What €768 million is building: the national investments behind the research

A network of sites testing new tuberculosis drugs across several countries. Malaria vaccines reaching the children who need them most. A push to make more medicines in Africa and to get the continent’s regulators to approve medicines faster. Although none of these was financed by Global Health EDCTP3 directly, all of them contribute to the programme’s objectives.

They are In-Kind contributions to Additional Activities (IKAAs): health research and capacity development projects that EDCTP Association member countries directly fund and manage with their own national funding and align with Global Health EDCTP3 goals. One of the lesser-known aspects of Global Health EDCTP3 is that these member state-led initiatives are the counterpart to the calls for proposals managed by the Joint Undertaking and are an integral part of the programme. By the end of 2025, member countries had collectively planned to invest €767.8 million for this work, of which €346.7 million had already been incurred. 

The more useful question is what that money is actually doing.

Why it adds value

The diseases Global Health EDCTP3 targets attract little commercial investment, so progress depends less on industry than on governments aligning their own national hospitals, regulators and research agencies behind a shared research agenda. A cheque cannot do that alone; coordinating, aligning and integrating what countries fund can. For African member countries in particular, investing their own resources and expertise shifts the relationship from receiving aid to co-owning the work. This is a reason this takes the form of aligned national work rather than a simple cash contribution. 

The goal of this instrument is to stimulate research coordination across European and African governments, avoid duplication of efforts and promote a focus on global priorities. A great deal of health research funding sits within national budgets, spent well but separately. What the partnership model of Global Health EDCTP3 does is point it in the same direction, so that a trial network built in one country, a regulatory reform in another and a new manufacturing line in a third are working towards the same goals. That is how research translates into vaccines and medicines that people can access, and it is why these national investments count for as much as Global Health EDCTP3 grants themselves.

One agenda, less duplication
Public health money is too often spent country by country, with the same ground covered more than once. Because member countries plan their IKAA around a shared research and innovation agenda, they can align behind common priorities and invest their money where the gaps are, supporting complementary activities rather than duplicating efforts and working separately on the same problems.

More than four-fifths of the IKAA, some €638 million, goes into research and innovation itself; the trials, cohorts and studies. The rest supports what that research depends on: coordination, training and building the partnerships that hold it together. This clinical research ecosystem is the machinery that turns a promising idea into an accessible medicine that can be used.

Tackling the diseases the market ignores

Take tuberculosis, for example, which is among the world's deadliest infectious diseases, and where several member states have concentrated their spending. Germany is investing more than €9 million in UNITE4TB, a network of trial sites conducting mid-stage studies on new drug combinations under strict regulatory standards, aimed at shorter, more effective treatments and slowing the spread of drug resistance. South Africa is funding research across the whole span of the disease, from drug-resistant and subclinical infection to diagnostics, biomarkers and vaccines.

On malaria, the hard part is no longer whether a vaccine exists but getting it to the children who need it. The United Kingdom is investing close to €12 million in the roll-out of the two approved vaccines, RTS,S/AS01 and R21/Matrix-M, to ensure deployment is effective and reaches the right populations, rather than stalling after approval.

Stronger capacities and ecosystems to prepare for future outbreaks

Uganda is spending more than €10 million on trials of vaccines against COVID-19 and other epidemic-prone diseases, and a further €6 million to build its own vaccine research and manufacturing capacity, including the production of generic medicines. This investment is grounded by the goal of not having to wait for supplies from elsewhere the next time an outbreak hits. Similarly, South Africa is investing €1 million in research into the epidemiology, pathogenesis, transmission, and management of subclinical tuberculosis.

A skilled health research workforce is also essential to rapidly respond to disease outbreaks. France has committed over €10 million to research and training on HIV, viral hepatitis, sexually transmitted infections, tuberculosis and emerging infections, the long, unglamorous work of keeping expertise and clinical capacity ever warm between crises. Mozambique is investing €1.3 million to strengthen health research capacity, enabling its national health research system and international partners to generate the scientific evidence needed for informed decision-making and effective outbreak response, while Malawi is investing €600,000 to enhance good clinical and research practice for healthcare professionals.

Getting medicines approved, and getting them to people

Inventing a treatment counts for little if it cannot be approved or delivered. Belgium is backing the African Medicines Regulatory Harmonisation initiative with €2 million, helping regulators across the continent work to common standards so that approvals are quicker and more consistent. Sweden is investing over €4 million in the WHO’s Special Programme for Research and Training in Tropical Diseases focused on the translation of research into effective health interventions and policies, while Norway is contributing around €2 million to Unitaid, Rwanda around €1 million to the Global Fund, and Denmark over €3 million to Gavi, collectively funding the organisations that deliver diagnostics, treatments and vaccines of diseases within Global Health EDCTP3’s scope to the lowest-income countries.

A pipeline that is strengthened both ways
A trial network or patient cohort built by one country can be scaled up through a later EU call, while a treatment the EU helped develop can be carried to its next stage by a national programme. Neither partner has to start from scratch.

Not the only source

IKAA are the largest source of external investment behind the programme, but not the only one. Contributing Partners more than quadrupled their commitments over the year, reaching €148 million, with €101.8 million tied to contributions directly to specific projects, including from the Gates Foundation and BioNTech. 

At programme level, CEPI pledged €11.1 million in June 2025 to fund networks of excellence and fellowship projects. Recently, Global Health EDCTP3 and the Novo Nordisk Foundation launched a funding partnership to invest up to €18 million into the partnership’s activities. Additionally, EDCTP Association member countries put €14.6 million in cash directly into the 2025 calls.

For every euro the European Union puts into the programme through Horizon Europe, member countries and contributing partners are now committing €1.08 of their own.