Stakeholder perspectives on the 2020 global health strategy of the German federal government

BACKGROUND: The second German Global Health Strategy was published in 2020 after a development process including a consultation with non-state stakeholders. To date, there has been no systematic investigation of these stakeholders’ perspectives regarding the consultation processes and strategy. METHODS: Semi-structured interviews were conducted with 11 German global health stakeholders involved in the consultation, with purposive sampling informed by a stakeholder mapping applying Clarke et al.'s (2018) situational analysis approach. RESULTS: The German government's initiative to consult stakeholders for the strategy development was positively perceived. Perspectives on the consultation process varied, especially regarding the framework conditions (e.g. time and resource constraints), structure and composition of the stakeholder groups (e.g. no adequate reflection of diverse positions) as well as the participatory nature and the representativeness of the stakeholders involved. A particular critique was the limited information provided about the strategy development process, especially once stakeholder position papers were submitted. The inclusion of climate change, human rights and health system strengthening were seen as strengths of the final strategy. Perceived exclusions or weaknesses were (forced) migration, health workforce and financing issues, which were attributed to disagreements in inter-ministerial coordination. The need for a concrete action plan and fostering coherence between ministries was seen as vital for the strategy's implementation. The strategy provides stakeholders with a way to strategically position and justify their own work, and their continued involvement in strategy implementation efforts is desired. CONCLUSIONS: This study shows overall support for a participatory policy-making process and provides insights into stakeholder perspectives regarding the 2020 German Global Health Strategy, as well as ways future consultations can be strengthened. KEY MESSAGES: • Stakeholder perspectives on the 2020 German Global Health Strategy varied; identifying inclusion of social and planetary issues as strength, and exclusion of migration and an action plan as weakness. • Future global health strategy development processes should consider participatory approaches, transparent communication and stakeholder representativeness in stakeholder consultation.