LONDON — It’s a far cry from the ice age of U.K.-China relations that characterized Rishi Sunak’s leadership — and it’s not exactly David Cameron’s “golden era,” either.  As U.K. Prime Minister Keir Starmer embarks on his Chinese charm offensive against a turbulent economic backdrop, he has opted for a softly-softly approach in a bid to warm up one of Britain’s most important trading partners — a marked departure from his Tory predecessors. With the specter of U.S. President Donald Trump looming over the visit — not to mention national security concerns back home — Starmer’s cautious optimism is hardly surprising.  Despite reservations from China skeptics, Starmer’s trip — the first such visit by a British prime minister since 2018 — was peppered with warm words and a smattering of deals, some more consequential than others. Britain’s haul from the trip may be modest, but it’s just the beginning, Business and Trade Secretary Peter Kyle — who joined Starmer on the trip — told a traveling pack of reporters in Beijing. “This visit is a springboard,” the minister said. “This is not the last moment, it is a springboard into a future with far more action to come.” STEP-BY-STEP On the ground in Beijing, British officials gave the impression that the prime minister was focused on getting as many uncontroversial wins over the line as possible, in a bid to thaw relations with China. That’s not to say Starmer and his team don’t have a few tangible wins to write home about. Headline announcements include a commitment from China to allow visa-free travel for British tourists and business travelers, enabling visits of up to 30 days without the need for documents.   The provisions are similar to those extended to 50 other countries including France, Germany, Italy, Australia and Japan. The timings of the visa change have not yet been set out publicly, but one official — who, like others cited in this piece, was granted anonymity to speak freely — said they were aiming to get it nailed down in coming months. “From a business standpoint, it will reduce a lot of friction,” said a British business representative, adding it will make it easier for U.K. firms to explore opportunities and form partnerships. “China is very complicated. You have to be on the ground to really assess opportunities,” they said, adding visa-free travel “will make things a lot easier.” The commitment to visa-free travel forms part of a wider services package aimed at driving  collaboration for businesses in healthcare, financial and professional services, legal services, education and skills — areas where British firms often face regulatory or administrative hurdles.  The countries have also agreed to conduct a “feasibility study” to explore whether to enter negotiations towards a bilateral services agreement. If it goes ahead, this would establish clear and legally binding rules for U.K. firms doing business in China. Once again, the timeframe is vague. David Taylor, head of policy at the Asia House think tank in London, said “Xi’s language has been warmer and more expansive, signaling interest in stabilizing the relationship, but the substance on offer so far remains tightly defined.” “Beyond the immediate announcements, progress — particularly on services and professional access — will be harder and slower if it happens at all,” he added. WHISKY TARIFF RELIEF Another victory talked up by the British government is a plan for China to slash Scotch whisky tariffs by half, from 10 percent to 5 percent.  However, some may question the scale of the commitment, which effectively restores the rate that was in place one year ago, ahead of a doubling of the rate for whisky and brandy in February 2025. The two sides have not yet set out a timeframe for the reduction of tariffs.  Speaking to POLITICO ahead of Starmer’s trip, a senior business representative said the whisky and brandy issue had become “China leverage” in talks leading up to the visit. However, they argued that even a removal of the tariff was “not going to solve the main issue for British whisky companies in China and everywhere, which is that people aren’t buying and drinking whisky.” CHINA INVESTMENT WIN Meanwhile, China can boast a significant win in the form of a $15 billion investment in medicines manufacturing and research and development from British pharmaceutical giant AstraZeneca.  ING Bank’s global healthcare lead Stephen Farelly said that increasing investment into China “makes good business sense,” given the country is “now becoming a force in biopharma.” However, it “does shine a light on the isolation of Europe and the U.K. more generally, where there is a structural decline in investment and R&D.” AstraZeneca recently paused a £200 million investment at a Cambridge research site in September last year, which was due to create 1,000 jobs.  Britain recently increased the amount the NHS pays for branded, pharmaceutical drugs, following heavy industry lobbying and following trade negotiations with the Trump administration — all in the hopes of attracting new investment into the struggling sector.  Shadow Trade Secretary Andrew Griffith was blunt in his assessment. “AstraZeneca’s a great British company but under this government it’s investing everywhere in the world other than its U.K. home. When we are losing investment to communist China, alarm bells should be ringing in No 10 Downing Street.” Conspicuously absent from Starmer’s haul was any mention of net zero infrastructure imports, like solar panels, a reflection of rising concerns about China’s grip on Britain’s critical infrastructure. XI RETURNS So what next? As Starmer prepares to fly back home, attention has already turned to his next encounter with the Chinese leader.  On Thursday, Britain opened the door to an inward visit by Xi Jinping, with Downing Street repeatedly declining to rule out the prospect of welcoming him in future. Asked about the prospect of an inward visit — which would be the first for 11 years — Starmer’s official spokesperson told reporters: “I think the prime minister has been clear that a reset relationship with China, that it’s no longer in an ice age, is beneficial to British people and British business.” As Starmer’s trip draws to a close, one thing is certain: there is more to come. “This isn’t a question of a one-and-done summit with China,” Starmer’s spokesperson added. “It is a resetting of a relationship that has been on ice for eight years.”

C-ANPROM/EUC/NON/0052 -------------------------------------------------------------------------------- Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Takeda * The advertisement is linked to policy advocacy around and industrial policy agenda, including the Pharma Package, Biotech Act, Life Sciences Strategy, and related digital and innovation frameworks. More information here

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.

LONDON — In the corridors of Whitehall, armies of officials are working out how best to spend billions of pounds earmarked for defense equipment. However, they have yet to inform the people it concerns the most: Britain’s arms industry. Many in the sector now fear that they’ve wasted their own money developing cutting-edge gear, as the government drags its feet on awarding contracts. U.K. Prime Minister Keir Starmer’s Labour Party has made a lot of noise on defense since entering government last year, plundering the aid budget to get defense spending to reach 2.6 percent of GDP by 2027 and a promise of 3.5 percent by 2035.  Alongside the funding boost, Starmer asked George Robertson, a Labour Party politician who is a former NATO secretary-general, to lead a major inquiry into how the U.K. would meet geopolitical threats, known as the Strategic Defence Review (SDR). The SDR was well received across the defense industry and viewed as a statement of intent from the government to devote effort and resources to building up the sector, with an emphasis on resilience and innovation.  Those good intentions were supposed to be followed by a series of complementary announcements — including a defense industrial strategy, the appointment of a new national armaments director, and a defense investment plan.  The industrial strategy and armaments director both arrived late, while the defense investment plan is still missing in action. It is now expected after this week’s fall budget.  Six months since the SDR, many in the industry complain that they haven’t received the certainty they need about where the British government — in many cases, their sole buyer —plans to invest.  Business owners say this is limiting their ability to make long-term plans and risks skilled workers departing for other jobs.  One representative of a mid-sized arms manufacturer — granted anonymity like others in this piece in order not to damage commercial prospects — said the problem was that the “big, bold” prescription of the SDR has given way to “repeated deferral, which always happens with delivery plans of this complexity.” INNOVATING IN THE DARK The war in Ukraine has radically reshaped other countries’ understanding of what’s needed on the battlefield, and the SDR set out a clear expectation that innovation would be rewarded. At September’s DSEI — an industry jamboree held in London — it was plain to see that private companies had stepped up to deliver prototypes for novel weaponry and other equipment, from modular robots that can deliver materiel to a battlefield and can also serve as stretchers, to AI that can read and predict threats on the ground in real time.  Defence Minister Luke Pollard said:  “We need to move to war-fighting readiness, and the SDR gave industry a very clear direction of how an increasing defense budget will be spent on new technologies and looking after our people better.” | John Keeble/Getty Images Much of that research and development was done by companies drawing on their own budgets or taking out loans as they wait for news of any specific government contracts.  For small suppliers in particular, the lag could prove existential.  One small manufacturer based in England said: “We are ready to go; we have built factories that could start making equipment tomorrow. But we can’t until an order is placed.” Armored vehicle maker Supacat has said that while its business is stable, suppliers will suffer without a predictable path ahead. “This is about the wider industry and our partners in the supply chain that have been contributing,” Toby Cox, the company’s head of sales, told POLITICO. “Our assumption is we don’t get more [orders], some of these companies will have a downturn in their orders.” KEEPING PRODUCTION LINES WARM Andrew Kinniburgh, defense director general of manufacturers association Make UK, echoed those concerns. While the industry “warmly welcomed” the Defence Ministry’s commitment to boost SME spending, he said, “the MOD must give companies certainty of long-term demand signals and purchase orders, allowing businesses to make the private investments needed in people, capital, and infrastructure.” Mike Armstrong, U.K. managing director of German defense firm Stark, which has recently opened a plant in Britain, added: “Giving the industry a clear view of future requirements is the fastest way to ensure the U.K. and its allies stay ahead.” Even some bigger companies that deal with the government on components for aircraft and submarines have privately complained about putting money into research and development without knowing what the end result will be.  An engineer working at one of Britain’s largest defense firms said: “We have multi-use items that could be for both military and civilian purposes, but cannot invest until we know what government strategy is. If it’s bad for us, it must be so hard for SMEs.” Mike Armstrong, U.K. managing director of German defense firm Stark, added: “Giving the industry a clear view of future requirements is the fastest way to ensure the U.K. and its allies stay ahead.” | Andrew Matthews/Getty Images The issue is not only one of investment, but also of skills. Supacat’s Cox said that keeping production lines warm matters because the workforce behind complex fabrications is fragile. “The U.K. has a skill shortage, particularly around engineering fabrication. If we’ve got an employee in that sector, we absolutely don’t want to lose them in another sector,” he said.  NOT LONG TO GO The Ministry of Defence said it appreciates the need for clarity. Defence Minister Luke Pollard, speaking to POLITICO at DSEI, said:  “We need to move to war-fighting readiness, and the SDR gave industry a very clear direction of how an increasing defense budget will be spent on new technologies and looking after our people better.” He argued there was “a neat synergy” between the “duty of government to keep the country safe and the first mission of this Labour government to grow the economy.” An MOD spokesperson said the defense investment plan would “offer clear, long-term capability requirements that enable industry to plan and unlocking private investment.” They pointed out that £250 million had already been allocated for “defense growth deals” alongside a £182 million skills package, and that the MOD had placed £31.7 billion in orders with U.K. industry in the last financial year. A government official rejected claims that ministers were moving too slowly, pointing to Defence Secretary John Healey’s recent announcement on new munitions factories as exactly the kind of demand signal that industry is looking for.  The director of a large U.K. defense producer said the signs from the government were “encouraging,” specifying that Chancellor Rachel Reeves, having agreed to more money for defense, “wants to see a return on investment.” While most of the country will be braced for Reeves’s big moment on Wednesday when she announces the national budget, one sector will have to hold its breath a little longer. Luke McGee contributed to this report.

With multiple legislative processes underway, we are now in an important moment for Europe’s ambition to boost access and be a global leader in innovation. An agile, modernized regulatory system — coupled with supportive intellectual property and access policies — can attract research and development and advanced manufacturing to Europe. This will contribute to the earlier availability of new cures for European patients and a healthier innovative ecosystem. Unfortunately, today we see that Europe is falling behind global competition. Over the last decade, there has been a 10 percent decrease in clinical trials in the European Union, which has led to 60,000 fewer European patients participating in trials.[1] Europe’s fragmented system for clinical trial approvals is a leading cause of this decline, impacting early access to innovative treatments. As scientific breakthroughs can deliver better health outcomes for patients, governments need to keep pace with this speed of innovation. > Draghi report on EU competitiveness importantly identified pharmaceutical > innovation as a strategic sector for growth in Europe. That said, the report > also noted that what is missing is a simple and strong execution plan behind > it, with simplified regulation and coherent and predictable policies that > could drive the European goals of increased competitiveness and strategic > autonomy. Europe’s marketing authorisation process now exceeds 14 months (444 days), causing patients to wait nearly three months longer than in the US (356 days) and over five months longer than in Japan (290 days) for access to innovative medicines.[2] Such delays, combined with complex and lengthy country-level market access systems, mean patients in Europe are waiting an average of 20 months longer than people living in the United States to benefit from scientific innovation.[3] Last year’s Draghi report on EU competitiveness importantly identified pharmaceutical innovation as a strategic sector for growth in Europe. That said, the report also noted that what is missing is a simple and strong execution plan behind it, with simplified regulation and coherent and predictable policies that could drive the European goals of increased competitiveness and strategic autonomy. Ongoing discussions on the revision of the General Pharmaceutical Legislation and the In Vitro Diagnostic Regulation (IVDR), the Critical Medicines Act and the upcoming Biotech Act (Part 1) mark crucial opportunities for Europe to become a global leader for innovation. However, to make this vision a reality, the EU must address structural challenges that undermine innovation and patient access to novel, lifesaving medicines. > To reverse the worrying decline in European clinical trial activity, the EU > should implement a maximum two-month approval process for clinical trial > applications (CTAs), encompassing the reviews of both regulators and ethics > committees consistent with other global leaders. The successful implementation of structural, future-proof policy changes can ensure timely access to innovative medicines for EU citizens, and this can be achieved through five key policy recommendations: Facilitate and accelerate clinical trial applications To reverse the worrying decline in European clinical trial activity, the EU should implement a maximum two-month approval process for clinical trial applications (CTAs), encompassing the reviews of both regulators and ethics committees consistent with other global leaders. It is equally important to increase collaboration among EU member states to remove unique and specific national CTA requirements and questions, and to also introduce opportunities for an informal dialogue with regulators to expediently address smaller challenges that can be quickly fixed. Legislative overlaps and fragmentation between the Clinical Trials Regulation (CTR) and the IVDR should also be addressed to avoid delays in clinical trials that utilize companion diagnostics. Expand expedited pathways Despite their potential, the EU’s expedited pathways (such as the European Medicines Agency’s PRIME scheme for unmet medical needs, Conditional Marketing Authorisation and Accelerated Assessment) are underutilised, limiting rapid patient access to important medicines. Similar expedited pathways are widely used by other regulators around the world, like the United States and Japan. Expanding the use of expedited pathways in the EU to new indications and aligning eligibility criteria with global standards would ensure that the EU has more competitive regulatory pathways and earlier patient access to life-saving medicines. Shorten scientific advice and approval timelines Shortening the EU’s scientific advice procedure is critical to optimise the development of innovative products, ensure timely and efficient resource management for both applicants and regulators, and maintain the EU’s influence in global scientific and clinical research. By evolving to a more integrated and agile dialogue, the EU can provide comprehensive, consistent guidance throughout the product lifecycle and remain competitive with other regions. Given their growing number, scientific advice should be available for medicines used with all types of medical devices and in vitro diagnostics (including combinations diagnostics) to address the complexities of working across these regulatory frameworks. > An agile, modernized regulatory system — coupled with supportive intellectual > property and access policies — can attract research and development and > advanced manufacturing to Europe. Regarding the current lengthy approval times, the proposed reduction of EMA’s standard assessment timelines from 210 to 180 days — as suggested in the revision of the pharmaceutical legislation — would allow regulators to accelerate their scientific assessments. Furthermore, the European Commission can streamline its decision phase (currently requiring up to 67 days) by conducting its activities in parallel with the scientific assessment. Strengthen the EU Medicines Regulatory Network and embrace regulatory sandboxes Achieving greater speed and agility within a regulatory system requires an appropriately resourced, sustainable regulatory infrastructure. We support transparent regulatory budgets across the network, backed by consistent investments in expertise, funding and infrastructure to support continuous capacity and capability advancements. Collaborative regulatory pathways (such as the EMA OPEN framework) could be further expanded to encourage simultaneous approvals and supply chain resilience across geographies. Additionally, regulatory sandboxes would be beneficial to pilot and adapt frameworks for disruptive future innovations, while ensuring appropriate guardrails to enable the safe development and implementation of these innovations. Enhance patient engagement Effective regulatory decision-making requires both inclusivity and adaptability. Limited patient and expert input can hinder effective regulatory decision-making, while rapid pharmaceutical innovation requires adaptable frameworks. Expert and patient perspectives are crucial for informed benefit-risk and clinical meaningfulness determinations. Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Eli Lilly & Company * The advertisement is linked to General Pharmaceutical Legislation (GPL), In Vitro Diagnostic Regulation (IVDR), Critical Medicines Act (CMA), Biotech Act (Part 1), Clinical Trials Regulation (CTR), EU Medicines Regulatory Network More information here. -------------------------------------------------------------------------------- [1] IQVIA, Assessing the clinical trial ecosystem in Europe, Final Report, October 2024: efpia_ve_iqvia_assessing-the-clinical-trial-ct-ecosystem.pdf. [2] Lara J, Kermad A, Bujar M, McAuslane N. 2025. R&D Briefing 101: New drug approvals in six major authorities 2015-2024: Trends in an evolving regulatory landscape. Centre for Innovation in Regulatory Science. London, UK: https://cirsci.org/wp-content/uploads/dlm_uploads/2025/08/CIRS-RD-Briefing-101-v1.1.pdf. [3] The Patients W.A.I.T. Indicator 2024 Survey. https://www.efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf

LONDON — Britain’s Department of Health is pressing ahead with plans to open up a trove of pandemic-era patient data to outside researchers — despite concerns from doctors’ representatives. A formal direction titled “GP Data for Consented Research,” yet to be signed by Health Secretary Wes Streeting but shared in draft format with doctors’ reps, would enable NHS England to disseminate patient data originally collected solely for the purpose of Covid-19-related research to other studies. The Department of Health and Social Care (DHSC) confirmed to POLITICO that the direction has been drafted and is awaiting Streeting’s signature. A group of doctors has warned the government that the move could erode patient trust. While the direction says government will obtain patient consent to share the data more broadly, doctors groups are worried this won’t happen in practice, and that patients won’t be aware their data is being funneled to other studies. NHS England has been in discussions with the Joint GP IT Committee, which comprises representatives from the British Medical Association (BMA) and Royal College of General Practitioners (RCGP), about the data, a person close to the talks told POLITICO. DHSC confirmed it had been in dialogue with the doctors’ groups, and a spokesperson said it had delayed signing the direction in order to engage with doctors’ concerns. The JGPITC argued it hasn’t been properly consulted on the change in line with established governance processes, and that repurposing the dataset without asking patients’ permission risks damaging already-fragile public confidence in the profession, the same person said.  While the direction says government will obtain patient consent to share the data more broadly, doctors groups are worried this won’t happen in practice, and that patients won’t be aware their data is being funneled to other studies. | Pool photo by Hannah McKay/EPA It comes after the same group of doctors filed a formal complaint to the Information Commissioner’s Office in June alleging that NHS England had breached data protection law by training a general-purpose AI model on the same dataset without consent. The disagreement is also set against the wider backdrop of a long-running dispute between government and the BMA over doctors’ pay and working conditions. DHSC maintains that proper processes have been followed. “As the Secretary of State made clear last year during his speech to the Royal College of GPs in October 2024, we are committed to implementing this direction in line with patients’ explicit consent for their data to be used in research,” a DHSC spokesperson said. ‘CONSULTED EXTENSIVELY’ In his speech last month, Streeting said he would direct NHS England to take responsibility for sharing patient data with projects including UK Biobank, Genomics England and Our Future Health. “I know there are issues we need to work through together around information governance, risk and liabilities,” he said. “There’s also, let’s be honest, some producer interest in play.” NHS England asked the JGPITC to confirm whether it was happy with the direction on broadening access to the dataset by Nov. 4. The JGPITC couldn’t reach a consensus to give its blessing to the change, the same person close to the talks and cited above said. The doctors’ group has pushed for NHS England to notify consenting participants about where their data is going via text or the NHS App, they added. DHSC is not obligated to comply with any of the JGPITC’s requests. “We have consulted extensively with GP representatives over the past 18 months to ensure patients’ wishes are respected and their data used appropriately, while minimizing the burden on busy GPs,” DHSC’s spokesperson said.

Andrea Dugo is an economist at the European Centre for International Political Economy. In the late 1400s, Italy was the jewel of Europe. Venice ruled the seas; Florence dominated art and finance; and Milan led in trade and technology. No corner of the Western world was more advanced. Yet, within decades, both its political independence and economic primacy were gone. Europe today risks a similar fate. Once the envy of the world, the bloc’s lead has eroded. The EU isn’t just politically divided, it’s also falling behind in industries that will define the rest of this century. Young talent is fleeing for the U.S. and Asia, while its economy increasingly resembles an open-air museum of past achievements. Whether in growth, technology, industry or living standards, Europe is in jeopardy of becoming a province in a world defined by others. And it stands to learn from Italy’s decline. The warning signs are unmistakable: Since 2008, the EU’s GDP expanded by just 18 percent, while the U.S. grew twice as fast and China grew nearly three times bigger. Tourism across the continent is still booming, of course, but the millions chasing their Instagram-able escapes aren’t enough to offset stagnation, and also bring costs. The bloc’s fall in living standards echoes Renaissance Italy as well. Around 1450, Italy’s income per person was 50 percent higher than Holland’s. A century later, the Dutch were 15 percent richer, and by 1650, they were nearly twice as rich. Modern Europe is slipping even faster than that. In 1995, Germany’s GDP per capita was 10 percent higher than America’s, whereas today, the U.S. is 60 percent higher. At this pace, Germany’s prosperity levels could shrink to a third of its transatlantic partner’s within a generation. Much like in Renaissance Italy, this economic malaise reflects a deep technology gap. Once the queen of the seas, Venice clung to old technology and paid the price. Its galleys, superb in calm Mediterranean waters, were no match for the ocean-going caravels that carried Spain and Portugal across the world. Modern Europe is now doing the same: On artificial intelligence, the EU invests barely 4 percent of what the U.S. does. Today, OpenAI is valued at $500 billion, while Europe’s biggest AI startup Mistral is worth just $15 billion. And though it pioneered the science in quantum, Europe trails behind in commercialization — a single U.S. startup, IonQ, raised more capital than all the bloc’s quantum firms combined. Even when it comes to batteries, Sweden’s much-touted Northvolt collapsed in March, only to be snapped up by a Silicon Valley startup. Traditional industries are faltering too. Taken together, Germany’s top three carmakers are worth just an eighth of Tesla. Ericsson and Nokia, once world leaders in mobile network technology, lag behind Asian rivals in 5G. And France’s Arianespace, once dominant in satellite launches, now hitches rides on tech billionaire Elon Musk’s rockets. The problem isn’t invention, though — it’s scale. Despite its top engineers and universities, nearly 30 percent of the bloc’s unicorns have transferred to the U.S. since 2008, taking its most entrepreneurial spirits with them. It seems the continent sparks ideas, while America fuels them and profits — yet another pattern that mirrors Italy, which supplied talent as others built empires. Its greatest explorers like Columbus, Cabot, Vespucci and Verrazzano had also trained at home, only to sail under foreign flags. The prescriptions are known. Former Italian Prime Minister Mario Draghi detailed them in his report on the EU’s future. | Thierry Monasse/Getty Images The fundamental issue in both cases is political. Like Italy’s warring city-states in the 1500s, today’s Europe is divided and feeble. Capitals quarrel over energy, debt, migration and industrial policy; a common defense strategy remains only an aspiration; and ambitious plans for joint technology spending or deeper capital markets get drowned in debate. This disunity is what doomed Italy as it fell prey to foreign powers that eventually carved up the peninsula. And the bloc’s current divisions leave it similarly vulnerable to global competitors, as Washington dictates defense; Russia menaces the continent’s east; China dominates supply chains; and Silicon Valley rules the digital economy. But is this all fated? Not necessarily. The EU has built institutions Renaissance Italy could never have dreamed of: a single market, a currency, a parliament. It still hosts world-class research institutions and excels in advanced manufacturing, pharmaceuticals, aerospace, green energy and design. The continent can still lead — but only if it acts. Sixteenth-century Italy had no such chance. Geography trapped it in the Mediterranean while trade routes shifted to the Atlantic, and commerce stagnated. New naval technologies left its fleets behind, and its brightest minds sought their fortunes abroad. But Europe faces no such limit. Nothing is stopping it other than its own political timidity and fractiousness. The bloc needs to accept costs now in order to avoid the greatest of costs later: irrelevance. It needs to invest heavily in frontier technologies like AI, quantum, space and biotech, while also building real defense and creating deep capital markets so that start-ups can scale up at home. The prescriptions are known. Former Italian Prime Minister Mario Draghi detailed them in his report on the EU’s future. What’s missing is political will. Once Europe’s beating heart, Italy eventually became a land of visitors rather than innovators. And history’s lesson is clear: Its culture endured, but its power withered. The EU still has time to avoid that destiny. Europeans can either wake up or resign themselves to becoming a continent of monuments and echoing memories.

Ban Ki-moon is the eighth secretary-general of the U.N. and the co-chair of the Ban Ki-moon Centre for Global Citizens. Ana Toni is the CEO of COP30. As world leaders gather in Belém, Brazil for this year’s United Nations Climate Change Conference (COP30), we are standing at a global tipping point. 2024 broke temperature records, as the world temporarily surpassed the 1.5 degrees Celsius target for the first time. And now, we’re on track to cross it permanently within just five years. This means adaptation action has never been more vital for our survival. From the year 2000 to 2019, climate change already cost the world’s most vulnerable countries an estimated $525 billion. This burden only continues to rise, putting lives at risk and undoing hard-won development gains, with global annual damages likely to land somewhere between $19 trillion and $59 trillion in 2050. Even more sobering, the world economy is already locked into a 19 percent loss of income by 2050 due to climate change, no matter how successful today’s mitigation efforts are. This makes one thing clear: The consequence of inaction is far greater than the consequence of action. The world must stop seeing adaptation as a cost to bear but as an investment that strengthens economies and builds healthier, more secure communities. Every dollar invested in adaptation can generate more than 10 times that in benefits through avoided losses, as well as induced economic, social and environmental benefits. Every dollar invested in agricultural research and development generates similar returns for smallholder farmers, vulnerable communities and ecosystems too. This remains true even if climate-related disasters don’t occur. Effective adaptation does more than save lives — it makes the economic case for resilience. And if we really want to tackle the crises of today’s world, we need to put people — especially those most vulnerable — at the center of all our conversations and efforts. Those least responsible for climate change are the ones our financing must reach. Here, locally led adaptation provides a path forward, focusing on giving communities agency over their futures, addressing structural inequalities and enhancing local capacities. Today, more than 2 billion people depend on smallholder farms for their livelihoods, but as little as 1.7 percent of climate finance reaches Indigenous communities and locally operated farms. Small-scale agri-food systems, which are essential to many in developing countries, receive a mere 0.8 percent of international climate finance. This is deeply unjust. These are the people and systems most threatened by climate impacts — and they’re often the best-placed ones to deliver locally effective and regionally adaptive solutions. To that end, appropriate investments in global networks like the Consultative Group on International Agricultural Research (CGIAR) could accelerate and scale technologies that can be adopted by these local systems. These tools could then be used to improve resilience and increase productivity in low- and middle-income countries, while also reducing inequalities and advancing gender equity and social inclusion. The world economy is already locked into a 19 percent loss of income by 2050 due to climate change. | Albert Llop/Getty Images Scaling such efforts will be crucial in moving toward systemic climate solutions. Our ambition is to move from negotiation to implementation to protect lives, safeguard assets and advance equity. But it’s important to remember that adaptation is distinct — it is inherently local; shaped by geography, communities and governance systems. Meeting this challenge will require more than just pledges. It will necessitate high-quality public and private adaptation finance that is accessible to vulnerable countries and communities. That’s why governments around the world — especially those in high-income countries — must design institutional arrangements and policies that raise additional public funds, incentivize markets and embed resilience into every investment decision. The decade since the Paris Agreement laid the foundations for a world at peace with the planet. And with COP30 now taking place in the heart of the Amazon, we must make adaptation a global priority and see resilience as the investment agenda of the 21st century. At its core, climate finance should be driving development pathways that put people first. In Belém, leaders must now close the adaptation finance gap and ensure funding reaches those on the front lines. They need to back investable national resilience strategies, replicate successful initiatives and put resilience at the center of financial decision-making. COP30 needs to be transformative and lead to markets that reward resilience, communities that are better protected and economies built on firmer, more climate-resilient foundations. Let this be the moment we finally move from awareness to alignment, and from ambition to action. Our collective survival depends on it. Question is, will our leaders have the political will to seize it?

Today, as the world reaches a critical juncture in the fight against HIV/AIDS, tuberculosis (TB) and malaria, the EU must choose: match scientific breakthroughs with political will and investment or retreat, putting two decades of hard-won progress at risk. Having saved over 70 million lives, the Global Fund to Fight AIDS, Tuberculosis, and Malaria (the Global Fund) has proven what smart, sustained investment can achieve.  But the impact of its work — the lives protected, the life expectancy prolonged, the systems strengthened, the innovations deployed — is now under threat due to declining international funding.  > The real question is no longer whether the EU can afford to invest in the > Global Fund, but whether it can afford to let these hard-won gains unravel. The real question is no longer whether the EU can afford to invest in the Global Fund, but whether it can afford to let these hard-won gains unravel. Declining international funding, climate change, conflict and drug resistance are reversing decades of progress. HIV prevention is hampered by rising criminalization and attacks on key populations, with 1.3 million new infections in 2024 — far above targets. TB remains the deadliest infectious disease, worsened by spreading multidrug resistance, even in Europe. Malaria faces growing resistance to insecticides and drugs, as well as the impacts of extreme weather. Without urgent action and sustained investment, these threats could result in a dangerous resurgence of all three diseases. The stakes could not be higher  The Global Fund’s latest results reveal extraordinary progress. In 2024 alone: * 25.6 million people received lifesaving antiretroviral therapy, yet 630,000 still died of AIDS-related causes; * 7.4 million people were treated for TB, with innovations like AI-powered diagnostics reaching frontline workers in Ukraine; and * malaria deaths, primarily among African children under five, have been halved over two decades, with 2.2 billion mosquito nets distributed and ten countries eliminating malaria since 2020. Yet one child still dies every minute from this treatable disease.  What makes this moment unprecedented is not just the scale of the challenge, but the scale of the opportunity. Thanks to extraordinary scientific breakthroughs, we now have the tools to turn the tide:  * lenacapavir, a long-acting antiretroviral, offers new hope for the possibility of HIV-free generations; * dual active ingredient mosquito nets combine physical protection with intelligent vector control, transforming malaria prevention; and  * AI-driven TB screening and diagnostics are revolutionizing early detection and treatment, even in the most fragile settings. Some of these breakthroughs reflect Europe’s continued research and development and the private sector’s leadership in global health. BASF’s dual-active-ingredient mosquito nets, recently distributed by the millions in Nigeria, are redefining malaria prevention by combining physical protection with intelligent vector control. Delft Imaging’s ultra-portable digital X-ray devices are enabling TB screening in remote and fragile settings, while Siemens Healthineers is helping deploy cutting-edge AI software to support TB triage and diagnosis.  But they must be deployed widely and equitably to reach those who need them most. That is precisely what the Global Fund enables: equitable access to cutting-edge solutions, delivered through community-led systems that reach those most often left behind. A defining moment for EU Leadership The EU has a unique chance to turn this crisis into an opportunity. The upcoming G20 summit and the Global Fund’s replenishment are pivotal moments.  President Ursula von der Leyen and Commissioner Síkela can send a clear, unequivocal signal: Europe will not stop at “almost”. It will lead until the world is free of AIDS, tuberculosis and malaria.  The Global Fund is a unique partnership that combines financial resources with technical expertise, community engagement and inclusive governance. It reaches those often left behind — those criminalized, marginalized or excluded from health systems.  > Even in Ukraine, amid the devastation of war, the Global Fund partnership has > ensured continuity of HIV and TB services — proof that smart investments > deliver impact, even in crisis. Its model of country ownership and transparency aligns with Africa’s agenda for health sovereignty and with the EU’s commitment to equity and human rights. Even in Ukraine, amid the devastation of war, the Global Fund partnership has ensured continuity of HIV and TB services — proof that smart investments deliver impact, even in crisis. The cost of inaction Some may point to constraints in the Multiannual Financial Framework. But history shows that the EU has consistently stepped up, even in difficult fiscal times. The instruments exist. What’s needed now is leadership to use them. Failure to act would unravel decades of progress. Resurgent epidemics would claim lives, destabilize economies and undermine global health security. The cost of inaction far exceeds the price of investment. For the EU, the risks are strategic as well as moral. Stepping back now would erode the EU’s credibility as champion of human rights and global responsibility. It would send the wrong message, at precisely the wrong time.  Ukraine demonstrates what is at stake: with Global Fund support, millions continue to receive HIV and TB services despite war. Cutting funding now would risk lives not only in Africa and Asia, but also in Europe’s own neighborhood. A call to action Ultimately, this isn’t a question of affordability, but one of foresight. Can the EU afford for the Global Fund not to be fully financed? The answer, for us, is a resounding no. We therefore urge the European Commission to announce a bold, multi-year financial commitment to the Global Fund at the G20.  This pledge would reaffirm the EU’s values and inspire other Team Europe partners to follow suit. It would also support ongoing reforms to further enhance the Global Fund’s efficiency, transparency and inclusivity. > Ultimately, this isn’t a question of affordability, but one of foresight. Can > the EU afford for the Global Fund not to be fully financed? The answer, for > us, is a resounding no. This is more than a funding decision. It is a moment to define the kind of world we choose to build: one where preventable diseases no longer claim lives, where health equity is a reality and where solidarity triumphs over short-termism. Now is the time to reaffirm Europe’s leadership. To prove that when it comes to global health, we will never stop until the fight is won.

President Donald Trump has struck a multi-pronged deal with pharmaceutical giant Pfizer to lower the price of some of the company’s medicines, while clearing a path for the drugmaker to receive a three-year reprieve from certain tariffs. The drugmaker will participate in a new direct purchasing platform named TrumpRx.gov  that will let American patients buy a “large majority” of its primary care treatments and “some select specialty brands” at a discount. Those drugs will be offered at “savings that will range as high as 85% and on average 50%,” Pfizer said in a press release Tuesday. The deal comes after Trump demanded that 17 of the largest drugmakers voluntarily offer their medicines at levels similar to what they charge other nations. Pfizer said that it has agreed to voluntarily “implement measures designed to ensure Americans receive comparable drug prices to those available in other developed countries and pricing newly launched medicines at parity with other key developed markets.” “Pfizer is committing to offer all of their prescription medications to Medicaid, and it will be at the most-favored nations prices,” said Trump, who added during an Oval Office press conference that other drugmakers will also make commitments in the coming weeks. “It’s going to have a huge impact on bringing Medicaid costs down.” Chris Klomp, Medicare director at the Centers for Medicare and Medicaid Services, said the most-favored nation price will be based on a basket of other wealthy countries. “Pfizer will be putting virtually all of its portfolio of drugs at MFN prices available to Medicaid in the near future,” Klomp said. The deal marks a success for Trump, who has been pressuring industries to comply with his requests voluntarily. It is unclear how the deal will impact prices in the commercial insurance market. “While Democrats are threatening to shut down the federal government to subsidize health care for illegal aliens, President Trump is leveraging the power of the federal government to drastically cut drug prices for everyday Americans,” White House spokesperson Kush Desai said. “Democrats talked the talk for decades about drug prices, but only President Trump is actually walking the walk.” Pfizer said it would spend an additional $70 billion over the “next few years” on research and development, as well as capital projects, which would likely make it eligible for a three-year reprieve from tariffs stemming from the Trump administration’s section 232 investigation. That investigation on pharmaceuticals could result in tariffs being applied based on the effects of imports on national security. Trump announced last week that the government would place a 100 percent tariff on “any branded or patented” drug made by companies that are not building manufacturing facilities in the U.S. starting on Oct. 1. “We now have the certainty and stability we need on two critical fronts, tariffs and pricing, that have suppressed the industry’s valuations to historic lows,” Pfizer CEO Albert Bourla said in a statement. Brand drug lobby Pharmaceutical Research and Manufacturers of America announced Monday that its members would be investing $500 billion in new U.S.-based infrastructure investments.