research; civil society-driven initiatives, like the German Platform for Global Health, which hosts alternative civil society events alongside meetings like the World Health Summit; and student initiatives from the German Medical Students’ Association to WHO Youth Delegates.

The incorporation of more social science voices in pandemic response would improve not only public understanding of the coronavirus and other diseases but also the quality of research taking place on global health in Germany more generally and the country’s capacities to respond effectively to global health challenges.

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