This article is presented by EFPIA with the support of AbbVie I made a trip back to Europe recently, where I spent the vast majority of my pharmaceutical career, to share my perspectives on competitiveness at the European Health Summit. Now that I work in a role responsible for supporting patient access to medicine globally, I view Europe, and how it compares internationally, through a new lens, and I have been reflecting further on why the choices made today will have such a critical impact on where medicines are developed tomorrow. Today, many patients around the world benefit from medicines built on European science and breakthroughs of the last 20 years. Europeans, like me, can be proud of this contribution. As I look forward, my concern is that we may not be able to make the same claim in the next 20 years. It’s clear that Europe has a choice. Investing in sustainable medicines growth and other enabling policies will, I believe, bring significant benefits. Not doing so risks diminishing global influence. > Today, many patients around the world benefit from medicines built on European > science and breakthroughs of the last 20 years I reflect on three important points: 1) investment in healthcare benefits individuals, healthcare and society, but the scale of this benefit remains underappreciated; 2) connected to this, the underpinning science for future innovation is increasingly happening elsewhere; and 3) this means the choices we make today must address both of these trends. First, let’s use the example of migraine. As I have heard a patient say, “Migraine will not kill you but neither [will they] let you live.”[1] Individuals can face being under a migraine attack for more than half of every month, unable to leave home, maintain a job and engage in society.[2] It is the second biggest cause of disability globally and the first among young women.[3] It affects the quality of life of millions of Europeans.[4] From 2011-21 the economic burden of migraine in Europe due to the loss of working days ranged from €35-557 billion, depending on the country, representing 1-2 percent of gross domestic product (GDP).[5]   Overall socioeconomic burden of migraine as percentage of the country’s GDP in 2021 Source: WifOR, The socioeconomic burden of migraine. The case of 6 European Countries.5 Access to effective therapies could radically improve individuals’ lives and their ability to return to work.[6] Yet, despite the staggering economic and personal impacts, in some member states the latest medicines are either not reimbursed or only available after several treatment failures.[7] Imagine if Europe shifted its perspective on these conditions, investing to improve not only health but unlocking the potential for workforce and economic productivity? Moving to my second point, against this backdrop of underinvestment, where are scientific advances now happening in our sector? In recent years it is impressive to see China has become the second-largest drug developer in the world,[8] and within five years it may lead the innovative antibodies therapeutics sector,[9] which is particularly promising for complex areas like oncology. Cancer is projected to become the leading cause of death in Europe by 2035,[10] yet the continent’s share of the number of oncology trials dropped from 41 percent in 2013 to 21 percent in 2023.10 Today, antibody-drug conjugates are bringing new hope in hard-to-treat tumor types,[11] like ovarian,[12] lung[13] and colorectal[14] cancer, and we hope to see more of these advances in the future. Unfortunately, Europe is no longer at the forefront of the development of these innovations. This geographical shift could impact high-quality jobs, the vitality of Europe’s biotech sector and, most importantly, patients’ outcomes. [15] > This is why I encourage choices to be made that clearly signal the value > Europe attaches to medicines This is why I encourage choices to be made that clearly signal the value Europe attaches to medicines. This can be done by removing national cost-containment measures, like clawbacks, that are increasingly eroding the ability of companies to invest in European R&D. To provide a sense of their impact, between 2012 and 2023, clawbacks and price controls reduced manufacturer revenues by over €1.2 billion across five major EU markets, corresponding to a loss of 4.7 percent in countries like Spain.[16] Moreover, we should address health technology assessment approaches in Europe, or mandatory discount policies, which are simply not adequately accounting for the wider societal value of medicines, such as in the migraine example, and promoting a short-term approach to investment. By broadening horizons and choosing a long-term investment strategy for medicines and the life science sector, Europe will not only enable this strategic industry to drive global competitiveness but, more importantly, bring hope to Europeans suffering from health conditions. AbbVie SA/NV – BE-ABBV-250177 (V1.0) – December 2025 -------------------------------------------------------------------------------- [1] The Parliament Magazine, https://www.theparliamentmagazine.eu/partner/article/unmet-medical-needs-and-migraine-assessing-the-added-value-for-patients-and-society, Last accessed December 2025. [2] The Migraine Trust; https://migrainetrust.org/understand-migraine/types-of-migraine/chronic-migraine/, Last accessed December 2025. [3] Steiner TJ, et al; Lifting The Burden: the Global Campaign against Headache. Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. J Headache Pain. 2020 Dec 2;21(1):137 [4] Coppola G, Brown JD, Mercadante AR, Drakeley S, Sternbach N, Jenkins A, Blakeman KH, Gendolla A. The epidemiology and unmet need of migraine in five european countries: results from the national health and wellness survey. BMC Public Health. 2025 Jan 21;25(1):254. doi: 10.1186/s12889-024-21244-8. [5] WifOR. Calculating the Socioeconomic Burden of Migraine: The Case of 6 European Countries. Available at: [https://www.wifor.com/en/download/the-socioeconomic-burden-of-migraine-the-case-of-6-eu­ropean-countries/?wpdmdl=358249&refresh=687823f915e751752703993]. Accessed June 2025. [6] Seddik AH, Schiener C, Ostwald DA, Schramm S, Huels J, Katsarava Z. Social Impact of Prophylactic Migraine Treatments in Germany: A State-Transition and Open Cohort Approach. Value Health. 2021 Oct;24(10):1446-1453. doi: 10.1016/j.jval.2021.04.1281 [7] Moisset X, Demarquay G, et al., Migraine treatment: Position paper of the French Headache Society. Rev Neurol (Paris). 2024 Dec;180(10):1087-1099. doi: 10.1016/j.neurol.2024.09.008. [8] The Economist, https://www.economist.com/china/2025/11/23/chinese-pharma-is-on-the-cusp-of-going-global, Last accessed December 2025. [9] Crescioli S, Reichert JM. Innovative antibody therapeutic development in China compared with the USA and Europe. Nat Rev Drug Discov. Published online November 7, 2025. [10] Manzano A., Svedman C., Hofmarcher T., Wilking N.. Comparator Report on Cancer in Europe 2025 – Disease Burden, Costs and Access to Medicines and Molecular Diagnostics. EFPIA, 2025. [IHE REPORT 2025:2, page 20] [11] Armstrong GB, Graham H, Cheung A, Montaseri H, Burley GA, Karagiannis SN, Rattray Z. Antibody-drug conjugates as multimodal therapies against hard-to-treat cancers. Adv Drug Deliv Rev. 2025 Sep;224:115648. doi: 10.1016/j.addr.2025.115648. Epub 2025 Jul 11. PMID: 40653109.. [12] Narayana, R.V.L., Gupta, R. Exploring the therapeutic use and outcome of antibody-drug conjugates in ovarian cancer treatment. Oncogene 44, 2343–2356 (2025). https://doi.org/10.1038/s41388-025-03448-3 [13] Coleman, N., Yap, T.A., Heymach, J.V. et al. Antibody-drug conjugates in lung cancer: dawn of a new era?. npj Precis. Onc. 7, 5 (2023). https://doi.org/10.1038/s41698-022-00338-9 [14] Wang Y, Lu K, Xu Y, Xu S, Chu H, Fang X. Antibody-drug conjugates as immuno-oncology agents in colorectal cancer: targets, payloads, and therapeutic synergies. Front Immunol. 2025 Nov 3;16:1678907. doi: 10.3389/fimmu.2025.1678907. PMID: 41256852; PMCID: PMC12620403. [15] EFPIA, Improving EU Clinical Trials: Proposals to Overcome Current Challenges and Strengthen the Ecosystem, efpias-list-of-proposals-clinical-trials-15-apr-2025.pdf, Last accessed December 2025. [16] The EU General Pharmaceutical Legislation & Clawbacks, © Vital Transformation BVBA, 2024.

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.

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

PARIS — Algeria has agreed to a German proposal to pardon and release from jail acclaimed writer Boualem Sansal amid a diplomatic spat between Paris and Algiers. German President Frank-Walter Steinmeier on Monday urged Algerian President Abdelmadjid Tebboune to pardon the 81-year-old Sansal, who suffers from cancer, and transfer him to Germany for medical treatment. His pardon was then announced in a statement by the Algerian presidency on Wednesday. French Prime Minister Sébastien Lecornu said in parliament that he was relieved by the news and “thanked from the bottom of his heart those who worked towards this release.” Sansal, a Franco-Algerian dual national and a vocal critic of the Algerian regime, was jailed last November on charges of undermining national unity. His incarceration was met with outrage in France, where he has been seen as a political hostage amid worsening relations between the two countries. France triggered furor in Algeria when it recognized Morocco’s sovereignty over the disputed territory of Western Sahara in the summer of 2024. However, the head of France’s foreign intelligence service said in an interview on French radio Monday that he was seeing signs Algeria wanted to “renew the dialogue” with France. France has repeatedly called for Sansal’s release since his arrest, with French President Emmanuel Macron going as far as saying that Algeria was “dishonoring” itself in imprisoning him. But Algeria’s decision to respond to a German request for Sansal’s release, rather than a French one, is bound to raise eyebrows in Paris.

President Donald Trump’s deep cuts to foreign aid and plans to quit the UN body that coordinates efforts to combat disease are already splintering a global approach to public health strained by a once-in-a-century pandemic. Picking up the pieces is Tedros Adhanom Ghebreyesus’ job. Facing the loss of his biggest funder when the U.S. officially withdraws in January — America’s contribution was $640 million in 2023, the most recent year for which data is available — the World Health Organization’s director-general is trying to appeal to Trump. He’s fundraising and has launched the largest downsizing in the body’s history. He’s also warning the world that retreating from health cooperation right after a pandemic swept the globe doesn’t make any sense. He says the sudden aid cuts this year have cost lives. “If donors or others also see that what they give is no charity and it’s a security for everybody, I think we’ll be in a better situation,” Tedros told POLITICO. At the same time, he’s also found a silver lining that sounds like something he and Trump could agree on: America’s aid cuts are pushing countries that have depended on U.S. funding to become more self-reliant. The first African head of the WHO, Tedros has led the organization since 2017, including through the turmoil of Covid, two mpox outbreaks and yearslong negotiations on an international agreement aimed at improving the world’s response when the next pandemic comes. This year he’s had to reorganize the WHO leadership and let go of some 600 people out of roughly 10,000 employees after losing U.S. funding. Tedros outlined for POLITICO his efforts to address Trump’s complaints of “inappropriate political influence” at the WHO and “onerous payments,” and explained how he’s engaging Trump officials to get the administration to reconsider its withdrawal. This interview has been edited for length and clarity. How does the world move forward after the funding cuts and U.S. withdrawal? Solidarity is important, because unless we support each other, viruses could get an advantage. It’s not charity. By investing in it, countries are protecting themselves. On top of that, though, self reliance is also important, and each and every country should invest in health. If countries take ownership, I see a better future. Covid-19 has killed more people than any war in recent memory. We have to protect ourselves from a common enemy that can strike any time. It’s a matter of when, not if. Trump, Republicans and many global health experts say some countries have become dependent on the U.S. and the cuts will force them to become self-reliant. So were the cuts a good thing? It’s a good thing and it’s a bad thing. It’s a bad thing because people are dying. It’s a good thing for the long term, because countries are now waking up and saying: ‘OK, I have to mobilize domestic resources, and I have to cover the expenses for the health system.’ Of course, there is the immediate impact. If there was a transition, it would have been better to avoid the impact of the service cuts now in terms of morbidity or mortality. How have you engaged with the Trump administration and how did that go? We have done that formally, informally, because we think informal is more effective. And we ask for meetings, but for reasons they don’t tell us, it hasn’t happened yet. I’m not saying the door is closed. We’re in touch with [Health Secretary] Bobby Kennedy. He helped us in evacuating kids from Gaza. The president supported it. There are some kids who came here and many to other countries, especially kids with cancer. I would like to thank the president for the peace deal and also for helping kids with cancer in the evacuation. We have already reached more than 300 kids. Kennedy has said the WHO needs “radical reform.” Have you talked to him about what reforms he wants? We don’t know what kind of reform they want, but the U.S. says other countries should pay and they want to pay less. We agree. The WHO wants the U.S. and other major donors to pay less because we want the burden to be shared. We started the finance reform in 2017. In 2022, our member states, including the U.S., agreed to increase the assessed contributions by 50 percent. The largest increase in the past was 3 percent. And that helps the WHO prevent shocks like these in the future, and also to be more independent. And that, I think, is what the U.S. also wants, for the WHO to be independent. So if that’s what they want, then we’re doing it. So is this a good reason to leave? No. Trump administration officials have accused the WHO of being too close to China and helping it cover up the origins of Covid. Have you had conversations with Kennedy or other Trump officials about it? It’s outright wrong. I don’t know if people know that China is not happy with the position that we have on Covid’s origins, because our position is that all hypotheses are on the table, including spillover and lab leak. This position is very similar to the United States’. Based on science and evidence, actually, that’s the conclusion you can have. But when people don’t want to see what exactly are the facts and are interested in spreading misinformation and disinformation, what can you do? Are you worried other countries could follow the U.S. out of the WHO? I’m not worried that much. There are good reasons to stay, even for the U.S.

WARSAW — Polish lawmakers voted to strip former Justice Minister Zbigniew Ziobro of his parliamentary immunity and green-lighted his arrest Friday evening, marking an escalation of the political power struggle between the coalition government led by Prime Minister Donald Tusk and the opposition Law and Justice (PiS) party. Tusk made holding PiS to account for alleged corruption one of his headline promises in the campaign ahead of the 2023 general election, which his coalition won, ending eight years of PiS rule. Ziobro — who was justice minister in two PiS administrations — is a key figure in a probe seeking to find out why and how the PiS government allegedly purchased Pegasus spyware to spy on political opponents. The spyware purchase is part of a wider scandal, the Tusk government claims, involving alleged misuse of the so-called Justice Fund — a special pool of money under the justice minister’s control that was set up to help crime victims. Prosecutors accuse Ziobro specifically of leading an “organized crime group” in the Justice Ministry that embezzled some 150 million złoty (€35 million) from the Justice Fund. Other charges include lack of oversight and mishandling of documents. If indicted, Ziobro could face up to 25 years in prison. The parliamentary action on Friday was actually a series of 27 separate votes — one vote on each of the 26 charges levied against Ziobro by the prosecutors, plus a final vote on detention and arrest. The final vote was 244-198 against Ziobro, with no abstentions. A final decision to arrest Ziobro lies with the court. “Let the law always mean law, and justice — justice,” Tusk said on social media after the votes, referring to the name of the opposition party. Ziobro, who has been in Budapest since late October, denies all the charges. The former minister accused Tusk of acting to preempt corruption charges against himself. Tusk “knows that we were conducting, under my supervision, investigations into suspected corruption in which he may have been involved,” Ziobro told broadcaster TV Republika after the parliament’s action. PiS has stood firmly behind its former minister, attacking the government for exacting political revenge on the minister and accusing the administration of a lack of ethics in going after Ziobro, who has been undergoing treatment for esophageal cancer. “The prosecution has been taken over by force and has been operating illegally since. I believe it may take some time, but all those involved will face justice — and today’s developments will certainly increase their sentences,” PiS Chairman Jarosław Kaczyński told reporters in the parliament, according to Onet. Ziobro has been observing the events in Budapest, where he has found a safe haven alongside another former Justice Ministry official, Marcin Romanowski, who was granted political asylum by the administration of Prime Minister Viktor Orban. Ziobro also met with Orban last week. Ahead of the vote, Ziobro hinted he would not apply for asylum and plans to return to Poland. “Since this issue came up while I’m here, I decided to stay a bit longer, but I won’t extend my visit indefinitely. I will inform you of my next decisions in due course,” Ziobro said.

Prime minister’s questions: a shouty, jeery, very occasionally useful advert for British politics. Here’s what you need to know from the latest session in POLITICO’s weekly run-through. What they sparred about: Asylum seekers and prison. It was a duel of the deputies as Keir Starmer’s second in command, David Lammy, took on Shadow Defence Secretary, James Cartlidge, while the PM hung out at COP30 in Brazil. The deputy PM admitted he had expected to face Shadow Justice Secretary (and wannabe Tory leader) Robert Jenrick. The hardest word: Cartlidge, admittedly not the best known figure outside Westminster, referenced an ITV News interview with the father of the 14-year-old girl who had been sexually assaulted by Ethiopian national Hadush Kebatu … the man who was mistakenly freed for 48 hours. “Will he apologise to the family concerned?” Moment of contrition: Lammy insisted he’d already obliged with that request. “In the debate, of course, I said sorry for the anxiety caused whilst Kebatu was at large, and I repeat that.” Who knew a direct question could get a direct answer? Not so fast: The shadow defence secretary made clear Kebatu’s quick capture wasn’t good enough. Cartlidge wanted Lammy, the justice secretary after all, to guarantee that “no other asylum-seeking offender has been accidentally let out of prison” since the mistaken release. Answer, er, came there none. The justice secretary slammed Cartlidge’s former tenure as a justice minister, “who let our prisons get into that state in the first place.” This may be why: Just after their exchange, the Telegraph reported a manhunt was underway for an Algerian asylum seeker mistakenly released from HMP Wandsworth last week, but the Met Police was only informed on Tuesday. Hell yes, I’m tough enough: Aware that his question had gone unanswered, Cartlidge had another go, given how embarrassing Kebatu’s release was for the government. Lammy spoke about implementing the “toughest checks we have ever had in the prison system” and ripped into the “complicated system” introduced by, obvs, the Tories. Trappings of office: If at first you don’t succeed, try again — Cartlidge channeled interviewing legend Jeremy Paxman, no matter how awkward it became. “He’s the justice secretary. He’s responsible for the justice system. He needs to take responsibility,” the shadow defense secretary stressed. “Get a grip, man!” Lammy boomed back. “I know I’m the justice secretary. That’s why I’m at the despatch box.” Just wait till you get back to the MoJ … As per: There was the usual back and forth as Cartlidge continued probing and Lammy slammed his questioning efforts. “I spent 14 years in opposition, and I did a hell of a lot better than he has just done,” Lammy said, though MPs, hacks, and the public were left none the wiser until the Telegraph’s story broke. Six not out: Speaker Lindsay Hoyle originally went back to Cartlidge even after all six of the questions had been asked (if not answered). Much hilarity ensued as the Tory spokesperson briefly rose to the despatch box … before getting slapped down by the speaker. Admittedly, few people kept count, given it was the same question again and again. Helpful backbench intervention of the week: Erewash MP Adam Thompson praised the national minimum wage increase despite Tory and Reform UK’s opposition, asking whether any of Nigel Farage’s extra jobs paid below the minimum wage. Lammy, no changes here, took the bait and laid into the Reform UK chief’s outside earnings accordingly. Totally unscientific scores on the doors: Lammy 5/10. Cartlidge 6/10. Who knows whether Cartlidge had a tip-off about the Telegraph’s scoop, bringing yet more headaches for the government? Regardless, Lammy’s inability to provide certainty about mistaken releases became clearer after the revelation. Though Cartlidge didn’t specifically probe him on the manhunt, and incorrectly thought he had an extra question, pushing mistakenly released asylum seekers back up the news agenda has left ministers in a far weaker position.

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.

A group of 24 European politicians whose blood was tested for toxic PFAS chemicals over the summer all had the substances in their bodies, the NGOs involved in the testing revealed Tuesday. “I tested positive for four substances, and three of them can harm unborn children, act as endocrine disruptors, cause liver damage, and are suspected of being carcinogenic,” said Danish Environment Minister Magnus Heunicke in a written statement, describing his results as a “frightening reality.” It is “crucial that we take strong action against PFAS pollution so that we are no longer continuously exposed to these harmful chemicals,” he added. PFAS substances, commonly known as forever chemicals, don’t break down naturally and have been shown to accumulate in the environment and cause a host of health problems, including cancer, liver damage and decreased fertility. Most people in the world have some level of PFAS in their blood. For half of the EU leaders tested, contamination reached levels where health impacts are possible, according to the European Environmental Bureau and ChemSec. One person had levels indicating a potential risk of long-term health effects. The test results come days after the U.N. Special Rapporteur on Toxics and Human Rights Marcos Orellana slammed Brussels for proposing to dilute several chemical protection laws to help boost European industry. Denmark orchestrated the group test during a meeting of EU environment ministers in the northern Danish city of Aalborg in July. The country currently holds the rotating presidency of the Council of the EU and is one of five European countries that sent a joint proposal to the European Commission to phase out thousands of PFAS chemicals under EU chemicals law back in 2023. That proposal — currently in the hands of the European Chemicals Agency — has come under fire from industry groups, many of which are calling for exemptions to the proposed law. Tested politicians included EU Environment Commissioner Jessika Roswall, outgoing French Ecological Transition Minister Agnès Pannier-Runacher and Federal German Environment Minister Carsten Schneider. “Like many other citizens across Europe, I have PFAS in my body,” said Roswall in a written statement. “I tested positively on 6 out of 13 PFAS, including some that are classified as toxic for reproductive health. PFAS pollution is a vital public health issue.” The results of one of the test participants — Executive Director of the European Environment Agency Leena Ylä-Mononen — showed a decline in PFAS levels since she last had her blood tested, “reflecting trends observed among the European population for restricted PFAS.” Roswall has stated that the Commission will propose phasing out consumer uses of PFAS and exempt certain critical industries, which are yet to be defined. PFAS are involved in the production processes of several sectors, including semiconductors, batteries and pharmaceuticals. Those promises of exemptions have worried environmental groups, which are hoping for a wide-reaching phase-out of the chemicals. In a written statement on the tests, ChemSec’s Anne-Sofie Bäckar called for a “universal ban on all PFAS — not just in consumer products — before another generation pays the price for industry’s delay.” The Commission is expected to release its revision of the major chemicals regulation, REACH, this year, although the timeline is uncertain. The EU institutions are also working on a separate Commission proposal to simplify a set of EU laws spanning cosmetics, fertilizer and chemical classification regulations in a “chemicals omnibus” bill. U.N. Special Rapporteur on Toxics and Human Rights Marcos Orellana last week said the proposal risked undermining the European Union’s credibility as a “global leader in green policy and the rule of law.”

Europe has the highest rate of tobacco use in the world, overtaking Southeast Asia, a report from the World Health Organization found Monday. Just under a quarter (24.1 percent) of people aged 15 and over in Europe use tobacco, more than in any other WHO region, according to data from 2024. Women in the broader Europe region also have the highest global prevalence at 17.4 percent, the report found. The study also recorded global vaping rates for the first time; the WHO said the figures were especially “alarming” among young people. The data lands as the European Commission pledges to take a harder line against tobacco and vape products, with the EU health and tax commissioners pushing to hike taxes on both to curb related illnesses such as cancer and heart disease. Tedros Adhanom Ghebreyesus, the WHO director general, said tobacco control efforts prevent millions of people from smoking. But, “the tobacco industry is fighting back with new nicotine products, aggressively targeting young people,” he said, urging governments to act “faster and stronger” in implementing proven tobacco control policies. TAKING THE LEAD Globally, in 2024, there were an estimated 1.2 billion tobacco users aged 15 years and older. Tobacco prevalence is falling worldwide, but at a slower rate in Europe than other regions. The figures for the WHO’s Europe region include 53 countries and stretch as far east as Russia. However, the latest EU data also matches the WHO’s findings — a Eurobarometer survey from June 2024 found that 24 percent of people in the bloc smoked tobacco. Prevalence in Europe fell from almost 35 percent in 2000 to a little over 24 percent in 2020. In Southeast Asia, meanwhile, tobacco consumption has plummeted from around 54 percent to over 23 percent during the same period. Meanwhile, there were over 86 million adults who vape worldwide in 2024, the report found. The Americas and Europe had the highest prevalence rates of people aged 15 and over who use vapes, at 4.8 percent and 4.6 percent respectively. The WHO pointed to “concerning” data among adolescents aged 13 to 15, where around 7.2 percent use e-cigarettes globally, equating to around 14.7 million children. The U.N. organization cautioned, however, that the estimated total number of children using vapes is “almost certainly an undercount,” since only 75 percent of the world’s population are covered by national vaping surveys. The WHO said countries had to crack down on the tobacco industry’s efforts to create new addicts through the marketing of vapes toward young people. “E-cigarettes are fuelling a new wave of nicotine addiction,” said Etienne Krug, head of health determinants, promotion and prevention at the WHO. “They are marketed as harm reduction but, in reality, are hooking kids on nicotine earlier and risk undermining decades of progress.” European leaders have taken an increasingly strong position on vapes as of late. Tax Commissioner Wopke Hoekstra told POLITICO that vapes were “killing our kids” and pledged to follow through with his plan to extend the Tobacco Taxation Directive to new products. The vaping industry denied his claim, saying there have been no deaths caused directly by legal vapes. Meanwhile, Health Commissioner Olivér Várhelyi told a health conference in Austria last week he wanted to eventually raise minimum taxes on vapes in line with tobacco.