As the number and diversity of influential actors in global health has grown, public awareness and financial and personnel resources have increased. However, a larger array of actors also makes it difficult to develop coherent policies and action. This problem is particularly challenging for Europe where different actors at international and national level use their influence to support their specific interests.

Cooperation between actors with different interests - including government aid and health departments, private actors like pharmaceutical companies, NGOs and other civil society groups - is essential for health governance. The challenge for European global health institutions is to work together in a loose network towards common goals while recognizing the benefits of their diversity and range of interests and contacts.

European global health actors can be divided into several categories. Firstly, there are broadly based intergovernmental organizations such as the Council of Europe and the European Court of Human Rights, and the European Regional Office of the World Health Organization. Then there are the institutions of the European Union: the Council of Ministers and the EU presidency, the European Parliament and the European Commission. There are the many agencies of the European Commission, such as the European Centres for Disease Prevention and Control (ECDC). There are also many European civil society organizations working across Europe in NGO, academic and business networks. Within states, there are also research institutes and trusts of global importance.