Supporting financial institutions to scale up investments in health under the Global Gateway
Authors
What happens when health investment becomes a central part of Europe’s wider strategy for resilience and global partnerships? Karim Karaki and Laure Blanchard-Brunac examine how European development finance institutions can help scale up investment in health under the EU’s Global Gateway strategy.
Summary
Health is firmly embedded in the European Union’s strategic agenda, reflecting its importance for resilience, competitiveness, and global partnerships. This has translated into stronger policy alignment across internal instruments and external initiatives such as Global Gateway. Building on this solid foundation, there is a clear opportunity to further evolve the EU’s approach to meet rising health investment needs in partner countries by complementing grants with a broader set of financial instruments.
European financial institutions for development are well placed to mobilise additional capital for health. While their current portfolio allocations remain relatively modest, this reflects identifiable structural factors such as pipeline maturity, transaction complexity, and sector-specific capacity. Encouragingly, these constraints point to concrete areas where targeted policy action can unlock significant untapped potential:
First, the EU should invest in systematic pipeline development, including dedicated platforms and partnerships to generate bankable projects and strengthen technical expertise, building on models such as HDX.
Second, EU financial instruments, particularly guarantees, should be adapted to better support equity investments, innovation, and risk-sharing mechanisms (e.g., offtake and liquidity guarantees), while allowing greater geographic flexibility.
Third, scaling up technical assistance will be essential to improve project bankability, especially for early-stage investments, including through partnerships with philanthropic actors and results-based financing.
Fourth, a more coordinated strategy is needed to engage the European pharmaceutical industry, aligning DFIs, export credit agencies, and competitiveness policies.
Fifth, stronger integration between policy reforms and investment operations in partner countries will be critical to improve regulatory environments and unlock sustainable private investment in health.
