In the realm of global health, Germany has long been a quiet giant, offering financial support and expertise from the shadows. But as the world changes, so must Germany's role. The recent Health Policy Watch report highlights a concerning trend: Germany consistently falls short of its potential when it comes to securing leadership positions in global health. This is not due to a lack of expertise or credibility, but rather an overly cautious strategy that has been pursued for years. Germany has too rarely prepared candidates strategically for senior global positions, and has often failed to articulate its ambitions. It's time for a change. Germany needs a far more active, confident, and strategic approach to international appointments. Strong German candidates should be identified early, supported across government, and promoted internationally. Not out of national prestige, but because international organizations can benefit from German expertise, reliability, and experience. Germany already has internationally recognized institutions such as the Robert Koch Institute, Charité, the University of Berlin medical school and hospital, and the Bernhard Nocht Institute for Tropical Medicine. Their expertise has been instrumental in initiatives ranging from polio eradication to epidemic preparedness and outbreak response over many years. However, the current debate raises fundamental questions about the governance of the Global Fund itself. Reports of procedural irregularities and a lack of transparency in the selection process must be fully clarified. The appointment of the Executive Director of one of the world's most important global health institutions cannot be conducted through a process that leaves major stakeholders with unanswered questions. The Global Fund is responsible for millions of lives worldwide; its leadership cannot be decided behind closed doors. Trust must be earned, not claimed. Leadership aspirations must always go hand in hand with responsibility. If the United States wishes to play a leading role in global health again, this should be welcomed in principle. However, this requires a renewed and lasting commitment to the global health architecture. Those who have stepped back from international responsibility and contributed to uncertainty should first rebuild trust before seeking leadership positions. Germany should draw the right conclusions from this debate. Our ambition must be not only to support global health through our expertise and financial contributions, but also to help shape it politically and through leadership. A country that has long been among the largest contributors should also have the ambition to help shape global health governance through its people. But as a member of the German Bundestag who strongly advocates for these public expenditures, I am facing a difficult reality. It is becoming nearly impossible to justify sending billions of taxpayer Euros to an organization that cannot transparently explain how its leadership is chosen. At a time when many donor countries are debating whether to channel resources through bilateral programs or multilateral institutions, the Global Fund should do everything possible to strengthen confidence in its governance. Opaque leadership selection processes do not strengthen multilateralism. They undermine the trust on which it depends. It's time for Germany to step up and take a more active role in global health leadership. By identifying strong candidates early, supporting them across government, and promoting them internationally, Germany can help shape the future of global health governance. And by demanding transparency in the Global Fund's selection process, Germany can help ensure that the organization is accountable to the millions of lives it impacts around the world.
