LONDON — Scottish lawmakers on Tuesday evening rejected a bill allowing terminally ill adults to access assisted dying. Members of the Scottish Parliament (MSPs) opposed Liberal Democrat Liam McArthur’s legislation which would have given terminally ill adults with fewer than six months to live assistance to end their lives. The bill fell by 69 votes to 57, with Scottish Health Secretary Neil Gray abstaining. MSPs previously backed the initial principles of the bill and allowed it to progress through the parliament last May by 70 votes to 56. First Minister John Swinney, Deputy First Minister Kate Forbes, Scottish Labour Leader Anas Sarwar and Scottish Tory Leader Russell Findlay all rejected the bill, although Findlay voted in favor last May. Former Scottish First Ministers Humza Yousaf and Nicola Sturgeon also opposed the bill. McArthur told reporters he was “devastated” by the result as the current system “has been failing dying Scots for too long.”  But he told ITV News the vote against appeared “inevitable” as “the closer you get to that final vote, the enormity, the significance of what MSPs will be asked to do weighs more and more heavily.” A dozen MSPs from the Conservatives, Labour and SNP switched sides between the two votes to reject the bill. As a matter of conscience, parliamentarians were given a free vote and did not have to follow a whip. It marks the third time the Scottish parliament has rejected assisted dying since 1999, though previous bills fell at the first hurdle by far higher margins. McArthur predicted the issue would return to Holyrood after the May election “for so long as dying Scots continue to suffer as a result of the lack of choice and safety afforded to them by the current law,” which prohibits assisted dying. The vote followed an evening of impassioned debate, with supporters and opponents offering emotional personal testimonies. Both sides praised McArthur’s handling of the bill and agreed on the need for improved palliative care. The Scottish government, which retained a neutral position on the bill, said it “remains committed to ensuring that everyone in Scotland who needs it can access well-coordinated, compassionate and high-quality palliative and end of life care.”

DUBLIN — British Prime Minister Keir Starmer has finally found a friendly voice in the White House— albeit one that speaks with an Irish accent. When Taoiseach Micheál Martin visited the U.S. presidential mansion on Tuesday for St. Patrick’s Day, Donald Trump took the opportunity at their joint press conference to renew his verbal attacks on Starmer over the U.K. leader’s unwillingness to join the U.S.-Israeli air assault on Iran. Referencing a bust over his shoulder of Britain’s World War II leader, the president repeated his insult that Starmer “is no Winston Churchill.” The ultra-diplomatic and soft-spoken Martin picked that moment to interrupt a nearly 20-minute monologue from Trump bashing Iran and NATO. Martin noted that he had just hosted a productive summit with Starmer and other senior U.K. ministers in his home city, Cork. He credited the Labour leader with doing much to repair Anglo-Irish relations ravaged by Brexit. And he gently reminded Trump that not so long ago, he had been singing Starmer’s praises. “Keir Starmer has done a lot to reset the Irish-British relationship. I just want to put that on the record,” Martin told Trump, a crystal bowl filled with shamrock on the table between them. “I do believe that he’s a very earnest, sound person that you have a capacity to get along with. You’ve got along with him before.” Martin then pivoted to criticism of Iran in the hope of averting a hostile comeback from his host. It appeared to work, as Trump resumed bashing NATO — and didn’t utter a single syllable critical of Ireland, which doesn’t even belong to the transatlantic military alliance. Irish officials confirmed to POLITICO that Martin had been determined not to repeat the perceived mistake of German Chancellor Friedrich Merz when he visited the White House earlier this month. Merz failed to defend Starmer and other European allies when Trump belittled them in similar terms, drawing sharp rebukes from the Spanish government. Martin pulled off a second display of polite pushback on Tuesday after Trump repeated claims that Europe was threatened by immigration: “It’s a different place. Bad things have happened to Europe.” Martin tapped Trump on the thigh to get his attention. “Europe is still a very good place to live,” Martin said, prompting laughter in the room as Trump retorted: “I’m glad to hear that!” Martin then expanded on why Europe is so popular with migrants, noting the EU’s “free mobility of people” and how it allows Ireland to attract newcomers “from Europe and beyond” to swell its rapidly growing workforce. “Fundamentally, sometimes Europe gets characterized wrongly in terms of it being overrun,” he said in apparent reference to claims the Trump administration has made, including in the president’s sit-down interview with POLITICO last December. The visiting Irish press pack, perhaps disappointed to have no anti-Irish comments from Trump, twice tried to ask him about Irish President Catherine Connolly’s recent condemnations of the U.S.-Israel attack on Iran. Connolly — elected in October on an anti-government mandate — is a largely ceremonial head of state who plays no role in Ireland’s government. But Trump made it clear he had no clue who Connolly might be, far less her criticisms. “Who said that?” Trump asked a reporter, only to be told, without reference to Connolly’s gender, that it was Ireland’s president. “Look. He’s lucky I exist, that’s all I can say,” Trump said.

Teresa Graham, © EFPIA European governments navigate an ever more competitive global landscape, stagnating productivity and competing demands on budgets. We have successfully faced and solved many challenges in the past, but this situation is different: the choices we make today will shape our health care systems and patient care, and these choices will dictate Europe’s economic performance and global relevance for decades to come. For those of us in the life sciences, these aren’t just macroeconomic trends — they are the pulse of a system that determines how quickly a breakthrough reaches a patient. It is a high-stakes environment where policies on health care and innovation carry urgent human and economic consequences. When a medicine has the power to treat or potentially cure, neither innovators nor policymakers want to drag their heels, because no person requiring health care can afford the luxury of delay. > The true economic burden of health care isn’t financing health innovation, but > the cost of failing to do so. Europe’s challenge is clear: we must better align our industrial strength in life science with public health goals, ensuring innovation reaches both patients and economies faster. The question is no longer what Europe wants to be — it is where Europe chooses to invest to remain a global player. Health as e conomic i nfrastructure Under the weight of mounting budget pressures, it is understandable that governments often view health primarily as a cost to be contained. However, this perspective is disconnected from modern economic reality. And let me be clear: the true economic burden of health care isn’t financing health innovation, but the cost of failing to do so. For years, Europe has already been paying the price of lost productivity: citizens forced out of the workforce too early and chronic diseases managed too late. For instance, cardiovascular diseases alone cost the E uropean U nion economy up to €282 billion annually. This creates a massive yet avoidable strain on national budgets, especially as pharmaceutical innovation is estimated to be responsible for up to two-thirds of life expectancy gains in high-income countries . 1 > Every medical breakthrough that enables a citizen to return to work or care > for their family is a direct investment in Europe’s economic strength. We must shift our mindset . H ealth is not merely a social good; it is economic infrastructure. Healthier societies are inherently more productive and resilient, and every medical breakthrough that enables a citizen to return to work or care for their family is a direct investment in Europe’s economic strength. Investing in innovation today is the only way to secure a competitive workforce and reduce long-term systemic costs. The c ompetitiveness t est: a s trategic a sset, n ot a l ine i tem Europe’s life sciences sector is one of the few remaining areas that retains genuine global competitiveness and strength, contributing more than €300 billion to annual output and supporting 2 million high-skilled jobs across m ember s tates . 2 It anchors Europe’s trade resilience, generating a trade surplus 66 percent higher than all other EU sectors combined . 3 But the warning signs are clear: while Europe still accounts for 20 percent of global pharmaceutical research and development , its share of global investment is shrinking as capital and talent migrate elsewhere . 4 Europe’s world-class science is being held back by fragmentation and regulatory inertia. > We must treat this sector as a pillar of our sovereignty and a strategic > asset, not merely a cost to be managed. If we want to lead the next wave of medical breakthroughs, we must move at the speed of global change. This requires a fundamental shift: simplifying clinical trial regulations, deploying AI-driven digital tools, incentivizing research through strong intellectual property frameworks and establishing a public-private dialogue on innovative pharmaceuticals. We need a clear action plan, not just more legislation, to translate our scientific leadership into tangible health outcomes.   We must treat this sector as a pillar of our sovereignty and a strategic asset, not merely a cost to be managed.  A  c onsequential  c hoice  Europe has to choose. Either we can continue to approach life science innovation as a budgetary threat, only to reali z e too late that we have weakened our competitiveness and delayed new treatments for patients. Or we can recogni z e innovation for what it is  —  an economic multiplier that strengthens our productivity, resilience  and global influence  —  and ensure that Europe remains a place where the next generation of medical breakthroughs is discovered, developed  and delivered to patients.  There is no middle ground. Europe must stop focus ing solely on the cost of innovation and start asking how much innovation it can afford to lose. In the global race for talent and capital, hesitation is a decision. The rest of the world is not waiting. -------------------------------------------------------------------------------- References 1. The value of health: Investing in Europe’s future [EPC 2026] 2. Economic and Societal Footprint of the Pharmaceutical Industry in Europe [VE / PwC 2024] 3. International trade of EU and non-EU countries since 2002 by SITC [Eurostat 2026] 4. The 2025 EU Industrial R&D Investment Scoreboard [EC 2025] -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is European Federation of Pharmaceutical Industries and Associations (EFPIA) * The entity ultimately controlling the sponsor is European Federation of Pharmaceutical Industries and Associations (EFPIA) * The political advertisement is linked to  EU pharmaceutical regulation and innovation policy. More information here.

Dr. Daniel Steiners This is not an obituary for Germany’s economic standing. It is an invitation to shift perspective: away from the language of crisis and toward a clearer view of our opportunities — and toward the confidence that we have more capacity to shape our future than the mood indicators might suggest. For years, Germany seemed to be traveling along a self-evident path of success: growth, prosperity, the title of export champion. But that framework is beginning to fray. Other countries are catching up. Parts of our industrial base appear vulnerable to the pressures of transformation. And global dependencies are turning into strategic vulnerabilities. In short, the German model of success is under strain. Yet a glance at Europe’s economic history suggests that moments like these can also contain enormous potential — if strategic thinking and decisive action come together. One example, which I find particularly striking, takes us back to 1900. At the time, André and Édouard Michelin were producing tires in a relatively small market, when the automobile itself was still a niche product. They could have focused simply on improving their product. Instead, they thought bigger; not in silos, but in systems. With the Michelin Guide, they created incentives and orientation for greater mobility: workshop directories, road maps, and recommendations for hotels and restaurants made travel more predictable and attractive. What began as a service booklet for motorists gradually evolved into an entire ecosystem — and eventually into a globally recognized benchmark for quality. > In times of change, those who recognize connections and are willing to shape > them strategically can transform uncertainty into lasting strength. What makes this example remarkable is that the real innovation did not lie in the tire itself or merely even a clever marketing idea to boost sales. It lay in something more fundamental: connected thinking and ecosystem thinking. The decision to see mobility as a broad space for value creation. It was the courage to break out of silos, to recognize strategic connections, to deepen value chains — and to help define the standards of an emerging market. That is precisely the lesson that remains relevant today, including for policymakers. In times of change, those who recognize connections and are willing to shape them strategically can transform uncertainty into lasting strength. Germany’s industrial health economy is still too often viewed in public debate in narrowly sectoral terms — primarily through the lens of health care provision and costs. Strategically, however, it has long been an industrial ecosystem that spans research, development, manufacturing, digital innovation, exports and highly skilled employment. Just as Michelin helped shape the ecosystem of mobility, Germany can think of health as a comprehensive domain of value creation. The industrial health economy: cost driver or engine of growth? Yes, medicines cost money. In 2024, Germany’s statutory health insurance system spent around €55 billion on pharmaceuticals. But much of that increase reflects medical progress and the need for appropriate care in an aging society with changing disease patterns. Innovative therapies benefit both patients and the health system. They can improve quality and length of life while shifting treatment from hospitals into outpatient care or even into patients’ homes. They raise efficiency in the system, reduce downstream costs and support workforce participation. > In short, the industrial health economy is not merely part of our health care > system. It is a key industry, underpinning economic strength, prosperity and > the financing of our social security systems. Despite public perception, pharmaceutical spending has remained remarkably stable for years, accounting for roughly 12 percent of total expenditures in the statutory health insurance system. That figure also includes generics — medicines that enter the ‘world heritage of pharmacy’ after patent protection expires and remain available at low cost. Truly innovative, patent-protected medicines account for only about seven percent of total spending. Against these costs stands an economic sector in which Germany continues to hold a leading international position. With around 1.1 million employees and value creation exceeding €190 billion, the industrial health economy is among the largest sectors of the German economy. Its high-tech products, bearing the Made in Germany label, are in demand worldwide and contribute significantly to Germany’s export surplus. In short, the industrial health economy is not merely part of our health care system. It is a key industry, underpinning economic strength, prosperity and the financing of our social security systems. Its overall balance is positive. The central question, therefore, is this: how can we unlock its untapped potential? And what would it mean for Germany if we fail to recognize these opportunities while economic and innovative capacity increasingly shifts elsewhere? Global dynamics leave little room for hesitation Governments around the world have long recognized the strategic importance of the industrial health economy — for health care, for economic growth and for national security. China is demonstrating remarkable speed in scaling and implementing biotechnology. The United States, meanwhile, illustrates how determined industrial policy can look in practice. Regulatory authorities are being modernized, approval procedures accelerated and bureaucratic barriers systematically reduced. At the same time, domestic production is being strategically strengthened. Speed and market size act as magnets for capital — especially in a sector where research is extraordinarily capital-intensive and requires long-term planning security. When innovation-friendly conditions and economic recognition of innovation meet a large, well-funded market, global shifts follow. Today roughly 50 percent of the global pharmaceutical market is located in the United States, about 23 percent in Europe — and only 4 to 5 percent in Germany. This distribution is no coincidence; it reflects differences in economic and regulatory environments. At the same time, political pressure is growing on countries that benefit from the American innovation engine without offering an equally attractive home market or recognizing the value of innovation in comparable ways. Discussions around a Most Favored Nation approach or other trade policy instruments are moving in precisely that direction — and they affect Europe and Germany directly. For Germany, the implications are clear. Those who want to attract investment must strengthen their competitiveness. Those who want to ensure reliable health care must appropriately reward new therapies. Otherwise, these global dynamics will inevitably affect both the economy and health care at home. Already today, roughly one in four medicines introduced in the United States between 2014 and 2023 is not available in Europe. The gap is even larger for gene and cell therapies. The primacy of industrial policy: from consensus to action — now Germany does not lack potential or substance. We still have a strong industrial base, a tradition of invention, outstanding universities and research institutions, and a private sector willing to invest. Political initiatives such as the coalition agreement, the High-Tech Agenda and plans for a future strategy in pharmaceuticals and medical technology provide important impulses, which I strongly welcome. > A fair market environment without artificial price caps or rigid guardrails is > the strongest magnet for private capital, long-term investment and a resilient > health system. But programs must now translate into a coherent action plan for growth. We need innovation-friendly and stable framework conditions that consider health care, economic strength and national security together — as a strategic ecosystem, not as separate silos. The value of medical innovation must also be recognized in Germany. A fair market environment without artificial price caps or rigid guardrails is the strongest magnet for private capital, long-term investment and a resilient health system. Faster approval procedures, consistent digitalization and a determined reduction of bureaucracy are essential if speed is once again to become a competitive advantage and a driver of innovation. Germany can reinvent itself, of that I am convinced. With courage, strategic determination and an ambitious push for innovation. The choice now lies with us: to set the right course and unlock the potential that is already there.

Kari Lake was illegally empowered to run the U.S. Agency for Global Media — the federal agency that oversees Voice of America — and her actions in that role were illegitimate, a federal judge ruled Saturday. U.S. District Judge Royce Lamberth concluded that Lake was ineligible to serve as USAGM’s acting CEO when she was formally elevated to the position on July 31 in an “acting capacity” and without Senate confirmation. She relinquished that position on Nov. 19. Lamberth said any actions Lake took in that four-month timeframe must be treated as “void,” including an Aug. 29 reduction in USAGM’s workforce. Lamberth also invalidated actions Lake took when the agency’s previous acting CEO, Victor Morales, delegated nearly the entirety of his responsibilities to her, concluding that this was also an illegal end-run around the Senate’s advice and consent role. “The Court finds that these expansive delegations were an unlawful effort to transform Lake into the CEO of U.S. Agency for Global Media in all but name,” the judge wrote. In a statement to POLITICO, Lake said she “strongly disagrees” with the ruling and that the government will appeal. “The American people gave President Trump a mandate to cut bloated bureaucracy, eliminate waste, and restore accountability to government,” she added. “An activist judge is trying to stand in the way of those efforts at USAGM.” Lake specifically called out Lamberth, saying he has a “pattern of activist rulings — and this case is no different.” In a statement, Patsy Widakuswara, Kate Neeper and Jessica Jerreat, the named plaintiffs in the lawsuit against Lake, said they were “vindicated and deeply grateful.” “The judge’s ruling that Kari Lake’s actions shall have no force or effect is a powerful step toward undoing the damage she has inflicted on this American institution that we love,” they said. “Even as we work through what this ruling means for colleagues harmed by her actions, it brings renewed hope and momentum to the next phase of our fight: restoring VOA’s global operations and ensuring we continue to produce journalism, not propaganda.” At the heart of the fight is the federal Vacancies Reform Act, which limits the way agencies can appoint temporary leaders while awaiting permanent nominees to be confirmed. Lake, Lamberth concluded, did not fit any of the criteria required to assume the acting CEO position. Though Lake claimed that as Morales’ deputy — or “first assistant” — she was eligible to assume the acting CEO position once he was removed from it, Lamberth said this would essentially negate the Senate’s role in confirming powerful appointees. Lamberth leaned heavily on the ruling by the 3rd Circuit Court of Appeals that similarly invalidated the appointment of Alina Habba, President Donald Trump’s former personal lawyer, to lead the U.S. Attorney’s Office in New Jersey. “Adopting Lake’s position would require the Court to find that the President can fill a first assistantship at any time during a vacancy in a Senate-confirmed office and then … elevate the first assistant to serve as the acting officer,” Lamberth said, agreeing with other courts that instead only the person occupying the deputy role at the time the vacancy occurs is eligible to take on the acting role. “Because Lake was not first assistant at the time of the vacancy, she lacks authority to serve as the acting CEO,” Lamberth wrote.

President Donald Trump once won the loyalty of his base by promising no new wars. That promise now rings hollow for many, especially after his decision to strike Iran last week. Since the attacks began Saturday, six U.S. service members have been killed. Oil prices are rising. Gulf states are fielding Iranian counterattacks. It is a striking escalation by a president who seems increasingly emboldened by a series of successful military attacks since his return to the Oval Office. As the Middle East tumbles into uncertainty, it’s unclear what the administration’s endgame is, who Iran’s next successor could be or even when the war might end. To get a better understanding of how things might unfold, we convened a roundtable of top POLITICO reporters who cover the White House and Trump’s foreign policy — and have been closely following the administration’s moves. The discussion featured defense reporter Paul McLeary, White House reporter Diana Nerozzi, diplomatic correspondent Felicia Schwartz and energy reporter James Bikales. The group discussed the United States’ diminishing weapons stockpile, responses from ally countries and the political implications of starting yet another war in the Middle East eight months before the midterm elections. Here’s what they shared. This conversation has been edited for length and clarity. Eight months ago, the U.S. struck Iran, and here we are again. What’s different about the administration in 2026 and the recent attacks it is carrying out now? Paul McLeary: Unlike the first Trump administration, which was filled with people he didn’t know or trust, this time around it is stacked with Trump loyalists who have a good understanding of how he operates. They’re moving fast on international issues because they know his time is limited by the midterms and are embracing the fact that presidents may be constrained by courts and Congress at home, but can act as they see fit overseas. Felicia Schwartz: I think they are also very inspired by past successes. At the end of Trump’s first term, he killed Islamic Revolutionary Guard Corps leader Qassem Soleimani — something the so-called foreign policy blob and regional allies warned would inflame the Middle East. He got the same feedback about his plans to recognize Jerusalem as Israel’s capital and move the embassy, which he did in 2018 without major blowback. Add to that what he and his team see as the success of the Venezuela operation, and you have a very emboldened president who likes to wield power militarily. Diana Nerozzi: I agree. Trump is facing his last term as president and is feeling inspired by his successful capture of Maduro. The administration sees Iran as the number one sponsor of global terror, and taking out the Iranian government cripples their connections with foreign adversaries like Russia and China. Trump has spoken about his desire to leave a global mark and foreign policy legacy, and regime change in Iran would contribute to that greatly. James Bikales: On the energy side of things, the administration feels it has a little more leeway to act in ways that could disrupt the global oil market because the U.S. has cemented its place as a net crude exporter in the last few years. That’s helped keep oil prices lower and more stable since Trump took office, even with the conflicts in the Middle East and Venezuela. On the other hand, Trump has been laser-focused on keeping gas prices low — and the attack on Iran certainly won’t help with that. On that note, James, how soon are gas prices going to be affected by the conflict? What’s the worst-case scenario, and how would that occur? Bikales: It really depends on how long this conflict lasts. The main issue driving up oil prices has been the disruptions to shipping through the Strait of Hormuz, where 20 percent of global crude flows pass through every day. We’ve already seen oil prices jump significantly over the past few days as a result, and it won’t be long until that starts showing up for American consumers at the gas pump. Some analysts have predicted that if the conflict lasts more than three or four weeks, we could see triple-digit oil prices — which would be a major shock to the system and have a lot of cascading effects. Diana, the administration’s messaging has been muddled, with officials offering a range of rationales for starting the war now, from nuclear weapons to Iran’s crackdown on democracy to payback for the 1979 hostage crisis. Why has the administration’s messaging been so haphazard? Nerozzi: The reason for the apparent mixed messages is the variety of voices who are speaking on the rationale. There is the president, who has been very open to reporters’ questions, but with that openness comes a lot of different answers. Then there is Marco Rubio, Pete Hegseth and other administration officials. The reason is all of those combined. But more immediately, the administration argues the attacks were launched because of the refusal of Iran to negotiate honestly about nuclear weapons. Two administration officials went into detail yesterday about how the Iranians were “playing games” in negotiations, were really hiding nuclear material further underground, and were not going to come to the table honestly. That, coupled with the crackdown on protests and Iran’s hostile actions towards the U.S. over the past decades, pushed Trump over the edge. McLeary: The Iran attacks are also another way to undo what Republicans see as the signature disaster of the Obama years — the Joint Comprehensive Plan of Action deal with Iran. Trump has made it a priority to unwind virtually everything that Obama and Biden pushed through during their terms. Schwartz: I thought it was interesting that the administration chose not to go on the Sunday shows or do the usual things like a live prime-time address to justify the action to the nation. Seemed like they acted first, then worked on the messaging. And it’s shifted as Congress, the public and the Republican base have reacted to it. Secretary Rubio, for example, said that the U.S. assessed that its assets in the Middle East would be attacked if Israel were to go ahead, and Israel was planning to go ahead, so it may as well join. But the perception that Israel dragged Trump into war hasn’t played well. Felicia and Diana, do we know who has influenced Trump most on Iran? Is it someone in the administration, like Rubio or Hegseth? Or is it someone outside, like Israeli Prime Minister Benjamin Netanyahu? Schwartz: Our reporting and that of our colleagues suggest that Netanyahu did have a big influence. Sen. Lindsay Graham, a longtime Iran hawk, has been pressing Trump on this since he returned to office. I think the Venezuela success, that there was a model for something resembling regime change, helped to push him over the line. The U.S. Ambassador to Israel Mike Huckabee was also a strong proponent. On top of that, while there were not many other loud cheerleaders, none of the national security team was lobbying hard against it. Nerozzi: The administration has been very careful to not reveal who exactly is in Trump’s ear on Iran. Trump has a very close relationship with Netanyahu, and the U.S. has been working side-by-side with Israel on the attacks, so the prime minister did play a role. But I believe Trump had his sights set on Iran from the beginning, and the actions of the Iranians in the negotiations and killing protesters made Trump irate enough to pull the trigger. Who are the top succession candidates in Iran right now? Does the White House have its eye on anyone, especially since Trump has said the people the administration had in mind were killed in the strikes? Schwartz: While the situation is still fluid, the son of the now deceased Ayatollah Ali Khamenei has emerged as a frontrunner to replace his father. His son, Mojtaba Khamenei, is known for having close ties to Iran’s Revolutionary Guards Corps. Other candidates that have emerged include Alireza Arafi, part of the current transition council named in the elder Khamenei’s absence, and Seyed Hassan Khomeini, the grandson of Ayatollah Ruhollah Khomeini, the leader of the 1979 Iranian revolution that established the Islamic Republic. The administration and Israel are hoping that by targeting Iranian security forces and regime targets, they can create the conditions for a different kind of government to take the place of the current system. But the regime still controls the military and the weapons, so that is very unlikely. Nerozzi: Trump has refused to say whether the U.S. has anyone in mind as a successor, which leads me to believe they are not in that point of thinking quite yet. He said he is open to Reza Pahlavi in response to a reporter’s question. But the general response from the administration has been that the leaders they had in mind have been killed, and that the main focus right now is to take out the Iranian military. Some Pentagon officials were worried about dwindling weapons stockpiles even before the attack. Paul, at what point could this deplete munitions enough to make the U.S. more vulnerable? McLeary: The munitions being used are expensive and take months to make, and while the stockpiles are deep, they’re not unlimited as Trump and Hegseth have indicated over the past several days. There’s little capacity for the defense industry to ramp up production any time soon — workforce issues and thin supply chains make a quick ramp-up almost impossible. The U.S. can handle a campaign like this for several weeks before it becomes a major issue. The worry is that precision bombs meant to be sold to allies would suffer first, if the Pentagon wanted to redirect them back to its own warehouses. That could cause a major break with key NATO allies who are already looking for alternatives to the U.S. defense industry. European allies don’t seem sure what to think about this war. Do you think they will oppose it, sit on the sidelines or eventually get behind it, Felicia? And how are U.S. allies in the Middle East responding? Is there some discomfort among Arab states with being on the same side of a war as Israel? Schwartz: No one in Europe is sad to see the death of Ayatollah Ali Khamenei, and many governments there share Washington’s concerns about Iran’s nuclear program, ballistic missiles and support for regional proxies. They would have preferred to see the U.S. deal with this diplomatically, as these governments are generally more cautious than Trump is, and they are closer to Iran than we are and might feel the fallout more quickly. That being said, once Iran responded so forcefully and began hitting civilian targets throughout the Gulf, where many European citizens live and do business and many countries have military assets, they have generally supported the U.S. campaign. As for the Middle East, their discomfort isn’t about being on the same side as Israel. Many of these countries have had strong intelligence and military relationships with Israel for years, drawn together by the common threat of Iran. Some countries, like the UAE and Bahrain, have formalized and publicized these ties. Their unease is that Iran is targeting their people and infrastructure, and they worry about their own ability to defend themselves in a prolonged war. Unlike Israel, which has sirens and shelters, these countries don’t have any warning systems or protections for the public. And they are worried about their own air defense supplies. Nerozzi: In the Middle East, Iran striking neighboring Arab nations could be an opportunity for the U.S. to form stronger alliances with those who were critical of the strikes on Iran. The Arab nations are being brought into the war via the Iranian counterstrikes, and the Gulf states are finding themselves being directly impacted by Iran. Bikales: European countries are also very concerned about the impact of the war on energy prices — they remember well the impacts of the price shock after Russia’s invasion of Ukraine just a few years ago. We’ve already seen natural gas prices skyrocket in parts of Europe after Qatar shut down some of its LNG export facilities, so that’s just another reason Europe wants this fighting over quickly. But Trump has said the military campaign against Iran could last four to five weeks, even longer. Does the U.S. have an endgame? If so, what is it? Nerozzi: Trump gave the four-to-five-week deadline. Today, Pete Hegseth said, “We are just getting started.” There is no stated endgame 100 percent, but Hegseth said the U.S. and Israel are targeting Iranian military generals and are “finding, fixing and finishing the missiles and defense industrial base of the Iranian military.” At the end of the day, the U.S. has been firm that they don’t want to see Iran acquire a nuclear weapon, so the end may come when they feel satisfied enough with the destruction of the Iranian military and their enriched uranium. McLeary: Defense officials have so far outlined tactical successes and goals like taking out the Iranian Navy and ballistic missile sites and nuclear facilities, but we haven’t heard anything about the “day after” if the Iranian regime is to collapse. Destroying the Iranian ability to strike outside its borders is a goal, but without a larger strategic vision of what they want Iran to look like going forward, those goals don’t necessarily solve the larger issues of having a hostile regime in power in Tehran. Schwartz: When Trump first announced the campaign, he talked about regime change. That’s now more of a nice-to-have. As the administration has refined its message, officials have described Iran’s ballistic and other advanced missiles as a shield that it is building up rapidly and would eventually prevent the U.S. from doing anything about its nuclear program. So they want to eliminate Iran’s missile program, destroy its navy so it can’t harass American and other vessels at sea and end their support for proxies. But in terms of what should Iran look like next year, what role should it play in the region and other long-term strategic objectives, those are unclear. And while the regime is at its weakest point, it continues to have a monopoly on weapons and violence. That will be hard for the U.S. to destroy from the air. On Diana’s point about enriched uranium, that is another one they have not really spelled out how they will address. They did what they could militarily to target Iran’s nuclear program last June. All of Iran’s enriched uranium is buried under rubble. I think on that point, they want to pressure Iran to do what it hasn’t so far accepted: commit to zero enrichment and ship all of its remaining enriched material out of the country. Bikales: We’ve reported that the Trump administration went into the conflict with little plan to deal with the ensuing oil price spike. Essentially, they hoped the conflict would be over quickly, and prices would fall back naturally. In the last couple of days, they’ve had to scramble to start putting together a plan to calm the markets. In some ways, that gives Iran an opening. Tehran knows that President Trump is very focused on lowering prices at the pump, especially ahead of the midterms, so it could use oil prices as leverage to force his hand in potentially ending the war. James, speaking of oil, Iran has said it has closed the Strait of Hormuz. Is that possible? And what are the implications of making it challenging to travel through? Is there a workaround? Bikales: The short answer is no. Iran has fairly limited naval capabilities, especially after the initial wave of U.S. strikes, so it hasn’t mined or physically closed the strait in any way. That being said, it has warned ships not to try to transit it, and it has fired on some tankers, which has led insurance companies to cancel coverage and hike rates, essentially bringing traffic through the strait to a halt. The Trump administration announced a plan Tuesday to offer naval escorts and government risk insurance to those tankers, and we will be watching in the coming days whether that gets shipping moving again. One important thing to note: Iran itself exports much of the crude it produces through the Strait of Hormuz, so shutting it down could hurt its own economy — as well as that of its primary customer, China. Schwartz: I am very curious to see how the market will react to the government provision of insurance for ships, and whether it will make a real dent, given the environment. Bikales: It’s certainly a creative strategy from a U.S. perspective, but even with insurance, I’m not sure I would want my ship trying to transit the Strait of Hormuz right now if I were a ship owner. McLeary: Iran does possess the capability to mine the Strait or use drones to harass ships passing through it. If they launched a drone swarm at an American warship, it would be difficult for the ship’s air defenses to knock multiple drones down at once. So the situation remains incredibly dangerous and uncertain. Paul, the White House has pushed back on the language around this military operation. Is the U.S. in a war? And how does this military campaign in Iran affect Trump’s avowed goal of focusing more on the Western Hemisphere, like Venezuela and Cuba? Schwartz: Time to cue the meme, it’s only a war if it’s from the war region of France. McLeary: The war question is much like the Department of Defense rebranding itself as the Department of War! Call it what you want, but shooting at another country is an act of war, full stop. As far as the Western Hemisphere goes, the USS Gerald R. Ford carrier strike group — which was pulled from the Mediterranean in October to head to the Caribbean — is back in the Mediterranean, along with its destroyer escort ships. One can argue that those ships were never needed to intercept speedboats, but one can also argue that moving the ships away from the Caribbean undercuts the recently released National Defense Strategy and National Security Strategy, which gave scant attention to the Middle East in favor of the Western Hemisphere and a homeland security focus. In the end, strategy papers are just that — pieces of paper — once a president casts his gaze elsewhere. Schwartz: There are 50,000 American troops in the Middle East right now, and six have died so far. And Trump has told us to expect more of that. I think the average person sees this as a war, whatever the administration wants to call it. This all means a lot is at stake for the GOP right now: Trump’s approval ratings are poor, the attacks are fairly unpopular and midterms are coming. How do you think this will play out politically for Republicans? Democrats? Nerozzi: Polls are showing that the majority of Americans disapprove of the strikes, but a large majority of Republicans, around 75 percent, are in support. The GOP is going into the midterms with a disadvantage due to being the incumbent. The outcome of the war in the next few months may sway public opinion to be more in favor of the war, but it could also push voters away, especially if things go south. Trump will have to deliver internationally and domestically for Republicans to surge ahead and keep both the Senate and House. Schwartz: Voters rarely vote primarily on foreign policy, but drawn-out wars or the rising prices from them contribute heavily to the vibes leading into the election and how people feel about the direction of the country. If Trump can keep this to a few weeks and the fallout minimal, maybe it will be a blip that won’t carry through to the midterms. It could also present Democrats with an opportunity to curry favor with voters if gas prices climb further upward and inflation gets worse as a result. McLeary: War is always unpredictable. Americans tend to rally around the flag in times of conflict, even if we haven’t seen that happen yet in the case of Iran. Part of the reason is that the White House simply hasn’t bothered to make the case to the American people. That said, think back to George W. Bush winning re-election in 2004 when Iraq was going terribly and dozens of troops were being killed by roadside bombs every month while fighting — yes — Iranian-backed Iraqi militias. A lot will depend on how quickly Trump can get out of the fight. I don’t sense a lot of patience for a long war launched by a president who campaigned on “no new wars.” Bikales: President Trump has made energy affordability a key piece of his message heading into the midterms — in fact, just a few hours ahead of the strikes, he was in Corpus Christi, Texas, touting record U.S. oil production and lower prices at the pump. Democrats see an opening on that issue now with Iran, and they’ve already launched attacks that Trump is more focused on foreign wars than keeping energy prices down. So far, Republicans have largely dismissed those concerns, saying that prices will fall back naturally. But even if global crude prices fall, gas prices tend to be slower to recover — and we’re only eight months from the midterms.

Today, cancer remains one of Europe’s leading causes of death and disability, accounting for 23 percent of all deaths in 2022 and 17 percent of disability-adjusted life years in 2021. Four Europeans are diagnosed with cancer every minute, a number that is expected to rise over the next several decades due to population aging. As the EU Beating Cancer Plan reaches the end of its initial phase, Europe now stands at a critical moment. The question is not whether progress has been made, but whether Europe will build on that momentum or allow it to stall, with consequences not only for health outcomes, but also for economic growth and scientific leadership. Gilles Marrache At this juncture, cancer care must be understood not as a cost to be contained, but also as a strategic investment that delivers measurable returns in survival, productivity and Europe’s global competitiveness. > Continued investment in oncology is therefore not only a moral imperative but > also a proven economic and social multiplier. Cancer innovation delivers proven returns Investment in cancer innovation has already delivered extraordinary value for European patients and societies. Since 1989, advances in oncology have helped prevent an estimated 5.4 million deaths. More recently, since 2012, innovative cancer medicines have generated approximately 1.1 million quality-adjusted life years, all while accounting for just 6.6 percent of total health budgets. These gains are not abstract. They represent longer lives, improved quality of life, and the ability for people to remain active contributors to their families, workplaces and communities. Continued investment in oncology is therefore not only a moral imperative but also a proven economic and social multiplier. Delayed access is holding Europe back Despite these returns, Europe continues to struggle with timely access to innovative cancer medicines and diagnostics. According to EFPIA’s 2025 W.A.I.T. data, only 46 percent of centrally approved innovative medicines are available to patients on average across Europe, with a mean delay of 578 days between EU approval and patient access. In oncology, these waits have grown since 2023, which undermines patient outcomes and weakens Europe’s competitiveness in health innovation. Europe’s innovation edge is at risk Without decisive action, Europe risks falling further behind other regions. High-income European countries currently invest roughly half as much per capita in innovative medicines as the United States. This gap is driven largely by differences in how new therapies are valued, assessed and reimbursed. The impact of this underinvestment is already visible. Over the past two decades, Europe has lost around a quarter of its global share of biopharmaceutical research and development. Along with that loss comes fewer high-quality jobs, reduced private investment and weakened strategic autonomy in a sector that is increasingly central to economic and health security. > evidence suggests that every euro invested in health can generate up to four > euros in economic value, unlocking an estimated €10 trillion in GDP and saving > up to 60 million lives. Smart health investment drives growth and resilience By increasing targeted investment in innovative medicines, including in oncology, Europe can improve health outcomes for citizens, support workforce participation  and stimulate sustainable economic growth. Globally, evidence suggests that every euro invested in health can generate up to four euros in economic value, unlocking an estimated €10 trillion in GDP and saving up to 60 million lives. What European policymakers should do next To support oncology patients and safeguard innovation, regional and national governments must act across policy, funding and access: — Value what matters: modernize health technology assessment frameworks to better capture the full societal and economic benefits of innovation, while reducing duplicative and inefficient evidence requirements. This is particularly important as oncology products begin going through the new EU Joint Clinical Assessment. — Accelerate access: introduce time-bound, predictable pricing and reimbursement pathways; address regional and formulary-level delays; and invest in diagnostic and biomarker testing capacity to ensure patients receive the right treatment at the right time. — Back prevention and screening: fully finance the EU Beating Cancer Plan’s screening ambitions and scale proven pilot programmes that detect cancer earlier and improve outcomes. — Invest in innovation: increase public spending on innovative medicines in line with their true societal impact, while eliminating clawbacks and other cost-containment measures that disproportionately undermine the value of these therapies. A defining choice for Europe Europe stands at a crossroads. It can choose to invest now in cancer innovation, which would help to close survival gaps, strengthen competitiveness and deliver long-term value for citizens. Or it can allow delays, underinvestment and fragmented policies to widen those gaps further. Aligning policy, funding and access around innovation would not only improve cancer outcomes but make health one of Europe’s most powerful and sustainable investments for the future.     -------------------------------------------------------------------------------- POLITICAL ADVERTISEMENT * The sponsor is European Federation of Pharmaceutical Industries and Associations (EFPIA) * The political advertisement is linked to advocacy on securing a technology-neutral EU road-transport decarbonisation framework through recognition of renewable fuels, strengthened grid and infrastructure enablers, and avoiding mandates that limit operators’ choice and competitiveness. * The ultimate controlling entity is European Federation of Pharmaceutical Industries and Associations (EFPIA) More information here.

Europe stands at a crossroads. Cancer cases continue to rise, health systems are under visible strain and critical gaps in care remain unaddressed. Yet, just as the need for action grows more urgent, political attention to health — and to cancer — is fading. Now is the moment for Europe to build on hard-won work and ensure patients across the continent benefit from the care they deserve. As negotiations open on the EU’s next long-term budget (2028-34), priorities are shifting toward fiscal restraint, competitiveness and security. Health — once firmly on the political radar — is slipping down the agenda. This shift comes at a critical moment: Europe’s Beating Cancer Plan, a €4 billion flagship effort to turn the tide against cancer, is set to end in 2027 with no clear commitment to renew its mandate. With cancer incidence rising and systems struggling, letting Europe’s cancer framework fade would be a costly mistake. Across Europe, patients, clinicians and advocates are sounding the alarm. > With cancer incidence rising and systems struggling, letting Europe’s cancer > framework fade would be a costly mistake. “With 2.7 million cancer diagnoses and 1.3 million deaths each year, Europe must reach higher for cancer care, not step back,” says Dr. Isabel Rubio, president of the European Cancer Organisation. “Europe’s Beating Cancer Plan has set a new course, but sustained funding is now essential to protect progress and close the gaps patients still face.” Protecting the status quo is not enough. If the EU is serious about patient-centered cancer care, it must make a firm commitment to cancer and confront long-overlooked gaps, namely one with profound impact but minimal political attention: cancer-related malnutrition. The invisible crisis undermining cancer care Nutrition remains one of the most glaring blind spots in European cancer care. Cancer-related malnutrition affects up to seven out of ten patients, driven by the disease and its treatments.1 Increased nutritional needs — combined with symptoms such as nausea, fatigue and loss of appetite — mean that many patients cannot meet requirements through normal diet alone. The result is avoidable weight loss that weakens resilience, delays treatment and undermines outcomes.2 A new pan-European study by Cancer Patient Europe, spanning 12 countries, underscores the scale of this silent crisis: despite widespread nutritional challenges, support remains inconsistent and insufficient. Only 20 percent of patients reported receiving a nutritional assessment during treatment, and just 14 percent said their nutritional status was monitored over time — a clear mismatch between needs and the care provided. > If the EU is serious about patient-centered cancer care, it must make a firm > commitment to cancer and confront long-overlooked gaps, namely one with > profound impact but minimal political attention: cancer-related malnutrition. International authorities have repeatedly raised concerns about these gaps. The WHO Regional Office for Europe has warned that without proper training, healthcare providers lack the tools to screen, diagnose and address cancer-related malnutrition — highlighting a systemic weakness that continues to be overlooked. Patients themselves understand these shortcomings and seek more information and support. Most recognize nutrition as essential to their wellbeing, yet only 26 percent say they received guidance from their care team. As Antonella Cardone, CEO of Cancer Patient Europe, stresses: “Too many patients are left to face nutritional challenges alone, even when these difficulties directly affect their ability to cope with treatment.” She continues: “Malnutrition is not peripheral to their care. It is central. Addressing malnutrition can contribute to better treatment outcomes and recovery.” Without systematic action, malnutrition will continue to erode patients’ resilience — a preventable barrier that demands attention. A viable yet under-used solution Yet, the tools to address malnutrition already exist. In cancer care, systematic nutritional support has been shown to improve treatment tolerance and support recovery. Medical nutrition — taken orally or through tube feeding — is a science-based intervention designed for patients who cannot meet their nutritional needs through diet alone. Research shows it can reduce complications, limit treatment interruptions and help patients regain strength throughout their cancer journey. “Precision oncology is not only about targeting tumors, but about treating the whole patient. When nutritional needs are overlooked, the effectiveness of cancer therapies is compromised from the very start of the clinical journey,” says Alessandro Laviano, head of the Clinical Nutrition Unit at Sapienza University Hospital Sant’Andrea in Rome. The case is equally compelling for health systems. Malnourished patients face more infections, more complications and longer hospital stays — driving an estimated €17 billion in avoidable costs across Europe each year. In other words, tackling malnutrition is not only clinically essential; it is fiscally smart, precisely the kind of reform that strengthens systems under pressure. > Malnourished patients face more infections, more complications and longer > hospital stays — driving an estimated €17 billion in avoidable costs across > Europe each year. Ultimately, the challenge is not the absence of tools, but their inconsistent use. Nutritional care has proven benefits for patients and for health systems alike, yet it remains unevenly integrated in cancer care across Europe. To change this, the EU needs a clear policy framework that makes nutritional care a standard part of cancer care. This means ensuring routine malnutrition screening, equipping healthcare professionals with the practical skills to act and guaranteeing equal access to medical nutrition for eligible patients. Keep cancer high on the agenda and close the nutritional gap Europe has both the opportunity and the responsibility to keep cancer high on the political agenda. A more equitable and effective approach to cancer care is within reach, but only if EU leaders resist scaling back ambition in the next budget cycle. Europe’s Beating Cancer Plan, a major political and financial commitment, has strengthened prevention, screening, workforce training and patient rights. Yet the mission is far from complete. Cancer continues to affect millions of families and places a significant and rising burden on European health systems. Protecting progress means addressing persistent gaps in care. As the EU pushes for earlier detection, integrated pathways and stronger resilience, nutritional care must be part of that effort, not left on the margins. With such a patient-first approach — screening early, equipping clinicians and ensuring equitable access to medical nutrition — Europe can improve outcomes and further strengthen health systems. Now is the moment to build on hard-won progress and accelerate results for patients across the region. -------------------------------------------------------------------------------- References 1. Ryan AM, et al. 2019. https://www.danone.com/newsroom/stories/malnutrition-in-cancer.html 2. Ipsos European Oncology Patient Survey, data on file, 2023. -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Danone * The political advertisement is linked to advocacy on EU health and budgetary policy. It calls for sustained EU funding and political commitment to renew and strengthen Europe’s Beating Cancer Plan in the upcoming 2028–34 budget cycle, and urges integration of medical nutrition into EU cancer policy frameworks. The article explicitly addresses EU leaders and institutions, advocating policy and funding decisions to close gaps in cancer care across Member States. More information here.

Europe stands at a crossroads. Cancer cases continue to rise, health systems are under visible strain and critical gaps in care remain unaddressed. Yet, just as the need for action grows more urgent, political attention to health — and to cancer — is fading. Now is the moment for Europe to build on hard-won work and ensure patients across the continent benefit from the care they deserve. As negotiations open on the EU’s next long-term budget (2028-34), priorities are shifting toward fiscal restraint, competitiveness and security. Health — once firmly on the political radar — is slipping down the agenda. This shift comes at a critical moment: Europe’s Beating Cancer Plan, a €4 billion flagship effort to turn the tide against cancer, is set to end in 2027 with no clear commitment to renew its mandate. With cancer incidence rising and systems struggling, letting Europe’s cancer framework fade would be a costly mistake. Across Europe, patients, clinicians and advocates are sounding the alarm. > With cancer incidence rising and systems struggling, letting Europe’s cancer > framework fade would be a costly mistake. “With 2.7 million cancer diagnoses and 1.3 million deaths each year, Europe must reach higher for cancer care, not step back,” says Dr. Isabel Rubio, president of the European Cancer Organisation. “Europe’s Beating Cancer Plan has set a new course, but sustained funding is now essential to protect progress and close the gaps patients still face.” Protecting the status quo is not enough. If the EU is serious about patient-centered cancer care, it must make a firm commitment to cancer and confront long-overlooked gaps, namely one with profound impact but minimal political attention: cancer-related malnutrition. The invisible crisis undermining cancer care Nutrition remains one of the most glaring blind spots in European cancer care. Cancer-related malnutrition affects up to seven out of 10 patients, driven by the disease and its treatments.1 Increased nutritional needs — combined with symptoms such as nausea, fatigue and loss of appetite — mean that many patients cannot meet requirements through normal diet alone. The result is avoidable weight loss that weakens resilience, delays treatment and undermines outcomes.2 A new pan-European study by Cancer Patient Europe, spanning 12 countries, underscores the scale of this silent crisis: despite widespread nutritional challenges, support remains inconsistent and insufficient. Only 20 percent of patients reported receiving a nutritional assessment during treatment, and just 14 percent said their nutritional status was monitored over time — a clear mismatch between needs and the care provided. > If the EU is serious about patient-centered cancer care, it must make a firm > commitment to cancer and confront long-overlooked gaps, namely one with > profound impact but minimal political attention: cancer-related malnutrition. International authorities have repeatedly raised concerns about these gaps. The WHO Regional Office for Europe has warned that without proper training, healthcare providers lack the tools to screen, diagnose and address cancer-related malnutrition — highlighting a systemic weakness that continues to be overlooked. Patients themselves understand these shortcomings and seek more information and support. Most recognize nutrition as essential to their wellbeing, yet only 26 percent say they received guidance from their care team. As Antonella Cardone, CEO of Cancer Patient Europe, stresses: “Too many patients are left to face nutritional challenges alone, even when these difficulties directly affect their ability to cope with treatment.” She continues: “Malnutrition is not peripheral to their care. It is central. Addressing malnutrition can contribute to better treatment outcomes and recovery.” Without systematic action, malnutrition will continue to erode patients’ resilience — a preventable barrier that demands attention. A viable yet under-used solution Yet, the tools to address malnutrition already exist. In cancer care, systematic nutritional support has been shown to improve treatment tolerance and support recovery. Medical nutrition — taken orally or through tube feeding — is a science-based intervention designed for patients who cannot meet their nutritional needs through diet alone. Research shows it can reduce complications, limit treatment interruptions and help patients regain strength throughout their cancer journey. “Precision oncology is not only about targeting tumors, but about treating the whole patient. When nutritional needs are overlooked, the effectiveness of cancer therapies is compromised from the very start of the clinical journey,” says Alessandro Laviano, head of the Clinical Nutrition Unit at Sapienza University Hospital Sant’Andrea in Rome. The case is equally compelling for health systems. Malnourished patients face more infections, more complications and longer hospital stays — driving an estimated €17 billion in avoidable costs across Europe each year. In other words, tackling malnutrition is not only clinically essential; it is fiscally smart, precisely the kind of reform that strengthens systems under pressure. > Malnourished patients face more infections, more complications and longer > hospital stays — driving an estimated €17 billion in avoidable costs across > Europe each year. Ultimately, the challenge is not the absence of tools, but their inconsistent use. Nutritional care has proven benefits for patients and for health systems alike, yet it remains unevenly integrated in cancer care across Europe. To change this, the EU needs a clear policy framework that makes nutritional care a standard part of cancer care. This means ensuring routine malnutrition screening, equipping healthcare professionals with the practical skills to act and guaranteeing equal access to medical nutrition for eligible patients. Keep cancer high on the agenda and close the nutritional gap Europe has both the opportunity and the responsibility to keep cancer high on the political agenda. A more equitable and effective approach to cancer care is within reach, but only if EU leaders resist scaling back ambition in the next budget cycle. Europe’s Beating Cancer Plan, a major political and financial commitment, has strengthened prevention, screening, workforce training and patient rights. Yet the mission is far from complete. Cancer continues to affect millions of families and places a significant and rising burden on European health systems. Protecting progress means addressing persistent gaps in care. As the EU pushes for earlier detection, integrated pathways and stronger resilience, nutritional care must be part of that effort, not left on the margins. With such a patient-first approach — screening early, equipping clinicians and ensuring equitable access to medical nutrition — Europe can improve outcomes and further strengthen health systems. Now is the moment to build on hard-won progress and accelerate results for patients across the region. -------------------------------------------------------------------------------- References 1. Ryan AM, et al. 2019. https://www.danone.com/newsroom/stories/malnutrition-in-cancer.html 2. Ipsos European Oncology Patient Survey, data on file, 2023. -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Danone * The ultimate controlling entity is Danone More information here.

BERLIN — China was once the promised land for German industry. Now it’s a massive strategic headache for Chancellor Friedrich Merz, who departs on his inaugural visit to Beijing on Tuesday. For years, Berlin was the driving force behind closer EU relations with China — brushing aside human rights concerns to lobby for a landmark investment deal in 2020. Closer trade relations with China, German leaders argued, would have a moderating effect on the regime in Beijing, a justification encapsulated with the mantra Wandel durch Handel, or change through trade. For a long time, it was also good for business. Germany was one of the few EU countries to run surpluses with Beijing, supplying the vital components and machinery that fueled China’s economic ascent. Its industrial giants like carmaker Volkswagen and chemical company like BASF made huge investments to harness the Chinese market. But that all-in approach to China now increasingly appears to be a historic policy miscalculation on par with Germany’s misguided energy dependence on Russia before the Kremlin’s full-scale invasion of Ukraine four years ago. In public, Merz hasn’t admitted the scale of the challenge. Last week, he told fellow conservatives that he is traveling to China to forge closer cooperation. “We have a strategic interest in finding partners around the world who think like us, who act like us,” he said. But many German industry leaders are now urging the chancellor to take a far tougher line and are howling over what they call the “China shock.” Since the Covid pandemic, the trade relationship has flipped to an eye-watering deficit — €90 billion in 2025 — and China is widely blamed for much of the hemorrhaging of jobs in Germany’s all-important manufacturing sector — now running at roughly 10,000 job losses per month. Frustratingly for the reflexive transatlanticist Merz, pivoting to President Donald Trump’s U.S., which is locked in an unpredictable tariff showdown with Europe, is hardly a viable option. That means Merz has to find some way to engage with Chinese leader Xi Jinping. Jörg Wuttke, a long-time China watcher who briefed the chancellor on Feb. 17 ahead of his visit, said he was surprised by how “well prepared he was.” For close to two hours, Merz took notes from a group of six China experts, saying little beyond asking questions. His priority, Wuttke said, was conveying the problems in a way that would connect with Xi. “He realizes he is possibly the most important politician for China in Europe,” Wuttke said. But China seems to have the best cards. Germany has over time become reliant on critical raw materials imported from China, giving Beijing the power to shut down German plants almost at will even as Berlin tries to pursue a longer term policy of reducing such dependencies or “de-risking.” That goal will take years to realize, however. By then, a growing number of German industry leaders are arguing, much of the damage will have been inflicted as German companies buckle due to massive Chinese price advantages resulting from subsidies, deliberate dumping and an undervalued currency. Merz himself admits that Germany should hold no “illusions” about China and its ambition to “define a new multilateral order according to its own rules.” “Merz is going at the worst possible time in terms of the impact of the China shock on the German economy,” said Andrew Small, director of the Asia program at the European Council on Foreign Relations. “The numbers are obviously absolutely horrible, with no projection that they’ll get better.” WHO HAS THE LEVERAGE? In many ways, the trip will look like those taken by chancellors in the past, when China’s vast and fast-growing market was considered the hope of German industry. Merz is traveling with a delegation of some two-dozen business executives. Over the course of three days, with stops in Beijing and the tech hub of Hangzhou, he will dine with Xi and visit the Forbidden City as well as outposts of Mercedes Benz and Siemens Energy. But few expect any sweeping deals will be reached. German industry leaders are instead calling for more concrete and immediate progress to improve their circumstances. “Our companies are coming under increasing pressure because key competitive conditions are being systematically distorted,” Thilo Brodtmann, the managing director of VDMA, said in a statement ahead of Merz’s trip. As a consequence, he said, German machinery exports to China fell by 8.5 percent during the first 11 months of last year, while machinery imports from China rose by 12.5 percent. Brodtmann called on the chancellor to address Chinese export controls on rare earths and to end China’s practice of subsidizing loss-making “zombie companies” that offer cut-rate prices. “German companies are not competing with other companies, but with the Chinese treasury,” he said of subsidies more broadly. The most powerful tool Merz has at his disposal is China’s growing dependence on the European market, which only increased as Chinese domestic demand has fallen. For Merz, a longtime free-trade purist, a push to threaten defensive tariffs within the framework of the EU is not only anathema — it’s potentially reckless at time when Germany is also dealing with the fallout of Trump’s trade wars. Trump’s attempt to confront China also provides something of a cautionary tale. In the midst of a trade feud between the U.S and China last year, Beijing announced sweeping export controls on rare-earth magnets and the raw materials needed to make them. Weeks later, Trump and Xi reached a detente, with Beijing agreeing to delay rare earth export restrictions for one year. But Nicolas Zippelius, a lawmaker focusing on China relations for Merz’s conservatives, said Merz may be more forceful than he lets on in public. “I would say that China and Germany can hurt each other very badly,” said Zippelius. “We must not underestimate Germany’s strong voice within the EU. And the EU has shown in the past that it has power, for example through tariffs and other measures.” Such conversations would happen in private, Zippelius added. “I don’t think it helps to take risks against each other in the open,” he said. “But in closed-door talks, you can communicate that very clearly. And there you definitely have leverage.” To that end, Merz could choose to ally itself more closely with France, which has emerged as one of the loudest voices warning that China is steadily hollowing out Europe’s industrial base while the continent is distracted by Trump. The only question is whether China would take Merz’s warnings seriously. “The leverage is there,” said Small of the European Council on Foreign Relations. “But on the Chinese side, the assessment is that Europe is not willing to use it.” Indeed, China knows the EU has backed off in the past over potential trade conflicts with Beijing in sectors such as solar panels and telecommunications due to fear of Chinese retaliation. As Merz and other European leaders look for an answer, time is on China’s side, added Small. “Unless there is more serious concerted action on the European side, China will calculate that it can get away with exactly what it’s doing at the moment and all of these problems will continue,” he said. Nette Nöstlinger contributed to this report.