Integrating global health in Romanian policy: strategic alignment, crisis response and governance

Abstract Background As global health challenges intensify-from climate-related threats to pandemics and forced displacement-national health systems are increasingly called to align domestic policies with international health priorities. Romania's strategic position within the EU places it at the heart of regional and global health governance. This study explores how global health principles are reflected in Romanian policy. Methods This research was conducted within the EU Joint Action to maximise the impact of the EU global health strategy (JA GHI). A structured desk review of Romanian health, official development assistance and refugee support policies was carried out in 2024, focusing on active strategic-level documents. Thematic analysis was guided by the 20 principles of the EU Global Health Strategy, using a coding framework developed by JA partners. Results Romania incorporates global health principles across multiple policy layers-strategies, programs, legislation, and international collaborations. However, these are not explicitly labeled as “global health”. Ten key documents, including the National Health Strategy 2023-2030, referenced principles such as universal health coverage, One Health, digital health and emergency preparedness with key actions embedded in long-term planning. Despite clear institutional roles, coordination mechanisms remain fragmented. No standalone global health strategy or dedicated coordination body was identified. Conclusions Romania demonstrates operational commitment to global health, particularly through regional and emergency responses, yet lacks structured policy integration. A dedicated strategy and better intersectoral coordination could improve preparedness, coherence and international engagement. Key messages • Romania’s regional health actions are robust, yet global health remains fragmented in policy. • A dedicated strategy would enhance coherence, preparedness, and global engagement.