The corona pandemic has relentlessly exposed the strengths, but also the weaknesses, of the German healthcare system.
It is thanks to the excellent basic research and biotechnological know-how in Germany that the idea of using mRNA vaccines for cancer therapy was turned into an effective vaccine to combat the Sars-CoV-2 virus within a few months.
However, the clinical studies for the approval of the vaccine did not take place in Germany.
And an international pharmaceutical partner was needed to obtain the approvals of the national drug agencies and to expand production and sales.
That has to change if Germany wants to be better prepared for future health crises.
If it wants to make advances in the treatment of the many chronic diseases - from diabetes and cancer to dementia and Parkinson's - that resonate with patients.
By bundling forces in a National Institute for Health Research, Germany could suddenly and prominently place itself back on the map as a leading location for health research and development.
In clinical studies on Covid-19, Germany has fallen well short of expectations.
Of almost three thousand clinical studies worldwide, only 65 were conducted in Germany in 2020.
Only 27 were fully completed (see FAZ of September 14, 2021).
The verdict of the experts is clear: the German contribution is "modest".
An evaluation of the possibilities of conducting clinical studies in Germany is urgently needed.
It is not due to the lack of will of the scientists and nursing staff in the 352 German university clinics.
But the system is fragmented.
16 federal states are each struggling with their own strategies to secure the training of young medical professionals for their state,
to offer maximum care services and also to enable groundbreaking research - a conflict of goals that can hardly be resolved.
And the system is not sufficiently set up to help shape the changes and leaps in innovation.
Because health research and care are becoming increasingly digital and networked.
Prevention is gaining in importance, as is personalized therapy.
Global networking goes hand in hand with new local treatment options.
German university clinics are in danger of collapsing under the burden of claims if help does not come.
The situation is different in non-university research.
The health research institutes of the Helmholtz and Leibniz Associations as well as the Max Planck and Fraunhofer Societies have a first-class, globally recognized scientific backbone.
With six German Centers for Health Research, soon to be eight, which bundle research on individual clinical pictures - from lung diseases to cardiovascular diseases - the first network structures have already been created in Germany.
Selected non-university institutes and university hospitals work together here.
Federal funding programs such as medical informatics funding or the university medicine network strengthen individual hospital groups and their cooperation with each other.
But only if these health centers and the institutes involved were brought together under one roof - as a "one-stop shop" - would a simple, visible and nationwide structure be created that would coordinate all forces, would be a partner for spin-offs and contact persons for industry and the would be recognized internationally.