Health investments are strategic, not charity

In Germany, a debate has been unfolding about the affordability of healthcare, the restructuring of its health system and where to make cuts.^[1] With ageing populations across Europe, this is a reality that sooner or later most European societies will be confronted with. The persistent misconception is that health is merely a cost, when in fact it should be looked at as an investment. Healthy populations are the foundation of functioning societies, development, security and thriving sustainable economies.^[2]

A strategic decision

The covid-19 pandemic made it clear: investing in health is more than a humanitarian cause; it is a strategic decision. Investments in health have catalytic effects beyond the health sector, as they reduce future costs, make societies more resilient and strengthen long-term economic growth. One major example illustrating this potential is research by the Pandemic Fund, which suggests that every $1 invested in public-health preparedness can generate approximately $14 in health and economic returns.^[3]

Still, as public finances are under pressure, health spending is too often treated primarily as an expense to be contained. This risks missing the long-term perspective: prevention and preparedness require resources upfront, but they reduce much greater human and economic costs later.

The cost of inaction is stark. The covid-19 pandemic resulted in an estimated $12.5trn in economic losses globally and over 7m reported deaths.^[4] The lesson is that savings in the short term can create much greater costs later. Even under fiscal pressure, countries need to maintain core health-system capacity, prevention, and pandemic preparedness. This does not mean that health spending is exempt from scrutiny, rather that such scrutiny must take long-term consequences into account.

Well-targeted health investments can generate substantial returns

For example, evidence from the World Bank shows that every dollar invested in high-impact nutrition interventions can generate returns of between $4 and $35.^[5] This makes early nutrition a particularly cost-effective development investment: both because of its direct health benefits and its impact on investments in other areas. Improved nutrition can support learning, future earning potential, and productivity, creating benefits that extend well beyond the health sector. Beyond their direct health benefits, there is therefore a strong economic case for investments of this kind.

But the case for health investment extends beyond economic returns: at a time of rising security concerns, the case for resilient health systems becomes even stronger. In 2026, governments across Europe are prioritising defence and security while reassessing other areas of public spending.^[6] Health must be part of that conversation. Strong health systems are a core component of both human and national security. The risks range from pandemics and deliberate biological events to hybrid threats against critical health infrastructure including hospitals. In all scenarios, a country’s health system plays a crucial role in protecting its population and maintaining essential services.

Health is a core pillar of human and national security

This year, we have already seen multiple incidents of hybrid attacks on infrastructure in Germany and Europe including reported cyber-attacks on hospital IT and emergency-department operations in Berlin.^[7] Such incidents remind us that health systems are themselves critical infrastructure that need protection and should be included in ongoing conversations around security. We need to think about health, economic resilience and security together.

A sustainable investment

We should treat health spending with the same rigour as any strategic investment. Calling it an investment means asking: what it is likely to achieve, over what period, and whether its expected health, social and economic returns warrant the resources committed. This is especially difficult in politics, where annual budgets make today’s spending visible, while the full extent of benefits may emerge years later. Making sound decisions requires us to assess both with equal care, based on data and evidence, and to invest where we can reasonably expect a positive return.

These discussions will be central to the upcoming World Health Summit 2026.^[8] With its overarching theme “From Crisis to Resilience: Innovating for Health”, the summit will focus on how to turn innovation into future-ready systems.

The challenge, however, extends far beyond the summit and the health sector. Building resilient societies requires us to recognise health, economic resilience and security as deeply interconnected, and to rethink how we value and invest in health.

Views or opinions expressed are those of the author and any individuals cited, and do not necessarily reflect those of Economist Enterprise or any other member of The Economist Group.