Dr. Daniel Steiners This is not an obituary for Germany’s economic standing. It is an invitation to shift perspective: away from the language of crisis and toward a clearer view of our opportunities — and toward the confidence that we have more capacity to shape our future than the mood indicators might suggest. For years, Germany seemed to be traveling along a self-evident path of success: growth, prosperity, the title of export champion. But that framework is beginning to fray. Other countries are catching up. Parts of our industrial base appear vulnerable to the pressures of transformation. And global dependencies are turning into strategic vulnerabilities. In short, the German model of success is under strain. Yet a glance at Europe’s economic history suggests that moments like these can also contain enormous potential — if strategic thinking and decisive action come together. One example, which I find particularly striking, takes us back to 1900. At the time, André and Édouard Michelin were producing tires in a relatively small market, when the automobile itself was still a niche product. They could have focused simply on improving their product. Instead, they thought bigger; not in silos, but in systems. With the Michelin Guide, they created incentives and orientation for greater mobility: workshop directories, road maps, and recommendations for hotels and restaurants made travel more predictable and attractive. What began as a service booklet for motorists gradually evolved into an entire ecosystem — and eventually into a globally recognized benchmark for quality. > In times of change, those who recognize connections and are willing to shape > them strategically can transform uncertainty into lasting strength. What makes this example remarkable is that the real innovation did not lie in the tire itself or merely even a clever marketing idea to boost sales. It lay in something more fundamental: connected thinking and ecosystem thinking. The decision to see mobility as a broad space for value creation. It was the courage to break out of silos, to recognize strategic connections, to deepen value chains — and to help define the standards of an emerging market. That is precisely the lesson that remains relevant today, including for policymakers. In times of change, those who recognize connections and are willing to shape them strategically can transform uncertainty into lasting strength. Germany’s industrial health economy is still too often viewed in public debate in narrowly sectoral terms — primarily through the lens of health care provision and costs. Strategically, however, it has long been an industrial ecosystem that spans research, development, manufacturing, digital innovation, exports and highly skilled employment. Just as Michelin helped shape the ecosystem of mobility, Germany can think of health as a comprehensive domain of value creation. The industrial health economy: cost driver or engine of growth? Yes, medicines cost money. In 2024, Germany’s statutory health insurance system spent around €55 billion on pharmaceuticals. But much of that increase reflects medical progress and the need for appropriate care in an aging society with changing disease patterns. Innovative therapies benefit both patients and the health system. They can improve quality and length of life while shifting treatment from hospitals into outpatient care or even into patients’ homes. They raise efficiency in the system, reduce downstream costs and support workforce participation. > In short, the industrial health economy is not merely part of our health care > system. It is a key industry, underpinning economic strength, prosperity and > the financing of our social security systems. Despite public perception, pharmaceutical spending has remained remarkably stable for years, accounting for roughly 12 percent of total expenditures in the statutory health insurance system. That figure also includes generics — medicines that enter the ‘world heritage of pharmacy’ after patent protection expires and remain available at low cost. Truly innovative, patent-protected medicines account for only about seven percent of total spending. Against these costs stands an economic sector in which Germany continues to hold a leading international position. With around 1.1 million employees and value creation exceeding €190 billion, the industrial health economy is among the largest sectors of the German economy. Its high-tech products, bearing the Made in Germany label, are in demand worldwide and contribute significantly to Germany’s export surplus. In short, the industrial health economy is not merely part of our health care system. It is a key industry, underpinning economic strength, prosperity and the financing of our social security systems. Its overall balance is positive. The central question, therefore, is this: how can we unlock its untapped potential? And what would it mean for Germany if we fail to recognize these opportunities while economic and innovative capacity increasingly shifts elsewhere? Global dynamics leave little room for hesitation Governments around the world have long recognized the strategic importance of the industrial health economy — for health care, for economic growth and for national security. China is demonstrating remarkable speed in scaling and implementing biotechnology. The United States, meanwhile, illustrates how determined industrial policy can look in practice. Regulatory authorities are being modernized, approval procedures accelerated and bureaucratic barriers systematically reduced. At the same time, domestic production is being strategically strengthened. Speed and market size act as magnets for capital — especially in a sector where research is extraordinarily capital-intensive and requires long-term planning security. When innovation-friendly conditions and economic recognition of innovation meet a large, well-funded market, global shifts follow. Today roughly 50 percent of the global pharmaceutical market is located in the United States, about 23 percent in Europe — and only 4 to 5 percent in Germany. This distribution is no coincidence; it reflects differences in economic and regulatory environments. At the same time, political pressure is growing on countries that benefit from the American innovation engine without offering an equally attractive home market or recognizing the value of innovation in comparable ways. Discussions around a Most Favored Nation approach or other trade policy instruments are moving in precisely that direction — and they affect Europe and Germany directly. For Germany, the implications are clear. Those who want to attract investment must strengthen their competitiveness. Those who want to ensure reliable health care must appropriately reward new therapies. Otherwise, these global dynamics will inevitably affect both the economy and health care at home. Already today, roughly one in four medicines introduced in the United States between 2014 and 2023 is not available in Europe. The gap is even larger for gene and cell therapies. The primacy of industrial policy: from consensus to action — now Germany does not lack potential or substance. We still have a strong industrial base, a tradition of invention, outstanding universities and research institutions, and a private sector willing to invest. Political initiatives such as the coalition agreement, the High-Tech Agenda and plans for a future strategy in pharmaceuticals and medical technology provide important impulses, which I strongly welcome. > A fair market environment without artificial price caps or rigid guardrails is > the strongest magnet for private capital, long-term investment and a resilient > health system. But programs must now translate into a coherent action plan for growth. We need innovation-friendly and stable framework conditions that consider health care, economic strength and national security together — as a strategic ecosystem, not as separate silos. The value of medical innovation must also be recognized in Germany. A fair market environment without artificial price caps or rigid guardrails is the strongest magnet for private capital, long-term investment and a resilient health system. Faster approval procedures, consistent digitalization and a determined reduction of bureaucracy are essential if speed is once again to become a competitive advantage and a driver of innovation. Germany can reinvent itself, of that I am convinced. With courage, strategic determination and an ambitious push for innovation. The choice now lies with us: to set the right course and unlock the potential that is already there.

PARIS — The rising price of oil is undermining the European Union’s efforts to rein in Vladimir Putin’s shadow fleet of sanctioned oil tankers. Russian oil is in high demand as the war in the Middle East and tensions around the Strait of Hormuz tighten global supply, sending benchmark crude prices above $100 per barrel on Monday. That risks weakening a central plank of the EU’s efforts to cut off funding for the Russian president’s war in Ukraine: making it harder and more expensive for Moscow to export oil through a network of aging vessels operating outside the Western shipping system. EU countries have already sanctioned hundreds of tankers and are working on new measures aimed at the insurance, crewing and other maritime services that allow those ships to operate — tools Brussels hopes will make the shadow fleet increasingly costly and difficult to run. But a tighter oil market means buyers may still be willing to purchase discounted Russian crude. As prices rise, the financial incentive to secure cheaper Russian barrels grows, offsetting the higher risks and costs associated with sanctioned ships. The demand is expected to be driven by Asian countries like China and India — the world’s first and third-largest importers of oil — which rely heavily on Middle Eastern supplies and are likely to turn to Russia to make up for any shortfalls. Indian refiners have already reportedly moved to buy more Russian crude after the U.S. temporarily eased pressure on the South Asian country by allowing purchases to resume last week. India imports, on average, 10 million metric ton of crude oil per month through the Strait of Hormuz, said Vaibhav Raghunandan, an EU-Russia analyst at the Centre for Research on Energy and Clean Air. “Even if half of this volume is replaced with Russian volumes at sea, it will translate to huge profits for the Kremlin.” The shift comes after millions of barrels of oil were stranded at sea last week as escalating tensions blocked the Strait of Hormuz, a maritime choke point through which a fifth of the world’s oil and liquefied natural gas flows. Meanwhile, around €1.3 billion of Russian crude is currently at sea looking for buyers, Raghunandan estimates. SANCTIONS STALL The market squeeze also comes at a difficult moment for Brussels. The EU is trying to push through a new sanctions package aimed at tightening restrictions on Russia’s shadow fleet — including limits on maritime services — but the proposal is currently stalled after Hungary vetoed the plan. The shadow fleet includes hundreds of aging tankers used to transport Russian crude outside Western oversight. Last month, President Donald Trump announced a trade deal with Indian Prime Minister Narendra Modi that included a commitment from New Delhi to halt purchases of Russian oil in exchange for reduced trade barriers with the United States. | Andrew Harnik/Getty Images EU foreign policy chief Kaja Kallas warned last week that rising oil prices risk boosting Moscow’s war effort. “When the oil price goes up, it actually benefits Russia to fund its war,” she said, making the case for the maritime services ban at a virtual meeting of EU foreign ministers. Malte Humpert, founder and senior fellow at The Arctic Institute, said a prolonged Iran–U.S. conflict would likely benefit Moscow by pushing energy prices higher. “Rising prices for sure,” he said, noting that Russian oil and gas revenues have been declining in recent months.  “The question is how long the Hormuz situation is going to last,” he added. “If this is over in a week, the effects are probably negligible. If this continues for a few weeks … especially as we’re getting into the summer months, that’s when exports really pick up again from the Russian side.” Humpert argued that supply disruptions “always favor the seller who can deliver on time, reliably and discounted.” India has been a key buyer of Russian crude since the start of the war in Ukraine, though purchases had recently declined under pressure from Washington. Last month, President Donald Trump announced a trade deal with Indian Prime Minister Narendra Modi that included a commitment from New Delhi to halt purchases of Russian oil in exchange for reduced trade barriers with the United States. Before that, Indian ports had become a major destination for tankers carrying Russian crude that were shut out of Western markets by sanctions. Last September, the Boracay, a ship under EU sanctions carrying approximately $100 million in Russian oil, was boarded by the French navy, which found two Russian crew members presented by her captain as “security agents” on board.  Upon the ship’s release, it went on to the port of Vadinar in western India, home to an offshore oil terminal that supplies local refineries, maritime traffic data shows. Elena Giordano contributed reporting to this article.

LONDON — The Palace of Westminster stands on the banks of the River Thames as a proud symbol of British democracy.  But upon closer inspection, this neo-gothic mini-village, part of a UNESCO World Heritage site, is falling apart. Britain’s parliament has become an increasingly dangerous place to work for the 650 MPs, more than 800 members of the House of Lords, and thousands more staff who use it. The Restoration and Renewal (R&R) program, set up to deliver the long-delayed overhaul of the palace, warns of serious risks from fire, flooding, crumbling stonework and aging mechanical and electrical systems. Parliament needs fixing — and in the coming weeks, MPs and peers are expected to vote on what to do next. But there’s little consensus on how to proceed. The fight over the future of the site is now pitting politicians worried about spiraling costs against those who think the need to act is growing more urgent by the day. As this week’s POLITICO Westminster Insider podcast explores, fixing parliament is a story of seemingly endless division and delay. TWO OPTIONS, EYE-WATERING NUMBERS The way forward, presented to MPs and peers by the R&R team, has been boiled down to two stark options. The first is the so-called “full decant.” This would involve moving MPs and peers out of the palace to allow major works to be carried out. On current estimates, it would take 19 to 24 years and cost up to £15.6 billion. The second is an even slower, staged approach — catchily named “Enhanced Maintenance and Improvement plus”(EMI+) — where only the House of Lords is moved out, and works are done in phases while MPs’ parliamentary business continues on the estate. But that could take 38 to 61 years and cost up to £39.2 billion, the program’s figures suggest. In the coming weeks, MPs and peers are expected to vote on whether to at least green-light an initial seven-year package of preparatory works — a step that keeps both longer-term options alive, with a final decision pushed into the next decade. One of the most prominent advocates of the faster approach is Marie Goldman, the Liberal Democrat MP for Chelmsford. Goldman is a member of parliament’s Restoration and Renewal Programme Board, a cross-party body that scrutinizes the restoration team’s work.  For Goldman, the logic is blunt: if the work is going to happen at all, it is safer and ultimately cheaper to do it without thousands of staff, MPs and visitors continuing to use the building. “Trying to do those works with MPs and everyone else in place… feels like an absolute nightmare,” she says. The fight over the future of the site is now pitting politicians worried about spiraling costs against those who think the need to act is growing more urgent by the day. | Pool photo by Henry Nicholls via WPA/Getty Images Goldman is adamant that MPs and peers find a solution and believes Britain’s international reputation is at stake: “Nothing would say. Hey, look at the demise of Britain than watching the Houses of Parliament crumble into the Thames.” The government has said it will allow MPs a free vote on the restoration plans. Labour MP Mike Reader has followed the saga closely since his election in 2024. He backs option two, EMI+. Reader told POLITICO he has spoken directly with the consultants and contractors working across the estate — and believes the restoration team has underestimated the scale of the work needed, saying he fears “the discovery risk” of finding new problems as the work progresses. Reader says a longer-term approach would allow the restoration team greater scope “to learn and improve over time.” His “biggest fear” is that a different government decides to “stall and delay” the scheme or “require a complete rethink.” “Instability and uncertainty are the biggest risks to a program like this,” he warns. WASTING MONEY The fiercest critics see the project as typical of Westminster’s habit of wasting public money — and argue selling a multi-billion pound revamp will be impossible in a country grappling with the rising cost of living. Veteran Tory MP Edward Leigh, styled as the Father of the House for his long service, is a long-standing skeptic who argues that parliament should focus narrowly on essential safety upgrades rather than what he derides as “gold-plating.”  He believes plans to create a new visitors’ reception and steps to reduce the building’s carbon footprint are “bells and whistles.” “You don’t need all this, not when there’s an economic crisis. Our constituents are going to be absolutely furious.” Leigh wants what he describes as a “third option”: repealing parts of the current legal framework that mandates the restoration “in one go” and repairing the Palace in stages around MPs. His concerns over the costs involved are shared by the Conservative Party’s top brass. Leader Kemi Badenoch has raised “serious concerns about value for money.” She has instructed her party to vote against the plans in any parliamentary vote.  ‘CATASTROPHE’ Academic and parliament restoration specialist Alexandra Meakin — who has studied the project for years and previously worked in parliament — strongly disagrees with the Conservative Party’s position. Parliament needs fixing — and in the coming weeks, MPs and peers are expected to vote on what to do next. | Andy Rain/EPA “Desperately wanting there to be a third way or for it to not cost as much or for the repairs not to be as essential doesn’t make it less true,” she warns. Meakin adds: “Every review, every expert shows you cannot do this in any cheaper, quicker or safer way than just moving out entirely.” In her view, the core purpose of restoration is not gilding the palace — but preventing a future in which the building becomes unusable because of a major fire, flood or infrastructure failure. She warns: “The catastrophe is coming. The Palace of Westminster will become uninhabitable, whether it’s through fire, flood, or a failure of the essential infrastructure. And at that point, MPs and peers will have to face up to the fact that they have lost their own workplace, but they’ve also lost this iconic building for the nation.” LOOKING TO OTTAWA The U.K. is not the only old democracy grappling with decaying, neo-Gothic legislature buildings. Canada’s already moved its Commons chamber into a temporary home (known as West Block) while major works on Ottawa’s Centre Block proceed. Nick Taylor-Vaisey is POLITICO’s Ottawa bureau chief. He told Westminster Insider that Canada’s success was in part down to persuading hesitant MPs to move out entirely. The trick? Ensuring they were excited by their new alternative. “The West Block Chamber is actually a former courtyard and there is a glass ceiling on top, a novel, modern take on how you can build a legislature.”  Looking to the U.K., Taylor-Vaisey advised: “There is this chance to rethink what it could be.” Current plans in Westminster would likely involve MPs moving into Richmond House on the Whitehall estate, while the Lords would move into the QEII conference center. So far neither seems to have captured the imagination. 

Across Europe, governments are moving quickly to harness the potential of artificial intelligence (AI). National strategies are being announced, innovation hubs funded and pilot programs launched. From healthcare to taxation, I have seen how AI is emerging as a powerful lever to enhance public services and safeguard digital resilience. Europe’s population is aging and economic pressure is being felt across the continent. At the same time, citizens expect faster, simpler services. In this context, departments are looking for targeted AI uses that reduce manual workload and improve service quality without adding risk or cost. > In order for AI to add value to an organization, it needs up‑to‑date data, > clear ownership and simple routes to information sharing across teams. However, progress is uneven. Many organizations are still at the trial stage. Capgemini research shows that nearly 90 percent plan to explore, pilot or implement agentic AI within the next two to three years, while EU institutions and member states are committing billions to digital transformation centered around AI. Only 21 percent of public sector organizations have advanced beyond experimentation to pilots or actual deployment of generative AI. The practical blocker is not enthusiasm: it is whether data is accurate, shared when needed and safe to use. A reality check for AI maturity In order for AI to add value to an organization, it needs up‑to‑date data, clear ownership and simple routes to information sharing across teams. Less than one in four organizations globally report high maturity in these fields. For civil servants, this often translates into small teams juggling operational delivery with transformation agendas, learning new tools on the job and managing risk without clear playbooks. > More than half of public sector organizations are concerned about AI > sovereignty, which is becoming central to safeguarding digital resilience. This gap matters. AI initiatives built on fragile data foundations may face risks such as inefficiency, bias and security vulnerabilities, which can erode trust in automated decisions, both internally and with citizens. Strengthening public sector data is therefore not only key to enabling AI, but also essential for improving the accuracy, efficiency and reliability of government decision-making. Getting the basics right also helps deliver ‘once‑only’ service patterns so citizens no longer need to repeatedly provide the same information to different authorities. By creating greater interoperability and portability, governments can reduce lock-in and strengthen long-term resilience. The readiness gap Europe is not lacking in ambition. Progress is underway, but common challenges remain; data silos between agencies, varying quality standards, unclear governance for data sharing and legacy systems that limit interoperability. Cultural hesitancy toward data-driven decision-making adds complexity, but it is not insurmountable. The good news is that these issues can be addressed with a strategic focus on data foundations and practical steps that reflect how government works: small, safe changes; clear owners; and visible benefits to users and staff. When data is accessible, trusted, and well managed, civil servants can share information confidently, driving innovation while maintaining compliance and security. > Setting clear targets, aligning strategy with operational reality, and > encouraging collaboration and shared behaviors across teams helps embed data > use into everyday work rather than treating it as an added burden. Through engagement with industry and public-sector stakeholders, I see growing momentum around these priorities and an opportunity for Europe to lead the way in scaling AI responsibly to deliver smarter, more efficient public services for citizens. Building the foundations of public sector AI Governments cannot buy their way into AI readiness, but can work to build it through sustained investment in four interconnected pillars. First, data sharing. Solving complex public sector challenges with AI depends on information flowing safely across organizational boundaries. In practice, this means making it easier for departments and agencies to reuse data that already exists. While most public sector organizations have initiatives underway, only 35 percent have rolled out or fully deployed data-sharing methods. Second, data control and sovereignty. Concerns about compliance and control are a daily reality for public sector leaders, and they are slowing AI adoption. More than half of public sector organizations are concerned about AI sovereignty, which is becoming central to safeguarding digital resilience. Compliance with data-localization laws and control over sensitive information become more complex when AI services are hosted in foreign jurisdictions. A 2024 European Commission report found that 80 percent of Europe’s digital technologies and infrastructure are imported. Third, a data-driven culture. This is a critical pillar of AI readiness. Setting clear targets, aligning strategy with operational reality, and encouraging collaboration and shared behaviors across teams helps embed data use into everyday work rather than treating it as an added burden. Fourth, data infrastructure. Robust, cloud-based data infrastructure is essential for storing, processing and analyzing data at scale, while respecting sovereignty requirements. Today, the lack of such infrastructure is the primary obstacle to effective data use. Only 41 percent of public sector executives say they can access data at the speed required for decision-making. Budget constraints are a real barrier, but they need not be paralyzing. By focusing on gradual, outcome-driven improvements rather than costly overhauls, organizations can demonstrate value and realize business outcomes. Public sector organizations such as the City of Tampere illustrate this four-pillar approach. By building data foundations gradually and strategically, while addressing data sharing, sovereignty, culture and infrastructure together, Tampere has shown how thoughtful investment can deliver tangible results without losing sight of long-term ambition. Achieving digital maturity AI can transform the public sector, but only if data readiness becomes the true measure of digital maturity. With sustained focus on governance, interoperability, culture, and infrastructure, governments can start to turn ambition into impact and deliver smarter, more trusted public services for every citizen.

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

The center-right European People’s Party is eyeing “better implementation” of the Lisbon Treaty to better prepare the EU for what it sees as historic shifts in the global balance of power involving the U.S., China and Russia, EPP leader Manfred Weber said on Saturday. Speaking at a press conference on the second day of an EPP Leaders Retreat in Zagreb, Weber highlighted the possibility of broadening the use of qualified majority voting in EU decision-making and developing a practical plan for military response if a member state is attacked. Currently EU leaders can use qualified majority voting on most legislative proposals, from energy and climate issues to research and innovation. But common foreign and security policy, EU finances and membership issues, among other areas, need a unified majority. This means that on issues such as sanctions against Russia, one country can block agreement, as happened last summer when Slovakian Prime Minister Robert Fico vetoed a package of EU measures against Moscow — a veto that was eventually lifted. Such power in one country’s hands is something that the EPP would like to change.  As for military solidarity, Article 42.7 of the Lisbon Treaty obliges countries to provide “aid and assistance by all the means in their power” if an EU country is attacked. For Weber, the formulation under European law is stronger than NATO’s Article 5 collective defense commitment. However, he stressed that the EU still lacks a clear operational plan for how the clause would work in practice. Article 42.7 was previously used when France requested that other EU countries make additional contributions to the fight against terrorism, following the Paris terrorist attacks in November 2015.  Such ideas were presented as the party with a biggest grouping in the European Parliament — and therefore the power to shape EU political priorities — presented its strategic focus for 2026, with competitiveness as its main priority.  Keeping the pulse on what matters in 2026  The EPP wants to unleash the bloc’s competitiveness through further cutting red tape, “completing” the EU single market, diversifying supply chains, protecting economic independence and security and promoting innovation including in AI, chips and biotech, among other actions, according to its list 2026 priorities unveiled on Saturday. On defense, the EPP is pushing for a “360-degree” security approach to safeguard Europe against growing geopolitical threats, “addressing state and non-state threats from all directions,” according to the document. The EPP is calling for enhanced European defense capabilities, including a stronger defense market, joint procurement of military equipment, and new strategic initiatives to boost readiness. The party also stressed the need for better protection against cyberattacks and hybrid threats, and robust measures to counter disinformation campaigns targeting EU institutions and societies. On migration and border security, the EPP backs tougher asylum admissibility rules, faster returns, and strengthened external borders, including reinforced Frontex operations and improved digital systems like the Entry/Exit System.  The party also urged a Demographic Strategy for Europe amid the continent’s shrinking and aging population. The text, initiated by Croatian Democratic Union (HDZ), member of the EPP, wants to see demographic considerations integrated into EU economic governance, cohesion funds, and policymaking, while boosting family support, intergenerational solidarity, labor participation, skills development, mobility and managed immigration.  Demographic change is “the most important issue, which is not really intensively discussed in the public discourse,” Weber said. “That’s why we want to highlight this, we want to underline the importance.” 

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.”

BRUSSELS — Climate change was responsible for an estimated 16,500 additional deaths in Europe this summer, according to a study by epidemiologists and climate scientists published Wednesday. This represents 68 percent of the 24,400 estimated heat-related deaths that happened this summer in large European cities, according to researchers from Imperial College London and the London School of Hygiene and Tropical Medicine. “These numbers represent real people who have lost their lives in the last months due to extreme heat. Many of these would not have died if it wasn’t for climate change,” said Friederike Otto, a climate science professor at the Centre for Environmental Policy at Imperial College London, who contributed to the study. Climate change has made Europe’s largest cities, on average, 2.2 degrees Celsius warmer compared to a pre-industrial world. This not only makes them hotter in general, but increases the risk of heat waves, Otto said. This summer was the third hottest on record, according to the EU’s Copernicus Climate Change Service. Extreme heat is also putting older people and those with underlying health conditions, such as heart disease and diabetes, at higher risk. People aged 65 and over accounted for 85 percent of the estimated excess heat-related deaths this summer, according to the study, highlighting how hotter summers are becoming increasingly deadly for Europe’s aging population. “An increasing heat wave temperature of just 2 to 4 degrees [Celsius] can mean the difference between life and death for thousands of people,” said Garyfallos Konstantinoudis, a lecturer at the Grantham Institute for Climate Change, who contributed to the study. “This is why heat waves are known as silent killers.” But this estimated death toll is just a snapshot, according to the researchers, as the study only focused on 854 cities with more than 50,000 people in the EU and the U.K. This represents only about 30 percent of Europe’s population. However, these deaths are “preventable” if countries continue to reduce their emissions and combat climate change, said Malcolm Mistry, assistant professor at the London School of Hygiene and Tropical Medicine, who contributed to the study. Italy and Spain were the most severely affected, with climate change contributing to an estimated 4,597 additional heat-related deaths in Italy and 2,841 in Spain. But the researchers also found that “although the excess mortality rates are lower in northern Europe, mainly because temperatures were lower, the proportion of deaths attributable to climate change is higher.”