Thirty-six million Europeans — including more than one million in the Nordics[1] — live with a rare disease.[2] For patients and their families, this is not just a medical challenge; it is a human rights issue. Diagnostic delays mean years of worsening health and needless suffering. Where treatments exist, access is far from guaranteed. Meanwhile, breakthroughs in genomics, AI and targeted therapies are transforming what is possible in health care. But without streamlined systems, innovations risk piling up at the gates of regulators, leaving patients waiting. Even the Nordics, which have some of the strongest health systems in the world, struggle to provide fair and consistent access for rare-disease patients. Expectations should be higher. THE BURDEN OF DELAY The toll of rare diseases is profound. People living with them report health-related quality-of-life scores 32 percent lower than those without. Economically, the annual cost per patient in Europe — including caregivers — is around €121,900.[3] > Across Europe, the average time for diagnosis is six to eight years, and > patients continue to face long waits and uneven access to medications. In Sweden, the figure is slightly lower at €118,000, but this is still six times higher than for patients without a rare disease. Most of this burden (65 percent) is direct medical costs, although non-medical expenses and lost productivity also weigh heavily. Caregivers, for instance, lose almost 10 times more work hours than peers supporting patients without a rare disease.[4] This burden can be reduced. European patients with access to an approved medicine face average annual costs of €107,000.[5] Yet delays remain the norm. Across Europe, the average time for diagnosis is six to eight years, and patients continue to face long waits and uneven access to medications. With health innovation accelerating, each new therapy risks compounding inequity unless access pathways are modernized. PROGRESS AND REMAINING BARRIERS Patients today have a better chance than ever of receiving a diagnosis — and in some cases, life-changing therapies. The Nordics in particular are leaders in integrated research and clinical models, building world-class diagnostics and centers of excellence. > Without reform, patients risk being left behind. But advances are not reaching everyone who needs them. Systemic barriers persist: * Disparities across Europe: Less than 10 percent of rare-disease patients have access to an approved treatment.[6] According to the Patients W.A.I.T. Indicator (2025), there are stark differences in access to new orphan medicines (or drugs that target rare diseases).[7] Of the 66 orphan medicines approved between 2020 and 2023, the average number available across Europe was 28. Among the Nordics, only Denmark exceeded this with 34. * Fragmented decision-making: Lengthy health technology assessments, regional variation and shifting political priorities often delay or restrict access. Across Europe, patients wait a median of 531 days from marketing authorization to actual availability. For many orphan drugs, the wait is even longer. In some countries, such as Norway and Poland, reimbursement decisions take more than two years, leaving patients without treatment while the burden of disease grows.[8] * Funding gaps: Despite more therapies on the market and greater technology to develop them, orphan medicines account for just 6.6 percent of pharmaceutical budgets and 1.2 percent of health budgets in Europe. Nordic countries — Sweden, Norway and Finland — spend a smaller share than peers such as France or Belgium. This reflects policy choices, not financial capacity.[9] If Europe struggles with access today, it risks being overwhelmed tomorrow. Rare-disease patients — already facing some of the longest delays — cannot afford for systems to fall farther behind. EASING THE BOTTLENECKS Policymakers, clinicians and patient advocates across the Nordics agree: the science is moving faster than the systems built to deliver it. Without reform, patients risk being left behind just as innovation is finally catching up to their needs. So what’s required? * Governance and reforms: Across the Nordics, rare-disease policy remains fragmented and time-limited. National strategies often expire before implementation, and responsibilities are divided among ministries, agencies and regional authorities. Experts stress that governments must move beyond pilot projects to create permanent frameworks — with ring-fenced funding, transparent accountability and clear leadership within ministries of health — to ensure sustained progress. * Patient organizations: Patient groups remain a driving force behind awareness, diagnosis and access, yet most operate on short-term or volunteer-based funding. Advocates argue that stable, structural support — including inclusion in formal policy processes and predictable financing — is critical to ensure patient perspectives shape decision-making on access, research and care pathways. * Health care pathways: Ann Nordgren, chair of the Rare Disease Fund and professor at Karolinska Institutet, notes that although Sweden has built a strong foundation — including Centers for Rare Diseases, Advanced Therapy (ATMP) and Precision Medicine Centers, and membership in all European Reference Networks — front-line capacity remains underfunded. “Government and hospital managements are not providing  resources to enable health care professionals to work hands-on with diagnostics, care and education,” she explains. “This is a big problem.” She adds that comprehensive rare-disease centers, where paid patient representatives collaborate directly with clinicians and researchers, would help bridge the gap between care and lived experience. * Research and diagnostics: Nordgren also points to the need for better long-term investment in genomic medicine and data infrastructure. Sweden is a leader in diagnostics through Genomic Medicine Sweden and SciLifeLab, but funding for advanced genomic testing, especially for adults, remains limited. “Many rare diseases still lack sufficient funding for basic and translational research,” she says, leading to delays in identifying genetic causes and developing targeted therapies. She argues for a national health care data platform integrating electronic records, omics (biological) data and patient-reported outcomes — built with semantic standards such as openEHR and SNOMED CT — to enable secure sharing, AI-driven discovery and patient access to their own data DELIVERING BREAKTHROUGHS Breakthroughs are coming. The question is whether Europe will be ready to deliver them equitably and at speed, or whether patients will continue to wait while therapies sit on the shelf. There is reason for optimism. The Nordic region has the talent, infrastructure and tradition of fairness to set the European benchmark on rare-disease care. But leadership requires urgency, and collaboration across the EU will be essential to ensure solutions are shared and implemented across borders. The need for action is clear: * Establish long-term governance and funding for rare-disease infrastructure. * Provide stable, structural support for patient organizations. * Create clearer, better-coordinated care pathways. * Invest more in research, diagnostics and equitable access to innovative treatments. Early access is not only fair — it is cost-saving. Patients treated earlier incur lower indirect and non-medical costs over time.[10] Inaction, by contrast, compounds the burden for patients, families and health systems alike. Science will forge ahead. The task now is to sustain momentum and reform systems so that no rare-disease patient in the Nordics, or anywhere in Europe, is left waiting. -------------------------------------------------------------------------------- [1] https://nordicrarediseasesummit.org/wp-content/uploads/2025/02/25.02-Nordic-Roadmap-for-Rare-Diseases.pdf [2] https://nordicrarediseasesummit.org/wp-content/uploads/2025/02/25.02-Nordic-Roadmap-for-Rare-Diseases.pdf [3] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf [4] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf [5] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf [6] https://www.theparliamentmagazine.eu/partner/article/a-competitive-and-innovationled-europe-starts-with-rare-diseases? [7] https://www.iqvia.com/-/media/iqvia/pdfs/library/publications/efpia-patients-wait-indicator-2024.pdf [8] https://www.iqvia.com/-/media/iqvia/pdfs/library/publications/efpia-patients-wait-indicator-2024.pdf [9] https://copenhageneconomics.com/wp-content/uploads/2025/09/Copenhagen-Economics_Spending-on-OMPs-across-Europe.pdf [10] https://media.crai.com/wp-content/uploads/2024/10/28114611/CRA-Alexion-Quantifying-the-Burden-of-RD-in-Europe-Full-report-October2024.pdf Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Alexion Pharmaceuticals * The entity ultimately controlling the sponsor: AstraZeneca plc * The political advertisement is linked to policy advocacy around rare disease governance, funding, and equitable access to diagnosis and treatment across Europe More information here.

LONDON — Russian President Vladimir Putin was “morally responsible” for the 2018 Novichok poisonings which led to the death of an innocent British woman, an official inquiry concluded Thursday. Dawn Sturgess died in July 2018 after spraying herself with a perfume bottle that contained the Russian nerve agent Novichok in the English city of Salisbury. The bottle had been a gift from her then partner Charlie Rowley. Former Russian spy Sergei Skripal and his daughter Yulia were attacked with the nerve agent four months earlier. Anthony Hughes, who chaired the public inquiry into Sturgess’ death, said the attack was “expected to stand as a public demonstration of Russian power” and “amounted to a public statement, both for international and domestic consumption, that Russia will act decisively in what it regards are its own interests.” He said there were “failings” to adequately protect the Skripals, but acknowledged CCTV cameras, alarms or hidden bugs would not have stopped a “professionally mounted attack with a nerve agent.” The government believes the Russian president personally approved the poisoning on Skripal. The ex-Russian spy lived in an easily accessible property and declined the offer of CCTV. In a statement following publication of the report, Hughes said Sturgess’ death was “needless and arbitrary. She was the entirely innocent victim of the cruel and cynical acts of others.” He said: “I’ve concluded that the operation to assassinate Sergei Skripal must have been authorized at the highest level, indeed, by President Putin.” The U.K. government on Thursday said it has sanctioned the Russian military intelligence agency (GRU) in its entirety, and summoned Russian Ambassador to the U.K. Andrey Kelin. The public inquiry began in Salisbury last year more than six years after Sturgess’ death, which also left 80 other people in hospital. Nobody has been charged with Sturgess’ murder. Alexander Mishkin and Anatoliy Chepiga were named as the suspects responsible for deploying the nerve agent in Salisbury, but returned to Russia before they could be captured. They were charged with conspiracy to murder, three counts of attempted murder, two counts of grievous bodily harm with intent, and one count of use or possession of a chemical weapon. But those charges related to the attacks on the Skripals rather than Sturgess’ death.

After more than three decades in the pharmaceutical industry, I know one thing: science transforms lives, but policy determines whether innovation thrives or stalls. That reality shapes outcomes for patients — and for Europe’s competitiveness. Today, Europeans stand at a defining moment. The choices we make now will determine whether Europe remains a global leader in life sciences or we watch that leadership slip away. It’s worth reminding ourselves of the true value of Europe’s life sciences industry and the power we have as a united bloc to protect it as a European good. Europe has an illustrious track record in medical discovery, from the first antibiotics to the discovery of DNA and today’s advanced biologics. Still today, our region remains an engine of medical breakthroughs, powered by an extraordinary ecosystem of innovators in the form of start-ups, small and medium-sized enterprises, academic labs, and university hospitals. This strength benefits patients through access to clinical trials and cutting-edge treatments. It also makes life sciences a strategic pillar of Europe’s economy. The economic stakes Life sciences is not just another industry for Europe. It’s a growth engine, a source of resilience and a driver of scientific sovereignty. The EU is already home to some of the world’s most talented scientists, thriving academic institutions and research clusters, and a social model built on universal access to healthcare. These assets are powerful, yet they only translate into future success if supported by a legislative environment that rewards innovation. > Life sciences is not just another industry for Europe. It’s a growth engine, a > source of resilience and a driver of scientific sovereignty. This is also an industry that supports 2.3 million jobs and contributes over €200 billion to the EU economy each year — more than any other sector. EU pharmaceutical research and development spending grew from €27.8 billion in 2010 to €46.2 billion in 2022, an average annual increase of 4.4 percent. A success story, yes — but one under pressure. While Europe debates, others act Over the past two decades, Europe has lost a quarter of its share of global investment to other regions. This year — for the first time — China overtook both the United States and Europe in the number of new molecules discovered. China has doubled its share of industry sponsored clinical trials, while Europe’s share has halved, leaving 60,000 European patients without the opportunity to participate in trials of the next generation of treatments. Why does this matter? Because every clinical trial site that moves elsewhere means a patient in Europe waits longer for the next treatment — and an ecosystem slowly loses competitiveness. Policy determines whether innovation can take root. The United States and Asia are streamlining regulation, accelerating approvals and attracting capital at unprecedented scale. While Europe debates these matters, others act. A world moving faster And now, global dynamics are shifting in unprecedented ways. The United States’ administration’s renewed push for a Most Favored Nation drug pricing policy — designed to tie domestic prices to the lowest paid in developed markets — combined with the potential removal of long-standing tariff exemptions for medicines exported from Europe, marks a historic turning point. A fundamental reordering of the pharmaceutical landscape is underway. The message is clear: innovation competitiveness is now a geopolitical priority. Europe must treat it as such. A once-in-a-generation reset The timing couldn’t be better. As we speak, Europe is rewriting the pharmaceutical legislation that will define the next 20 years of innovation. This is a rare opportunity, but only if reforms strengthen, rather than weaken, Europe’s ability to compete in life sciences. To lead globally, Europe must make choices and act decisively. A triple A framework — attract, accelerate, access — makes the priorities clear: * Attract global investment by ensuring strong intellectual property protection, predictable regulation and competitive incentives — the foundations of a world-class innovation ecosystem. * Accelerate the path from science to patients. Europe’s regulatory system must match the speed of scientific progress, ensuring that breakthroughs reach patients sooner. * Ensure equitable and timely access for all European patients. No innovation should remain inaccessible because of administrative delays or fragmented decision-making across 27 systems. These priorities reinforce each other, creating a virtuous cycle that strengthens competitiveness, improves health outcomes and drives sustainable growth. > Europe has everything required to shape the future of medicine: world-class > science, exceptional talent, a 500-million-strong market and one of the most > sophisticated pharmaceutical manufacturing bases in the world. Despite flat or declining public investment in new medicines across most member states over the past 20 years, the research-based pharmaceutical industry has stepped up, doubling its contributions to public pharmaceutical expenditure from 12 percent to 24 percent between 2018 and 2023. In effect, we have financed our own innovation. No other sector has done this at such scale. But this model is not sustainable. Pharmaceutical innovation must be treated not as a cost to contain, but as a strategic investment in Europe’s future. The choice before us Europe has everything required to shape the future of medicine: world-class science, exceptional talent, a 500-million-strong market and one of the most sophisticated pharmaceutical manufacturing bases in the world. What we need now is an ambition equal to those assets. If we choose innovation, we secure Europe’s jobs, research and competitiveness — and ensure European patients benefit first from the next generation of medical breakthroughs. A wrong call will be felt for decades. The next chapter for Europe is being written now. Let us choose the path that keeps Europe leading, competing and innovating: for our economies, our societies and, above all, our patients. Choose Europe. -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is European Federation of Pharmaceutical Industries and Associations (EFPIA) * The ultimate controlling entity is European Federation of Pharmaceutical Industries and Associations (EFPIA) * The political advertisement is linked to the Critical Medicines Act. More information here.

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

A Belgian soldier participating in a NATO mission in Lithuania died during an exercise on Friday, Belgian officials said late Saturday. Belgium’s federal public prosecutor has launched an investigation into the incident. The soldier sustained an injury during a mortar exercise and died in hospital on Saturday, Belgian Defense Minister Theo Francken and Chief of Defense Frederik Vansina confirmed in a joint statement. Francken said in a post on X that he is “deeply saddened by the tragic accident,” sending “thoughts and solidarity” to the soldier’s friends and colleagues. Lithuanian President Gitanas Nausėda also offered his condolences in a post, saying Belgian troops serving with NATO in Lithuania “make an invaluable contribution to the security of our nation and the entire Alliance,” adding: “Their dedication and sacrifice will never be forgotten.” The Belgian national, who was not identified, was part of the Artillery Battalion in Brasschaat. Nearly 200 Belgian soldiers have been deployed to Lithuania since the summer, as part of NATO’s Forward Land Forces mission, a series of multinational battle groups stationed in eight Eastern European countries. The Belgian federal public prosecutor’s office said it has opened an investigation into the soldier’s death without providing more information on the case, Belga newswire reported. A federal magistrate and two detectives from the federal police, specializing in military affairs investigations, visited the scene on Saturday, VRT reported.  Belgium’s defense ministry also has launched an internal investigation to determine the exact circumstances of the accident, according to media reports.

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

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

BERLIN — A joint military exercise in Bavaria went badly wrong this week after a German soldier was shot and wounded by police officers who mistook him for an armed threat, authorities said Thursday. The incident occurred Wednesday evening in the town of Erding, northeast of Munich, when police received an emergency call reporting “a man with a long gun,” according to the Bavarian police. Officers responding to the call surrounded the area and, amid what officials later described as a “miscommunication,” opened fire. “It was a communication failure,” a police spokesperson told the German press agency dpa, adding that the local police were unaware that a Bundeswehr training exercise was taking place in the area. The soldier, who was participating in a drill simulating combat during wartime, was hit and lightly injured. He was treated in hospital and released later that night, police said. The shooting happened during “Marshal Power,” a large-scale defense exercise involving several hundred soldiers across 12 Bavarian districts. The Bundeswehr said the drill was meant to test coordination between soldiers, police, firefighters and rescue services in a mock national defense scenario. According to Bild, the Bundeswehr’s military police may have fired training blanks at the responding officers, apparently mistaking them for part of the ongoing drill. The police, unaware of the exercise, allegedly returned fire with live ammunition, injuring the soldier. The police confirmed that the local units had not been involved in planning the drill and were unaware that armed personnel would be active in the area that day. “We are now intensively examining where the communication broke down,” a police spokesperson said. The Bavarian state criminal police and prosecutors in Landshut have opened an investigation into the incident. Bavaria’s Interior Minister Joachim Herrmann, who oversees the Bavarian police, has not yet commented publicly.

CAGLIARI, Italy — Sardinia is one of the world’s most beautiful islands, which raises the question: Where is everyone? Not tourists — there are plenty of those — but locals. The island’s population is 1.57 million, down from 1.64 million three decades ago, but half live in its two largest urban areas, while smaller towns and villages are withering. The big problem is that people aren’t having babies. With an average of 1.18 children per woman, Italy has one of the lowest fertility rates in the European Union. Sardinia recorded the lowest rate in Italy, at 0.91 children per woman. Just to keep a population stable, women should have an average of 2.1 children. High unemployment on the island and better job prospects elsewhere are doing the rest, emptying dozens of villages of their young people. “The last child was born here 10 years ago,” said Maria Anna Camedda, the mayor of Baradili, Sardinia’s smallest village with a population of 76. The place is tiny — less than 500 meters separates the “Welcome to Baradili” sign from the one marking the end of the village, which is well-maintained and adorned with photos — like a big family house. The risk of places like Baradili becoming ghost towns is prompting the island to try to lure in newcomers. A couple moving to a Sardinian village of fewer than 3,000 residents can receive up to €15,000 to purchase or renovate a home, up to €20,000 to start a business that creates local jobs, and a monthly subsidy of €600 for their first child plus €400 for each subsequent child until they turn 5. These incentives are part of an anti-depopulation package introduced by the island. They come on top of local emergency measures, such as the municipality of Ollolai’s offer of €1 houses for newcomers. Despite the incentives, migrants are snubbing the island. The risk of places like Baradili becoming ghost towns is prompting the island to try and lure in newcomers. | Tommaso Lecca/POLITICO Romania, Senegal, Morocco, China and Ukraine are the home countries of roughly half of the 52,000 foreigners residing in Sardinia, which is about 3.3 percent of the island’s population. The national average is 8.9 percent. In 2022, the number of foreigners moving to Sardinia did not account for even a quarter of the population decline that occurred that year. The Italian demographic winter, which is even tougher in Sardinia, recently forced Giorgia Meloni’s right-wing government to allow 500,000 foreign workers into the country over the next three years. But the population collapse remains stark in small communities like Baradili. Over 30 years ago, the village closed its one-room primary school, in which all 15 local children, ranging in age from 6 to 10, learned together. Baradili and nearby villages opted for a rotating school system in which children attend classes in three different villages throughout the year. A free bus picks them up every morning. Attending high school or reaching a hospital is much harder, as both services are over 30 kilometers away. The challenges of serving communities like Baradili prompted Meloni’s government to acknowledge in the recent National Strategic Plan for Internal Areas that some parts of the country “cannot set themselves any goals for reversing the [depopulation] trend, but neither can they be left to their own devices.” The document proposed setting up “a targeted plan to assist them in a process of chronic decline and aging.” This wording provoked indignation, even among 140 Catholic Church representatives, who denounced the government’s plan as “support for a happy death” of villages. But Camedda is not impressed. “It was simply put down in black and white what the government — not just this government — has been doing for several decades,” she said. Baradili is doing everything it can to survive. It introduced a €10,000 subsidy on top of the incentives granted at the regional level. The village is served by a swimming pool, a football field, tennis and padel courts and even a motorhome park. In 2022, Baradili celebrated the arrival of four families, which brought nine new residents. EXPAT CAVALRY While many young Sardinians are leaving small rural villages to embrace urban life, some expats are taking the opposite direction. Ivo Rovira, a Spanish photographer working for the America’s Cup sailing competition, ended up in his new home village of Armungia by chance. In 2023 he spent several months in Cagliari, the capital city of Sardinia, snapping photos for the Italian sailboat Luna Rossa. “One day, in January, I was driving toward the interior of the island looking for some snow. I arrived in Armungia, a place I had never heard of before.” Rovira’s photographer’s eye was captivated by the landscape of the village, which has fewer than 400 residents. Ivo Rovira, a Spanish photographer working for the America’s Cup sailing competition, ended up in his new home village of Armungia by chance. | Tommaso Lecca/POLITICO “I parked the car and went for a walk. I found a house in the historic center with a ‘For Sale’ banner. Ten days later, I put down a deposit to buy it,” he said. After renovating the old house, which used to be a wine shop but had sat empty for 30 years, Rovira and his wife, Ana Ponce, moved to Armungia permanently. They also set up a restaurant that is open a few days per month, depending on demand. “It takes half an hour to drive to a supermarket along winding roads, but there is an international airport an hour away,” he said. “We don’t feel like digital nomads; we are real Armungians,” Rovira added. Bianca Fontana, an Australian with Italian roots, dreamed of moving to Italy after the pandemic. She joined a friend who was staying in Nulvi, a town of around 2,500 — larger than some tiny communities, but still eligible for the regional grants. A historical photo of the Secci family store, the house purchased by Ivo Rovira. Courtesy of the Sa Domu de is Ainas – Armungia Ethnographic Museum Collection. | Tommaso Lecca/POLITICO “I bought a house within two weeks. And I moved here about six months later,” Fontana said. She grew up in a country town in Australia before living in London and Shanghai. “I did get to a point where I was feeling quite exhausted in bigger cities, and I wanted to find a smaller, quieter place,” she said. Fontana now talks about her new life in Sardinia on her YouTube channel, which has over 3,000 subscribers. Many of them regularly comment on her videos about renovation grants, work on her own house, archaeological excursions and local wine. There is also an effort to keep locals from leaving. Marcello Contu left Sardinia at the age of 18 to move to Turin, and then lived in Barcelona and Australia. Bianca Fontana sits in front of a mural in the village of Nulvi. Courtesy of Bianca Fontana. | Tommaso Lecca/POLITICO But then he moved to the 120-person village of Bidonì to start a vegan cheese-making business. “The artisanal production of plant-based cheeses requires great attention, waiting times, experimentation, and daily care that are difficult to reconcile with chaotic environments,” he said. Contu’s products are now available in dozens of restaurants and shops across Sardinia and the rest of Italy. “Geographical isolation and a lack of services translate into a constant practical challenge: Sourcing raw materials or making deliveries often requires long journeys, with longer times and higher costs than for those working in better-connected areas,” he said. But Contu believes that small villages can become “ideal places for developing craft, creative, and sustainability-related activities, because they offer what large cities have often lost: time, spaces on a human scale, authentic relationships, and a strong connection with the local area and nature.” Rovira and Fontana are also impressed by the capacity of Sardinian villagers to stick together. Ivo Rovira and Ana Ponce in front of their new house in Armungia. | Tommaso Lecca/POLITICO Rovira was once told by a neighbor: “We live in such a small village that if we don’t help each other, we’re dead.” REALLY, REALLY CHEAP HOUSES Ollolai made a name for itself as the town of €1 houses — a project that started in 2016. According to Francesco Columbu, the local mayor, about 100,000 people registered interest in the €1 houses, but the municipality could only accommodate a few aspiring Ollolai residents. The scheme acts as an intermediary between owners of old houses — often split across different families of heirs — and those seeking to obtain them for peanuts. As a result, only a handful of foreign families have obtained a €1 house. Meanwhile, the village has continued to lose inhabitants, dropping from 1,300 when the offer began to 1,150 now. “While it’s possible that a cultured American or German who loves stone architecture or that of another Sardinian village moves there, this does not create the economic benefits needed to solve problems,” said Anna Maria Colavitti, professor of urban planning at the University of Cagliari. Colavitti analyzed the results of the €1 houses, concluding that they “alone are not enough, just as incentives for having kids are not enough,” she said. Colavitti’s study also showed that new owners sometimes decide to resell the €1 property at the same price they paid for it because they cannot afford the higher-than-expected renovation costs or are dissatisfied with their choice. But the mayor of Ollolai keeps fighting with the tools he has. “Ollolai will not die so easily. The inland villages of Sardinia have seen their fair share of crises. They went through periods of plague in the 1600s … yet they recovered,” Columbu said. “We have a better quality of life, and we’re an hour away from some of the most beautiful beaches in the world. I say the beautiful things will never die.”

A Russian drone strike on a railway station in northeastern Ukraine struck a passenger train and injured dozens of people, Ukrainian President Volodymyr Zelensky said on Saturday. “A savage Russian drone strike on the railway station in Shostka, Sumy region,” Zelenskyy wrote on X. “So far, we know of at least 30 victims.” He posted a video of the wreckage of a burning train carriage and another with its windows blown out. “The Russians could not have been unaware that they were striking civilians,” added Zelenskyy. Russia struck two trains, first hitting a local passenger train and then another headed for Kyiv, said Ukraine’s Deputy Prime Minister Oleksiy Kuleba. “Medical teams have already transported the injured to hospitals and are providing necessary assistance. Others (who were at the site) are in shelters overseen by rescuers,” Kuleba wrote on Telegram, according to NBC News. Moscow has increased air and drone attacks on rail and energy infrastructure ahead of the winter. In a separate attack, a wave of overnight strikes by Russian forces on Saturday cut off power to thousands households in the northern Chernigiv region, according to the AFP news agency.