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

By Kathryn Kranhold and Jason McLure of The Examination and Rory O’Neill and Antonia Zimmermann of POLITICO. This article was reported in collaboration with The Examination, a nonprofit newsroom that investigates global health threats. BRUSSELS — When the world’s largest tobacco company needed help lifting international restrictions on its products, it enlisted an unlikely ally: the European Union, a leader in tobacco control.  EU officials met with Philip Morris International representatives at least six times from September 2022 through 2024, according to documents released through public records requests. The tobacco giant’s agenda: Enlist EU officials’ help in loosening restrictions or setting favorable tax rates on its products — including IQOS, a heated tobacco device key to the company’s future — in 10 countries outside the EU. Officials with the European Commission, the EU’s executive arm, took action at least three times that would have benefitted the company, The Examination and POLITICO found. They published a notice saying Mexico’s ban on new nicotine products was a possible barrier to free trade. They asked Turkish officials whether they planned to maintain the country’s requirement that cigarettes contain a minimum amount of local tobacco. And in a high-level report for EU officials, they flagged that rule and Turkey’s cigarette tax rate as issues that could affect ties between it and the EU.  The Commission’s actions regarding Turkey were “of great help for us,” a PMI representative wrote to staffers at the Commission. “We would like to express our gratitude in regard of (sic) the actions that you took.”  A Philip Morris International representative thanked European Commission trade officials for flagging Turkey’s cigarette tax and a rule on domestic tobacco as possible trade issues. (Redactions by the European Commission. Highlighting by The Examination) The revelations, contained in documents released through public information requests by the French anti-tobacco group Contre-Feu, raise questions about whether the EU breached its commitment to a global treaty to combat smoking signed by the EU and member countries. Guidelines to implement that treaty — the Framework Convention on Tobacco Control (FCTC) — say that when setting and implementing public health policies, governments should restrict their dealings with the tobacco industry and disclose any meetings whenever possible. None of the meetings with PMI or other industry groups cited in the documents were disclosed, according to The Examination and POLITICO’s review of the EU’s disclosure websites. The “fact that EU officials acted upon PMI’s requests signals a troubling willingness to give the tobacco industry privileged access. That is precisely what the FCTC was designed to prevent,” said Tilly Metz, a member of the European Parliament with the Greens. “It undermines both public trust and the EU’s credibility as a global leader in tobacco control.” A spokesperson for the European Commission told The Examination and POLITICO  that it “strictly follows” the treaty guidelines. But tobacco products are covered by EU trade policy, and the Commission can negotiate tariffs and trade rules, the spokesperson said.  “The Commission does not shape, influence or lobby for specific health policies in third countries on behalf of any industry,” the spokesperson said.  While industry associations and companies can share concerns on market access in non-EU countries with the Commission, and the Commission may meet with complainants to get more information, the spokesperson said such meetings are “strictly related to trade facilitation and market access.” European parliamentarians appeared divided over whether the dealings were improper.  Vytenis Andriukaitis with the Socialists and Democrats and a former EU health commissioner said the European Commission “cannot represent the interests of tobacco companies,” nor “press other countries to weaken” their tobacco controls. Barry Andrews, a member of the centrist Renew Europe Group, said: “These regular meetings with big tobacco lobbyists and the flurry of emails should not have happened.” By contrast, Stine Bosse, a member of the same political group, said: “The tobacco industry has every right to employ lobbyists.” However, Bosse added: “Morally, I stand in a very different place. While they constantly try to reinvent new products to get people hooked on nicotine and tobacco, I am fighting for precisely the opposite.”  Philip Morris International did not answer questions from The Examination and POLITICO about its dealing with EU officials. On its website, the company said it shares its perspectives with policymakers and it is “particularly active with respect to policies regarding less harmful alternatives to cigarettes, trade and fiscal matters, and intellectual property.” (The company is separate from Philip Morris USA, which is part of Altria Group.) The Examination and POLITICO have not found evidence that any of the 10 countries targeted by PMI altered their tobacco taxes or regulations following meetings with EU officials, including where the EU took action with regard to Mexico and Turkey. Most of PMI’s entreaties focused on IQOS, which it says is better than cigarettes because heating tobacco releases fewer toxins than burning it. Public health experts say the long-term risks of heated tobacco are unknown and products like IQOS could increase tobacco use. IQOS devices with heated tobacco sticks. Philip Morris International says IQOS is better than cigarettes because heating tobacco releases fewer toxins than burning it. Public health experts say the long-term risks of heated tobacco are unknown. | Roberto Pfeil/picture alliance via Getty Images Public health advocates said Commission officials’ actions were especially surprising because the EU has been one of the strongest supporters of the FCTC.  This year, the Commission proposed hiking EU-wide taxes on most tobacco products and setting minimum taxes for vapes and heated tobacco for the first time. Health Commissioner Olivér Várhelyi has pledged to drive e-cigarette taxes even higher; his tax counterpart, Wopke Hoekstra, has called vapes the “revenge of the tobacco industry.” The countries that PMI sought help with were outside the EU. Nearly all of them — Argentina, Brazil, India, Mexico, Singapore, Thailand, Turkey and Vietnam — had banned heated tobacco. Taiwan had what PMI described as a burdensome approval process. Japanese leaders were in discussions to raise taxes on heated tobacco to the same rate as cigarettes. Philip Morris International asked for the EU’s help in loosening restrictions or setting favorable tax rates on its IQOS product in 10 countries outside the EU. (Redactions by the European Commission. Highlighting by The Examination) PMI officials wanted people in those countries to be able to buy IQOS as easily as cigarettes. The company calls IQOS part of its “dream team” of alternative nicotine products, including e-cigarettes and nicotine pouches, that are meant to offset declining cigarette consumption.  So the company sought help in the EU’s distinctive 15-story glass trade building, the Charlemagne, in Brussels. PMI SEEKS HELP IN MEXICO Mexico was the first country that PMI sought help with, according to the documents. That country was a key market for IQOS, but a ban on vapes and heated tobacco was set to go into effect in December 2022.  In an investor meeting on Sept. 6, 2022, an analyst asked about IQOS’ “lack of success” in the Americas. Emmanuel Babeau, the company’s chief financial officer, blamed “some restrictions” in Mexico but said, “it’s going to be a very successful market for IQOS once we can really sell the device really without any issue.” That same day, company staff had an online meeting with EU officials to discuss the ban. It was one of several discussions about Mexico. After the ban went into effect, PMI sought more help from EU officials. In an April 3, 2023, email, an executive at the company’s Swiss office asked for another meeting, explaining that Mexico’s “business environment is still marked by uncertainty, judicial processes, interpretations, and doubtful, temporary and unclear administrative acts.”    After a ban on vapes and heated tobacco went into effect in Mexico, Philip Morris International sought more help from EU officials. (Redactions by the European Commission. Highlighting by The Examination) Soon after the email, European trade officials issued what is known as a barrier to trade notice, reporting Mexico’s IQOS ban as a potential trade treaty violation. PMI representatives and trade officials met later that month, when the company contended similar bans in Argentina, Brazil and Vietnam were trade barriers, according to a Commission report summarizing the meeting. The Commission spokesperson said it had acted in response to a formal complaint that “involved discriminatory treatment of like products” and that it did not undertake any further action regarding Mexico. Mexico’s Supreme Court struck down the ban in November 2024, allowing PMI to continue selling IQOS there.  The correspondence shows how PMI leveraged its status as a major European employer and exporter. The company employed more than 21,500 people in Europe as of 2023 and had 20 manufacturing sites there. In one email, a PMI representative told a European trade official that a meeting would be a “good opportunity to update you [on] the most recent data on EU exports in the tobacco sector and PMI’s investments in the EU.” OFFICIALS QUESTION TURKEY’S TAXES, RULES ON LOCAL TOBACCO EU officials also assisted PMI in trying to change rules on cigarettes.  In July 2023, a company representative complained to EU officials about Turkey’s cigarette tax, saying in an email that Turkey had “one of the highest ad valorem duty levels in the world.” The representative also flagged Turkey’s “local content” rule, which required that cigarettes made and sold in the country contain a certain amount of domestic tobacco. The PMI representative wrote that the company had “prepared a few suggestions” for the Commission’s upcoming report on Turkey’s economic and diplomatic relationships with the EU.  That report, which came out in November 2023, flagged Turkey’s taxes and the local content rule. That elicited the email from PMI thanking EU officials for their help. Meanwhile, the company was pushing European Commission officials to raise the local content rule again, but in a different forum: an upcoming World Trade Organization (WTO) review of Turkey’s trade policies. PMI provided EU trade officials with questions to ask Turkey. EU officials then submitted a question prior to the review, asking whether the local content requirement for tobacco and other industries would continue, according to meeting minutes. The Commission spokesperson did not directly answer questions from The Examination and POLITICO about its actions regarding Turkey. Turkey has not changed its requirements on local tobacco or its tax rate.  MEETINGS PART OF A MULTIMILLION-DOLLAR LOBBYING EFFORT The meetings are part of an industry lobby that spends $16.2 million (14 million euros) a year in the EU, according to a report by Contre-Feu and STOP, another anti-tobacco group, released Wednesday. Contre-Feu mapped a network of 49 organizations and companies, including Philip Morris International and British American Tobacco, that lobbied the European Commission and Parliament to weaken tobacco regulations and set lower taxes on new nicotine products, both within and outside the EU. (British American Tobacco did not respond to requests for comment.) The interactions between the tobacco industry and EU officials appear to be extensive, according to the documents. They include several dozen email exchanges and refer to at least nine meetings between EU officials and tobacco companies or industry-supported groups.  In addition to the six meetings with PMI, there were three other meetings with tobacco representatives. Trade staff met with three other companies and a tobacco trade group in March 2024 to hear their requests for more favorable tariff rules for new nicotine products. In a separate video conference, British American Tobacco asked trade staff to intervene at a WTO hearing over Saudi Arabia’s proposed tax hike on e-cigarette cartridges. (The EU did not take action, according to the documents.) And in a third meeting, the EU’s former agriculture commissioner, a Polish member of the EU parliament and two tobacco farming lobby groups discussed tobacco subsidies and the Commission’s position on the global tobacco treaty. Nathalie Darge, secretary general of Tobacco Europe, the trade group included in one of those meetings, said its input focused on technical requirements and that it wanted to “ensure legal certainty for operators and customs authorities.” One European Commission report recapping a meeting with PMI was sent to 32 trade department officials and staff, including EU representatives assigned to Mexico, Brazil, Argentina and Vietnam and division directors. Contre-Feu wrote that the dealings between government officials and tobacco representatives showed that “current rules to limit industry influence are falling short and European policymakers continue to be heavily lobbied by the tobacco industry and those working on its behalf.” PMI’s efforts are part of a long history of the tobacco industry using trade and investment pacts to expand markets and undermine health policies, said Suzanne Zhou, who works for the World Health Organization FCTC Knowledge Hub on Legal Challenges and a senior fellow at the Melbourne Law School in Australia. “Tobacco companies have lost the argument from a health perspective,” Zhou said. “So they are reframing the issue as a trade issue in the hopes that they can advance their interests in that forum instead.”  In the 1980s, the U.S. Trade Representative threatened sanctions if Japan, Taiwan, South Korea and Thailand didn’t open their markets to U.S. cigarette companies. A study later concluded that cigarette consumption in those four markets was nearly 10 percent higher than it would have been if they had remained closed to U.S. companies.  More recently, Australia and Uruguay faced trade litigation from the industry or industry-aligned governments over their tobacco control policies.  COMMISSION CRITICIZED FOR UNDISCLOSED MEETINGS Contre-Feu contended that the documents also show that EU officials didn’t disclose meetings with the industry when they should have. To aid countries in implementing the tobacco treaty, delegates wrote a set of guidelines. They state that when setting and implementing public health policies, interactions with the tobacco industry should be limited to what is strictly necessary for effective regulation. Interactions should be conducted in public and disclosed whenever possible. And the guidelines emphasize that “all branches of government” should be made aware of industry efforts to interfere with policies. The Commission spokesperson said that’s exactly what it does: “Meetings with the tobacco industry are avoided, unless they are strictly necessary. If the applicable conditions are met, meetings are held in a fully transparent manner and are appropriately documented.” But EU trade officials did not disclose any of these meetings on the website where the trade department reports such contacts. One batch of documents was released through a request for access; another batch was obtained by Contre-Feu. One of the meetings not disclosed by trade officials occurred in July 2023. Global health leaders were scheduled to meet that November to update the FCTC. The European Commission was considering supporting strict limitations on heated tobacco products.  A Commission report summarizing a July 19, 2023, meeting with PMI said that the company had “alerted” the Commission about language “calling on WHO members to adopt import bans on heated tobacco products.” The company asserted that EU tobacco policy should take into account WTO agreements, which the company has contended would preclude countries from banning IQOS.  Philip Morris International met with European Commission trade officials in July 2023 to discuss a proposed change to a global tobacco control treaty that would have banned heated tobacco. Though such meetings are supposed to be disclosed, this one wasn’t. (Redactions by the European Commission. Highlighting by The Examination) The documents don’t say anything about whether the Commission took action, and tobacco-friendly countries in the EU such as Italy and Greece pushed back against restrictive guidelines. But in the end, the Commission took no position on heated tobacco— a victory for the industry.  During the period covered by the documents, the EU required only high-ranking Commission officials to report meetings with companies or special-interest groups. In December 2024, the Commission tightened rules to require disclosure by additional staff. It’s unclear whether those rules would’ve required disclosure of these meetings.  Former EU ombudsman, Emily O’Reilly, found other instances in which the Commission didn’t disclose meetings with the tobacco industry, which she concluded failed to meet transparency rules required under international law.  Contre-Feu has urged the EU to tighten transparency guidelines even further by extending disclosure requirements to all staff, among other things. The group said in its report that the extensive lobbying and lack of disclosure “reveal either a repeated violation of the FCTC by the European Commission or, at the very least, an insufficient implementation of the treaty’s measures.” Mathieu Tourliere of Proceso contributed reporting. STOP has received support from Bloomberg Philanthropies, which also provides financial support to The Examination. The Examination operates independently and is solely responsible for its content. Correction: This story has been corrected to say that the report on tobacco industry lobbying was jointly published by Contre-Feu and STOP, and that STOP has received support from Bloomberg Philanthropies.

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

Voters in Switzerland rejected by large majorities two initiatives in a referendum on Sunday, one proposing to tax the super-rich on their inheritance and another to extend mandatory civic or military service to women. Some 84 percent of voters said no to the civic duty proposal, while around 79 percent voted against the inheritance tax initiative, according to initial projections after polling closed at noon on Sunday. The tax measure was a proposal to impose a 50 percent levy on inheritance above a tax-free amount of 50 million Swiss francs (€53.6 million) and direct the funds toward measures to mitigate climate change. It was put forward by the youth wing of the leftist Social Democrats. The “For a committed Switzerland” initiative wanted to see compulsory military or civilian service for men extended to women and expanded to additional forms of service to benefit society such as protecting the environment, assisting vulnerable people and helping with disaster prevention. The civic duty proposal was launched by Geneva-based association servicecitoyen.ch, backed by a petition with 107,613 signatures and the support of the Liberal Greens, the Evangelical Party, the Pirate Party, the youth wing of the Centre Party and other associations. Both initiatives failed to garner wider political support from the Swiss government or other parties, and a poll 10 days before the vote predicted ballot-box defeats for both.

LONDON — Milkshakes and lattes will be subject to a sugar tax for the first time, U.K. Health Secretary Wes Streeting said Tuesday. Speaking ahead of the budget, Streeting said the government would remove the exemption that milk-based products currently have from the Soft Drinks Industry Levy in January 2028. The threshold at which the levy is imposed will also be lowered from 5 grams to 4.5 grams (g) per 100 milliliters (ml). Commonly dubbed the “sugar tax,” the levy, which was introduced in 2018 under the previous Conservative government, aims to reduce obesity and improve child health.  “Obesity robs children of the best possible start in life,” Streeting told MPs Tuesday. “It hits the poorest hardest — sets them up for a lifetime of problems.” Bottles and cartons of milkshakes, flavored milk,  sweetened yoghurt drinks, chocolate milk drinks, ready-to-drink coffees and milk substitute drinks will now be eligible for the levy. Drinks prepared in cafes and bars remain out of scope. The levy requires companies producing drinks that contain between 5g and 8g of sugar per 100ml to pay 19.4 pence per liter while drinks with 8g or more of sugar must pay 25.9 pence per liter. A government document published Tuesday said ministers expect the Treasury to raise between £40 million and £45 million a year as a result of the changes. The average sugar content in drinks has fallen by almost 50 percent since the levy’s introduction. It is associated with a fall in rotten tooth extractions in kids and an estimated 8 percent relative reduction in obesity levels among young girls. Sarah Woolnough, chief executive of the King’s Fund health think tank, said the measure was “not only common sense but also a quick win for government and, most importantly, for children and young people.”

LONDON — Boris Johnson, look away now. The 800-page report from Britain’s official inquiry into the coronavirus pandemic landed Thursday evening. It makes for grim reading for the country’s former prime minister, and much of his top team. Johnson has yet to respond. But the inquiry machine-guns a “too little, too late” government response to the early raging of the virus in 2020, a “toxic culture” in No. 10 Downing Street under the then-PM — and a serious failure to take heed of mistakes made. “Unless the lessons are learned and fundamental change is implemented, the human and financial cost and sacrifice of the Covid-19 pandemic will have been in vain,” the inquiry’s chair Heather Hallett, warned as the report was published Thursday. POLITICO pored over the full report to full out some of the biggest recipients of criticism. 1) BORIS JOHNSON COULDN’T MAKE HIS MIND UP Johnson is roundly criticized for failing to take the virus seriously enough in the initial months, for “oscillating” between different decisions on whether to actually introduce a lockdown, and for a host of controversial comments which caused offense to victims’ families when they came out during the inquiry’s evidence gathering process.  Particular criticism is reserved for Johnson as boss. The culture in Johnson’s No. 10 is described as “toxic and chaotic.” He is accused of “reinforcing” a workplace where the views of others, particularly women, were ignored — and of “encouraging” the behavior of his chief aide, Dominic Cummings. 2) DOMINIC CUMMINGS MADE THE CULTURE WAY WORSE — BUT SAVED LIVES Cummings arguably comes in for even harder criticism than Johnson. The report accuses the then-PM’s chief aide of having “materially contributed to the toxic and sexist workplace culture at the heart of the U.K. government.” It says he was a “destabilising influence” at a time of crisis — and that he was at fault for a “culture of fear, mutual suspicion and distrust” in government. Cummings is, however, praised by the report for his “commendable action” in bringing about a change in the government’s early pandemic strategy, which saved lives.  The culture in Boris Johnson’s No. 10 is described as “toxic and chaotic.” | Wiktor Szymanowicz/Getty Images 3) MATT HANCOCK WASN’T TRUSTED TO BE STRAIGHT WITH PEOPLE The short-lived reality TV star Matt Hancock is a figure of fun in U.K. politics these days — but he once held a role of enormous importance as health secretary during the pandemic.  For his contribution to Britain’s efforts as the virus initially spread, Hancock earns multiple instances of harsh criticism in the report.  Hancock is slammed for the “overenthusiastic impression” he gave to Johnson and top officials on his department’s readiness to face a pandemic, and it is said he gained a reputation for “overpromising and underdelivering.” The report even says concerns were raised about Hancock’s reliability and trustworthiness in meetings as Britain grappled with how to respond in the early days. The report ultimately says Britain should have locked down a week earlier than it did in March 2020, blaming officials, politicians and scientists for not moving quicker. It argues that the failure to do so came at a cost of around 23,000 lives. 4) CHRIS WORMALD SHOULD’VE DONE MORE Government officials were concerned that the Covid inquiry could prove embarrassing for Chris Wormald — who now serves as Prime Minister Keir Starmer’s cabinet secretary, a supremely powerful role at the head of Britain’s civil service. During the pandemic, Wormald was the top civil servant at Hancock’s Department of Health and Social Care, which is repeatedly criticized for giving false impressions on how prepared it was. While Hancock is widely blamed for this, the report does slam Wormald for failing to “rectify” the health secretary’s overconfidence. It says his failure to take any action “gave rise to additional concerns about the effectiveness of Wormald’s leadership.  That was as bad as it got for the current Cabinet Secretary, who might breathe a sigh of relief. Dominic Cummings is praised by the report for his “commendable action” in bringing about a change in the government’s early pandemic strategy, which saved lives. | Wiktor Szymanowicz/Getty Images 5) BITS OF THE BRITISH STATE ITSELF WERE SERIOUSLY SHAKY Whitehall itself comes in for some stark criticism, although the report stops short of a damning indictment of the whole system. The Cabinet Office — often referred to as the wiring at the center of government — is particularly slammed for failing to take more of a lead in early pandemic decision making. The report says that the government’s decision making structures “required improvement” during the pandemic, and that Johnson often sidelined his cabinet in favor of “centralised decision making.”  Brief sections on Welsh and Scottish governing cultures during the pandemic conclude that neither had real issues with relationships, though then-First Minister Nicola Sturgeon is accused of hogging the limelight with her daily lockdown press conferences, even if there’s praise for her “serious and diligent” approach to leading Scotland through the pandemic.

COPD affects over 390 million people, including more than 36 million in Europe, and is poised to be the leading cause of hospital admissions over the next decade worldwide.1,2,3 In Europe, countries such as Ireland, Romania and Denmark have among the highest hospital admission rates for people with COPD, representing significant costs for health systems.4 Meanwhile, countries like Norway and Germany spend the most per patient on COPD management.5 Awareness is rising, and more stakeholders are taking a proactive approach to address the growing burden of COPD. However, it remains an underestimated and under-resourced disease. Innovation in COPD offers significant opportunities for more proactive patient care, where exacerbations and hospitalizations could be prevented. By investing in the latest wave of healthcare innovation and prioritizing preventative methods, the growing economic and patient burden of COPD can be mitigated. Understanding the patient burden To truly understand COPD, it’s critical to recognize its impact on patients. For most, COPD means a daily struggle with breathlessness, persistent coughing and increased fatigue as their lung function gradually deteriorates. These symptoms can severely limit their ability to do everyday tasks such as walking the dog, climbing stairs or even carrying groceries, impacting their quality of life and overall well-being.6 This, in turn, can lead to considerable financial burden for people affected by this condition due to limitations on workplace and home productivity, and the costs of medical treatment, impacting the EU’s competitiveness.6 And the picture gets worse when patients experience exacerbations. The patient cost of COPD exacerbations, and resulting hospitalizations, is equally profound. Tragically, one in ten patients hospitalized for COPD will die during their stay.7 About one in four will not live to see another year,8 and half will succumb to the disease within five years.9  But even before these dire outcomes, the impact of COPD is felt in the diminished quality of life, frequent sick leave and increasing disability that patients endure between exacerbations, creating dependencies within families and adding to the emotional and financial strain. > Tragically, one in ten patients hospitalized for COPD will die during their > stay.7 About one in four will not live to see another year,8 and half will > succumb to the disease within five years.9 For individuals who recover, each exacerbation inflicts irreversible damage, significantly degrading lung function, increasing disability and severely impacting quality of life. This leads to a greater reliance on healthcare services over time, creating a vicious cycle of health decline. The disease also takes an immense emotional toll on families and caregivers, who stand witness to their loved one’s devastating disease progression and often bear the care burden. In the Netherlands, caregivers of COPD patients with exacerbations provide up to 14 hours of informal care weekly.10 In Spain, it’s estimated that over 220,000 caregivers are needed to support those with COPD-related disabilities.11 > Since my diagnosis with COPD, the biggest challenge for my wife and I is the > uncertainty. I wake up every morning wondering if this will be a good day or a > bad day. Will I be able to go about my usual activities or face a debilitating > exacerbation? Durham, person living with COPD Currently, resources are often concentrated on managing advanced disease, missing the crucial opportunity for earlier and more effective intervention through disease-specific programs and early detection. Prioritizing prevention is essential to improving outcomes for patients and alleviating pressure on already strained health systems. A proactive shift toward prevention and sustained disease management is urgently needed. Hospitalizations and the growing financial burden on health systems Global COPD expenditures are projected to reach €3.7 trillion by 2050, with 45-70% of these costs linked to managing exacerbations. Comparatively, EU governments spent €1.25 trillion on healthcare overall in 2023, implying an increasing cost burden related to COPD in the coming years.12,13,14 Remarkably, approximately 70 percent of the total costs associated with treating COPD stem directly from hospital stays.15 Collaborative efforts such as the Joint Action on Chronic Respiratory Diseases (JARED) and the MEP Lung Health Group are crucial for driving policy changes and improving COPD management across the EU. > Policymakers increasingly see COPD as a driver of hospital admissions: 41 > percent now rank it among the top three causes of hospital admissions in their > country behind only heart disease and stroke — a sharp rise from 8 percent in > 2022.16 Although this awareness is rising, so are the costs. In Europe, the estimated annual medical cost of COPD ranges from €1,963 to over €10,701 per person among adults aged 45 years and older, depending on disease severity. COPD-related hospitalizations are 2-3 times more expensive than other disease-related hospitalizations.17,18,19 This is primarily driven by longer stays, higher rates of intensive care unit use, a greater need for post-discharge support, and increased risk of readmissions, reflecting the complex and resource-intensive nature of managing exacerbations. Current COPD management focuses on symptom control, often overlooking the critical need to reduce exacerbations and hospitalizations. Prioritizing early intervention and prevention: A call to action While the challenges posed by COPD are significant, there is an opportunity to take decisive action. By implementing concerted, consistent and coordinated efforts to tackle COPD in a systemic way, we can mitigate its impact and improve patient outcomes. We can lead in this area, setting a standard for proactive COPD management and demonstrating the value of investing in early intervention and prevention.   To address the multifaceted patient and health system costs of COPD, a shift toward proactive strategies is essential. There are already promising initiatives of such strategies being implemented across Europe, such as national lung health programs that emphasize early diagnosis in primary care settings and integrated vaccination programs for at-risk adults, demonstrating that progress is within reach through collaboration and shared learning. Complementing these systemic efforts, patient engagement is a crucial component in effective COPD management. When patients are engaged and actively involved in their care, they are better equipped to recognize worsening symptoms and seek timely help. Tools like the COPD Exacerbation Recognition Tool play a vital role by increasing patient awareness of early signs and empowering them to respond quickly, potentially reducing the severity of flare-ups and avoiding costly hospitalizations.20 Shifting the system from reactive crisis care toward proactive, preventative approaches and early intervention is what ultimately may keep more people out of hospital. A lot of progress has been made on prioritizing the ongoing burden of COPD, but there is more to do. It’s time that we rethink our approach to care and ask ourselves, what more can we do to truly support patients and national healthcare systems? At GSK, we believe in working across the healthcare ecosystem and with governments to learn from one another, support new innovation, and build a system that prioritizes early intervention and prevention of unnecessary exacerbations and hospitalizations. It is our collective responsibility to act now. This should be seen not just as a medical imperative, but as a strategic investment in healthy populations and economic stability. November 2025 NP-GBL-CPU-WCNT-250002 -------------------------------------------------------------------------------- 1. Boers E, Barrett M, Su JG, et al. Global Burden of Chronic Obstructive Pulmonary Disease Through 2050. JAMA Netw Open. 2023 Dec 1;6(12):e2346598. doi: 10.1001/jamanetworkopen.2023.46598. 2. Benjafield A, Tellez D, Barrett M, et al. An estimate of the European prevalence of COPD in 2050. European Respiratory Journal 2021;58(suppl 65):OA2866; doi: DOI: 10.1183/13993003.congress-2021.OA2866. 3. Khakban, Amir et al. “The Projected Epidemic of Chronic Obstructive Pulmonary Disease Hospitalizations over the Next 15 Years. A Population-based Perspective.” American journal of respiratory and critical care medicine vol. 195,3 (2017): 287-291. doi:10.1164/rccm.201606-1162PP. Accessed April 2025. 4. Organisation for Economic Co-operation and Development. (2022). Health at a glance: Europe 2022. OECD Publishing. https://doi.org/10.1787/507433b0-en 5. Rehman, M., et al. (2021). Cost analysis of chronic obstructive pulmonary disease (COPD): a systematic review. Health Economics Review, 11 : 31. https://doi.org/10.1186/s13561-021-00329-9. 6.WHO. Fact Sheet: Chronic obstructive pulmonary disease (COPD). Accessible at: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) [last accessed October 2025] 7. Sin DD. Should COPD stand for “comorbidity-related obstructive pulmonary disease”? Eur Respir J. 2015;46(4):901-2. doi: 10.1183/13993003.01112-2015 8. Serra-Picamal X, Roman R, Escarrabill J, et al. Hospitalizations due to exacerbations of COPD: A big data perspective. Respir Med. 2018;145:219-225. doi: 10.1016/j.rmed.2018.01.008 9. Suissa S, Dell’Aniello S, Ernst P. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax. 2012;67(11):957–963. doi: 10.1136/thoraxjnl-2011-201518.  10. Melles, M.C., et al. “The cost impact of informal care for patients with COPD and exacerbations in the Netherlands.” American Journal of Respiratory and Critical Care Medicine, vol. 211, no. Abstracts, May 2025, https://doi.org/10.1164/ajrccm.2025.211.abstracts.a3256. 11. PMC, Europe. Europe PMC, europepmc.org/article/PMC/4334315. Accessed 31 Oct. 2025. 12. Chen S, Kuhn M, Prettner K, et al. The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020-50: a health-augmented macroeconomic modelling study. Lancet Glob Health. 2023;11(8):e1183-e1193. doi: 10.1016/S2214-109X(23)00217-6 13. Koff PB, Min SJ, Freitag TJ, et al. 2021. Impact of Proactive Integrated Care on Chronic Obstructive Pulmonary Disease. Chronic Obstr Pulm Dis 8(1): 100-16 14. Government Expenditure on Health – Statistics Explained – Eurostat, ec.europa.eu/eurostat/statistics-explained/index.php?title=Government_expenditure_on_health. Accessed 31 Oct. 2025. 15. Hunter LC, Lee RJ, Butcher I, et al. Patient characteristics associated with risk of first hospital admission and readmission for acute exacerbation of chronic obstructive pulmonary disease (COPD) following primary care COPD diagnosis: a cohort study using linked electronic patient records. BMJ Open. (2016) 6:e009121. 16. Ipsos (2025) Data on file: Global Policymakers’ Perspectives on COPD | Survey of Attitudes and Perceptions – Wave 2 Final Report (conducted on behalf of Global Allergy and Airways Patient Platform). 17. Rehman AU, Hassali MAA, Muhammad SA, et al. The economic burden of chronic obstructive pulmonary disease (COPD) in Europe: results from a systematic review of the literature. Eur J Health Econ. 2020;21:181–94. 18. Agarwal D. COPD generates substantial cost for health systems. Lancet Glob Health. 2023;11:e1138-9. 19. Løkke A, Lange P, Lykkegaard J, et al. Economic Burden of COPD by Disease Severity – A Nationwide Cohort Study in Denmark. Int J Chron Obstruct Pulmon Dis. 2021;16:603-613. doi: 10.2147/COPD.S295388 20. Jones PW et al. (2022). The Development of a COPD Exacerbation Recognition Tool (CERT) to Help Patients Recognize When to Seek Medical Advice. International Journal of Chronic Obstructive Pulmonary Disease, 17, 213‑222. DOI: 10.2147/COPD.S337644. --------------------------------------------------------------------------------

The European Commission is set to unveil the Biotech Act I, an EU cardiovascular health plan and a simplification of the bloc’s medical devices and in vitro diagnostics rules on Dec. 16, according to the latest Commission agenda published Monday. The first part of the Biotech Act will focus on the pharmaceutical industry and is being produced without a dedicated impact assessment. The second part — covering other biotech sectors — is expected in the third quarter of 2026. The upcoming cardiovascular health plan — inspired by the bloc’s Beating Cancer Plan — will cover prevention, early detection and screening, treatment and management, and rehabilitation. Meanwhile, simplification of the bloc’s medical devices and in vitro diagnostics rules comes after the regulations drove up assessment costs, caused certification delays, and led to product withdrawals from the market. Europe’s Health Commissioner Olivér Várhelyi has previously said the sector needs a “major overhaul.” Additionally, the Commission’s agenda includes a “drugs package” comprising new rules on drug precursors and an EU Drugs Strategy and European action plan against drug trafficking — both scheduled for Dec. 3.