As trilogue discussions on the Critical Medicines Act (CMA) approach, its potential effects on medicine supply, patient access and Europe’s competitiveness are increasingly in focus. From an industry standpoint, several considerations are central to understanding how this act can best achieve its objectives and support a robust pharmaceutical ecosystem in Europe.  Keeping the CMA focused where it matters  Much of the debate around the CMA has centered on its promises to strengthen the availability and security of supply of critical medicines in the EU while improving accessibility to other medicines. These are goals that our industry fully supports.   The European Commission’s proposal is designed to focus on critical medicines, with a vulnerability assessment foreseen to identify which products are truly at risk of disruption and tailor solutions accordingly. Alongside critical medicines, the proposal also introduces a new definition of ‘medicinal products of common interest’. Under current wording, this would include any medicine unavailable in at least three member states, regardless of the underlying reason.   Such a broad definition risks turning a targeted framework for resilience into an all-encompassing mechanism covering almost every medicine on the market, blurring the distinction between supply and access challenges. These are fundamentally different issues that require fundamentally different policy tools.   > Applying the CMA’s tools across the entire medicines market would dilute > priorities, stretch healthcare budgets and create administrative burdens for > industry without delivering real benefits for patients.   The act will be far more effective if it remains focused on where the risks are greatest — in other words, by limiting the ‘medicinal products of common interest’ definition to cases of demonstrable market failure and directing measures toward genuinely critical medicines with a proven risk of supply disruption.  Fixing supply and access hurdles needs more than joint procurement   The CMA places joint procurement at the center of its strategy to address both supply and access challenges. While this approach can contribute to improving availability in certain circumstances, joint procurement will only deliver lasting results if it is designed to address the underlying causes of access delays and shortages, which vary across geographies and products.  For medicines where the main challenge lies in fragile supply chains, joint procurement can play a role, particularly when it enhances predictability and economic viability for suppliers. Experience from the Covid-19 pandemic has shown that coordinated purchasing can be effective in targeted situations. For medicines facing access delays, joint procurement could help improve availability in countries where genuine market failures exist. However, the value of joint procurement for countries where products are already available, or where access barriers can be better addressed by improving national pricing and reimbursement systems, is very questionable.  To ensure that joint procurement does not hinder access, several safeguards are essential. Tenders should reward quality and promote innovation, recognizing the value that innovative medicines bring to patients and society. Price confidentiality must be protected to prevent unintended spillovers, such as reference pricing effects. Once joint procurement agreements are concluded, to ensure commercial and supply predictability there should be no additional national renegotiations or expenditure control measures. Finally, allowing national procurement processes to run in parallel will be key to avoid delays and maintain flexibility.  Beyond these design safeguards, real progress will depend on tackling the broader root causes of shortages and access delays. For supply fragility, this means, among other actions, reducing strategic dependencies where necessary, improving transparency across supply chains and avoiding rigid national stockpiling rules. For access delays, progress will require addressing national pricing and reimbursement challenges, and a greater willingness from governments to reward the value that innovative medicines deliver.  Protectionism won’t make Europe stronger  Few elements of the CMA debate have attracted as much attention as the idea of prioritizing EU-made medicines. The rationale is straightforward: producing more within Europe is expected to reduce reliance on third countries, reinforce strategic autonomy and, ultimately, improve supply security. While this narrative is understandable, taking it at face value risks overlooking the realities of how medicines are manufactured and supplied today.  Europe already has one of the world’s strongest pharmaceutical manufacturing footprints and, unlike some other pharma manufacturing regions, Europe exports 71 percent of its pharmaceutical production. This output depends on global supply networks for active substances, raw materials and specialized technologies. Introducing local-content requirements or preferential treatment for EU-made products would disrupt those networks, fragment supply chains and drive up costs, with limited evidence that such measures would enhance resilience. Local-content requirements could also affect Europe’s trade relationships and weaken, rather than strengthen, its industrial base in the long term, while distorting competition within the single market and undermining the competitiveness of both European and international companies operating in Europe. The likely outcome would be less diversity and greater concentration in supply chains: the opposite of what a resilient system requires.  If procurement criteria referencing resilience or strategic autonomy are used, they should be proportionate and tied to clearly demonstrated dependencies or supply risks. Protectionist approaches, however well-intentioned, cannot substitute for the broader policy environment needed to keep Europe attractive for investment in research and development and manufacturing. A competitive European ecosystem depends first and foremost on predictable intellectual-property rules, timely regulatory processes, access to capital, and a strong scientific and technical skills base.  The EU institutions still have time to steer the CMA on course  The CMA offers a real chance to get things right. The European Parliament’s proposal for more consistent contingency stock rules could help if it stays focused on medicines genuinely at risk of shortage. The act can also make reporting more efficient by using existing systems rather than creating new ones. Policymakers should also be aware that wider regulatory initiatives directly affect Europe’s ability to manufacture and supply medicines. A more coherent policy framework will be essential to strengthen resilience.  Europe’s goal must be to build an environment where pharmaceutical innovation and production can thrive. Europe’s choice is clear: supply security cannot be achieved by weakening the industry that ensures it. The CMA will only work if it tackles the right problems with the right tools and keeps competitiveness at its core.   > Europe’s goal must be to build an environment where pharmaceutical innovation > and production can thrive. Our industry remains ready to engage with EU and national policymakers to make that happen. A high-level forum on the CMA involving all stakeholders could help guide the act’s implementation in a way that improves supply security and speeds up access for patients, while reinforcing Europe’s position as a global player in life sciences.  Disclaimer POLITICAL ADVERTISEMENT * The sponsor is European Federation of Pharmaceutical Industries and Associations (EFPIA) * The political advertisement is linked to the Critical Medicines Act More information here.

Sanna Marin is a Tony Blair Institute’s strategic counselor. She’s the former prime minister of Finland. As the world’s leaders gather in Rome for this year’s Ukraine Recovery Conference, there is no illusion as to what’s at stake. Ending Russia’s war of aggression remains Ukraine’s overriding priority. But the truth is, even that won’t secure lasting stability. True recovery will demand more than reconstruction funds or military deterrence. It will require deep, sustained investment in the systems that underpin a strong sovereign state. One of the most vital — and most overlooked — of those systems is Ukraine’s own people. Too often, the conversation surrounding Ukraine’s workforce begins and ends with refugee return. But recovery cannot be deferred until people come home. Nor can it depend entirely on external support. Ukraine’s greatest untapped asset is already within its borders: millions of citizens ready to work, retrain and rebuild, if allowed the opportunity. This isn’t a soft-side issue — it’s a strategic imperative. And new research from the Tony Blair Institute shows that taking bold action now could expand Ukraine’s workforce by 25 percent, even while war continues. There are more than 3 million people inside Ukraine today who, with the right policies and support, could be brought into the workforce. Unlocking this potential isn’t just the most realistic way to stimulate economic growth and power Ukraine’s recovery, it’s also the smartest and fastest way to build long-term resilience in the face of ongoing war. This isn’t about abstractions. It’s about mothers who can’t find childcare; displaced people struggling to rebuild their lives after being forced to flee; job seekers struggling to find work that matches their skills and offers the stability that formal employment should provide. It’s also about veterans and individuals with disabilities who are ready to contribute but often encounter barriers due to limited workplace accommodation. Ukraine’s workforce is motivated, but it’s constrained by systems that haven’t kept up. Today, 83 percent of Ukrainians with disabilities are out of work. Women face a 15-point participation gap compared to men. And over one-third of internally displaced people are unemployed. Meanwhile, 40 percent of businesses say they can’t find the skilled talent they need. This mismatch is more than a missed opportunity — it’s a risk to Ukraine’s recovery and long-term sovereignty. Ukraine’s greatest untapped asset is already within its borders: millions of citizens ready to work, retrain and rebuild, if allowed the opportunity. | Sergey Kozlov/EPA The good news is, Ukraine has the tools to change this, and the country has momentum on its side: billions in donor support, a nearly finalized new labor code and real political will. It has digital infrastructure that’s the envy of governments across Europe. It also has a population ready to adapt, with almost 40 percent of Ukraine’s unemployed saying they’re willing to retrain and a quarter of them willing relocate for the right job. That’s an extraordinary national resource. And Ukraine’s partners can help turn this potential into progress by acting on four fronts: First, bring Ukraine’s job market into the 21st century. The country is already a world leader in digital ID. It has ambitious plans to build platforms that would match workers with jobs and training opportunities — especially in regions where the disconnect between supply and demand is stark. It needs international funding and expertise to do this.  Second, put employers in the driver’s seat by tying every reskilling program to a real job opportunity. Even though there are hundreds of available courses, many teach skills that businesses don’t need, or they target workers who already have jobs instead of those seeking work. Reskilling support should be contingent upon employers co-designing curriculums and committing to hire successful graduates. Third, finalize the new labor code. The current one dates back to 1971. Reform is essential — not just for EU accession but for unlocking flexibility, formality and fairness in the workplace. Technical assistance and public advocacy from international partners can help here. Finally, break down the systemic barriers to participation. This means scaling up access to childcare, improving workplace accessibility for those with disabilities and supporting underrepresented groups, from women and young people to the elderly and displaced. These changes are morally right, economically vital and should align with donor priorities. I’m proud to join that conversation, and urge us all to keep people — not just infrastructure — at the heart of recovery. Of course, the return of refugees will be critical to Ukraine’s long-term recovery. But with only half of them currently planning on returning, and most of them uncertain exactly when, this cannot be the cornerstone of today’s strategy. Ukraine cannot afford to wait. The focus must be on unlocking the potential of those already inside the country’s borders. And that starts with modernizing the job market, removing the barriers that prevent people from working, and investing in the skills that will power Ukraine’s reconstruction from the ground up. Recovery doesn’t begin with return, it begins with reform. Ukraine has already proven its courage. Now its people can build a workforce ready to win the peace. But the country needs partners to expedite this task and help its people scale with what they have. With the right investment, Ukrainians won’t just rebuild — they’ll lead.