Israel reopened the Rafah crossing from Gaza to Egypt on Sunday in a limited capacity after two years, allowing only foot traffic, as violence continued across the Gaza Strip. The move comes amid fresh bloodshed in the enclave, with Gaza’s civil defense agency reporting dozens killed in Israeli strikes on Saturday. The Israel Defense Forces said it was responding to ceasefire violations. Around 80,000 Palestinians who left Gaza during Israel’s war on the enclave are seeking to return through the crossing from Egypt, a Palestinian official told Al Jazeera. At the same time, Israel announced it was terminating the operations of Doctors Without Borders in Gaza, accusing the group of failing to submit lists of its Palestinian staff — a requirement Israeli authorities say applies to all aid organizations in the territory. Israel’s Ministry of Diaspora Affairs and Combating Antisemitism alleged that two employees had ties to Hamas and Palestinian Islamic Jihad, accusations the medical charity has strongly denied. The ministry said the group must halt its work and leave Gaza by Feb. 28. The tightly controlled reopening of Rafah — alongside the expulsion of a major humanitarian actor — is likely to intensify scrutiny of Israel’s handling of civilian access and aid as the conflict drags on.

The world has been rewired. The post-war order is fragmenting, public pessimism has reached crisis levels, and the gap between elite and public opinion is wider than ever. The FGS Global Radar 2026 — drawing on 175 interviews with senior leaders and polling nearly 20,000 people across 27 democracies — maps the new terrain. For leaders gathering in Davos this week, understanding it is critical. Via FGS Global Previous Radar reports were defined by volatility and uncertainty. These remain constants. But in 2026, the shape of the world is now more clearly defined — and the question for leaders is whether they can see it clearly enough to navigate it. A rewired world The multilateral consensus in place since World War II — guided by international institutions and liberal democracies — is being rewritten. Those institutions are weakening, with strongman leaders increasingly calling the shots within their own spheres of influence. > The post-war rules-based order is fragmenting into spheres of influence, with > transactional relationships and strongman leadership supplanting shared > values. As one expert put it: “The post-war rules-based order is fragmenting into spheres of influence, with transactional relationships and strongman leadership supplanting shared values.” The United States and China are now in fierce, direct competition for dominance — across trade, technology and an emerging space race. Gray zone conflict will be common. The rest of the world is having to align accordingly, navigating constantly shifting sands. For those gathering in Davos, the implications are stark. We are shifting from “What are our shared principles?” to “What can you do for me?” As another expert observed: “America doesn’t have anyone’s back anymore.” Our polling finds that seven in 10 people want their country to be more assertive of national interests, even if this creates friction with others. Nationalist sentiment is ascending. And Europe? “If Trump and Xi are talking, Europe isn’t even at the table.” The elite-public divide This year’s Radar report reveals something leaders at Davos must confront directly: a profound and widening gap between elite opinion and public sentiment. Ideas widely favored by leaders — letting artificial intelligence flourish, cutting spending, incentivizing entrepreneurs — are roundly opposed by voters. More troubling still, the public is susceptible to populist claims that difficult trade-offs don’t need to be made. In our poll, most people agreed: “There are clear and easy solutions to the big challenges facing the country, if only we had better political leaders.” > We are shifting from ‘What are our shared principles?’ to ‘What can you do for > me?’ We are living in a K-shaped world. The winners are high-income earners and technology industries. Those on lower incomes and in traditional sectors are struggling. Most people across the 27 countries polled expect to be worse off next year; only those on high incomes believe they will be better off. The cost of living remains the most important issue across generations and political affiliations. This feeds directly into attitudes on tax. Large majorities want more of the burden borne by business and the wealthy. Sixty-four percent support a wealth tax. These are not fringe positions — they are mainstream sentiment across developed democracies. The generational divide compounds the problem. Fifty-four percent of 18-34 year olds believe too much support goes to the elderly. Fifty percent of over-55s think too much goes to the young. Each generation feels the other is getting a better deal. And across all age groups, 73 percent believe life will be harder for the next generation. Pessimism at crisis levels Public confidence has been eroding for years. But the mood has now intensified to a crisis point. Across all 27 countries polled, 76 percent say their country feels divided. Sixty-eight percent believe their political system is failing and needs fundamental reform. Sixty-two percent feel their national identity is disappearing. > Pessimism on this scale, replicated across democracies, isn’t normal — and may > not be sustainable. To be clear: pessimism on this scale, replicated across democracies, isn’t normal — and may not be sustainable. It is fueling political instability and populism. Systems and governments that appear analog in a digital world, and fail to deliver better outcomes, will increasingly be challenged. Trust in traditional institutions continues to collapse. Sixty-one percent believe mainstream media have their own agenda and cannot be trusted. The hierarchy of trust is stark: medical doctors at 85 percent, big business at 41 percent, ChatGPT at 34 percent and politicians at just 22 percent. Perhaps most striking: 47 percent of people report feeling disconnected from society. When presented with the Matrix dilemma — a choice between blissful ignorance and complex reality — a quarter chose ignorance. Among Gen Z, it rises to over a third. Disengagement is becoming a generational norm. Europe’s pivotal moment For European leaders, the report offers both warning and opportunity. Our polling finds overwhelming support — 70-80 percent — in every EU country for major reform and stronger control of national borders. The Draghi and Letta reports are seen as offering the most coherent reform roadmap in years, but implementation is stuck at just 11 percent. As one expert noted: “Things are bad — but not so bad people are willing to be pushed through a pain barrier.” That may not remain true for long. What leaders must do The Radar concludes with a clear message: in a rewired world, long-term strategy matters more than ever. “If you haven’t got a strategy, you’re lost,” said one leader we interviewed. But strategy alone is not enough. The next most cited quality was agility — the ability to move fast and adapt. One compelling analogy: leaders need satellite navigation. Be clear on your destination, but flexible on how you get there. “You need a North Star, but like a GPS, you’re going to have to re-route — roadworks, delays, traffic jams.” Authenticity emerged as essential. “Authenticity by definition is infinitely durable. You are what you are.” And finally, storytelling: “Social media divides us, hates complexity, kills concentration. Nothing sticks. Leaders must repeat their message relentlessly.” Strategy. Agility. Authenticity. Storytelling. These are what 2026 demands. Download the full FGS Global Radar 2026 report here: https://fgsglobal.com/radar.

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.

Prime minister’s questions: a shouty, jeery, very occasionally useful advert for British politics. Here’s what you need to know from the latest session in POLITICO’s weekly run-through. What they sparred about: The year that was. Prime Minister Keir Starmer and Tory Leader Kemi Badenoch’s last hurrah of 2025 saw everyone’s favorite duo row about the turkey Labour’s record over the last 12 months — and who caused the nightmare before Christmas. Pull the other one: Badenoch wished everyone a festive break in the season of goodwill — but then the gloves came off. She raised the PM’s own frustration at pulling levers but struggling to get change (Labour’s favorite word). “Does he blame himself or the levers?” Cutting. Starmer used the free airtime to rattle through his achievements, stressing “I’ve got a whole list … I could go on for a very long time.” Comparisons to Santa write themselves. Jobbing off:  “The Prime Minister promised economic growth, but the only thing that’s grown is his list of broken promises,” Badenoch hit back. This list analogy was really gaining momentum. She lambasted rising unemployment under Labour, yet the PM was able to point to lower inactivity under his watch and, of course, mentioned the boost of falling inflation this morning. Backhanded compliment: Starmer, no doubt desperate for a rest, used the imminent break to “congratulate” Badenoch for breaking a record on the number of Tories defecting to Reform UK. “The question is who’s next,” he mused, enjoying the chance to focus on the Conservatives’ threat to their right, rather than Labour’s troubles to its left. Clucking their tongues: Outraged at her Shadow Cabinet getting called non-entities, Badenoch kept the seasonal attacks going by labeling the Cabinet a “bunch of turkeys.” She said Starmer was no longer a caretaker PM but the “undertaker prime minister.” Bruising stuff. Last orders: Amid all the metaphorical tinsel and bells of holly, Starmer adopted a lawyerly tone on Labour’s support for pubs (even though many greasy spoons have banned Labour MPs) and condemned ongoing industrial action by resident doctors. But the Tory leader went out on (possibly) a new low by arguing Starmer “doesn’t have the baubles” to ban medical staff from striking and said all Labour MPs want “is a new leader.” Grab the mince pies: The prime minister’s speechwriters clearly did their homework with Starmer, not a natural on the humor front, comparing the Tories to “The Muppets Christmas Carol” and joking that all the defections meant Badenoch would be “left Home Alone.” Penalty shootout: Hold the homepage — PMQs actually delivered a news line. The PM confirmed the government issued a licence to transfer to Ukraine £2.5 billion of Russian billionaire Roman Abramovich’s cash from his sale of Chelsea football club. Starmer told Abramovich to “pay up now,” or he’d be taken to court. Teal bauble: The end-of-year vibes allowed Starmer to deploy a festive jibe of advice to Reform UK: “If mysterious men from the East appear bearing gifts, this time, report it to the police!” Labour just won’t let ex-Reform UK Leader in Wales Nathan Gill’s conviction for pro-Russian bribery go. Even Nigel Farage, sat up above in the VIP public gallery, had a chuckle, admitting “that’s quite funny” to nearby hacks. Helpful backbench intervention of the week: Tipton and Wednesbury MP Antonia Bance commended the government’s efforts to support the West Midlands by striking the U.S. trade deal, ripping into Reform. The PM just couldn’t resist another attack line against his party’s main opponent. Totally unscientific scores on the doors: Starmer 8/10. Badenoch 5/10. The final PMQs exchange was never going to be a serious exchange, given the opportunity to make Christmas gags. The Tory leader followed a scattergun approach, highlighting the various broken promises, but none landed a blow. The PM, doubtless relieved to bag a few weeks away from the interrogation, brushed them off and used his pre-scripted lines to deliver a solid concluding performance.

The World Health Organization has recommended the use of novel weight-loss drugs to curb soaring obesity rates, and urged pharma companies to lower their prices and expand production so that lower-income countries can also benefit. The WHO’s new treatment guideline includes a conditional recommendation to use the so-called GLP-1s — such as Wegovy, Ozempic and Mounjaro — as part of a wider approach that includes healthy diet, exercise and support from doctors. The WHO described its recommendation as “conditional” due to limited data on the long-term efficacy and safety of GLP-1s. The recommendation excludes pregnant women. While GLP-1s are a now well-established treatment in high-income countries, the WHO warns they could reach fewer than 10 percent of people who could benefit by 2030. Among the countries with the highest rates of obesity are those in the Middle East, Latin America and Pacific islands. Meanwhile, Wegovy was only available in around 15 countries as of the start of this year. The WHO wants pharma companies to consider tiered pricing (lower prices in lower-income countries) and voluntary licensing of patents and technology to allow other producers around the word to manufacture GLP-1s, to help expand access to these drugs. Jeremy Farrar, an assistant director general at the WHO, told POLITICO the guidelines would also give an “amber and green light” to generic drugmakers to produce cheaper versions of GLP-1s when the patents expire. Francesca Celletti, a senior adviser on obesity at the WHO, told POLITICO “decisive action” was needed to expand access to GLP-1s, citing the example of antiretroviral HIV drugs earlier this century. “We all thought it was impossible … and then the price went down,” she said.  Key patents on semaglutide, the ingredient in Novo Nordisk’s diabetes and weight-loss drugs Ozempic and Wegovy, will lift in some countries next year, including India, Brazil and China. Indian generics giant Dr. Reddy’s plans to launch a generic semaglutide-based weight-loss drug in 87 countries in 2026, its CEO Erez Israeli said earlier this year, reported Reuters. “U.S. and Europe will open later … (and) all the other Western markets will be open between 2029 to 2033,” Israeli told reporters after the release of quarterly earnings in July. Prices should fall once generics are on the market, but that isn’t the only barrier. Injectable drugs, for example, need cold chain storage. And health systems need to be equipped to roll out the drug once it’s affordable, Celletti said. 

VENICE, Italy — Luca Zaia, a towering force in northern Italian politics, is plotting his next move and that’s turning into a headache for his party, the far-right League, led by firebrand Deputy Prime Minister Matteo Salvini. As regional president of Veneto, the wealthy region of 5 million people around Venice, Zaia is one of the League’s superstars, but his mandate comes to an end after an election this weekend. That is sparking intense speculation about his ambitions — not least because his political vision is so different from Salvini’s. While Salvini is steering the League away from its separatist roots — no longer seeking to rip the rich industrialized north away from poorer southern Italy — Zaia remains a vocal advocate for northern autonomy from Rome. He is also more moderate on immigration, climate and LGBTQ+ rights than his right-wing populist party chief. One of the big questions looming over Italian politics is whether these two rival visions can survive within the League, a party at the heart of Giorgia Meloni’s coalition government. Zaia himself suggests the League could split into two allied factions along the lines of the Christian Democratic Union and Christian Social Union on Germany’s center right.   MEET THE DOGE Nicknamed the “Doge of Venice,” Zaia, a former Italian agriculture minister, has spent 15 of his 57 years running Veneto from an office lined with emerald silk in a 16th-century palazzo on the Grand Canal. He won eight out of 10 votes cast in 2020, the highest approval rating of any regional chief, but is barred from running again because of a two-term limit. In an interview with POLITICO, he joked about the whirl of theories about his next steps. “I am in the running for everything: [energy giant] ENI, Venice, parliament, minister.” But when pressed on what he will do, he gave nothing away, only that his focus is squarely on the north. “I gave up a safe seat in Brussels a year ago to stay here,” he said, only adding he would work until the last day of his mandate. “Then I’ll see.” Amid internal power struggles in the League, Zaia is increasingly seen as an alternative leadership figure by those unhappy with its trajectory.  Zaia has clashed with Salvini’s deputy leader Gen. Roberto Vannacci over his revisionist views of the fascist era under Benito Mussolini, but has held back from criticizing Salvini openly. Zaia, right, at the closing event of the center-right coalition’s campaign for the Veneto regional elections in support of Alberto Stefani, left, Nov. 18. | Alessandro Bremec/NurPhoto via Getty Images When asked whether Salvini made strategic mistakes as party leader, he stayed cryptically diplomatic. “We all make mistakes,” he replied. A CHANGING LEAGUE When Zaia joined what was then the Northern League in the 1990s it was a separatist movement, opposed to tax redistribution from the wealthy north to the south, perceived as corrupt and inefficient. But under Salvini’s leadership, the rebranded League became a nationwide party, with a strand increasingly courting the extreme right. This approach has alienated both mainstream voters, and more moderate and north-focused activists, for whom Zaia is a political lodestar. One major bugbear is Salvini’s drive to build a €14 billion bridge between Calabria and Sicily, seen by separatists as a wasteful southern project sucking in northern tax revenue. In a sign of the shifting tectonic plates, one faction, supported by the Northern League’s founder Umberto Bossi, and that has in recent years unsuccessfully tried to oust Salvini, last week launched a new party, the Pact for the North. Its leader, former MP Paolo Grimoldi, expelled from the League after 34 years, told POLITICO his group would welcome Zaia “with open arms.”  Zaia and other northern governors “just have to find the courage to say publicly what they have been saying privately for some time, that Salvini has completely betrayed the battles of the League.” Zaia himself is recommending a new-look League modeled on the German CDU-CSU, with sister League parties catering to Italy’s north and south. He aired the idea in a new book by journalist Bruno Vespa, pointing out the CSU had a separate Bavarian identity within the German Christian Democrat family. “We could do the same here,” he said. Most political insiders and observers think it unlikely that Zaia would seek a national leadership role — being too associated with Veneto — but he would be an obvious choice to lead the northern wing of a divided party. For Salvini, this internal schism is an obvious challenge. He has said he’s intrigued by the CDU-CSU idea, but few believe him. He needs to find something to prevent Zaia from turning into a nuisance, and has proposed him for a vacant parliamentary seat in Rome and as mayor of Venice. “It’s up to him to decide if he stays in Veneto or brings Veneto to Rome,” Salvini said at an event in Padua last weekend. MAYOR OF VENICE? Which way will Zaia jump? A return to Rome seems unappetizing. “When he was minister, he didn’t like Rome”, said a political colleague. “Rome’s values are not the values of Veneto.  In Veneto, we value meritocracy, work, effort, seriousness in politics. In Rome it’s all compromise.” Which makes Venice the more likely option, if he does decide to avoid a head-on clash with Salvini. Zaia would be very well set to run for mayor of Venice next May, according to the MP and two friends of Zaia’s from Veneto. He has a manifesto ready: Autonomy for Venice. Venice should become a city-state with special powers to address its unique problems of depopulation, overtourism and climate change, he said in the interview. Zaia’s popularity in Veneto, according to the locals, derives from his down-to-earth persona. He’s better known for speaking in regional dialect and attending traditional events, rather than being snapped at glamorous galas or on the fleet of speedboats at his disposal, rocking gently at his Grand Canal doorstep.   He was also lauded for his handling of the Covid pandemic, readying Veneto for the Winter Olympics next year and even helping boost exports of Prosecco sparkling wine. Local lore holds that half of Veneto’s 5 million residents have his phone number. “Maybe even more,” he quipped. “I have never changed my number, people know they can call me if they have a serious problem.” DISCO DOGE Raised in a small village near Treviso, just 30 kilometers from Venice, he was an unusually independent and motivated teenager, passionate about horses and teaching himself Latin on Sundays, according to one classmate. At university, where he graduated in animal husbandry, he supported himself by running club nights in local discos. It was a useful training for politics, Zaia said. “Clubs are a great school of life. You meet humanity in all its forms: rich, poor, good, bad, violent, peaceful.” One of the big questions looming over Italian politics is whether these two rival visions can survive within the League, a party at the heart of Giorgia Meloni’s coalition government. | Ivan Romano/Getty Images Indeed, it seems he took the role ultraseriously. “I never saw Luca dance. For him it was work,” said the same former classmate. He entered politics in the aftermath of the 1990s Clean Hands scandal, a nationwide corruption investigation, which took down a generation of politicians, and became a rising star in the region. As well as being the youngest provincial president in Italy, adorning Treviso with numerous surprisingly popular roundabouts, he was minister of agriculture in Silvio Berlusconi’s government. He is sufficiently self-assured to diverge from central League dogma when he sees fit. He tried to bring in a law this year to regulate doctor-assisted suicide in contrast to national League policy. He also supports sex education in schools, something the League opposes. “When it’s an ethical matter … I  have my own ideas, regardless of what the party says,” he said. But he is clearly smarting about the party’s deal with Meloni to keep the Zaia brand out of the campaign for this weekend’s Veneto election. The original plan, which would have given him significant ongoing influence in the region, was for him to choose a list of regional councilors to go on the ballot and for the League logo to feature his name, he told journalists on the sidelines of a Venice Commission event in October. “If they see me as a problem, I’ll become a real problem,” he threatened. (He will still appear on the ballot as a candidate for regional councilor, giving him yet another option — stay on to assist his successor.) If he does decide to chart his own political path as mayor of Venice next year, at least he won’t have far to go. The doge needs only to step into one of his speedboats to whizz off to the mayor’s equally opulent palazzo along the Grand Canal.

LONDON — The robots are coming for us all — even the parliamentary researchers. British politicians — and the industries seeking to influence them — are increasingly embracing artificial intelligence tools in a bid to make their jobs easier.  But the rise of the emerging tech is prompting big questions about the output and job security of young people working in politics — and the vital ladder into the world of Westminster their entry-level gigs provide. “Across the whole of public affairs, you’ll be able to write and communicate better. I think there’s a positive here,” said Peter Heneghan, a former No. 10 deputy digital communications director and now an AI advocate in the public affairs world.  “The negative side of that is there will be a lot of roles that go alongside it,” he added. “It’s inevitable.”  Politicians and the people supporting them are already jumping on AI to help write everything from books, speeches and media briefings to policy proposals and responses to constituency casework.  In public affairs, it’s already proving useful for all manner of run-of-the-mill jobs, including drafting strategies, press releases, communiqués, timelines and media monitoring.  It’s cutting the need to trawl through large documents like Hansard — the official record of the British parliament — or Westminster’s register of all-party parliamentary groups, a frequent source of influence for lobbyists.  Both sources have hundreds of pages added in each routine update — and entry-level staffers can often be found combing them for insight to brief their bosses or clients.  So far, British officialdom is leaning into the trend. The government’s own AI incubator has even created “Parlex,” a research tool leting anybody with a government email address examine a parliamentarian’s stated position on even the most minor issues in little to no time.  Proponents argue these tools will free up people working in politics to do the kind of work AI simply can’t.  But there are frustrations too.   The only sanctioned AI tool for the majority of parliamentary work, as outlined in House of Commons guidance, is Microsoft’s Copilot, which the government has licensed for internal use. | Algi Febri Sugita/SOPA Images/LightRocket via Getty Images The only sanctioned AI tool for the majority of parliamentary work, as outlined in House of Commons guidance, is Microsoft’s Copilot, which the government has licensed for internal use. The use of other chatbots — including ChatGPT, Elon Musk’s Grok, and Claude — is still frequent in parliament, however, amid some grumbling about the official offering.  In June last year, one MP included in a trial emailed the Parliamentary Digital Service — which oversees tech in the Commons — to fume that they “do not want my staff to spend time testing Copilot when the productivity tools are not those that we want or need,” according to correspondence obtained under freedom of information by POLITICO Pro.  ROBOTS TALKING TO ROBOTS  Parliamentarians in the digital age are already inundated with correspondence over email. And artificial intelligence could turn that deluge into an unmanageable flood.  AI-generated email campaigns are now a frequent bugbear for MPs’ offices, with staff feeling pressured to respond to more and more material of a lower and lower quality. One person working in public affairs called it “slop campaigning.”  Heneghan suggests that the “sheer volume” of constituency correspondence that MPs are now getting — and the need to sift through it and reply — means the future of interacting with parliamentarians could become “AI talking to AI.” It would, he says, be “awful” for an already record-low trust in politicians.  Tom Hashemi, the boss of comms consultancy Cast from Clay, echoed that concern. “It’s almost insulting to the point of democracy. MPs are there to respond to genuine constituent concerns, not to have to spend hours of their time responding to AI-generated messages.”  He added that, in his own conversations with ministers and MPs, “they always say those campaigns” — labelled “clicktivism” by Labour MP Mike Reader — “don’t work.”  One parliamentary staffer said: “I can tell that now lots of the email campaigns [by charities] are written by AI — the ones that we get in — whereas before they weren’t. They want it to seem like lots of people are, so they use AI to change the subject lines in the first line of the email very slightly, and the language is all bizarre.”  SQUEEZE ON JOBS AI’s widening use in politics comes amid an increasingly difficult job market for U.K. graduates across the board.  Heneghan suggests there will be a “massive squeeze” on junior jobs available for people working in public affairs, which he argues represents a “double-edged sword” in that menial tasks can be performed more efficiently — while the gains that young people themselves could make from performing them will also be lost.  Prospective job losses will, he predicts, go further than just junior level jobs, with roles for middle managers, human resources, sales and more all being affected.  Meanwhile, Hashemi suggests a route for public affairs firms to continue to expand would be to train new hires to use AI, saying the tech will “affect junior public affairs jobs in firms that don’t adapt to using it and integrating it.”  As trivial as these jobs can seem, many a high-flying politician or adviser got their start shifting around a lot of paper. None other than the prime minister’s chief of staff Morgan McSweeney, for example, got his start in Labour’s headquarters entering data into spin doctor Peter Mandelson’s famed “Excalibur” rebuttal machine.  Current parliamentary aides expressed less concern that AI is coming for them just yet.  Almost all those POLITICO spoke to in parliament said they wouldn’t use AI to write speeches for their bosses, because it is too easy to spot.  However, a Conservative adviser said they imagined junior staffers could become “checkers” of work as opposed to creators of it, due to the ease of asking AI to generate a first pass at materials.  Meanwhile, a second parliamentary staffer said: “It’s like an aid. I don’t think it can replace jobs yet.”  AI’s one attempt to imitate an MP has so far have been widely derided. Labour MP Mark Sewards became the first parliamentarian to create an AI version of himself that constituents could speak to at any hour — to mixed results. It garbled a Guardian reporter’s Northern accent into unintelligibility, and offered relationship advice, alongside producing a deficient haiku about Nigel Farage to PoliticsHome.  That might be the case right now. But as AI continues to develop at breakneck pace, it could soon seem like child’s play. 

LONDON — Britain’s Department of Health is pressing ahead with plans to open up a trove of pandemic-era patient data to outside researchers — despite concerns from doctors’ representatives. A formal direction titled “GP Data for Consented Research,” yet to be signed by Health Secretary Wes Streeting but shared in draft format with doctors’ reps, would enable NHS England to disseminate patient data originally collected solely for the purpose of Covid-19-related research to other studies. The Department of Health and Social Care (DHSC) confirmed to POLITICO that the direction has been drafted and is awaiting Streeting’s signature. A group of doctors has warned the government that the move could erode patient trust. While the direction says government will obtain patient consent to share the data more broadly, doctors groups are worried this won’t happen in practice, and that patients won’t be aware their data is being funneled to other studies. NHS England has been in discussions with the Joint GP IT Committee, which comprises representatives from the British Medical Association (BMA) and Royal College of General Practitioners (RCGP), about the data, a person close to the talks told POLITICO. DHSC confirmed it had been in dialogue with the doctors’ groups, and a spokesperson said it had delayed signing the direction in order to engage with doctors’ concerns. The JGPITC argued it hasn’t been properly consulted on the change in line with established governance processes, and that repurposing the dataset without asking patients’ permission risks damaging already-fragile public confidence in the profession, the same person said.  While the direction says government will obtain patient consent to share the data more broadly, doctors groups are worried this won’t happen in practice, and that patients won’t be aware their data is being funneled to other studies. | Pool photo by Hannah McKay/EPA It comes after the same group of doctors filed a formal complaint to the Information Commissioner’s Office in June alleging that NHS England had breached data protection law by training a general-purpose AI model on the same dataset without consent. The disagreement is also set against the wider backdrop of a long-running dispute between government and the BMA over doctors’ pay and working conditions. DHSC maintains that proper processes have been followed. “As the Secretary of State made clear last year during his speech to the Royal College of GPs in October 2024, we are committed to implementing this direction in line with patients’ explicit consent for their data to be used in research,” a DHSC spokesperson said. ‘CONSULTED EXTENSIVELY’ In his speech last month, Streeting said he would direct NHS England to take responsibility for sharing patient data with projects including UK Biobank, Genomics England and Our Future Health. “I know there are issues we need to work through together around information governance, risk and liabilities,” he said. “There’s also, let’s be honest, some producer interest in play.” NHS England asked the JGPITC to confirm whether it was happy with the direction on broadening access to the dataset by Nov. 4. The JGPITC couldn’t reach a consensus to give its blessing to the change, the same person close to the talks and cited above said. The doctors’ group has pushed for NHS England to notify consenting participants about where their data is going via text or the NHS App, they added. DHSC is not obligated to comply with any of the JGPITC’s requests. “We have consulted extensively with GP representatives over the past 18 months to ensure patients’ wishes are respected and their data used appropriately, while minimizing the burden on busy GPs,” DHSC’s spokesperson said.