Biotechnology is central to modern medicine and Europe’s long-term competitiveness. From cancer and cardiovascular disease to rare conditions, it is driving transformative advances for patients across Europe and beyond . 1         Yet innovation in Europe is increasingly shaped by regulatory fragmentation, procedural complexity and uneven implementation across  m ember s tates. As scientific progress accelerates, policy frameworks must evolve in parallel, supporting the full lifecycle of innovation from research and clinical development to manufacturing and patient access.  The proposed EU Biotech Act seeks to address these challenges. By streamlining regulatory procedures, strengthening coordination  and supporting scale-up and manufacturing, it aims to reinforce Europe’s position in a highly competitive global biotechnology landscape .2       Its success, however, will depend less on ambition than on delivery. Consistent implementation, proportionate oversight and continued global openness will determine whether the  a ct translates into faster patient access, sustained investment and long-term resilience.  Q: Why is biotechnology increasingly seen as a strategic pillar for Europe’s competitiveness, resilience and long-term growth?  Gilles Marrache, SVP and regional general manager, Europe, Latin America, Middle East, Africa and Canada, Amgen:  Biotechnology sits at the intersection of health, industrial policy and economic competitiveness. The sector is one of Europe’s strongest strategic assets and a leading contributor to  research and development  growth . 3    At the same time, Europe’s position is under increasing pressure. Over the past two decades, the EU has lost approximately 25  percent of its global share of pharmaceutical investment to other regions, such as the  United States  and China.   The choices made today will shape Europe’s long-term strength in the sector, influencing not only competitiveness and growth, but also how quickly patients can benefit from new treatments.  > Europe stands at a pivotal moment in biotechnology. Our life sciences legacy > is strong, but maintaining global competitiveness requires evolution .” 4   > >  Gilles Marrache, SVP and regional general manager, Europe, Latin America, > Middle East, Africa and Canada, Amgen. Q: What does the EU Biotech Act aim to do  and why is it considered an important step forward for patients and Europe’s innovation ecosystem?  Marrache: The EU Biotech Act represents a timely opportunity to better support biotechnology products from the laboratory to the market. By streamlining medicines’ pathways and improving conditions for scale-up and investment, it can help strengthen Europe’s innovation ecosystem and accelerate patient access to breakthrough therapies. These measures will help anchor biotechnology as a strategic priority for Europe’s future  —  and one that can deliver earlier patient benefit  —  so long as we can make it work in practice.  Q: How does the EU Biotech Act address regulatory fragmentation, and where will effective delivery and coordination be most decisive? Marrache: Regulatory fragmentation has long challenged biotechnology development in Europe, particularly for multinational clinical trials and innovative products. The Biotech Act introduces faster, more coordinated trials, expanded regulatory sandboxes and new investment and industrial capacity instruments.   The proposed EU Health Biotechnology Support Network and a  u nion-level regulatory status repository would strengthen transparency and predictability. Together, these measures would support earlier regulatory dialogue, help de-risk development   and promote more consistent implementation across  m ember  s tates.   They also create an opportunity to address complexities surrounding combination products  —  spanning medicines, devices and diagnostics  —  where overlapping requirements and parallel assessments have added delays.5 This builds on related efforts, such as the COMBINE programme,6 which seeks to streamline the navigation of the In Vitro Diagnostic Regulation , 7 Clinical Trials Regulation8 and the Medical Device Regulation9 through a single, coordinated assessment process. Continued clarity and coordination will be essential to reduce duplication and accelerate development timelines .10 Q: What conditions will be most critical to support biotech scale-up, manufacturing  and long-term investment in Europe?  Marrache: Europe must strike the right balance between strategic autonomy and openness to global collaboration. Any new instruments under the Biotech Act mechanisms should remain open and supportive of all types of biotech investments, recogni z ing that biotech manufacturing operates through globally integrated and highly speciali z ed value chains.   Q: How can Europe ensure faster and more predictable pathways from scientific discovery to patient access, while maintaining high standards of safety and quality?   Marrache: Faster and more predictable patient access depends on strengthening end-to-end pathways across the lifecycle.  The Biotech Act will help ensure continuity of scientific and regulatory experti z e, from clinical development through post-authori z ation. It will also support stronger alignment with downstream processes, such as health technology assessments, which  are  critical to success.   Moreover, reducing unnecessary delays or duplication in approval processes can set clearer expectations, more predictable development timelines and earlier planning for scale-up.    Gilles Marrache, SVP and regional general manager, Europe, Latin America, Middle East, Africa and Canada, Amgen. Via Amgen. Finally, embedding a limited number of practical tools (procedural, digital or governance-based) and ensuring they are integrated within existing  European Medicines Agency and EU regulatory structures can help achieve faster patient access . 11 Q: What role can stronger regulatory coordination, data use and public - private collaboration play in strengthening Europe’s global position in biotechnology?  Marrache: To unlock biotechnology’s full potential, consistent implementation is essential. Fragmented approaches to secondary data use, divergent  m ember   state interpretations and uncertainty for data holders still limit access to high-quality datasets at scale. The Biotech Act introduces key building blocks to address this.   These include Biotechnology Data Quality Accelerators to improve interoperability, trusted testing environments for advanced innovation, and alignment with the EU AI Act ,12  European Health Data Space13 and wider EU data initiatives. It also foresees AI-specific provisions and clinical trial guidance to provide greater operational clarity.  Crucially, these structures must simplify rather than add further layers of complexity.   Addressing remaining barriers will reduce legal uncertainty for AI deployment, support innovation and strengthen Europe’s competitiveness.  > These reforms will create a moderni z ed biotech ecosystem, healthier > societies, sustainable healthcare systems and faster patient access to the > latest breakthroughs in Europe .” 14 > > Gilles Marrache, SVP and regional general manager, Europe, Latin America, > Middle East, Africa and Canada, Amgen.  Q: As technologies evolve and global competition intensifies, how can policymakers ensure the Biotech Act remains flexible and future-proof?  Marrache:  To remain future-proof, the Biotech Act must be designed to evolve alongside scientific progress, market dynamics and patient needs. Clear objectives, risk-based requirements, regular review mechanisms and timely updates to guidance will enhance regulatory agility without creating unnecessary rigidity or administrative burden.  Continuous stakeholder dialogue combined with horizon scanning will be essential to sustaining innovation, resilience and timely patient access over the long term. Preserving regulatory openness and international cooperation will be critical in avoiding fragmentation and maintaining Europe’s credibility as a global biotech hub.  Q: Looking ahead, what two or three priorities should policymakers focus on to ensure the EU Biotech Act delivers meaningful impact in practice?  Marrache: Looking ahead, policymakers should focus on three priorities for the Biotech Act:    First, implementation must deliver real regulatory efficiency, predictability and coordination in practice. Second, Europe must sustain an open and investment-friendly framework that reflects the global nature of biotechnology.  And third, policymakers should ensure a clear and coherent legal framework across the lifecycle of innovative medicines, providing certainty for the use of  artificial intelligence   —  as a key driver of innovation in health biotechnology.  In practical terms, the EU Biotech Act will be judged not by the number of new instruments it creates, but by whether it reduces complexity, increases predictability and shortens the path from scientific discovery to patient benefit. An open, innovation-friendly framework that is competitive at the global level will help sustain investment, strengthen resilient supply chains and deliver better outcomes for patients across Europe and beyond. -------------------------------------------------------------------------------- References 1. Amgen Europe, The EU Biotech Act Unlocking Europe’s Potential, May 2025. Retrieved from https://www.amgen.eu/media/press-releases/2025/05/The_EU_Biotech_Act_Unlocking_Europes_Potential 2. European Commission, Proposal for a Regulation to establish measures to strengthen the Union’s biotechnology and biomanufacturing sectors, December 2025. Retrieved from https://health.ec.europa.eu/publications/proposal-regulation-establish-measures-strengthen-unions-biotechnology-and-biomanufacturing-sectors_en 3. EFPIA, The pharmaceutical sector: A catalyst to foster Europe’s competitiveness, February 2026. Retrieved from https://www.efpia.eu/media/zkhfr3kp/10-actions-for-competitiveness-growth-and-security.pdf 4. The Parliament, Investing in healthy societies by boosting biotech competitiveness, November 2024. Retrieved from https://www.theparliamentmagazine.eu/partner/article/investing-in-healthy-societies-by-boosting-biotech-competitiveness#_ftn4 5. Amgen Europe, The EU Biotech Act Unlocking Europe’s Potential, May 2025. Retrieved from https://www.amgen.eu/docs/BiotechPP_final_digital_version_May_2025.pdf   6. European Commission, combine programme, June 2023. Retrieved from https://health.ec.europa.eu/medical-devices-topics-interest/combine-programme_en  7. European Commission. Medical Devices – In Vitro Diagnostics, March 2026. Retrieved from https://health.ec.europa.eu/medical-devices-vitro-diagnostics_en 8. European Commission, Clinical trials – Regulation EU No 536/2014, January 2022. Retrieved from https://health.ec.europa.eu/medicinal-products/clinical-trials/clinical-trials-regulation-eu-no-5362014_en 9. European Commission, Simpler and more effective rules for medical devices – Commission proposal for a targeted revision of the medical devices regulations, December 2025. Retrieved from https://health.ec.europa.eu/medical-devices-sector/new-regulations_en#mdr 10. Amgen Europe, The EU Biotech Act Unlocking Europe’s Potential, May 2025. Retrieved from https://www.amgen.eu/docs/BiotechPP_final_digital_version_May_2025.pdf   11. AmCham, EU position on the Commission Proposal for an EU Biotech Act 12. European Commission, AI Act | Shaping Europe’s digital future, June 2024. Retrieved from https://digital-strategy.ec.europa.eu/en/policies/regulatory-framework-ai 13. European Commission, European Health Data Space, March 2025. Retrieved from https://health.ec.europa.eu/ehealth-digital-health-and-care/european-health-data-space-regulation-ehds_en 14. The Parliament, Why Europe needs a Biotech Act, October 2025. Retrieved from https://www.theparliamentmagazine.eu/partner/article/why-europe-needs-a-biotech-act -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Amgen Inc * The ultimate controlling entity is Amgen Inc * The political advertisement is linked to advocacy on the EU Biotech Act. More information here.

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

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

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

Developed and funded by AbbVie in collaboration with the World Ovarian Cancer Coalition (the Coalition) and based on an interview with Christel Paganoni-Bruijns, chief executive officer of the Coalition, and Frances Reid, programme director of the Coalition -------------------------------------------------------------------------------- Late diagnoses, burdensome treatments and disease recurrence are realities for many women with ovarian cancer.1,2,3,4,5 Their stories are evidence of systemic challenges impacting care that policymakers have the power to combat. The World Ovarian Cancer Coalition (the Coalition), the only global ovarian cancer patient advocacy organization, is driving evidence generation to inform tangible policy reforms that could reduce the socioeconomic burden of this disease on individuals and wider societies.6 Ovarian cancer is one of the deadliest cancers affecting women in Europe, yet it remains overlooked.7,8 While other areas of women’s health benefit from policy frameworks and public awareness, ovarian cancer continues to sit in the margins, creating real human consequences. In 2022, Europe recorded the highest rates of ovarian cancer incidence and mortality worldwide.8 Only 40 percent of women in Europe remain alive five years after being diagnosed with ovarian cancer, with advanced-stage diagnoses often having poorer outcomes.8 Despite this, ovarian cancer remains absent from many national cancer plans and there is still no unified European policy framework to address it.  In partnership with European patient groups, the Coalition is convening a series of workshops for ovarian cancer survivors to share their experiences. Alongside leading clinicians and advocates, the Coalition is leveraging these testimonies to develop policy recommendations to inform national and European cancer strategies. Christel Paganoni-Bruijns, the Coalition’s chief executive officer, and Frances Reid, programme director and Every Woman Study lead, share their insights into the challenges women with ovarian cancer face and how policy changes can offer improved support. The hidden emotional and physical cost  There are education and awareness gaps that can impede diagnosis and prioritization. Many women believe that cervical cancer screening (otherwise known as the Pap smear) can detect ovarian cancer.9 Another widespread misconception is that ovarian cancer has no symptoms until very advanced stages.10 However, the Coalition’s Every Woman Study (2021) found that nine in 10 women do experience symptoms, even during the early stages.11  “These misconceptions cause real harm. They delay diagnosis, they delay action and they stop women from being heard,” Reid comments.  The ovarian cancer journey can be distressingly complex. Women frequently undergo major surgery, multiple rounds of treatment and long recovery periods.4,12,13 Even after treatment ends, the fear of recurrence can cast a shadow over daily life.  Ovarian cancer often strikes when many women are still working, caring for children, supporting aging parents and contributing to their communities in a variety of ways. 14,15 When they fall ill, the consequences ripple outwards. Some partners have to reduce their working hours or leave employment entirely to care for their loved ones.16 Families may take on emotional strain and financial pressure that can carry lasting impacts.17,18  Reid says: “These women are mothers, daughters, employees, carers, community anchors. When they are affected, the impact is not only personal — it is economic, social and predictable.” The Coalition’s socioeconomic burden study explored the cost to health services, the impact of informal caregiving, productive time lost by patients traveling to and receiving care, and longer-term productivity impacts.17 It found that the majority of the socioeconomic impact of ovarian cancer does not come from health service costs, but from the value of lives lost.17 Across the 11 countries examined, ill-health from ovarian cancer led to lost labor productivity equivalent to 2.5 million days of work.17 In the U.K. alone, productivity losses amounted to over US$52 million per year.17 In 2026, the Coalition will look further into the socioeconomic impact across high-income countries across Europe. Despite this measurable burden, ovarian cancer remains under-prioritized in health planning and funding decisions. Why women still struggle to get the care they need  Across Europe, many women face delays at various stages along their journey, some due to policy and system design choices. For example, without screening methods for early detection, diagnosis relies heavily on recognizing symptoms and receiving timely referrals.1,19,20 Yet many women often struggle to access specialists or face long waits for investigations.2,11,21   While Europe benefits from world-class innovation in ovarian cancer research, access to that innovation can be inconsistent. Recently published data from the European Federation of Pharmaceutical Industries and Associations (EFPIA) found that average time to availability for oncology products in Europe continues to increase, with 2024 data showing time from approval to access was 33 days slower than in 2023 and 66 days slower than in 2022.22 In 2024, it took an average of 586 days — or ~19 months — for patients to access new therapies after approval, with significant variation between countries.22 Delays in treatment impact prognosis and survival for patients with ovarian cancer.23 The challenges in care also extend to psychological and emotional support. The Every Woman Study found that only 28 percent of women were offered mental health support, despite the known vulnerabilities throughout treatment, recovery and recurrence.12   Paganoni-Bruijns and Reid reinforce that through the Coalition’s work, they have often found that “women feel unseen and unheard. They see progress in other cancers and ask: why not us?” What a better future looks like A better future starts with addressing ovarian cancer as part of a holistic vision and plan for women’s health. Europe has the foundational frameworks, infrastructure and clinical expertise to lead the way. What is needed now is political attention and policy alignment that includes ovarian cancer as part of these broader programs.  Paganoni-Bruijns comments: “We cannot keep treating gynecological cancers as if they exist in separate boxes. Women experience their health as one reality, so policies must reflect that.”  Existing structures in breast and cervical cancer offer valuable lessons. Across Europe, millions of women already move through screening programs, health promotion initiatives and established diagnostic pathways.24 These systems could be used to increase awareness of ovarian cancer symptoms, improve referral routes and access to specialist care, and support earlier detection. Increased investment in genetic and biomarker testing, as well as emerging early detection research, can be accelerated by aligning with these established programs. The Coalition is partnering with global experts to translate these lessons into the first-ever evidence-based framework for ovarian cancer mortality rate reduction, however, policy action at the regional and national level must keep pace.  The EU-funded DISARM project is a promising example of the progress underway to help Europe ‘disarm’ the threat of ovarian cancer. DISARM is a coordinated, multi-country effort to strengthen ovarian cancer risk assessment, validate affordable early-detection tools and understand how these innovations can be implemented within real-world health systems. Crucially, it is designed both to generate evidence and to address feasibility, uptake and system readiness, the factors that, together, determine whether innovation actually reaches patients.   As Paganoni-Bruijns explains, “DISARM shows what progress looks like when science, policy and patient experience are designed to work together. It is not about a single breakthrough or ‘quick fix’, but about building the conditions for earlier detection — through better risk assessment, validated tools and systems that are ready to use them.”  Yet projects like DISARM, while essential, cannot carry the burden alone. Without a cohesive European or global World Health Organization framework for ovarian cancer, progress remains fragmented, uneven and vulnerable to delay. Europe has often set the pace for global cancer policy and ovarian cancer should be no exception. By recognizing ovarian cancer as a priority within European women’s health, policymakers can be part of setting the global standard for a new era of coordinated and patient-centered care. Paganoni-Bruijns shares the Coalition’s call-to-action: “The systems exist. The evidence exists. We know that we need to include ovarian cancer in national cancer plans, improve diagnostic pathways, strengthen genetic testing and commit to EU-level monitoring. What is missing is prioritization. With leadership and accountability, ovarian cancer does not have to remain one of Europe’s deadliest cancers.” The stakes are rising and the window for meaningful action is narrowing. But with focused leadership, Europe can change the trajectory of ovarian cancer. Women across the continent deserve earlier diagnoses, access to innovation and the chance to live not just longer, but better. To understand why action on ovarian cancer cannot wait, listen to the Coalition’s Changing the Ovarian Cancer Story podcast series, or visit the Coalition’s website. -------------------------------------------------------------------------------- References 1 Rampes S, et al. Early diagnosis of symptomatic ovarian cancer in primary care in the UK: opportunities and challenges. Prim Health Care Res Dev. 2022;23:e52. 2 Funston G, et al. Detecting ovarian cancer in primary care: can we do better? Br J Gen Pract. 2022;72:312-313.  3 Tookman L, et al. Diagnosis, treatment and burden in advanced ovarian cancer: a UK real-world survey of healthcare professionals and patients. Future Oncol. 2024;20:1657-1673.  4 National Cancer Institute. Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ) – Health Professional Version. Available at: https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq [Last accessed: January 2026]. 5 Beesley et al. Evaluating patient-reported symptoms and late adverse effects following completion of first-line chemotherapy for ovarian cancer using the MOST (Measure of Ovarian Symptoms and Treatment concerns). Gynecologic Oncology 164 (2022):437-445.  6 World Ovarian Cancer Coalition. About the World Ovarian Cancer Coalition. Available at: https://worldovariancancercoalition.org/about-us/ [Last accessed: January 2026]. 7 Manzano A, Košir U, Hofmarcher T. Bridging the gap in women’s cancers care: a global policy report on disparities, innovations and solutions. IHE Report 2025:12. The Swedish Institute for Health Economics (IHE); 2025. 8 ENGAGe. Ovarian Cancer. Available at: https://engage.esgo.org/gynaecological-cancers/ovarian-cancer/ [Last accessed: January 2026].  9 Target Ovarian Cancer. Driving change through knowledge – updated NHS cervical screening guide. Available at: https://targetovariancancer.org.uk/news/driving-change-through-knowledge-updated-nhs-cervical-screening-guide [Last accessed: January 2026]. 10 Goff BA, et al. Frequency of Symptoms of Ovarian Cancer in Women Presenting to Primary Care Clinics. JAMA. 2004;291(22):2705–2712.  11 Reid F, et al. The World Ovarian Cancer Coalition Every Woman Study: identifying challenges and opportunities to improve survival and quality of life. Int J Gynecol Cancer. 2021;31:238-244.  12 National Health Service (NHS). Ovarian cancer. Treatment. Available at: https://www.nhs.uk/conditions/ovarian-cancer/treatment/ [Last accessed: January 2026].  13 Cancer Research UK. Recovering from ovarian cancer surgery. Available at: https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/treatment/surgery/recovering-from-surgery [Last accessed: January 2026]. 14 National Health Service (NHS). Ovarian cancer. Causes. Available at: https://www.nhs.uk/conditions/ovarian-cancer/causes/ [Last accessed: January 2026].  15 American Cancer Society. Ovarian Cancer Risk Factors. Available at: https://www.cancer.org/cancer/types/ovarian-cancer/causes-risks-prevention/risk-factors.html [Last accessed: January 2026].  16 Shukla S, et al. VOCAL (Views of Ovarian Cancer Patients and Their Caregivers – How Maintenance Therapy Affects Their Lives) Study: Cancer-Related Burden and Quality of Life of Caregivers [Poster]. Presented at: International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe; 2022 Nov 6–9; Vienna, Austria. 17 Hutchinson B, et al. Socioeconomic Burden of Ovarian Cancer in 11 Countries. JCO Glob Oncol. 2025;11:e2400313. 18 Petricone-Westwood D, et al.An Investigation of the Effect of Attachment on Distress among Partners of Patients with Ovarian Cancer and Their Relationship with the Cancer Care Providers. Current Oncology. 2021;28(4):2950–2960.  19 World Ovarian Cancer Coalition. Ovarian Cancer Testing & Detection. Available at: http://worldovariancancercoalition.org/about-ovarian-cancer/detection-testing/ [Last accessed: January 2026]. 20 National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. Available at: https://www.nice.org.uk/guidance/ng12/resources/suspected-cancer-recognition-and-referral-pdf-1837268071621 [Last accessed: January 2026]. 21 Menon U, et al. Diagnostic routes and time intervals for ovarian cancer in nine international jurisdictions; findings from the International Cancer Benchmarking Partnership (ICBP). Br J Cancer. 2022;127:844-854.  22 European Federation of Pharmaceutical Industries and Associations (EFPIA). New data shows no shift in access to medicines for millions of Europeans. Available at: https://www.efpia.eu/news-events/the-efpia-view/statements-press-releases/new-data-shows-no-shift-in-access-to-medicines-for-millions-of-europeans/ [Last accessed: January 2026].  23 Zhao J, et al. Impact of Treatment Delay on the Prognosis of Patients with Ovarian Cancer: A Population-based Study Using the Surveillance, Epidemiology, and End Results Database. J Cancer. 2024;15:473-483.  24 European Commission. Europe’s Beating Cancer Plan: Communication from the commission to the European Parliament and the Council. Available at: https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf [Last accessed: January 2026].  -------------------------------------------------------------------------------- ALL-ONCOC-250039 v1.0  February 2026 -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is AbbVie * The ultimate controlling entity is AbbVie More information here.

The UK has historically been a global leader in life sciences innovation, but recent statistics paint a worrying picture for medicines access. The right policy can start to reverse this. We are living in a time where the intersection between breakthrough science, technology and data insights has the potential to transform treatment options for some of the toughest health conditions faced by patients in the UK. The UK has long played a central role in driving innovation when it comes to healthcare, and at Johnson & Johnson (J&J) we were pleased to see some positive signs from the Government at the end of 2025, illustrating an intent to reverse a decade of decline of investment in how the UK values innovative treatments. It was a positive first step, but now the real work begins to enable us to deliver the best possible outcomes for UK patients. To achieve this, our focus must be on ensuring our health system is set up to match the pace and gain the benefits of innovation that science provides. We need a supportive medicines environment that fully fosters growth, because even the most pioneering drugs and therapies are only valuable if they can be accessed by patients when they need them most. > even the most pioneering drugs and therapies are only valuable if they can be > accessed by patients when they need them most. At J&J, we are proud to have been part of the UK’s health innovation story for more than a century. We believe that turning ambition into delivery requires a clearer focus on the foundations that enable innovation to reach patients. We have had a substantial and long-term economic presence, with our expertise serving as the grounds for successful partnerships with patients, healthcare providers, clinical researchers and the NHS. Recent national developments are a step in the right direction The UK Government’s recent announcements on the life sciences industry are an important move to help address concerns around medicines access, innovation and the UK’s international standing. This includes a welcome planned increase to the baseline cost-effectiveness threshold (the first change to be made since its introduction in the early 2000s). While it is crucial to get this implemented properly, this seems like a step in the right direction — providing a starting point towards meaningful policy reform, industry partnership and progress for patients. The true impact of stifling medicine innovation in the UK compared with our peers These positive developments come at a critical time, but they do not fix everything. Over the past decade, spending on branded medicines has fallen in real terms, even as the NHS budget has grown by a third.[i] Years of cost-containment have left the UK health system ill-prepared for the health challenges of today, with short-term savings creating long-term consequences. Right now, access to innovative medicines in the UK lags behind almost every major European country[ii]; the UK ranks 16th and 18th among 19 comparable countries for preventable and treatable causes of mortality.[iii]These are conditions for which effective medicines already exist. Even when new medicines are approved, access is often restricted. One year after launch, usage of innovative treatments in England is just over half the average of comparator countries such as France, Germany and Spain.[iv] The effect is that people living with cancer, autoimmune conditions and rare diseases wait longer to access therapies that are already transforming lives elsewhere in Europe. And even at its new level, the UK’s Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG) clawback rate remains higher than in comparable countries.[v] J&J is committed to working together to develop a new pricing and access framework that is stable, predictable and internationally competitive — enabling the UK to regain its position as a leading destination for life sciences. Seeing the value of health and medicines investment as a catalyst for prosperity and growth Timely access to the right treatment achieves two things; it keeps people healthy and prevents disease worsening so they can participate in society and a thriving economy. New research from the WifOR Institute, funded by J&J, shows that countries that allocate more resources to health — especially when combined with a skilled workforce and strong infrastructure — consistently achieve better outcomes.[vi] > Timely access to the right treatment achieves two things; it keeps people > healthy and prevents disease worsening so they can participate in society and > a thriving economy. The UK Government’s recent recognition of the need for long-term change, setting out plans to increase investment in new medicines from 0.3 percent of GDP to 0.6 percent over the next 10 years is positive. It signals a move towards seeing health as one of our smartest long-term investments, underpinning the UK’s international competitiveness by beginning to bring us nearer to the levels in other major European countries. This mindset shift is critical to getting medicines to patients, and the life sciences ecosystem, including the pharmaceutical sector as a cornerstone, plays a pivotal role. It operates as a virtuous cycle — driven by the generation, production, investment in, access to and uptake of innovation. Exciting scientific developments and evolving treatment pathways mean that we have an opportunity to review the structures around medicines reimbursement to ensure they remain sustainable, competitive and responsive. At J&J, we have the knowledge and heritage to work hand-in-hand with the Government and all partners to achieve this. Together, we can realise the potential of medicine innovation in the UK Patients have the right to expect that science and innovation will reach them when they need it. Innovative treatments can be transformative for patients, meaning an improved quality of life or more precious time with loved ones. We fully support the Government’s ambitions for life sciences and the health of the nation. Now is the moment to deliver meaningful change — the NHS, Government and all system partners, including J&J, must look at what valuing innovation actually means when it comes to modernising the frameworks and mechanisms that support access and uptake. Practical ways to do this include: * Establishing a new pricing and access framework that is stable, predictable and internationally competitive. * Evolving medicines appraisal methods and processes, to deliver on the commitments of the UK-US Economic Prosperity Deal. * Adapting thresholds and value frameworks to ensure they are fit for the future — in the context of wider system pressures, including inflation, and the evolution of medical innovation requiring new approaches to assessment and access. > the NHS, Government and all system partners, including J&J, must look at what > valuing innovation actually means when it comes to modernising the frameworks > and mechanisms that support access and uptake. By truly recognising the value of health as an investment, rather than as a cost, we can return the UK to a more competitive position. The direction of travel is positive. At J&J, we stand ready to work in partnership to help ensure the UK is once again the best place in the world to research, develop and access medicines. Follow Johnson & Johnson Innovative Medicine UK on LinkedIn for updates on our business, our people and our community. CP-562703 | January 2026 -------------------------------------------------------------------------------- [i] House of Commons Library (2026). ‘NHS Funding and Expenditure’ Research Briefing. Available at: https://commonslibrary.parliament.uk/research-briefings/sn00724/ (Accessed January 2026). [ii] IQVIA & EFPIA (2025). EFPIA Patients W.A.I.T Indicator 2024 Survey. Available at: https://efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf. (Accessed January 2026) [iii] The Kings Fund (2022). ‘How does the NHS compare to the health care systems of other countries?’ Available at: https://www.kingsfund.org.uk/insight-and-analysis/reports/nhs-compare-health-care-systems-other-countries (Accessed January 2026) [iv] Office for Life Sciences (2024). Life sciences competitiveness indicators 2024: summary. Available at: https://www.gov.uk/government/publications/life-sciences-sector-data-2024/life-sciences-competitiveness-indicators-2024-summary (Accessed January 2026). [v] ABPI. VPAG payment rate for newer medicines will be 14.5% in 2026. December 2025. Available at: https://www.abpi.org.uk/media/news/2025/december/vpag-payment-rate-for-newer-medicines-will-be-145-in-2026/. (Accessed January 2026). [vi] WifOR Institute (2025). Healthy Returns: A Catalyst for Economic Growth and Resilience. Available at: https://www.wifor.com/en/download/healthy-returns-a-catalyst-for-economic-growth-and-resilience/?wpdmdl=360794&refresh=6942abe7a7f511765977063. (Accessed January 2026).

BRUSSELS — Europe is on track to pay at least €440 billion to deal with the pollution and health impacts from toxic PFAS chemicals by the middle of the century, according to a study released Thursday by the European Commission. The cost could soar to nearly €2 trillion under more ambitious clean-up goals, the analysis warns, describing the roughly half-trillion-euro estimate as a baseline for addressing PFAS pollution across the European Economic Area. PFAS or “forever chemicals” — man-made chemicals used in a wide variety of industrial processes and consumer products — have been linked to a range of health problems, including cancer and fertility problems. The EU is preparing to propose a ban on their use later this year, with exemptions for “critical sectors” — a position likely to draw pushback from industry and some political groups. But even a full ban would leave Europe with costs of €330 billion by 2050, the report warned. “Providing clarity on PFAS with bans for consumer uses is a top priority for both citizens and businesses,” said EU environment chief Jessika Roswall. “That is why this is an absolute priority for me to work on this and engage with all relevant stakeholders. Consumers are concerned, and rightly so. This study underlines the urgency to act.” The study, carried out by consultancies WSP, Ricardo, and Trinomics, shows that how Europe acts matters just as much as whether it acts. In one scenario, where emissions continue, and authorities rely largely on wastewater treatment to meet strict environmental standards, the total bill would soar to around €1.7 trillion by 2050, driven mainly by clean-up costs. If the EU bans forever chemicals, the health costs would fall from about €39.5 billion a year in 2024 to roughly €0.5 billion by 2040, under a full phase-out scenario. “The Commission’s study exposes the staggering costs of PFAS pollution. Every day of inaction inflates the bill,” said Noémie Jégou, policy officer for Chemicals at the European Environmental Bureau. “The EU must turn off the tap now through an ambitious EU restriction of PFAS present in consumer products and used in industrial processes.”

BRUSSELS — The European Commission suspects that a massive tranche of pro-industry comments on the EU’s proposed tobacco tax hike was “probably” a coordinated attempt to distort public feedback. The Commission received thousands of anonymous submissions promoting pro-tobacco industry arguments in the final hours of the public feedback period on its proposal on the Tobacco Tax Directive. There were also fake submissions purporting to be from public health experts opposing the plan. “We have been looking at the submissions in the public consultation and we saw some elements that indicated, indeed, some of the submissions were probably submitted in a coordinated manner and not necessarily representing individual views,” said David Boublil from the Commission’s tax department, in response to a question from POLITICO. Boublil didn’t say who was behind the coordinated submissions but said the lobbying from the tobacco industry on the file was “gigantic.” He was speaking at an event on tobacco taxation hosted by the European Respiratory Society in Brussels. Public consultations on controversial products like tobacco have attracted suspicious activity in the past. A 2024 U.K. consultation on tobacco and vaping policies received over 90,000 fraudulent responses that the government said was consistent with the use of bots. In Europe, this year is likely to see increased industry lobbying as two pieces of tobacco legislation are slated for review. The Commission’s plan to hike tobacco taxes is likely to be a contentious political issue: It wants to raise the EU-wide minimum levy on tobacco from €90 per 1,000 cigarettes to €215, but some countries think that’s too aggressive. Cyprus, which holds the presidency of the Council of the EU until the end of June, has suggested paring that back to €200 and giving countries an extra two years to implement the directive. The Commission also plans to overhaul its rules on the marketing and sale of nicotine products to cover e-cigarettes, heated tobacco and nicotine pouches in 2026. A draft European Parliament report said the Commission should extend its tobacco control laws to all non-medicinal nicotine products, including a crackdown on marketing, flavors and packaging.

Europeans’ world-leading drinking habits are putting their health at risk, but governments are failing to use higher taxes to help curb consumption, warned the World Health Organization. Beer has become more affordable in 11 EU countries since 2022, and less affordable in six, the WHO report revealed Tuesday. There was a similar but even more dramatic trend for spirits, which became more affordable in 17 EU countries and less affordable in two. And for wine, 14 EU countries do not tax it at all, including big producers Italy and Spain, the report found. The EU includes seven of the 10 countries with the highest per-capita alcohol consumption globally, with Romania, Latvia and Czechia among the biggest drinkers. Alcohol is a major driver of cancer, with risk scaling alongside higher consumption. It’s also linked to a wide range of illnesses including cardiovascular disease and depression, all of which are adding pressure to stretched health systems. The WHO said governments should target alcohol consumption to protect people from its ill effects. Increasing the cost of booze through taxes is one of the most effective measures governments can take, the WHO said. Yet, some EU countries have minimal or no taxes on certain types of alcohol. The fact that more than half of EU countries don’t tax wine at all is “unusual” by international standards, WHO economist Anne-Marie Perucic said. She pointed out that the more affordable alcohol is, the more people consume. “Excluding a product is not common. It’s always for political reasons, socio-economic reasons [like] trying to protect the local industry. Clearly, it doesn’t make sense from a health perspective,” Perucic told POLITICO. Those 14 countries span the EU’s northern and central regions, such as Germany, Austria and Bulgaria. “More affordable alcohol drives violence, injuries and disease,” said Etienne Krug, director of the WHO’s department of health determinants, promotion and prevention. “While industry profits, the public often carries the health consequences and society the economic costs.” The EU has touted its plans to protect its wine industry from threats including declining consumption and climate change. EU institutions agreed a package of measures to prop up the sector in December. Meanwhile, the European Commission recently backed down from proposing an EU-wide tax on alcopops; the sweet, pre-mixed alcoholic drinks that taste like sodas, as part of its Safe Hearts plan.  In a separate report, the WHO reported that sugary drinks have also become more affordable in 13 EU countries since 2022, data published in a separate WHO report found. A diet high in sugar is linked to obesity, Type 2 diabetes, heart disease, fatty liver disease and certain cancers.

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