As European health systems grapple with how to deliver increasingly advanced therapies, rare disease patients in Sweden still face everyday challenges — from securing a diagnosis to accessing appropriate care. Although rights are strong on paper, families often find themselves stitching together services across a decentralized system. Ågrenska is a national competence center in Sweden working to bridge those gaps. It supports people with rare diagnoses and their families in navigating health and social services. “But there’s a limit to what one organization can do,” says Zozan Sewger Kvist, Ågrenska’s CEO. POLITICO Studio spoke with her about where the Swedish system falls short and what must change across Europe to ensure patients are not left behind. POLITICO Studio: From Ågrenska’s experience working with families of rare disease patients across Sweden, where does the system most often break down? Zozan Sewger Kvist: For 25 years the families have been telling us the same thing: the system doesn’t connect. Zozan Sewger Kvist, CEO, Ågrenska The breakdown is most evident in health care, especially when transitioning from pediatric to adult care. But it also happens when patients are transitioning between schools, social services and medical teams. No one is looking at their care from a holistic point of view. Families become their own project managers. They are the ones booking appointments, chasing referrals, explaining the diagnosis again and again. It’s a heavy burden. That’s largely why our organization exists. We provide families with the knowledge, networks and tools to navigate the system and understand their rights. But there’s a limit to what one organization can do. In a perfect world, these functions would already be embedded within public care. > Without clear national coordination, it becomes much harder to monitor whether > families are actually receiving the support they are entitled to. PS: Access to rare disease care varies widely within many European countries and Sweden is no exception. In practical terms, what do those regional disparities look like? ZSK: Swedish families have the same rights across the country, but regional priorities differ. That leads to unequal access in practice. For example, areas with university hospitals tend to have stronger specialist networks and rehabilitation services. In more rural parts of the country, especially in the north, it is harder to attract expertise, and families feel that gap directly. In practical terms, that can mean something as basic as access to rehabilitation. In some regions, children receive coordinated physiotherapy, speech therapy and follow-up. In others, families struggle to access rehabilitation at all. And that’s a big issue because a lot of Sweden’s health care runs through rehabilitation — without it, referrals to other services and treatments can stall. PS: Would a comprehensive national rare disease strategy meaningfully change outcomes across regions? ZSK: The problem is compliance, not regulation. Sweden has strong rules but regions have almost full freedom to organize care, which makes consistency difficult. As it stands, without clear national coordination, it becomes much harder to monitor whether families are actually receiving the support they are entitled to. A national rare disease strategy would not solve everything but it would set expectations such as what the minimum level of care should look like, what coordination should include and how outcomes are followed up. A draft national strategy was developed in 2024, and there was real momentum. Patient organizations, health care experts and the government were all involved. Everyone was optimistic the framework would provide guidance and accountability. After some delays, work on the national strategy has resumed, so hopefully we will see it implemented soon. > Families often feel they need to take on a coordinating role themselves. They > describe an endless search — calling clinics, repeating their story, trying to > connect the dots. PS: Families often describe a long and fragmented path to diagnosis. Where does that journey tend to go wrong, and what would shorten it most? ZSK: Coordinated multidisciplinary teams would make the biggest difference — teams that can look at the whole condition, not just one symptom at a time. The challenge is that rare diseases often affect multiple organ systems. Several specialists may be involved, but they do not always work together, and it may not be clear who is taking responsibility for the whole case. When no one holds that overview, delays multiply. Sweden also lacks a fully integrated national health record system, so specialists may be looking at different pieces of the same case without seeing the full picture. Families often feel they need to take on a coordinating role themselves. They describe an endless search — calling clinics, repeating their story, trying to connect the dots. PS: Sweden participates in the European Reference Networks, yet you’ve suggested they’re underused. What’s missing in how Sweden leverages that expertise? ZSK: The ERNs are a strong, established framework for connecting specialists across borders. Swedish experts participate, but we are not using that structure to its full potential. Participation often appears project-based rather than long-term. Neighboring countries such as Norway, Denmark and Finland are more proactive in leveraging these collaborations. I would like to see Sweden invest more in turning these networks into durable partnerships that support clinical practice — not just research initiatives. > Rare disease care needs sustained political and financial follow-through. > Without that, families will continue to carry burdens that the system should > be managing. PS: Sweden often falls behind other EU countries in terms of access to orphan medicines (drugs that treat rare diseases). What needs to change in Sweden’s approach to ensure patients aren’t left behind? ZSK: Families are very aware of how access compares across Europe. They follow these discussions closely, and when a treatment is available in one country but not another, it is difficult for them to understand why. In Sweden, reimbursement decisions often come down to cost-effectiveness calculations. That makes access an ethical as well as an economic question. But for a family, it is hard to accept that a few additional years of life or stability are weighed against a financial threshold. Some families choose to cross borders for treatment. But that can be quite a complex, expensive process, depending on the kind of treatment. I think greater transparency and clearer communication about the criteria and long-term impact — not only the immediate cost — would make difficult outcomes easier to understand. PS: You’ve worked with families for decades. Have things materially improved — and what worries you most if reforms stall? ZSK: Unfortunately, I cannot say that things have materially improved. When I look back at the challenges families described 15 or 20 years ago, many of them are still the same. There have been some positive developments. Digital access means families are more informed and can connect more easily with others in similar situations. That has strengthened their voice. But structurally, many of the underlying gaps remain. Rare disease care needs sustained political and financial follow-through. Without that, families will continue to carry burdens that the system should be managing. Disclaimer POLITICAL ADVERTISEMENT * The sponsor is Alexion Pharmaceuticals * The entity ultimately controlling the sponsor: AstraZeneca plc * The political advertisement is linked to policy advocacy around rare disease governance, funding, and equitable access to diagnosis and treatment across Europe More information here.

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

PARIS — The United States is calling on the world’s most influential energy organization to abandon net zero emissions scenario modeling that has informed much of the global green transition, arguing the targets are unrealistic. U.S. Energy Secretary Chris Wright made the call to other energy ministers at a closed-door ministerial meeting of the International Energy Agency in Paris on Wednesday, two people who were part of the discussions told POLITICO. The comments met with a muted response from other ministers, the people said. It comes just a day after Wright publicly threatened to quit the organization unless it abandoned its focus on the energy transition— a call that several countries rejected, including the U.K., Austria and France. The International Energy Agency is a key venue for inter-governmental cooperation around climate and energy policy but has drawn criticism from the U.S. for its increasing advocacy for the green transition. Wright on Tuesday warned the U.S. would quit the IEA outright if it didn’t abandon “leftist fantasies.” At the closed-door meeting Wednesday, Wright said the agency should stop basing its modeling on assumptions that it’s possible to cut emissions to zero, arguing such targets will never be met, according to four people present. Doing away with those baseline assumptions would be a significant shift for the IEA, which has made them central to forecasts that have in turn formed the basis of global political decision-making around the green transition and underpinned billions in green energy investments. Officials familiar with the discussions said Wright’s comments were more diplomatic than his public rhetoric, casting them as an attempt to rationalize the more hardline, anti-renewables stance of U.S. President Donald Trump. Unlike Trump, Wright acknowledges the scientific basis of global warming. One said that Wright didn’t specifically mention renewables — a key source of energy in much of Europe — and instead focused on a broader criticism of the emissions target that other members might find reasonable. “He’s being diplomatic, saying it’s a fantastic organization,” said the official, granted anonymity to discuss the closed-door talks. “He very smartly divided the political from the organizational, saying, ‘Let’s leave politics out of this, let’s focus on the real world [and] stop wasting our resources on scenarios that are zero percent likely.” EUROPE SHRUGS A steady line of European energy ministers pushed back against Wright’s pressure on Wednesday, dismissing his calls to abandon the phase-out of fossil fuels and insisting they would continue building renewables. Austria’s energy secretary told POLITICO Europe would not be “blackmailed” by the U.S. on clean energy policy. “We should not [allow ourselves to be] blackmailed by him,” Austrian State Secretary for Energy Elisabeth Zehetner said in an interview with POLITICO on the sidelines of a summit of IEA member countries.  Renewables are key for growth and affordability, Zehetner argued, adding that the U.S. focus on fossil fuels at the expense of green energy went against its own interests.  “I can’t understand the argument of the U.S. — they have huge potential in renewable energy, so for one who wants to make a lot of economic deals, they reject a lot of economic chances,” she said. “Maybe it’s an ideological thing.”  U.K. Energy Secretary Ed Miliband said, “For the vast majority of countries, the clean energy transition is unstoppable.” He said the U.S. membership of the IEA was Washington’s choice, but added: “The U.S. needs to make its own decisions about whether it stays in the IEA or not. I hope they stay. But that’s their call.” EU energy chief Dan Jorgensen also defended the roll-out of renewables. “The clean energy transition is not some distant scenario. It’s the reality. Not only for Europe, but around the globe. The deployment of clean energy and technologies is accelerating because it makes clear economic sense — for growth, resilience, and long-term prosperity,” he said in a written statement Wednesday. Canada also joined in. “The United States is free to have a perspective,” Canadian Energy Minister Tim Hodgson told POLITICO. “What makes the world interesting is we have a multilateral world … I believe what the IEA is doing today is showing multiple perspectives. They show current trends.” Talks will continue on Thursday, with no outcome expected till the afternoon.

LONDON — Reform UK would scrap Britain’s planned carbon border tax if it wins power, the party’s business and trade chief Richard Tice has said.  Speaking to POLITICO on Tuesday, Tice vowed to ditch the U.K.’s new carbon border adjustment mechanism (CBAM) as part of a broader rollback of climate levies.  Reform would look “to promote oil and gas, but also scrap all these levies and green taxes, CBAM, the whole lot of it all goes,” he said.  Britain is currently drawing up its own carbon tax regime — which would charge importers of carbon-intensive goods a fee based on their carbon emissions. Ministers plan to link the regime to the EU’s equivalent scheme as part of their wider effort to reset post-Brexit trade ties — in a move designed to shield British exporters from being hit by Brussels’ carbon border tax. Business groups warn that scrapping the system could backfire.  “It is an illusion that cutting CBAM or cutting carbon prices would have a long-term benefit for U.K. competitiveness,” said Adam Berman, director of policy and advocacy at Energy UK.  The short-term consequence of scrapping the policy, he argued, would be to leave British exporters facing “a substantial new tax at the border on their exports with Europe.” In the longer term, Britain would be increasingly locked out of key markets, not just Europe, Berman said.  “Major trading blocs around the world are doing the same thing,” said Berman. “In that context, we are going to see a proliferation of CBAMs around the world. China doesn’t have one today, but you can be certain they will implement one at some point in the future.  “India doesn’t have one today, but we can be absolutely certain that it will come as soon as they have a robust domestic carbon price. They will want to protect their industrial base from unfair competition.”  TICE WARNS EU ‘CHANGE IS COMING’ Tice made clear the carbon border tax would not be the only casualty.  Reform UK has already pledged to shred Keir Starmer’s EU reset if they get into power. | Pool photo by Andy Rain via EPA “There are going to be aspects that this government is negotiating with the EU that we will unwind immediately,” he said. “There will be some significant renegotiations in a number of different areas.” Reform has already pledged to shred Keir Starmer’s EU reset if they get into power — with the EU reportedly weighing a “Farage-clause” to protect the deal from regressing.  Other than CBAM, Tice pointed to several aspects of the reset, including the agri-food deal, Erasmus participation, and the SAFE loan program for defense procurement.  “They need to understand that change is coming,” he warned. “We shouldn’t be paying vast amounts of money for SAFE, we shouldn’t be rejoining Erasmus at vast cost for no benefit to ourselves whatsoever,” he added. “We shouldn’t be dynamically aligning with any of their rules. Remember, this is an EU where, even though we’re flatlining, actually, Germany and France’s economies are in even worse shape than our own. Why would you handcuff yourself to a failing economic model?” ‘PRO-BRITISH’ PROCUREMENT PUSH Alongside the rollback of green levies, Tice signaled a more interventionist industrial strategy at home.  More details on a pro-British procurement strategy will be unveiled next week, he said, centered on a “strong presumption in favor of buying steel manufactured in the U.K.”  The proposed steel mandate would apply to infrastructure including rail, defense, housing construction and public buildings. Tice also said the new mega Chinese embassy should be built using British steel. Tice acknowledged there are limits to how far such a policy could go.  A blanket mandate to use British steel risks breaching World Trade Organization non-discrimination rules — a legal constraint that would need to be navigated.

Gavin Newsom’s message to world leaders in Munich: It’s time to start thinking about the next president. “Donald Trump is temporary,” the California governor and likely presidential candidate said during a panel about climate change Friday at the Munich Security Conference. “He’ll be gone in three years.” Newsom r has long positioned California as a durable counterweight to Trumpism, particularly on climate policies that California has expanded as the White House retreats. He carried a similar banner at an international climate conference in Brazil last year, casting California as America’s premiere climate mover in Trump’s absence. While it’s not unusual for California governors to wield the state’s economic clout to shape global climate policy, Newsom’s advocacy for the state doubles as a pitch for himself, allowing him to practice his diplomatic acumen, fortify relationships with heads of state, and sharpen his pitch for a post-Trump foreign policy. He is one of a half dozen potential Democratic presidential contenders offering a contrast to Vice President JD Vance’s scathing criticism of the continent in the same forum last year. On Friday, global leaders suggested they, too, understand a leadership change is coming, though it is unclear if the next administration will be any more sympathetic to concerns about climate change. Asked on a panel with Newsom about how to navigate the Trump administration’s rollback of climate policies, Vanuatu’s minister of climate adaptation noted other nations are already used to presidential elections shifting their relationship with the United States. “We are waiting for the U.S. to come back on board,” Minister Ralph Regenvanu said. “It happened once. I think it will happen again.”

BRUSSELS — The U.S. is reorienting its foreign funding program to export MAGA ideology to Europe — and a growing set of far-right and conservative think tanks and political groups are lining up to take Washington’s money. U.S. State Department officials have held early talks about government funding with representatives of the new MAGA-supporting French think tank Western Arc and Britain’s Free Speech Union, an advocacy group. Those approaches were informed by a list provided to U.S. officials by the Washington-based Heritage Foundation of groups the MAGA-aligned think tank described as “like-minded.” Other far-right and conservative groups in Italy and Brussels told POLITICO they would also be interested in support from a U.S. administration they see as an ally. POLITICO spoke to representatives from 10 European think tanks and policy groups, all of them aligned in some way with far-right politics. They described a burgeoning ecosystem of ideologically-aligned organizations that had rapidly professionalized in recent years and were working to build cooperation with similar groups across the Atlantic. With U.S. President Donald Trump’s second presidency giving European nationalists and hardline conservatives a champion at the head of the world’s largest economic and military power, groups on both sides of the Atlantic want to seize the moment. Their ambition is to repurpose the soft-power tools America once deployed to spread the gospel of liberalism, to expand their reach and power and ultimately rebuild the West in their image — a project both sides call a “civilizational alliance.” FRENCH CONNECTION Nicolas Conquer, a former media director for Republicans Overseas France, launched Western Arc, a self-described “MAGA-inspired” think tank in Paris in December. Conquer, a French-American citizen, said he had discussed specific projects that could receive funding with several U.S. State Department officials. Western Arc pledges to connect “ideas, people and projects” across the Atlantic to “organize western civilizational renewal.” Its mission statement aligns closely with language from the U.S. National Security Strategy, released earlier that month, as well as a prior essay from Samuel Samson, a senior adviser for the U.S. State Department. Conquer said he had been in touch with Samson and others in the U.S. State Department in the past few months and was exploring ideas for projects of mutual interest, such as stakeholder mapping or transatlantic trips for targeted groups, including around the 250th anniversary celebrations of U.S. independence this July. “There is this logic, which I think is very healthy, of project-based funding,” Conquer said.  The U.S. State Department did not answer a detailed list of questions. But in response to a query about U.S. funding of European organizations, a spokesperson said: “This is a transparent, lawful use of resources to advance U.S. interests and values abroad.”  Samson made headlines last year for proposing the use of American taxpayer funds to support far-right leader Marine Le Pen. He traveled to European capitals last May to meet with NGOs and civil society groups. U.S. State Department officials approached The Heritage Foundation in the second half of last year to ask which organizations in Europe would be viable targets for funding, said Heritage Foundation Senior Research Fellow Paul McCarthy. Throughout the postwar era the U.S. has supported projects that promoted democratic ideals and American-style liberalism. | Andrew Harnik/Getty Images “We’ve suggested some institutions, just a few names of organizations back in the late summer, early fall. And maybe that formed the basis of it,” he said.  The amount of money discussed at that time was “tiny.” That was before the U.S. National Security Strategy laid out a policy of “cultivating resistance” in Europe and boosting organizations that stood against left wing “censorship” and migration policies that it said were “transforming the continent and creating strife.” “Once they got the imprimatur in the national strategy, it’s really taking off right now,” said McCarthy, while stressing he had no inside knowledge of the State Department’s latest plans. Last week the FT reported that U.S. Under Secretary of State Sarah Rogers was pushing a funding program for think tanks and institutes, with a focus on London, Brussels, Paris and Berlin. In December she met with Toby Young, a British social commentator and founder of the Free Speech Union.  “We’ve discussed the possibility of the State Department funding some of the FSU’s sister organisations in other parts of the world, but not the organisation I run,” Young said. He would not be drawn on which organizations he meant, but the British Free Speech Union is affiliated with similar bodies in Australia, Canada, South Africa and New Zealand, indicating the U.S. State Department’s plans may not be confined to Europe. AMERICAN TRADITION U.S. government funding for European institutions is not a new phenomenon: Throughout the postwar era the U.S. has supported projects that promoted democratic ideals and American-style liberalism. Since the 1950s, Radio Free Europe floated the sounds of capitalist freedom into Eastern Europe, all on the U.S. taxpayer dime. This, along with U.S. philanthropic funding, helped many think tanks and other organizations grounded in mainstream liberal values flourish in Europe. Many became highly-networked policy shops that acted as a pseudo civil service, crafting reports and laws that could be transposed into ministerial proclamations. The right has taken note of that playbook. “There was a time when the right were incredibly unprofessional, unconnected, and so concerned with their own national concerns that it’s very difficult for them to see beyond that,” said John O’Brien, head of communications at MCC Brussels, a think tank funded by a private educational institute in Hungary with close ties to the government of Trump ally Viktor Orbán. That has rapidly changed, O’Brien said. Though unlike many networks of progressive institutions, the right has yet to set up a WhatsApp group for collaboration — “If there is, we’re not part of it,” said O’Brien — right-wing operatives and thinkers meet regularly at major events, like the CPAC and NatCon summit series.  They also invite one another to co-host meetings or attend events as panelists. From the U.S. side, The Heritage Foundation, which authored Trump’s Project 2025 blueprint for government, is a frequent guest of the European right.  On Tuesday, The Heritage Foundation’s McCarthy appeared on a panel in Rome co-hosted with the Fondazione Machiavelli. McCarthy said The Heritage Foundation was fostering ties with groups in Europe through joint summit hosting and research. Their aim is to push back against “European federalism” and the “green transition madness” while fostering a vision for families that excludes gay couples, trans rights and promotes higher birth rates.  U.S. government funding for European institutions is not a new phenomenon: Throughout the postwar era the U.S. has supported projects that promoted democratic ideals and American-style liberalism. | Saul Loeb/AFP via Getty Images Collaboration among such groups is “growing,” said Fondazione Machiavelli President Scalea. On its website, the center advertises formal partnerships or signed memoranda with a series of other right-wings groups: The Heritage Foundation, the Jerusalem Institute for Strategy and Security, Hungary’s Oeconomus Economic Research Foundation, and the Center for Fundamental Rights, which organizes CPAC. “But it’s most like a friendship,” he said. “Since we have common missions, we have shared values and shared views of the future … We’re not formally intertwined, we have no institutional bond and link, we are not exchanging money or resources … We are just working together because this is making it more effective for everyone else.” Scalea added that his institute had a “lot of commonality with the Trump administration.” So far he hasn’t heard directly from the U.S. government about funding being made available to organizations like his, but he said he would look at any funding proposal. “We will see. But for now, we do not have any concrete opportunity or thing to look at.” ‘EUROPEAN INDEPENDENCE’ This year, Trump has poured accelerant on existing tensions between Europe and the U.S. by pressuring Denmark to cede control of Greenland, the world’s largest island. That left many right-wing groups walking a narrow line between standing up for European sovereignty and maintaining their ideological alliance with the White House. But calls for “European independence” by leaders such as European Commission President Ursula von der Leyen have presented right-wingers with an opportunity to frame themselves as the true defenders of the Western alliance. “It’s quite important, especially in this moment, to maintain a unity inside the Western world,” said Francesco Giubilei, president of Nazione Futura, another Italian think tank that has partnered with The Heritage Foundation. “It’s not easy. We understand that sometimes the position of Trump is different from the position of Europe. But we think that if in this moment, we create a split between the United States and Europe, we are doing a favor for China, we are doing a favor for Russia.”  Some of the organizations POLITICO contacted said they weren’t interested in funding from a foreign government. But where European laws prevent direct foreign funding of political parties, some are finding other means of collaboration. Gerald Otten, a lawmaker with the far-right Alternative for Germany (AfD) party, traveled to Washington in January as part of a delegation from the German Bundestag. Prior to his visit he had been invited by the U.S. embassy to discuss possible joint work. AfD officials are planning to travel to the U.S. for an event in March billed as a “counter Davos” by Republican member of Congress Anna Paulina Luna. Markus Frohnmaier, a leading AfD foreign policy lawmaker and trustee of co-chair Alice Weidel, will meet Rogers on the sidelines of the Munich Security Conference this week. Scalea, of the Fondazione Machiavelli, said having Trump in the White House gave groups in Europe a sense they were no longer on the fringes.  “We have an ally, a powerful voice,” he said. “It’s not just a conspiracy theory that we are saying mass migration is making us weaker as a nation, but it’s something that is said also by the leader of our alliance. This is obviously useful for us.”

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.

Second Amendment advocates are warning that Republicans shouldn’t count on them to show up in November, after President Donald Trump insisted that demonstrator Alex Pretti “should not have been carrying a gun.” The White House labels itself the “most pro-Second Amendment administration in history.” But Trump’s comments about Pretti, who was legally carrying a licensed firearm when he was killed by federal agents last week, have some gun rights advocates threatening to sit out the midterms. “I’ve spent 72 hours on the phone trying to unfuck this thing. Trump has got to correct his statements now,” said one Second Amendment advocate, granted anonymity to speak about private conservations. The person said Second Amendment advocates are “furious.” “And they will not come out and vote. He can’t correct it three months before the election.” The response to Pretti’s killing isn’t the first time Second Amendment advocates have felt abandoned by Trump. The powerful lobbying and advocacy groups, that for decades reliably struck fear into the hearts of Republicans, have clashed multiple times with Trump during his first year back in power. And their ire comes at a delicate moment for the GOP. While Democrats are unlikely to pick up support from gun-rights groups, the repeated criticisms from organizations such as the National Association for Gun Rights suggest that the Trump administration may be alienating a core constituency it needs to turn out as it seeks to retain its slim majority in the House and Senate. It doesn’t take much to swing an election, said Dudley Brown, president of the National Association for Gun Rights. “All you have to do is lose four, five, six percent of their base who left it blank, who didn’t write a check, who didn’t walk districts, you lose,” he said. “Especially marginal districts — and the House is not a good situation right now.” And it wasn’t only the president who angered gun-rights advocates. Others in the administration made similar remarks about Pretti, denouncing the idea of carrying a gun into a charged environment such as a protest. FBI Director Kash Patel said “you cannot bring a firearm, loaded, with multiple magazines to any sort of protest that you want,” and DHS Secretary Kristi Noem said she didn’t “know of any peaceful protester that shows up with a gun and ammunition rather than a sign.” These sentiments are anathema to many Republicans who have fought for years against the idea that carrying a gun or multiple magazine clips implies guilt or an intent to commit a crime. “I sent a message to high-place people in the administration with three letters, W.T.F.,” Brown said. “If it had just been the FBI director and a few other highly-placed administration officials, that would have been one thing but when the president came out and doubled down that was a whole new level. This was not a good look for your base. You can’t be a conservative and not be radically pro-gun.” A senior administration official brushed off concerns about Republicans losing voters in the midterms over the outrage. “No, I don’t think that some of the comments that were made over the past 96 hours by certain administration officials are going to impede the unbelievable and strong relationship the administration has with the Second Amendment community, both on a personal level and given the historic successes that President Trump has been able to deliver for gun rights,” the official said. But this wasn’t the only instance when the Trump administration angered gun-rights advocates. In September after the shooting at a Catholic church in Minneapolis that killed two children, reports surfaced that the Department of Justice was looking into restricting transgender Americans from owning firearms. The suspect, who died from a self-inflicted gunshot wound at the scene of the shooting, was a 23-year-old transgender woman. “The signaling out of a specific demographic for a total ban on firearms possession needs to comport with the Constitution and its bounds and anything that exceeds the bounds of the Constitution is simply impermissible,” Adam Kraut, executive director of the Second Amendment Foundation, told POLITICO. At the time, the National Rifle Association, which endorsed Trump in three consecutive elections, said they don’t support any proposals to “arbitrarily strip law-abiding citizens of their Second Amendment rights without due process.” Additionally, some activists, who spoke to the gun-focused independent publication “The Reload,” said they were upset about the focus from federal law enforcement about seizing firearms during the Washington crime crackdown in the summer. U.S. Attorney Jeanine Pirro said her office wouldn’t pursue felony charges in Washington over carrying guns, The Washington Post reported. Trump, during his first term, infuriated some in the pro-gun movement when in 2018 his administration issued a regulation to ban bump stocks. The Supreme Court ultimately blocked the rule in 2024. “I think the administration clearly wants to be known as pro-Second Amendment, and many of the officials do believe in the Second Amendment, but my job at Gun Owners of America is to hold them to their words and to get them to act on their promises. And right now it’s a mixed record,” said Gun Owners for America director of federal affairs Aidan Johnston. In the immediate aftermath of the Pretti shooting, the NRA called for a full investigation rather than for “making generalizations and demonizing law-abiding citizens.” But now, the lobbying group is defending Trump’s fuller record. “Rather than trying to extract meaning from every off-the-cuff remark, we look at what the administration is doing, and the Trump administration is, and has been, the most pro-2A administration in modern history,” said John Commerford, NRA Institute for Legislative Action executive director. “From signing marquee legislation that dropped unconstitutional taxes on certain firearms and suppressors to joining pro-2A plaintiffs in cases around the country, the Trump administration is taking action to support the right of every American to keep and bear arms.” In his first month in office, Trump directed the Department of Justice to examine all regulations, guidance, plans and executive actions from President Joe Biden’s administration that may infringe on Second Amendment rights. The administration in December created a civil rights division office of Second Amendment rights at DOJ to work on gun issues. That work, said a second senior White House official granted anonymity to discuss internal thinking, should prove the administration’s bona fides and nothing said in the last week means they’ve changed their stance on the Second Amendment. “Gun groups know and gun owners know that there hasn’t been a bigger defender of the Second Amendment than the president,” said a second senior White House official, who spoke on the condition of anonymity to speak on a sensitive issue. “But I think the president’s talking about in the moment— in that very specific moment— when it is such a powder keg going on, and when there’s someone who’s actively impeding enforcement operations, things are going to happen. Or things can happen.” Andrew Howard contributed to this report.

Vice President JD Vance on Friday said the United States will stop funding any organization working on diversity and transgender issues abroad. Vance called the policy, which has been widely expected, “a historic expansion of the Mexico City Policy,” which prevents foreign groups receiving U.S. global health funding from providing or promoting abortion, even if those programs are paid for with other sources of financing. President Donald Trump reinstated the Mexico City Policy last year, following a tradition for Republican presidents that Ronald Reagan started in 1984. Democratic presidents have repeatedly rescinded the policy. “Now we’re expanding this policy to protect life, to combat [diversity, equity and inclusion] and the radical gender ideologies that prey on our children,” Vance told people attending the March for Life in Washington, an annual gathering of anti-abortion activists on the National Mall. The rule covers non-military U.S. foreign assistance, making the Mexico City Policy “about three times as big as it was before, and we’re proud of it because we believe in fighting for life,” Vance said. That means that any organizations receiving U.S. non-military funding will not be able to work on abortion, DEI and issues related to transgender people, even if that work is done with other funding sources. POLITICO reported in October that the Trump administration was developing the policy. The State Department made the rule change Friday afternoon. Vance accused the Biden administration of “exporting abortion and radical gender ideology all around the world.” The Trump administration has used that argument to massively reduce foreign aid since it took office a year ago. Vance said the Trump administration believes that every country in the world has the duty to protect life. “It’s our job to promote families and human flourishing,” he said, adding that the administration “turned off the tap for NGOs whose sole purpose is to dissuade people from having kids.” Chris Smith, a New Jersey Republican who chairs the House Foreign Affairs Africa Subcommittee, called the new aid restrictions “the best and most comprehensive iteration” of the Mexico City Policy since Reagan. Smith, who opposes abortion, was also speaking at the March for Life. But domestic and international groups deplored the expanded policy, noting that it would make women and girls in some parts of the world more vulnerable. “History shows that the Mexico City policy not only diminishes access to essential services for women and girls, but also breaks down networks of organizations working on women’s rights, and silences civil society,” the International Crisis Group, which works to prevent conflicts, said in a statement. “This expansion will amplify those effects and is set to compound the global regression on gender equality that we have seen accelerate in the last year,” the group added. The expanded Mexico City Policy, which international groups have called the ‘global gag rule’ because of the restrictions it imposes, will limit how humanitarian groups and other organizations “can engage in advocacy, information dissemination and education related to reducing maternal mortality, sexual and reproductive health, and reducing stigma and inequalities anywhere in the world, with any funding they receive,” said Defend Public Health, a network of volunteers fighting against the Trump administration’s health policies. “This would effectively coerce them into denying that transgender, nonbinary, and intersex people exist,” the group said. Alice Miranda Ollstein contributed to this report.