The German government rejected claims by U.S. Health Secretary Robert F. Kennedy Jr. that Berlin prosecuted doctors and patients for refusing Covid-19 vaccinations or mask mandates. “The statements made by the U.S. Secretary of Health are completely unfounded, factually incorrect, and must be rejected,” German Health Minister Nina Warken said in a statement late Saturday. “I can happily explain this to him personally,” she said. “At no time during the coronavirus pandemic was there any obligation for doctors to carry out vaccines against Covid-19,” Warken added. “Anyone who did not wish to offer vaccines for medical, ethical or personal reasons were not criminally liable and did not have to fear penalties,” she said. Warken added that “criminal prosecution took place only in cases of fraud and forgery of documents, such as the issuing of false vaccine certificates” or exemption certificates for masks.  “Doctors [in Germany] decide independently and autonomously on the treatment of patients,” the minister stressed, adding that “patients are also free to decide which treatment they wish to receive.” Kennedy said in a video post on Saturday that he had written to Warken after receiving reports that Germany was restricting “people’s abilities to act on their own convictions” in medical decisions. He claimed that “more than a thousand German physicians and thousands of their patients” faced prosecution for issuing exemptions from mask-wearing or Covid-19 vaccination requirements during the pandemic. Kennedy did not provide specific examples or identify the reports he cited, but he said Germany was “targeting physicians who put their patients first” and was “punishing citizens for making their own medical choices.” He accused Berlin of undermining the doctor–patient relationship and replacing it with “a dangerous system that makes physicians enforcers of state policies.” Former German Health Minister Karl Lauterbach also pushed back on the claims, telling Kennedy on X to “take care of health problems in his own country.”

President Donald Trump has told his health secretary, Robert F. Kennedy Jr., to consider aligning the U.S. vaccination schedule with those in Europe, where many countries recommend fewer vaccines. Kennedy has taken up the charge with gusto and is considering advising parents to follow Denmark’s childhood schedule rather than America’s. Many who specialize in vaccination and public health say that would be a mistake. While wealthy European countries do health care comparatively well, they say, there are lots of reasons Americans are recommended more shots than Europeans, ranging from different levels of access to health care to different levels of disease. “If [Kennedy] would like to get us universal health care, then maybe we can have a conversation about having the schedule adjusted,” Demetre Daskalakis, who led the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases before resigning in protest in August, told POLITICO. Children, especially those who live in poor and rural areas, would be at greater risk for severe disease and death if the U.S. were to drop shots from its schedule, Daskalakis said. Denmark, for instance, advises immunizing against only 10 of the 18 diseases American children were historically recommended immunizations against. It excludes shots for potentially serious infections, including hepatitis A and B, meningitis and respiratory syncytial virus. Under Kennedy, the government has already changed its hepatitis B vaccine recommendations for newborns this year, even as critics warned the new advice could lead to more chronic infections, liver problems and cancer. The health department points out that the new guidance on hepatitis B — that mothers who test negative for the virus may skip giving their newborn a shot in the hospital — now align more closely with most countries in Europe. Public health experts and others critical of the move say slimmer European vaccine schedules are a cost-saving measure and a privilege afforded to healthier societies, not a tactic to protect kids from vaccine injuries. Kennedy’s interest in modeling the U.S. vaccine schedule after Europe, they point out, is underpinned by his belief that some childhood vaccines are unsafe and that American kids get too many too young. Kennedy’s safety concerns don’t align with the rationale underpinning the approach in Europe, where the consensus is that childhood vaccines are safe. Wealthy European countries in many cases eschew vaccines based on a risk-benefit calculus that doesn’t hold in America. European kids often don’t get certain shots because it would prevent a very small number of cases — like hepatitis B — or because the disease is rarely serious for them, such as Covid-19 and chickenpox. But since the U.S. doesn’t have universal access to care, vaccinating provides more return on investment, experts say. “We just have a tradition to wait a little bit” before adding vaccines to government programs, said Johanna Rubin, a pediatrician and vaccine expert for Sweden’s health agency. Swedish children are advised to get vaccines for 11 diseases before they turn 18. Rubin cited the need to verify the shots’ efficacy and the high cost of new vaccines as reasons Sweden moves slowly to add to its schedule. “It has to go through the health economical model,” she said. VACCINE SAFETY’S NOT THE ISSUE Martin Kulldorff, a Swedish native and former Harvard Medical School professor who led Kennedy’s vaccine advisory panel until this month, pointed to that country’s approach to vaccination and public health in an interview with POLITICO earlier this year. Before the Centers for Disease Control and Prevention this month dropped its recommendation that children of mothers who test negative for hepatitis B receive a vaccine within a day of birth, Kulldorff cited Sweden’s policy. “In Sweden, the recommendation is that you only do that if the mother has the infection. That’s the case in most European countries,” he said. “You could have a discussion whether one or the other is more reasonable.” The U.S. policy, as of Dec. 16, more closely resembles Sweden’s, with hepatitis B-negative mothers no longer urged to vaccinate their newborns against the virus at birth. But Sweden’s public health agency recommends that all infants be vaccinated, and the country’s regional governments subsidize those doses, which are administered as combination shots targeting six diseases starting at 3 months. Public health experts warn that even children of hepatitis B-negative mothers could catch the virus from others via contact with caregivers who are positive or shared household items. The prevalence of chronic hepatitis B in the U.S. is 6.1 percent compared to 0.3 percent in Sweden, according to the Coalition for Global Hepatitis Elimination, a Georgia-based nonprofit which receives funding from pharmaceutical companies, the CDC and the National Institutes of Health, among others. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the U.S. has taken a more comprehensive approach to vaccination, in part because its population is sicker than that of some Western European countries, and the impact of contracting a disease could be more detrimental. Osterholm pointed to the Covid pandemic as an example. By May 2022, the U.S. had seen more than 1 million people die. Other high-income countries — though much smaller — had more success controlling mortality, he said. “People tried to attribute [the disparity] to social, political issues, but no, it was because [peer nations] had so many more people who were actually in low-risk categories for serious illness,” Osterholm said. Kennedy and his advisers also cited European views on Covid vaccination in the spring when the CDC dropped its universal recommendation, instead advising individuals to talk to their providers about whether to get the shot. Last month, the Food and Drug Administration’s top vaccine regulator, Vinay Prasad, linked the deaths of 10 children to Covid vaccination without providing more detailed information about the data behind his assertion. European countries years ago stopped recommending repeat Covid vaccination for children and other groups not considered at risk of becoming severely sick. Covid shots have been linked to rare heart conditions, primarily among young men. European vaccine experts say Covid boosters were not recommended routinely for healthy children in many countries — not because of safety concerns, but because it’s more cost-effective to give them to high-risk groups, such as elderly people or those with health conditions that Covid could make severely sick and put in the hospital. In the U.K., Covid-related hospitalizations and deaths declined significantly after the pandemic, and now are “mostly in the most frail in the population, which has led to more restricted use of the vaccines following the cost-effectiveness principles,” said Andrew Pollard, the director of the Oxford Vaccine Group in the United Kingdom, which works on developing vaccines and was behind AstraZeneca’s Covid-19 shot. Pollard led the Joint Committee on Vaccination and Immunization, which advises the U.K. government, for 12 years before stepping down in September. In the U.S., more moves to follow Europe are likely. At a meeting of Kennedy’s vaccine advisers earlier this month, Tracy Beth Høeg, now acting as the FDA’s top drug regulator, pointed to Denmark’s pediatric schedule, which vaccinates for 10 diseases, while questioning whether healthy American children should be subject to more vaccines than their Danish counterparts. Danish kids typically don’t get shots for chickenpox, the flu, hepatitis A and B, meningitis, respiratory syncytial virus and rotavirus, like American children do, though parents can privately pay for at least some of those vaccines. The country offers free Covid and flu vaccines to high-risk kids. After the vaccine advisory meeting wrapped, Trump said he was on board, directing Kennedy to “fast track” a review of the U.S. vaccine schedule and potentially align it with other developed nations. He cited Denmark, Germany and Japan as countries that recommend fewer shots. Last week, Kennedy came within hours of publicly promoting Denmark’s childhood vaccine schedule as an option for American parents. The announcement was canceled at the last minute after the HHS Office of the General Counsel said it would invite a lawsuit the administration could lose, a senior department official told POLITICO. The notion that the U.S. would drop its vaccine schedule in favor of a European one struck health experts there as odd. Each country’s schedule is based on “the local situation, so the local epidemiology, structure of health care services, available resources, and inevitably, there’s a little bit of political aspect to it as well,” said Erika Duffell, a principal expert on communicable disease prevention and control at the European Centre for Disease Prevention and Control, an EU agency that monitors vaccine schedules across 30 European countries. Vaccine safety isn’t the issue, she said. For example, even though most Europeans don’t get a hepatitis B shot within 24 hours of birth, the previous U.S. recommendation, “there is a consensus that the effectiveness and safety of the vaccine has been confirmed through decades of research” and continuous monitoring, she said. European nations like Denmark and the U.K. have kept new cases of hepatitis B low. Denmark recorded no cases of mother-to-child transmission in 2023, and Britain’s rate of such spread is less than 0.1 percent — though the latter does routinely recommend vaccinating low-risk infants beginning at 2 months of age. European experts point to high levels of testing of pregnant women for hepatitis B and most women having access to prenatal care as the reasons for success in keeping cases low while not vaccinating all newborns. The major differences between the U.S. and the U.K. in their approach to hepatitis B vaccination are lower infection rates and high screening uptake in Britain, plus “a national health system which is able to identify and deliver vaccines to almost all affected pregnancies selectively,” Pollard said. The CDC, when explaining the change in the universal birth dose recommendation, argued the U.S. has the ability to identify nearly all hepatitis B infections during pregnancy because of ”high reliability of prenatal hepatitis B screening,” which some European experts doubt. “If we change a program, we need to prepare the public, we need to prepare the parents and the health care providers, and say where the evidence comes from,” said Pierre Van Damme, the director of the Centre for the Evaluation of Vaccination at the University of Antwerp in Belgium. He suggested that, if there was convincing evidence, U.S. health authorities could have run a pilot study before changing the recommendation to evaluate screening and the availability of testing at birth in one U.S. state, for example. WHERE EUROPEANS HAVE MORE DISEASE In some cases, European vaccination policies have, despite universal health care, led to more disease. France, Germany and Italy moved from recommending to requiring measles vaccination over the last decade after outbreaks on the continent. The U.S., until recently, had all but eradicated measles through a universal recommendation and school requirements. That’s starting to change. The U.S. is at risk of losing its “measles-elimination” status due to around 2,000 cases this year that originated in a Texas religious community where vaccine uptake is low. The 30 countries in the European Union and the European Economic Area, which have a population of some 450 million people combined, reported more than 35,000 measles cases last year, concentrated in Romania, Austria, Belgium and Ireland. Europe’s comparatively high rate is linked to lower vaccination coverage than the level needed to prevent outbreaks: Only four of the 30 countries reached the 95-percent threshold for the second measles dose in 2024, according to the European Centre for Disease Prevention and Control. Kennedy touted the U.S.’s lower measles rate as a successful effort at containing the sometimes-deadly disease, but experts say the country could soon see a resurgence of infectious diseases due to the vaccine skepticism that grew during the pandemic and that they say Kennedy has fomented. Among kindergarteners, measles vaccine coverage is down 2.7 percentage points as of the 2024-2025 school year, from a peak of 95.2 percent prior to the pandemic, according to CDC data. That drop occurred before Kennedy became health secretary. Kennedy and his advisers blame it on distrust engendered by Covid vaccine mandates imposed by states and President Joe Biden. But Kennedy led an anti-vaccine movement for years before joining the Trump administration, linking shots to autism and other conditions despite scientific evidence to the contrary, and he has continued to question vaccine safety as secretary. In some EU nations, vaccines aren’t compulsory for school entry. Swedish law guarantees the right to education and promotes close consultation between providers and patients. Some governments fear mandates could push away vaccine-hesitant parents who want to talk the recommended shots over with their doctor before giving the vaccines to their children, Rubin explained. In the U.S., states, which have the authority to implement vaccine mandates for school entry, rely on the CDC’s guidance to decide which to require. Vaccine skeptics have pushed the agency to relax some of its recommendations with an eye toward making it easier for American parents to opt out of routine shots. Scandinavian nations maintain high vaccine uptake without mandates thanks to “high trust” in public health systems, Rubin said. In Sweden, she added, nurses typically vaccinate young children at local clinics and provide care for them until they reach school age, which helps build trust among parents. CHICKENPOX Another example of where the U.S. and Europe differ is the chickenpox vaccine. The U.S. was the first country to begin universal vaccination against the common childhood illness in 1995; meanwhile, 13 EU nations broadly recommend the shot. Denmark doesn’t officially track chickenpox — the vaccine isn’t included on its schedule — but estimates 60,000 cases annually in its population of 6 million. The vastly larger U.S. sees fewer than 150,000 cases per year, according to the CDC. Many European countries perceive chickenpox as a benign disease, Van Damme said. “If you have a limited budget for prevention, you will spend usually the money in other preventative interventions, other vaccines than varicella,” he said, referring to the scientific term for chickenpox. But there’s another risk if countries decide to recommend chickenpox vaccination, he explained. If the vaccination level is low, people remain susceptible to the disease, which poses serious risks to unborn babies. If it’s contracted in early pregnancy, chickenpox could trigger congenital varicella syndrome, a rare disorder that causes birth defects. If children aren’t vaccinated against chickenpox, almost all would get the disease by age 10, Van Damme explained. If countries opt for vaccination, they have to ensure robust uptake: vaccinate virtually all children by 10, or risk having big pockets of unvaccinated kids who could contract higher-risk infections later. Europe’s stance toward chickenpox could change soon. Several countries are calculating that widely offering chickenpox vaccines would provide both public health and economic benefits. Britain is adding the shot to its childhood schedule next month. Sweden is expected to green-light it as part of its national program in the coming months. While the public doesn’t see it as a serious disease, pediatricians who see serious cases of chickenpox are advocating for the vaccine, Rubin told POLITICO. “It is very contagious,” she said. “It fulfills all our criteria.” The U.K. change comes after its vaccine advisory committee reviewed new data on disease burden and cost-effectiveness — including a 2022 CDC study of the U.S. program’s first 25 years that also examined the vaccine’s impact on shingles, a painful rash that can occur when the chickenpox virus reactivates years later. Scientists had theorized for years that limiting the virus’ circulation among children could increase the incidence of shingles in older adults by eliminating the “booster” effect of natural exposure, but the U.S. study found that real-world evidence didn’t support that hypothesis.

Health Secretary Robert F. Kennedy Jr. came within hours of publicly promoting Denmark’s childhood vaccine schedule as an option for American parents — before legal and political concerns got in the way. A senior HHS official told POLITICO that a press conference set for Friday was canceled at the last minute after the HHS Office of the General Counsel said it would invite a lawsuit the administration could lose. A second senior official at the Department of Health and Human Services confirmed the press conference, which HHS had publicly announced, was to be about the Danish schedule. The second official said it was canceled because it was deemed politically risky. Billed as an “announcement regarding children’s health,” Kennedy was to appear alongside his top agency heads and Tracy Beth Høeg, the Food and Drug Administration’s top drug regulator. Høeg touted the Danish schedule at a vaccine advisory committee meeting earlier this month. HHS canceled the event Thursday evening, hours after announcing it. Andrew Nixon, an HHS spokesperson, called accounts of the cancellation that didn’t come directly from the department “pure speculation” in a statement. HHS officials skeptical of moving to the Danish schedule, which recommends immunization for only 10 of the 17 diseases on the U.S. list, were relieved it was never publicly recommended, the first official said. The internal confusion and disagreement follow similar management bungling within HHS’ Food and Drug Administration that has frustrated the White House. On Dec. 5, President Donald Trump signed a presidential memorandum titled “Aligning United States Core Childhood Vaccine Recommendations with Best Practices from Peer, Developed Countries.” The memorandum directed HHS and the Centers for Disease Control and Prevention, one of its subagencies that sets the vaccine schedule, to review peer-country best practices for vaccines recommended for all children and, if those practices were judged superior, to update the U.S. schedule while preserving access to vaccines already available. In the memorandum, Trump mentioned Denmark, Japan and Germany as examples of countries that recommend fewer shots than the U.S. According to the first official, Kennedy and his top aide, Stefanie Spear, helped sell the peer-country framing to West Wing officials as the clearest way to turn internal vaccine skepticism into a signed White House directive. Spear is Kennedy’s principal deputy chief of staff and senior counselor. Kennedy is a longtime vaccine skeptic who believes the U.S. schedule has grown too quickly, has not been tested in its entirety for adverse effects, and is a likely cause of rising autism rates. Numerous studies have not found a link between vaccines and the neurological disorder that now affects one in 31 U.S. children, up from one in 150 two decades ago. Experts in the condition, which affects the ability to communicate, say expanded diagnostic criteria and awareness are responsible for most of that rise. The condition’s cause is usually genetic, they believe, but researchers are studying possible environmental causes. HHS has made it a priority to learn more about what causes autism and why diagnoses are rising. The department’s research arm, the National Institutes of Health, announced an Autism Data Science Initiative on May 27 and has awarded around $50 million to fund 13 projects investigating potential causes. In April, Kennedy promised to reveal autism’s cause in September, but HHS later said it would reveal preliminary findings early next year. Autism researchers, who have studied the condition for years, have called that unrealistic. The first indication Kennedy might be considering the slimmer Danish schedule, which excludes vaccines for chickenpox, the flu, hepatitis A and B, meningitis, respiratory syncytial virus and rotavirus, came earlier this month during the CDC’s Advisory Committee on Immunization Practices meeting in Atlanta. Høeg presented a slide deck titled “U.S. vs. Danish Vaccine Schedule,” which the CDC posted among the meeting presentations. The department then circulated Høeg’s presentation to top officials at HHS, the first senior official said. In the ensuing debate, Høeg’s supporters proposed offering the Danish schedule as a government-recommended alternative to the U.S. one. The first senior official and two others inside HHS familiar with internal discussions, all of whom were granted anonymity to reveal deliberations they were not authorized to discuss publicly, said proponents of the Danish schedule felt that offering it would help restore trust in vaccines; many Americans were turned off by Covid-era vaccine mandates and claims that Covid shots would halt transmission that turned out to be incorrect, they argued. The three officials said the view of proponents inside the administration was that the Danish schedule could be pitched as a “reset” that might convince hesitant parents to vaccinate their kids. Critics inside the administration, the officials said, argued the plan to recommend the Danish schedule was not rigorous and science-based — and that promoting it publicly would invite criticism. Rather than restoring trust, they said it could undermine it by signaling doubt about the need for, and safety of, routine immunization. Going forward without laying the scientific groundwork or going through normal regulatory processes could also make the department vulnerable to lawsuits, the HHS general counsel’s office argued, according to the first senior official. Mike Stuart, who was a U.S. attorney in West Virginia in Trump’s first term, now is HHS general counsel. The American Academy of Pediatrics, which represents doctors who care for children, along with other physician and public health groups, has already sued HHS for changes it made earlier this year to Covid vaccine recommendations, saying the department violated rules governing how regulatory changes are made. That case is pending in federal district court in Boston. HHS has stopped recommending Covid boosters for previously vaccinated people under 65 who are not at high risk of the disease. Instead, the department says Americans should talk to their doctor and make a shared decision. Carmen Paun contributed to this story. Tim Röhn is senior editor of the Axel Springer Global Reporters Network.

LONDON — A mutated influenza strain is spreading early in Europe this winter, but some experts warn talk of a “superflu” is misleading, erodes public trust and distracts from the underlying problems of the National Health Service. The new strain has triggered dramatic headlines in the U.K., where health leaders are warning of a “worst-case scenario” for the country’s NHS. Health Secretary Wes Streeting described it as a “tidal wave of flu tearing through our hospitals” and labelled it a “challenge unlike any [the NHS] has seen since the pandemic.” While hospital admissions have been rising sharply due to the early arrival of flu season, there is currently no evidence that this season’s variant is more deadly or transmissible, experts at the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) told POLITICO. Neither does the data suggest hospital admissions will peak higher than previous years — although this is possible — just that they’re a few weeks early. But some experts in the U.K. have criticized the government’s “superflu” narrative, suggesting it’s being used as leverage in talks on doctor pay and conditions ahead of a looming strike. Prime Minister Keir Starmer wrote in The Guardian Friday it was “beyond belief” doctors would consider striking in these “potentially dire” circumstances, citing “a superflu epidemic.” The British Medical Association (BMA), the union representing resident doctors due to go on strike Wednesday, claimed it was “irresponsible to portray the current winter flu crisis as unprecedented” given that rates of infection and hospitalization were “comparable to most years,” a spokesperson told POLITICO. Mathematician Christina Pagel, a professor at University College London, said the “superflu” line was based on the “highly misleading use of statistics” and had more to do with the impending doctors’ strike than real trends. When contacted by POLITICO, the U.K. government stood by its health leaders’ warnings of the current flu season, in which they described it as an “unprecedented wave of super flu.” They said staff were being “pushed to the limit.” The government also pointed to stats showing the NHS is under pressure. A DHSC spokesperson told POLITICO the government had offered the BMA an extended mandate so they could strike in January instead, but the union rejected it. The BMA told POLITICO the extension included “several restrictive conditions.” THE IMPORTANCE OF TRUST The government and NHS bosses have warned the heavy burden on hospitals in December could set the health system up for a very severe winter. NHS statistics published last week show an average of 2,660 patients in hospital with flu per day, a record for this time of year, while the Health Foundation has said the NHS could face “major pressures” if cases continue to climb rapidly in the weeks ahead. Yet, while NHS staff are stretched, Pagel and others argue this year is largely consistent with previous severe flu seasons. However, without being clear about this with the public, some experts are concerned the government’s messaging could do more harm than good. “One of the real issues we have with governments everywhere is trust,” Martin McKee, professor of public health at the London School of Hygiene and Tropical Medicine, told POLITICO. While NHS staff are stretched, experts argue this year is largely consistent with previous severe flu seasons. | Geography Photos/Getty Images “The difficulty is we’ve seen them do all sorts of things for all sorts of motives. That then becomes a problem whenever they are saying something accurate,” McKee said, adding that the government should be more careful in its flu messaging given the declining trust in science. POLITICO put these concerns over trust in science to DHSC, but the department did not respond by the time of publication. A spokesperson for government-sponsored NHS England told POLITICO: “The NHS is not misleading the public — this is the earliest flu season we have seen in recent years with the latest data showing the numbers of patients in hospital with flu is extremely high for this time of year.” The NHS is struggling as it often does in winter, with a spike in delayed discharges — people who are ready to leave hospital but have nowhere to go — posing an extra challenge for hospitals, The Guardian reported Sunday. Hospital admissions for flu per 100,000 rose 23 percent in last week’s data, compared to 69 percent the previous week, but this doesn’t rule out another surge in the weeks ahead. McKee said the NHS was paying the price for chronic underinvestment. “We almost seem surprised that it’s arrived,” he said of the current flu wave, citing a “massive shortage” in beds, IT equipment and scanners.  WHAT THE EXPERTS SAY There is no reason to think the current flu strain (H3N2 sub-clade K) causes more severe disease than other types of flu, Hans Kluge, head of the World Health Organization’s Europe office, told POLITICO. Nor is there any solid evidence that it is more transmissible, said Edoardo Colzani, a flu expert at the European Centre for Disease Prevention and Control. It’s possible the lower level of immunity to this strain could lead to more cases “but this is still speculative at this stage,” Colzani said. “The epidemiological situation at the moment [in the EU] does not seem worse than in previous years apart from the fact that it is two-to-three weeks earlier,” Colzani said. Kluge said it was “about 4 weeks earlier than usual,” which “is not out of the ordinary” and trending similar to the 2022–2023 influenza season. There were some concerns the available flu vaccine might not be a “perfect match” for the current strain, Kluge said, but early data from the U.K. suggests it provides “meaningful protection” and may prevent severe disease and death, especially among vulnerable groups. “We [could] end up having a much bigger wave than usual but we have no evidence,” Pagel said, adding she thought it was “most likely” to peak “in a couple of weeks.” But the available data can’t tell us whether it will be a normal wave that starts and ends early, or an especially bad season, she added.  “We don’t know when it will turn the corner but the actual shape of the wave doesn’t look that different from previous years,” McKee said. The NHS has previously warned of the risk of a “long and drawn-out flu season” due to the early start. According to the WHO, some countries in the southern hemisphere had unusually long flu seasons this year.  “Based on previous trends, this season is expected to peak in late December or early January,” Kluge said. The advice from EU and U.K. authorities remains the same — get a flu vaccine as soon as possible, especially for those in a vulnerable group.

When the Franco-German summit concluded in Berlin, Europe’s leaders issued a declaration with a clear ambition: strengthen Europe’s digital sovereignty in an open, collaborative way. European Commission President Ursula von der Leyen’s call for “Europe’s Independence Moment” captures the urgency, but independence isn’t declared — it’s designed. The pandemic exposed this truth. When Covid-19 struck, Europe initially scrambled for vaccines and facemasks, hampered by fragmented responses and overreliance on a few external suppliers. That vulnerability must never be repeated. True sovereignty rests on three pillars: diversity, resilience and autonomy. > True sovereignty rests on three pillars: diversity, resilience and autonomy. Diversity doesn’t mean pulling every factory back to Europe or building walls around markets. Many industries depend on expertise and resources beyond our borders. The answer is optionality, never putting all our eggs in one basket. Europe must enable choice and work with trusted partners to build capabilities. This risk-based approach ensures we’re not hostage to single suppliers or overexposed to nations that don’t share our values. Look at the energy crisis after Russia’s illegal invasion of Ukraine. Europe’s heavy reliance on Russian oil and gas left economies vulnerable. The solution wasn’t isolation, it was diversification: boosting domestic production from alternative energy sources while sourcing from multiple markets. Optionality is power. It lets Europe pivot when shocks hit, whether in energy, technology, or raw materials. Resilience is the art of prediction. Every system inevitably has vulnerabilities. The key is pre-empting, planning, testing and knowing how to recover quickly. Just as banks undergo stress tests, Europe needs similar rigor across physical and digital infrastructure. That also means promoting interoperability between networks, redundant connectivity links (including space and subsea cables), stockpiling critical components, and contingency plans. Resilience isn’t theoretical. It’s operational readiness. Finally, Europe must exercise authority through robust frameworks, such as authorization schemes, local licensing and governance rooted in EU law. The question is how and where to apply this control. On sensitive data, for example, sovereignty means ensuring it’s held in Europe under European jurisdiction, without replacing every underlying technology component. Sovereign solutions shouldn’t shut out global players. Instead, they should guarantee that critical decisions and compliance remain under European authority. Autonomy is empowerment, limiting external interference or denial of service while keeping systems secure and accountable. But let’s be clear: Europe cannot replicate world-leading technologies, platforms or critical components overnight. While we have the talent, innovation and leading industries, Europe has fallen significantly behind in a range of key emerging technologies. > While we have the talent, innovation and leading industries, Europe has fallen > significantly behind in a range of key emerging technologies. For example, building fully European alternatives in cloud and AI would take decades and billions of euros, and even then, we’d struggle to match Silicon Valley or Shenzhen. Worse, turning inward with protectionist policies would only weaken the foundations that we now seek to strengthen. “Old wines in new bottles” — import substitution, isolationism, picking winners — won’t deliver competitiveness or security. Contrast that with the much-debated US Inflation Reduction Act. Its incentives and subsidies were open to EU companies, provided they invest locally, develop local talent and build within the US market. It’s not about flags, it’s about pragmatism: attracting global investments, creating jobs and driving innovation-led growth. So what’s the practical path? Europe must embrace ‘sovereignty done right’, weaving diversity, resilience and autonomy into the fabric of its policies. That means risk-based safeguards, strategic partnerships and investment in European capabilities while staying open to global innovation. Trusted European operators can play a key role: managing encryption, access control and critical operations within EU jurisdiction, while enabling managed access to global technologies. To avoid ‘sovereignty washing’, eligibility should be based on rigorous, transparent assessments, not blanket bans. The Berlin summit’s new working group should start with a common EU-wide framework defining levels of data, operational and technological sovereignty. Providers claiming sovereign services can use this framework to transparently demonstrate which levels they meet. Europe’s sovereignty will not come from closing doors. Sovereignty done right will come from opening the right ones, on Europe’s terms. Independence should be dynamic, not defensive — empowering innovation, securing prosperity and protecting freedoms. > Europe’s sovereignty will not come from closing doors. Sovereignty done right > will come from opening the right ones, on Europe’s terms. That’s how Europe can build resilience, competitiveness and true strategic autonomy in a vibrant global digital ecosystem.

Rick Pazdur, the FDA’s top drug regulator, told staff Tuesday he submitted his resignation to the agency, an abrupt departure weeks after he was convinced by Commissioner Marty Makary to take the post to help bring stability to an agency reeling from months of upheaval, according to four people familiar with the decision granted anonymity to discuss the move. The decision — which comes days after top vaccine regulator Vinay Prasad said the agency would ratchet up regulatory requirements for new vaccines — is almost certain to raise new questions about Makary’s leadership of the FDA. Pazdur in recent weeks clashed with Makary over the Commissioner’s National Priority Voucher program, according to media reports. That program — which aims to speed final review of drugs that address health priorities, pose a transformative innovative impact, address an unmet medical need, help onshoring efforts or increase affordability — was also criticized by Pazdur’s predecessor, George Tidmarsh. FDA experts have worried the involvement of political appointees in the process of choosing which firms receive a voucher could raise questions about the program’s integrity. STAT first reported the news of Pazdur’s decision to retire. It is unclear if the decision is final — one person familiar with the decision said the longtime cancer drug regulator has 30 days to change his decision. “We respect Dr. Pazdur’s decision to retire and honor his 26 years of distinguished service at the FDA,” an FDA spokesperson said in a statement. “As the founding director of the Oncology Center of Excellence, he leaves a legacy of cross-center regulatory innovation that strengthened the agency and advanced care for countless patients. His leadership, vision, and dedication will continue to shape the FDA for years to come.” The White House and Pazdur did not immediately respond to requests for comment. Pazdur, a 26-year agency veteran, initially rebuffed efforts by Makary to convince him to assume leadership of the FDA’s Center for Drug Evaluation and Research — but ultimately agreed to take the job after being assured he would be given autonomy in the role free from political influence and the ability to rehire staff.

Pediatric respiratory diseases are among the most common and serious health challenges we face worldwide. From examples such as respiratory syncytial virus (RSV) to pertussis (also known as whooping cough), these infections can cause significant illness, hospitalizations, and with some, possible long-term consequences.[1],[2] Worldwide, RSV causes approximately 3.6 million hospitalizations and 100,000 deaths each year in children under five years of age.[3] Yet, many of these infections may be prevented, if we continue to prioritize and strengthen immunization. Immunization is not just a scientific achievement; it’s a public health imperative. And in this new era, Sanofi is at the forefront, driving innovation and access to pediatric immunization, especially when it comes to respiratory disease prevention. Our commitment is global, our ambition bold: to help protect people everywhere against preventable illnesses, with the confidence that every child, every parent, every person, and every healthcare professional deserves. > Immunization is not just a scientific achievement; it’s a public health > imperative. RSV, a leading cause of infant hospitalizations globally, exemplifies both the challenge and the opportunity.[4],[5],[6],[7] With an estimated 12.9 million lower respiratory infections and 2.2 million hospitalizations annually among infants under one year of age,3 the burden is immense. For decades, RSV lacked preventive options for the broad infant population. Some countries in Europe are a good illustration of what is possible when prevention is prioritized. For example, in Galicia, Spain, implementation of a universal program offered to the broad infant population led to notable reductions in RSV-related hospitalization compared with previous seasons.[8] The lesson is clear: when prevention is prioritized like it matters, delivered equitably and integrated into routine care, the impact is quickly seen. This principle applies to other childhood respiratory diseases. Hexavalent combination vaccinations have helped to revolutionize pediatric immunization by combining protection against six diseases into one vaccine. One of these is pertussis, which is especially dangerous for children who haven’t received all their vaccinations yet, and have a four-fold higher risk of contracting whooping cough.[9]  For younger infants pertussis is high risk, with over 40 percent of infants under six months of age requiring hospitalization.[10] These data demonstrate how delayed or missed vaccine doses can leave children vulnerable. By combining vaccines into a single shot, immunization uptake can be improved, increasing acceptance with efficient and equitable delivery and helping reduce disease burden at scale.[11],[12] > Some countries in Europe are a good illustration of what is possible when > prevention is prioritized. For example, in Galicia, Spain, implementation of a > universal program offered to the broad infant population led to notable > reductions in RSV-related hospitalization compared with previous seasons. Good uptake is crucial for protecting children. Where programs are fragmented, under-resourced or underfunded, equity gaps worsen along familiar lines – income, access and information. The recent resurgence of some preventable diseases is not just a warning; it’s a call to action.[13],[14],[15] Sustaining protection against respiratory diseases in children, increasing vaccination coverage rates, and embracing innovation to help protect against more diseases must be a collective priority.[11],[12] We must not let misinformation or complacency erode public trust in immunization. The evidence is clear: prevention works. Today, we have a unique opportunity to showcase that impact and redefine the future of respiratory health in children. > We must not let misinformation or complacency erode public trust in > immunization. The evidence is clear: prevention works. The science is sound. The approach for protecting infants against respiratory infections is clear. Our children deserve nothing less. -------------------------------------------------------------------------------- [1] Glaser EL, et al. Impact of Respiratory Syncytial Virus on Child, Caregiver, and Society. Journal of Infectious Diseases. 2022;226(Supplement_2):S236-S241 [2] Kardos P, et al. Understanding the impact of adult pertussis and its complications. Hum Vaccin Immunother. 2024. [3] Li Y, Wang X, Blau DM, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet 2022;399:2047-2064. [4] Leader S, Kohlhase K. Respiratory syncytial virus-coded pediatric hospitalizations, 1997 to 1999. The Pediatric infectious disease journal. 2002;21(7):629-32. [5] McLaurin KK, Farr AM, Wade SW, Diakun DR, Stewart DL. Respiratory syncytial virus hospitalization outcomes and costs of full-term and preterm infants. Journal of Perinatology: official journal of the California Perinatal Association. 2016;36(11):990-6. [6] Rha B, et al. Respiratory Syncytial Virus-Associated Hospitalizations Among Young Children: 2015-2016. Pediatrics. 2020;146:e20193611. [7] Arriola CS, et al. Estimated Burden of Community-Onset Respiratory Syncytial Virus-Associated Hospitalizations Among Children Aged <2 Years in the United States, 2014-15. J Pediatric Infect Dis Soc. 2020;9:587-595. [8] Ares-Gómez S, et al. NIRSE-GAL Study Group. Effectiveness and impact of universal prophylaxis with nirsevimab in infants against hospitalisation for respiratory syncytial virus in Galicia, Spain: initial results of a population-based longitudinal study. Lancet Infectious Diseases. 2024; 24: 817-828. [9] Centers for Disease Control and Prevention. 2019 Final Pertussis Surveillance Report. Accessed 4 March 2025 [10] Glanz, J. M., et al. (2013) Association between undervaccination with diphtheria, tetanus toxoids, and acellular pertussis (DTaP) vaccine and risk of pertussis infection in children 3 to 36 months of age. JAMA Pediatr. doi: 10.1001/jamapediatrics.2013.2353 [11] Fatima M, Hong KJ. Innovations, Challenges, and Future Prospects for Combination Vaccines Against Human Infections. Vaccines (Basel). 2025 Mar 21;13(4):335. doi: 10.3390/vaccines13040335. PMID: 40333234; PMCID: PMC12031483. [12] Maman K, Zöllner Y, Greco D, Duru G, Sendyona S, Remy V. The value of childhood combination vaccines: From beliefs to evidence. Hum Vaccin Immunother. 2015;11(9):2132-41. doi: 10.1080/21645515.2015.1044180. PMID: 26075806; PMCID: PMC4635899. [13] Liu J, Lu G, Qiao J. Global resurgence of pertussis in infants BMJ 2025; 391 :r2169 doi:10.1136/bmj.r2169 [14] Jenco M. AAP, CHA call for emergency declaration to address surge of pediatric illnesses. AAP News. 2022 [15] Wang, S., Zhang, S., & Liu, J. (2025). Resurgence of pertussis: Epidemiological trends, contributing factors, challenges, and recommendations for vaccination and surveillance. Human Vaccines & Immunotherapeutics, 21(1). https://doi.org/10.1080/21645515.2025.2513729 MAT-GLB-2506084 

As Europe redefines its life sciences and biotech agenda, one truth stands out: the strength of our innovation lies in its interconnection between human and animal health, science and society, and policy and practice. This spirit of collaboration guided the recent “Innovation for Animal Health: Advancing Europe’s Life Sciences Agenda” policy breakfast in Brussels, where leading voices from EU politics, science and industry came together to discuss how Europe can turn its scientific excellence into a truly competitive and connected life sciences ecosystem. Jeannette Ferran Astorga / Via Zoetis Europe’s role in life sciences will depend on its ability to see innovation holistically. At Zoetis we firmly believe that animal health innovation must be part of that equation, as this strengthens resilience, drives sustainability, and connects directly to the wellbeing of people. Innovation without barriers Some of humanity’s greatest challenges continue to emerge at the intersection of human, animal and environmental health, sometimes with severe economic impact. The recent outbreaks of diseases like avian influenza, African swine fever and bluetongue virus act as reminders of this. By enhancing the health and welfare of animals, the animal health industry and veterinarians are strengthening farmers’ livelihoods, supporting thriving communities and safeguarding global food security. This is also contributing to protecting wildlife and ecosystems. Meanwhile, companion animals are members of approximately half of European households. Here, we have seen how dogs and cats have become part of the family, with owners now investing a lot more to keep their pets healthy and able to live to an old age. Because of the deepening bonds with our pets and their increased longevity, the demand for new treatment alternatives is rising continuously, stimulating new research and innovative solutions making their way into veterinary practices. Zoonotic diseases that can be transferred between animals and humans, like rabies, Lyme disease, Covid-19 and constantly new emerging infectious diseases, make the rapid development of veterinary solutions a necessity. Throughout the world, life sciences are an engine of growth and a foundation of health, resilience and sustainability. Europe’s next chapter in this field will also be written by those who can bridge human and animal health, transforming science into solutions that deliver both economic and societal value. The same breakthroughs that protect our pets and livestock underpin the EU’s ambitions on antimicrobial resistance, food security and sustainable agriculture. Ensuring these innovations can reach the market efficiently is therefore not a niche issue, it is central to Europe’s strategic growth and competitiveness. This was echoed at the policy event by Dr. Wiebke Jansen, Policy Lead at the Federation of Veterinarians of Europe (FVE) when she noted that ‘innovation is not abstract. As soon as a product is available, it changes the lives of animals, their veterinarians and the communities we serve. With the many unmet needs we still face in animal health, having access to new innovation is an extremely relevant question from the veterinary perspective.’ Enabling innovation through smart regulation To realize the promise of Europe’s life sciences and biotech agenda, the EU must ensure that regulation keeps pace with scientific discovery. The European Commission’s Omnibus Simplification Package offers a valuable opportunity to create a more innovation-friendly environment, one where time and resources can be focused on developing solutions for animal and human health, not on navigating overlapping reporting requirements or dealing with an ever increasing regulatory burden. > In animal health, biotechnology is already transforming what’s possible — for > example, monoclonal antibodies that help control certain chronic conditions or > diseases with unprecedented precision. Reviewing legislative frameworks, developing the Union Product Database as a true one-stop hub or introducing digital tools such as electronic product information (e-leaflets) in all member states, for instance, would help scientists and regulators alike to work more efficiently, thereby enhancing the availability of animal health solutions. This is not about loosening standards; it is about creating the right conditions for innovation to thrive responsibly and efficiently. Science that serves society Europe’s leadership in life sciences depends on its ability to turn cutting-edge research into real-world impact, for example through bringing new products to patients faster. In animal health, biotechnology is already transforming what’s possible — for example, monoclonal antibodies that help control certain chronic conditions or diseases with unprecedented precision. Relieving itching caused by atopic dermatitis or alleviating the pain associated with osteoarthritis significantly increases the quality of life of cats and dogs — and their owners. In addition, diagnostics and next-generation vaccines prevent outbreaks before they start or spread further. Maintaining a proportionate, benefit–risk for veterinary medicines allows innovation to progress safely while ensuring accelerated access to new treatments. Supporting science-based decision-making and investing in the European Medicines Agency’s capacity to deliver efficient, predictable processes will help Europe remain a trusted partner in global health innovation. Continuum of Care / Via Zoetis A One Health vision for the next decade Europe is not short of ambition. The EU Biotech Act and the Life Sciences Strategy both aim to turn innovation into a driver of growth and wellbeing. But to truly unlock their potential, they must include animal health in their vision. The experience of the veterinary medicines sector shows that innovation does not stop at species’ borders; advances in immunology, monoclonal antibodies and the use of artificial intelligence benefit both animals and humans. A One Health perspective, where veterinary and human health research reinforce each other, will help Europe to play a positive role in an increasingly competitive global landscape. The next five years will be decisive. By fostering proportionate, science-based adaptive regulation, investing in digital and institutional capacity, and embracing a One Health approach to innovation, Europe can become a genuine world leader in life sciences — for people and the animals that are essential to our lives. -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Zoetis Belgium S.A. * The political advertisement is linked to policy advocacy on the EU End-of-Life Vehicles Regulation (ELVR), circular plastics, chemical recycling, and industrial competitiveness in Europe. More information here.

Liz Truss looks out of place. In her neat pink jacket and white blouse, the former U.K. prime minister, who served a brief but eventful 49 days in the role back in 2022, strikes a contrast to the hoopla around her in the packed ballroom. Truss has come to Liberty University in Lynchburg, Virginia this October evening for the yearly “CEO summit,” drawing corporate figures, conservative influencers and donors for a night of fiery speeches about the triumphs of the MAGA movement — seasoned with the university’s Christian conservative tradition of mixing politics with prayer. Truss rises somberly as the crowd is enjoined to repent, soul-search and double down on tithe payments to the Baptist mega-church originally founded by the late televangelist Jerry Falwell. From the stage at the front of the room, she nods along to the heady mixture of God and politics, waiting to start a talk about the so-called “deep state” — which, she claims, includes the Bank of England and the U.K. Treasury. She announces that she is “on a mission” to transform the U.K., and when someone cries a noisy “amen,” that throws her for a moment before she resumes. If the juxtaposition between the ex-prime minister and fire-and-brimstone MAGA evangelicals seems unlikely — Truss later tells me she is still a stalwart of the Church of England, which is much more establishment than evangelical, even if she thinks it has gone a bit “woke” on social issues like trans rights — her presence here nonetheless represents an increasingly popular trend. A transatlantic “Magafication” movement is luring traditional conservatives from the U.K. to identify with the provocative style of U.S. President Donald Trump — and to try their hands at imitating him on his home turf, participating in rousing conservative speaking events across the U.S. For some, like Truss, these events are a lucrative, mood-enhancing chance to establish a new identity after the stinging defeat of the Tory party at the last general election in July 2024. For her more charismatic predecessor Boris Johnson, they are a chance to hear the roar of the crowd that more sedate speaking gigs with hedge funds and law firms can’t deliver. For Nigel Farage, from the ultraconservative Reform UK party, they are a chance to re-forge British politics in the image of Trump — a benediction and a bro-mance all in one. Whether it’s connecting with voters on either side of the Atlantic, however, is a less certain proposition. Most of the students going about their early evening outside the hall don’t seem to know who Truss is. “They kind of told us she was the leader in the U.K.,” muses one business studies major, “but I never heard of her.” Just a few weeks earlier, it was Johnson — the premier who rose on the wings of Brexit and preceded Truss in a carousel of Tory leaders after the Leave vote — who spoke on campus at the new-term convocation, following a sequence of Christian rock numbers.  “We’re in a congregation, folks, convocation — I mean, we’ve been convoked,” Johnson riffed. The ruffle-haired charm and Old Etonian levity were a preamble to a speech about the Christian university as a “bastion of freedom” and a paean to the memory of Charlie Kirk, the murdered conservative activist, whom Johnson hailed as “a martyr to our inalienable right as human beings to say what is in our hearts.” Later, he zoned in on the need to keep supporting Ukraine and lambasted the authoritarianism of Russian President Vladimir Putin — to a muted response from the audience. It’s not exactly a popular take here; there are no follow-up questions on the topic. And at the CEO event, none of the speakers mention Ukraine or the U.S. role in its future at all. Much like the isolationism Johnson encountered, the British MAGA trail is a sign of the times. Trump’s twofold electoral success is attractive to some U.K. conservatives who feel there must be something in the president’s iconoclasm they can bottle and take home. And unlike tight-lipped debate forums in the U.K., such events give them a chance to be noisy and outspoken, to paint arguments in bold and provocative colors. In other words, to be Brits on tour — but also more like Trump. And, for added appeal, these tours are a lucrative field for former inhabitants of 10 Downing Street. One person who has previously worked at the Washington Speakers Bureau, one of the main hubs for booking A-list speakers, said that the fee for a former premier is around $200,000 for a substantial speech, plus private plane travel and commercial flights for a support team. That is a level of luxury unparalleled at home. Well known figures like Johnson and David (Lord) Cameron, the British premier from 2010 to 2016, can aim even higher if travel is complicated. -------------------------------------------------------------------------------- Having “former prime minister” in front of your name in writing may open a lot of doors, but these politicians nonetheless have to tailor their resumes to appeal to American audiences.” Political CVs are duly bowdlerized to appeal to the target market of U.S. institutions and interests. Johnson’s profile at the Harry Walker agency in Washington, for instance, stresses his interest in deregulation and claims that he “successfully delivered Brexit — taking back control of U.K. law, marking the biggest constitutional change for half a century and enabling the United Kingdom to generate the fastest vaccine approval in the world.” This sequence of events and superlatives is debatable at best. Failures are routinely airbrushed out — Johnson’s premiership crashed in a mess of mismanagement during the pandemic and party divisions unleashed by the Brexit vote and his controversial handling of the aftermath, including the temporary dissolution of parliament to push through his legislation. But for characters whose legacy at home is either polarizing (like Johnson) or more likely to elicit a sly British eye roll outside a small fan base (Truss), there is also a degree of absolution on the American performance circuit that feels refreshing, in the same way that U.K. Indie bands stubbornly try to conquer America. Neither of the former Conservative leaders however, have as much to gain or lose by speaking at Trump-adjacent events as Farage, the leader of Britain’s Reform party — an “anti-woke,” Euro-skeptic, immigration-hostile party that is leading in the polls and attempting to expand its handful of lawmakers in the House of Commons into a party in contention for the next government. Farage has the closest access to Trump — a status previously enjoyed by Johnson, who last met Trump at the Republican National Convention in 2024 to discuss Ukraine. Proximity to Trump is the ultimate blessing, but it’s far harder to secure out of office than in it. Johnson endorsed Trump’s comeback at CPAC in February 2024 and wrote a column in support of Trump’s attack on the BBC for splicing footage of the January 6 uprising, which was deemed to be misleading and led to the abrupt departure of the broadcaster’s director general. Johnson was at Trump’s inauguration along with Truss (no other former U.K. politician was asked), but the invitations appear to have dropped off since chummy relations in Trump world can be ephemeral. Farage, by contrast, is a frequent visitor at both Mar-a-Lago and the White House. On November 7, he joined Trump at a fundraising auction for military veterans and has arranged to donate the prize of a walk with a centenarian veteran on Omaha beach, commemorating the D-Day landing site for U.S. forces. “I see him often,” he told me of his visits to Trump. Farage’s relationship with Trump could prove advantageous to him if he and his party claim greater power at home. He’d have the ear of the president, perhaps even the ability to sway Trump into a more sympathetic stance toward the U.K., even as the Americans embrace a more isolationist foreign policy. For now, Farage is certainly the most in-demand Brit on the MAGA circuit. He was the main speaker at the $500-a-head Republican party dinner in Tallahassee, Florida in March. Guests paid around $25,000 for a VIP ticket, which included having a photograph taken with the Reform UK leader. For the leader of a party that has a skimpy presence in parliament and faces the challenge of keeping its surge momentum and newsworthiness intact on a long road to the next election, being in the Trump limelight is a vote of confidence and a sign that he is taken seriously across the pond. The quid pro quo is performative loyalty — Farage, by turns genial and threatening in his manner, has echoed the president’s rancorous tone toward public broadcasters and media critics of MAGA. -------------------------------------------------------------------------------- All of this transatlantic networking has threatened to ensnare the British visiting troupe in ethical quagmires about how their lucrative American freelancing relates to duties and strictures at home. Farage has attracted envious attention among his peers in parliament for earning around $1.5 million a year in addition to his MP salary, but he was forced to apologize recently for failing to declare the March dinner appearance and any fees associated with it in the official registry. So far, he’s revealed only that the trip was “remunerated in three separate installments over the course of two months,” without naming the funder.  Even Farage’s friendship with Trump — the envy of his compatriots on the MAGA trail — could present vulnerabilities among the U.K. electorate. Farage’s base of Reform voters largely supports Trumpian stances on immigration and diversity, and they love Trump’s personality. But beyond core Reform voters, the president does not enjoy broad support in the U.K. Recent polling shows only 16 percent of British people like the president. That’s a challenge for the Reform UK leader, whose party polls at just under 30 percent support in the U.K.; he needs to reach Trump-skeptical voters beyond his base in order to claim power. On top of those liabilities, avid Christian nationalism of the kind Truss encountered at the Liberty event presents a cultural problem for British politicians. Mixing ideology with religious fervor is awkward back home where church-going is largely regarded as a private matter, even if there are signs of more evangelical commitment among influential Christian Conservatives like Paul Marshall, a hedge-funder who recently acquired The Spectator, the house publication of well-heeled Tories, expanding its digital reach into America. Hardline evangelical stances could undermine support for campaigners like Farage, says Tim Bale, an expert on elections and political trends at Queen Mary College, University of London. Farage “probably needs to be careful of getting into things like anti-abortion arguments or even term limits on abortion. That does not play in the U.K.,” he told me. Duly, on their U.S. pilgrimages, both Truss and Johnson side-step direct engagement with the religiosity of their hosts. Johnson, who once joked that his own Anglican faith “comes and goes like Classic FM in the Chiltern hills,” basks in his reputation as a cheerful libertine with an array of past wives and mistresses. He fathered one child by an affair, and a scandal arising from allegations that he paid for an abortion during another affair got him sacked from his party’s front bench in 2004. (Johnson married his current wife, with whom he has four children, in 2021.) Religion isn’t the only subject that makes British MAGA-philes modulate their tone toward Trump. Johnson spoke of Trump’s “boisterous and irreverent” treatment of journalists, but dismissed it as minor compared to the attacks on the fourth estate in Moscow. Despite her previous support for Ukraine as Johnson’s foreign secretary, Truss awkwardly ducked questions on the Westminster Insider interview podcast when I pressed her about whether the administration should send Tomahawk missiles to Ukraine, which Trump opposes. “I’d have to know about the facts on the ground,” she said. But Farage, Johnson and Truss are betting that the benefits of being a transatlantic Trump acolyte well outweigh the risks. And there might be more to it than personal vanity tours and cushy earnings. The sense of grievances unheard or unaddressed that first elevated Trump to power have echoes across the Atlantic: worries about national decline, a feeling that traditional parties have lost touch with voters and a capacity for making Barnum-style entertainment out of the business of politics. It is a long way from being interrupted by the Speaker of the House of Commons shouting, “Order, order!”- Whether it is a flattering transatlantic afterlife for fallen leaders or a precursor to pitch for power at Westminster for Farage (who tells me that, like Trump, he is “building an unstoppable movement”) the MAGA circuit is the place to be — even if it’s not where everybody knows your name. It is also about embodying something these political pilgrims reckon their rivals fail to grasp: namely, the way one man’s MAGA movement has redefined Conservatism and opened up space for imitators in Europe to identify with more than their own election flops — and for newcomers to seek to remake their own political landscape. After all, if it happened to America, it might turn out to be a bankable export.