14 Apr Generate evidence, include knowledge institutions & mitigate funding shifts: AIGHD’s input to the EU Global Health Resilience Initiative
In a time of negative headlines about global health, AIGHD applauds the European Commission’s efforts to shore up the sector’s resilience worldwide.
As an academic institution working at the intersection of research, implementation, and capacity strengthening in global health, we are well-positioned to offer recommendations to the commission about its new Global Health Resilience Initiative (GHRI). Over the past 17 years, AIGHD has collaborated across over forty countries and five continents to build up expertise in HIV, tuberculosis, antimicrobial resistance, emerging infectious diseases, health system resilience, and climate and health.
In answer to the EU’s call for evidence, here are five crucial considerations:
1. Generate evidence for effective implementation
We welcome the GHRI’s emphasis on evidence-based policy-making. A central pillar of the initiative should be the generation of robust evidence to support the effective and cost-efficient transformation of health systems into resilient systems capable of delivering universal health coverage.
To this end, the GHRI should build on, reinforce, and expand established EU partnership instruments, such as the European and Developing Countries Clinical Trials Partnership (EDCTP) and Horizon Europe programme joint initiatives, to strengthen the scientific basis for policy and decision-making, specifically by funding critically needed evidence generation and innovation addressing key priorities such as antimicrobial resistance, infectious diseases, and maternal and child health – while reinforcing EU and partner country leadership in global health governance.
The GHRI rightly identifies the transformative potential of digital and artificial intelligence technologies to enhance health system efficiency and expand equitable access to care. However, a significant gap persists between technological readiness and effective deployment at scale. The bottleneck lies not in the technologies themselves but in the capacity of implementation settings to absorb and sustain them. We therefore call on the Commission to make evidence generation for safe, equitable, and sustainable implementation a dedicated funding priority, including research that addresses systematic biases in AI systems, and establish robust ethical and governance frameworks that safeguard data sovereignty. This must include strengthening applied research capacity at national and regional levels.
Critically, the effective deployment of health solutions – whether technological, pharmaceutical, or systemic – demands a transdisciplinary approach that goes beyond biomedical and technical disciplines to integrate social, behavioural, and cultural dimensions. Overcoming vaccine hesitancy, fostering trust in health institutions, and ensuring community acceptance of new interventions are implementation challenges that require a deeper understanding of the social, cultural, and political contexts in which health systems operate. The GHRI should therefore embed transdisciplinary frameworks across its priority areas. Citizens should be recognised not merely as end-users of health technologies but as active contributors to their development, participating in tool design, validation, and monitoring to ensure that solutions reflect the needs and realities of the communities they are intended to serve. Addressing these human dimensions with the same strategic priority as technical infrastructure is a precondition for sustainable impact.
2. The role of education and strong local knowledge institutions
The GHRI should explicitly recognise the central role of education and strong local knowledge institutions as foundational pillars of sustainable global health resilience. This requires sustained and strategic investment in higher education cooperation, including the strengthening of universities, research institutes, and training networks in European and partner countries.
The EU should build on and expand existing instruments such as Erasmus+, the Marie Skłodowska-Curie Actions, and Horizon Europe partnerships to support structured training and exchange programmes in the health sciences. A particular priority should be the development and retention of a qualified health workforce (physicians, nurses, epidemiologists, public health specialists, and biomedical researchers), whose expertise is indispensable to the functioning of resilient health systems and to the generation of locally relevant evidence.
Through initiatives such as the EDCTP and EU-funded Regional Centres of Excellence, the Commission should reinforce institutional capacity building that not only develops but also retains critical talent, directly addressing the persistent challenge of health workforce emigration from resource-constrained settings.
3. Strengthen and connect existing systems
The GHRI should prioritise identifying and strengthening existing mechanisms over establishing new parallel structures. Streamlining intra-EU coordination and integrating proven frameworks will yield greater and more sustainable impact. We recommend that the initiative reinforce and better connect established instruments – notably the EDCTP, Horizon programme joint initiatives, and EU regulatory cooperation mechanisms such as mutual recognition agreements, the AU–EU Health Partnership and the work of the European Medicines Agency with African and other regional regulatory bodies – and explore how these can more effectively feed into the broader global health architecture.
At present, these programmes often operate in silos, with insufficient integration into global health governance structures. Regional blocs, particularly in Africa, should be supported to collaborate more effectively on joint manufacturing, regulatory harmonisation, and supply chain diversification. New EU–Africa supply chains for health products represent a significant opportunity that the GHRI should actively facilitate.
4. Map and mitigate the consequences of funding shifts
The withdrawal of major bilateral funders (including USAID) is already creating critical gaps in health service delivery across sub-Saharan Africa and beyond. Where countries lose access to essential medicines, such as those for antiretroviral treatment for HIV, patients who previously had access to life-saving care may find themselves unable to afford or obtain them.
This does not remain a health crisis alone: when populations lose access to treatment, the resulting deterioration in health, economic capacity, and social stability can drive displacement and regional migration. And, where migration flows are large, sustained, or poorly managed, the conditions for conflict emerge. We call on the Commission to systematically map where healthcare provision is most at risk under the current funding environment and to invest proactively in closing those gaps. The mapping should be completed within 12 months and inform a dedicated GHRI emergency bridging fund.
Financial instruments should account for the social, political, and mobility dynamics of vulnerable contexts. It must be recognised that certain settings (e.g. those affected by disaster, conflict and political instability) may not realistically transition toward aid independence and health sovereignty in the near term. These contexts require thoughtfully designed support mechanisms grounded in local realities, rather than constructions that overly focus on self-sufficiency.
5. Address health impacts of conflict and instability
A significant gap in the current GHRI framework is its limited treatment of the health dimensions of conflict and instability, including the spillover effects on neighbouring countries and on EU health systems that absorb patients from conflict zones. Conflicts generate cascading health challenges: wounded populations that may carry antimicrobial-resistant infections, overwhelmed hospital systems in receiving countries, disease outbreaks triggered by displacement, and the disruption of routine immunisation and essential health service delivery, which in turn creates conditions for the re-emergence of infectious diseases. The health consequences of regional instability – whether driven by conflict, funding withdrawal, or governance failures – warrant dedicated and systematic attention within the initiative, just as climate-related health impacts are increasingly recognised within EU policy frameworks.
In a period of rising global military expenditure, the GHRI should recognise that robust and resilient health systems are not merely a development objective but a strategic component of broader global stability. Healthy populations and strong health systems contribute to social cohesion, reduce drivers of displacement and migration, and can serve as powerful regional stabilisers. The GHRI should be understood and resourced as a strategic security investment, not solely a humanitarian one.