“Assessing inclusiveness in Team Europe Initiatives: a mixed-methods study of EU-Africa health cooperation”

BACKGROUND: Team Europe Initiatives have become a central mechanism for the European Union's engagement as a global development actor. Grounded in principles of inclusive partnership, the initiatives aim to improve the effectiveness and visibility of European contributions. However, questions remain about the geographical inclusiveness of health-related initiatives and the extent to which they incorporate local priorities and actors. OBJECTIVES: This study examines how health-related Team Europe Initiatives are distributed geographically and explores stakeholder perceptions of their inclusiveness, partnership dynamics, and implementation on the ground. METHODS: A mixed-methods design was used, combining a quantitative mapping of the distribution of health-related Team Europe Initiatives with 23 semi-structured interviews conducted between January and April 2024 with stakeholders in Europe and Africa. Quantitative findings informed the qualitative sampling and analysis. The interviews were analysed using thematic analysis. RESULTS: Health-related Team Europe Initiatives are predominantly concentrated in Africa, with uneven participation across European Union Member States. Interviewees generally viewed the initiatives as a promising tool for strengthening collaboration, improving trust, enhancing coordination, and creating more stable engagement that may attract investment. Nonetheless, significant concerns persist, particularly regarding limited involvement of local partners in decision-making, resulting power imbalances, and challenges when it comes to coordination. Stakeholders broadly agreed on the need to widen participation beyond European institutions to meaningfully reflect local priorities. CONCLUSIONS: While Team Europe Initiatives hold potential to support more inclusive and coordinated global health action, the initiatives' impact could be enhanced by strengthening the role of partner-country actors in their formulation and implementation.