The EU’s Engagement with the Global Health Regime Complex

In the wake of the COVID-19 pandemic, the importance of global health as an area of global governance and EU external action requires no elaboration. Consistent with neofunctionalist expectations, the pandemic directed significant attention and resources to global health and galvanised a more unified health policy within the EU. At the same time, however, it accelerated the fragmentation of global health governance: the WHO became severely questioned and got caught in the crossfire of great-power competition, whereas other entities vaulted into the limelight. This chapter scrutinises how the EU has consolidated itself as an actor in global health and interacted with its disjointed governance architecture, which may be characterised as a "regime complex". We focus on two drivers of fragmentation: power diffusion from states and traditional intergovernmental international organisations (e.g. the WHO) into non-state and multi-stakeholder actors, and power transition from the West to the East, which is having some incipient global health repercussions. In our analysis of the EU’s role in global health, we look at the most relevant political-institutional developments that have taken place over recent decades, stemming from policy spill-overs and health crises. We explore how these stepping stones, together with the increased complexity of the global health architecture, have elicited Europeanist, Atlanticist and nationalist responses within the EU. To examine these dynamics in depth, we focus on Member States and key EU institutions, delving into high-profile documents such as the 2022 EU Global Health Strategy. We conclude that Europeanist responses to the fragmentation of global health governance have been widespread, although the reactions by several Member States blur the boundaries of Europeanism, Atlanticism and nationalism.