LONDON — Reza Pahlavi was in the United States as a student in 1979 when his father, the last shah of Iran, was toppled in a revolution. He has not set foot inside Iran since, though his monarchist supporters have never stopped believing that one day their “crown prince” will return.  As anti-regime demonstrations fill the streets of more than 100 towns and cities across the country of 90 million people, despite an internet blackout and an increasingly brutal crackdown, that day may just be nearing.   Pahlavi’s name is on the lips of many protesters, who chant that they want the “shah” back. Even his critics — and there are plenty who oppose a return of the monarchy — now concede that Pahlavi may prove to be the only figure with the profile required to oversee a transition.  The global implications of the end of the Islamic Republic and its replacement with a pro-Western democratic government would be profound, touching everything from the Gaza crisis to the wars in Ukraine and Yemen, to the oil market.  Over the course of three interviews in the past 12 months in London, Paris and online, Pahlavi told POLITICO how Iran’s Supreme Leader Ayatollah Ali Khamenei could be overthrown. He set out the steps needed to end half a century of religious dictatorship and outlined his own proposal to lead a transition to secular democracy. Nothing is guaranteed, and even Pahlavi’s team cannot be sure that this current wave of protests will take down the regime, never mind bring him to power. But if it does, the following is an account of Pahlavi’s roadmap for revolution and his blueprint for a democratic future.  POPULAR UPRISING  Pahlavi argues that change needs to be driven from inside Iran, and in his interview with POLITICO last February he made it clear he wanted foreign powers to focus on supporting Iranians to move against their rulers rather than intervening militarily from the outside.  “People are already on the streets with no help. The economic situation is to a point where our currency devaluation, salaries can’t be paid, people can’t even afford a kilo of potatoes, never mind meat,” he said. “We need more and more sustained protests.” Over the past two weeks, the spiraling cost of living and economic mismanagement have indeed helped fuel the protest wave. The biggest rallies in years have filled the streets, despite attempts by the authorities to intimidate opponents through violence and by cutting off communications. Pahlavi has sought to encourage foreign financial support for workers who will disrupt the state by going on strike. He also called for more Starlink internet terminals to be shipped into Iran, in defiance of a ban, to make it harder for the regime to stop dissidents from communicating and coordinating their opposition. Amid the latest internet shutdowns, Starlink has provided the opposition movements with a vital lifeline. As the protests gathered pace last week, Pahlavi stepped up his own stream of social media posts and videos, which gain many millions of views, encouraging people onto the streets. He started by calling for demonstrations to begin at 8 p.m. local time, then urged protesters to start earlier and occupy city centers for longer. His supporters say these appeals are helping steer the protest movement. Reza Pahlavi argues that change needs to be driven from inside Iran. | Salvatore Di Nolfi/EPA The security forces have brutally crushed many of these gatherings. The Norway-based Iranian Human Rights group puts the number of dead at 648, while estimating that more than 10,000 people have been arrested. It’s almost impossible to know how widely Pahlavi’s message is permeating nationwide, but footage inside Iran suggests the exiled prince’s words are gaining some traction with demonstrators, with increasing images of the pre-revolutionary Lion and Sun flag appearing at protests, and crowds chanting “javid shah” — the eternal shah. DEFECTORS Understandably, given his family history, Pahlavi has made a study of revolutions and draws on the collapse of the Soviet Union to understand how the Islamic Republic can be overthrown. In Romania and Czechoslovakia, he said, what was required to end Communism was ultimately “maximum defections” among people inside the ruling elites, military and security services who did not want to “go down with the sinking ship.”  “I don’t think there will ever be a successful civil disobedience movement without the tacit collaboration or non-intervention of the military,” he said during an interview last February.  There are multiple layers to Iran’s machinery of repression, including the hated Basij militia, but the most powerful and feared part of its security apparatus is the Islamic Revolutionary Guard Corps. Pahlavi argued that top IRGC commanders who are “lining their pockets” — and would remain loyal to Khamenei — did not represent the bulk of the organization’s operatives, many of whom “can’t pay rent and have to take a second job at the end of their shift.”  “They’re ultimately at some point contemplating their children are in the streets protesting … and resisting the regime. And it’s their children they’re called on to shoot. How long is that tenable?” Pahlavi’s offer to those defecting is that they will be granted an amnesty once the regime has fallen. He argues that most of the people currently working in the government and military will need to remain in their roles to provide stability once Khamenei has been thrown out, in order to avoid hollowing out the administration and creating a vacuum — as happened after the 2003 U.S.-led invasion of Iraq.  Only the hardline officials at the top of the regime in Tehran should expect to face punishment.  In June, Pahlavi announced he and his team were setting up a secure portal for defectors to register their support for overthrowing the regime, offering an amnesty to those who sign up and help support a popular uprising. By July, he told POLITICO, 50,000 apparent regime defectors had used the system.  His team are now wary of making claims regarding the total number of defectors, beyond saying “tens of thousands” have registered. These have to be verified, and any regime trolls or spies rooted out. But Pahlavi’s allies say a large number of new defectors made contact via the portal as the protests gathered pace in recent days.  REGIME CHANGE In his conversations with POLITICO last year, Pahlavi insisted he didn’t want the United States or Israel to get involved directly and drive out the supreme leader and his lieutenants. He always said the regime would be destroyed by a combination of fracturing from within and pressure from popular unrest.  He’s also been critical of the reluctance of European governments to challenge the regime and of their preference to continue diplomatic efforts, which he has described as appeasement. European powers, especially France, Germany and the U.K., have historically had a significant role in managing the West’s relations with Iran, notably in designing the 2015 nuclear deal that sought to limit Tehran’s uranium enrichment program.  But Pahlavi’s allies want more support and vocal condemnation from Europe. U.S. President Donald Trump pulled out of the nuclear deal in his first term and wasted little time on diplomacy in his second. He ordered American military strikes on Iran’s nuclear facilities last year, as part of Israel’s 12-day war, action that many analysts and Pahlavi’s team agree leaves the clerical elite and its vast security apparatus weaker than ever.  U.S. President Donald Trump pulled out of the nuclear deal in his first term and wasted little time on diplomacy in his second. | Pool photo by Bonnie Cash via EPA Pahlavi remains in close contact with members of the Trump administration, as well as other governments including in Germany, France and the U.K. He has met U.S. Secretary of State Marco Rubio several times and said he regards him as “the most astute and understanding” holder of that office when it comes to Iran since the 1979 revolution.  In recent days Trump has escalated his threats to intervene, including potentially through more military action if Iran’s rulers continue their crackdown and kill large numbers of protesters.  On the weekend Pahlavi urged Trump to follow through. “Mr President,” he posted on X Sunday. “Your words of solidarity have given Iranians the strength to fight for freedom,” he said. “Help them liberate themselves and Make Iran Great Again!” THE CARETAKER KING  In June Pahlavi announced he was ready to replace Khamenei’s administration to lead the transition from authoritarianism to democracy.   “Once the regime collapses, we have to have a transitional government as quickly as possible,” he told POLITICO last year. He proposed that a constitutional conference should be held among Iranian representatives to devise a new settlement, to be ratified by the people in a referendum.  The day after that referendum is held, he told POLITICO in February, “that’s the end of my mission in life.”  Asked if he wanted to see a monarchy restored, he said in June: “Democratic options should be on the table. I’m not going to be the one to decide that. My role however is to make sure that no voice is left behind. That all opinions should have the chance to argue their case — it doesn’t matter if they are republicans or monarchists, it doesn’t matter if they’re on the left of center or the right.”  One option he hasn’t apparently excluded might be to restore a permanent monarchy, with a democratically elected government serving in his name.  Pahlavi says he has three clear principles for establishing a new democracy: protecting Iran’s territorial integrity; a secular democratic system that separates religion from the government; and “every principle of human rights incorporated into our laws.” He confirmed to POLITICO that this would include equality and protection against discrimination for all citizens, regardless of their sexual or religious orientation.  COME-BACK CAPITALISM  Over the past year, Pahlavi has been touring Western capitals meeting politicians as well as senior business figures and investors from the world of banking and finance. Iran is a major OPEC oil producer and has the second biggest reserves of natural gas in the world, “which could supply Europe for a long time to come,” he said.  “Iran is the most untapped reserve for foreign investment,” Pahlavi said in February. “If Silicon Valley was to commit for a $100 billion investment, you could imagine what sort of impact that could have. The sky is the limit.”  What he wants to bring about, he says, is a “democratic culture” — even more than any specific laws that stipulate forms of democratic government. He pointed to Iran’s past under the Pahlavi monarchy, saying his grandfather remains a respected figure as a modernizer.  “If it becomes an issue of the family, my grandfather today is the most revered political figure in the architect of modern Iran,” he said in February. “Every chant of the streets of ‘god bless his soul.’ These are the actual slogans people chant on the street as they enter or exit a soccer stadium. Why? Because the intent was patriotic, helping Iran come out of the dark ages. There was no aspect of secular modern institutions from a postal system to a modern army to education which was in the hands of the clerics.”   Pahlavi’s father, the shah, brought in an era of industrialization and economic improvement alongside greater freedom for women, he said. “This is where the Gen Z of Iran is,” he said. “Regardless of whether I play a direct role or not, Iranians are coming out of the tunnel.”  Conversely, many Iranians still associate his father’s regime with out-of-touch elites and the notorious Savak secret police, whose brutality helped fuel the 1979 revolution. NOT SO FAST  Nobody can be sure what happens next in Iran. It may still come down to Trump and perhaps Israel.  Anti-regime demonstrations fill the streets of more than 100 towns and cities across the country of 90 million people. | Neil Hall/EPA Plenty of experts don’t believe the regime is finished, though it is clearly weakened. Even if the protests do result in change, many say it seems more likely that the regime will use a mixture of fear tactics and adaptation to protect itself rather than collapse or be toppled completely.  While reports suggest young people have led the protests and appear to have grown in confidence, recent days have seen a more ferocious regime response, with accounts of hospitals being overwhelmed with shooting victims. The demonstrations could still be snuffed out by a regime with a capacity for violence.  The Iranian opposition remains hugely fragmented, with many leading activists in prison. The substantial diaspora has struggled to find a unity of voice, though Pahlavi tried last year to bring more people on board with his own movement.  Sanam Vakil, an Iran specialist at the Chatham House think tank in London, said Iran should do better than reviving a “failed” monarchy. She added she was unsure how wide Pahlavi’s support really was inside the country. Independent, reliable polling is hard to find and memories of the darker side of the shah’s era run deep. But the exiled prince’s advantage now may be that there is no better option to oversee the collapse of the clerics and map out what comes next. “Pahlavi has name recognition and there is no other clear individual to turn to,” Vakil said. “People are willing to listen to his comments calling on them to go out in the streets.”

KYIV — The Russian army attacked Ukraine with more than 90 killer drones in the early hours of Thursday morning, causing complete blackouts in the key industrial regions of Dnipro and Zaporizhzhia, Kyiv’s energy ministry reported. “While energy workers managed to restore power in the Zaporizhzhia region in the morning, some 800,000 households in the nearby Dnipro region were still without electricity and heating on Thursday morning,” Artem Nekrasov, acting energy minister of Ukraine, said during a morning briefing. In Dnipro, eight coal mines stopped working because of a power outage. All the miners were safely evacuated to the surface, Nekrasov added. Power outages were also reported in Chernihiv, Kyiv, Ivano-Frankivsk, Poltava and other regions. Freezing weather is coming to Ukraine over the next three days, with temperatures forecast to drop to minus 20° C during the night, when Russia often launches massive missile and drone attacks. Precipitation and cold could cause additional electricity supply disruptions due to snow accumulating on power lines, Ukrainian Prime Minister Yulia Svyrydenko said Wednesday evening. “Ukraine’s energy system is under enemy attack every day, and energy workers work in extremely difficult conditions to provide people with light and heat. Deteriorating weather conditions create additional stress on critical infrastructure. We are working to minimize the consequences of bad weather,” Svyrydenko added. Local governors in the eastern regions of Zaporizhzhia and Dnipro reported that hospitals and other critical infrastructure had to turn to emergency power supplies because of the latest Russian attack. President Volodymyr Zelenskyy thanked Ukrainian energy workers for the speedy power restoration in Zaporizhzhia, and used the opportunity to remind Kyiv’s partners around the world they need to respond “to this deliberate torment of the Ukrainian people by Russia.” “There is absolutely no military rationale in such strikes on the energy sector and infrastructure that leave people without electricity and heating in wintertime. This is Russia’s war specifically against our people, against life in Ukraine — an attempt to break Ukraine,” Zelenskyy added.

President Donald Trump has told his health secretary, Robert F. Kennedy Jr., to consider aligning the U.S. vaccination schedule with those in Europe, where many countries recommend fewer vaccines. Kennedy has taken up the charge with gusto and is considering advising parents to follow Denmark’s childhood schedule rather than America’s. Many who specialize in vaccination and public health say that would be a mistake. While wealthy European countries do health care comparatively well, they say, there are lots of reasons Americans are recommended more shots than Europeans, ranging from different levels of access to health care to different levels of disease. “If [Kennedy] would like to get us universal health care, then maybe we can have a conversation about having the schedule adjusted,” Demetre Daskalakis, who led the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases before resigning in protest in August, told POLITICO. Children, especially those who live in poor and rural areas, would be at greater risk for severe disease and death if the U.S. were to drop shots from its schedule, Daskalakis said. Denmark, for instance, advises immunizing against only 10 of the 18 diseases American children were historically recommended immunizations against. It excludes shots for potentially serious infections, including hepatitis A and B, meningitis and respiratory syncytial virus. Under Kennedy, the government has already changed its hepatitis B vaccine recommendations for newborns this year, even as critics warned the new advice could lead to more chronic infections, liver problems and cancer. The health department points out that the new guidance on hepatitis B — that mothers who test negative for the virus may skip giving their newborn a shot in the hospital — now align more closely with most countries in Europe. Public health experts and others critical of the move say slimmer European vaccine schedules are a cost-saving measure and a privilege afforded to healthier societies, not a tactic to protect kids from vaccine injuries. Kennedy’s interest in modeling the U.S. vaccine schedule after Europe, they point out, is underpinned by his belief that some childhood vaccines are unsafe and that American kids get too many too young. Kennedy’s safety concerns don’t align with the rationale underpinning the approach in Europe, where the consensus is that childhood vaccines are safe. Wealthy European countries in many cases eschew vaccines based on a risk-benefit calculus that doesn’t hold in America. European kids often don’t get certain shots because it would prevent a very small number of cases — like hepatitis B — or because the disease is rarely serious for them, such as Covid-19 and chickenpox. But since the U.S. doesn’t have universal access to care, vaccinating provides more return on investment, experts say. “We just have a tradition to wait a little bit” before adding vaccines to government programs, said Johanna Rubin, a pediatrician and vaccine expert for Sweden’s health agency. Swedish children are advised to get vaccines for 11 diseases before they turn 18. Rubin cited the need to verify the shots’ efficacy and the high cost of new vaccines as reasons Sweden moves slowly to add to its schedule. “It has to go through the health economical model,” she said. VACCINE SAFETY’S NOT THE ISSUE Martin Kulldorff, a Swedish native and former Harvard Medical School professor who led Kennedy’s vaccine advisory panel until this month, pointed to that country’s approach to vaccination and public health in an interview with POLITICO earlier this year. Before the Centers for Disease Control and Prevention this month dropped its recommendation that children of mothers who test negative for hepatitis B receive a vaccine within a day of birth, Kulldorff cited Sweden’s policy. “In Sweden, the recommendation is that you only do that if the mother has the infection. That’s the case in most European countries,” he said. “You could have a discussion whether one or the other is more reasonable.” The U.S. policy, as of Dec. 16, more closely resembles Sweden’s, with hepatitis B-negative mothers no longer urged to vaccinate their newborns against the virus at birth. But Sweden’s public health agency recommends that all infants be vaccinated, and the country’s regional governments subsidize those doses, which are administered as combination shots targeting six diseases starting at 3 months. Public health experts warn that even children of hepatitis B-negative mothers could catch the virus from others via contact with caregivers who are positive or shared household items. The prevalence of chronic hepatitis B in the U.S. is 6.1 percent compared to 0.3 percent in Sweden, according to the Coalition for Global Hepatitis Elimination, a Georgia-based nonprofit which receives funding from pharmaceutical companies, the CDC and the National Institutes of Health, among others. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the U.S. has taken a more comprehensive approach to vaccination, in part because its population is sicker than that of some Western European countries, and the impact of contracting a disease could be more detrimental. Osterholm pointed to the Covid pandemic as an example. By May 2022, the U.S. had seen more than 1 million people die. Other high-income countries — though much smaller — had more success controlling mortality, he said. “People tried to attribute [the disparity] to social, political issues, but no, it was because [peer nations] had so many more people who were actually in low-risk categories for serious illness,” Osterholm said. Kennedy and his advisers also cited European views on Covid vaccination in the spring when the CDC dropped its universal recommendation, instead advising individuals to talk to their providers about whether to get the shot. Last month, the Food and Drug Administration’s top vaccine regulator, Vinay Prasad, linked the deaths of 10 children to Covid vaccination without providing more detailed information about the data behind his assertion. European countries years ago stopped recommending repeat Covid vaccination for children and other groups not considered at risk of becoming severely sick. Covid shots have been linked to rare heart conditions, primarily among young men. European vaccine experts say Covid boosters were not recommended routinely for healthy children in many countries — not because of safety concerns, but because it’s more cost-effective to give them to high-risk groups, such as elderly people or those with health conditions that Covid could make severely sick and put in the hospital. In the U.K., Covid-related hospitalizations and deaths declined significantly after the pandemic, and now are “mostly in the most frail in the population, which has led to more restricted use of the vaccines following the cost-effectiveness principles,” said Andrew Pollard, the director of the Oxford Vaccine Group in the United Kingdom, which works on developing vaccines and was behind AstraZeneca’s Covid-19 shot. Pollard led the Joint Committee on Vaccination and Immunization, which advises the U.K. government, for 12 years before stepping down in September. In the U.S., more moves to follow Europe are likely. At a meeting of Kennedy’s vaccine advisers earlier this month, Tracy Beth Høeg, now acting as the FDA’s top drug regulator, pointed to Denmark’s pediatric schedule, which vaccinates for 10 diseases, while questioning whether healthy American children should be subject to more vaccines than their Danish counterparts. Danish kids typically don’t get shots for chickenpox, the flu, hepatitis A and B, meningitis, respiratory syncytial virus and rotavirus, like American children do, though parents can privately pay for at least some of those vaccines. The country offers free Covid and flu vaccines to high-risk kids. After the vaccine advisory meeting wrapped, Trump said he was on board, directing Kennedy to “fast track” a review of the U.S. vaccine schedule and potentially align it with other developed nations. He cited Denmark, Germany and Japan as countries that recommend fewer shots. Last week, Kennedy came within hours of publicly promoting Denmark’s childhood vaccine schedule as an option for American parents. The announcement was canceled at the last minute after the HHS Office of the General Counsel said it would invite a lawsuit the administration could lose, a senior department official told POLITICO. The notion that the U.S. would drop its vaccine schedule in favor of a European one struck health experts there as odd. Each country’s schedule is based on “the local situation, so the local epidemiology, structure of health care services, available resources, and inevitably, there’s a little bit of political aspect to it as well,” said Erika Duffell, a principal expert on communicable disease prevention and control at the European Centre for Disease Prevention and Control, an EU agency that monitors vaccine schedules across 30 European countries. Vaccine safety isn’t the issue, she said. For example, even though most Europeans don’t get a hepatitis B shot within 24 hours of birth, the previous U.S. recommendation, “there is a consensus that the effectiveness and safety of the vaccine has been confirmed through decades of research” and continuous monitoring, she said. European nations like Denmark and the U.K. have kept new cases of hepatitis B low. Denmark recorded no cases of mother-to-child transmission in 2023, and Britain’s rate of such spread is less than 0.1 percent — though the latter does routinely recommend vaccinating low-risk infants beginning at 2 months of age. European experts point to high levels of testing of pregnant women for hepatitis B and most women having access to prenatal care as the reasons for success in keeping cases low while not vaccinating all newborns. The major differences between the U.S. and the U.K. in their approach to hepatitis B vaccination are lower infection rates and high screening uptake in Britain, plus “a national health system which is able to identify and deliver vaccines to almost all affected pregnancies selectively,” Pollard said. The CDC, when explaining the change in the universal birth dose recommendation, argued the U.S. has the ability to identify nearly all hepatitis B infections during pregnancy because of ”high reliability of prenatal hepatitis B screening,” which some European experts doubt. “If we change a program, we need to prepare the public, we need to prepare the parents and the health care providers, and say where the evidence comes from,” said Pierre Van Damme, the director of the Centre for the Evaluation of Vaccination at the University of Antwerp in Belgium. He suggested that, if there was convincing evidence, U.S. health authorities could have run a pilot study before changing the recommendation to evaluate screening and the availability of testing at birth in one U.S. state, for example. WHERE EUROPEANS HAVE MORE DISEASE In some cases, European vaccination policies have, despite universal health care, led to more disease. France, Germany and Italy moved from recommending to requiring measles vaccination over the last decade after outbreaks on the continent. The U.S., until recently, had all but eradicated measles through a universal recommendation and school requirements. That’s starting to change. The U.S. is at risk of losing its “measles-elimination” status due to around 2,000 cases this year that originated in a Texas religious community where vaccine uptake is low. The 30 countries in the European Union and the European Economic Area, which have a population of some 450 million people combined, reported more than 35,000 measles cases last year, concentrated in Romania, Austria, Belgium and Ireland. Europe’s comparatively high rate is linked to lower vaccination coverage than the level needed to prevent outbreaks: Only four of the 30 countries reached the 95-percent threshold for the second measles dose in 2024, according to the European Centre for Disease Prevention and Control. Kennedy touted the U.S.’s lower measles rate as a successful effort at containing the sometimes-deadly disease, but experts say the country could soon see a resurgence of infectious diseases due to the vaccine skepticism that grew during the pandemic and that they say Kennedy has fomented. Among kindergarteners, measles vaccine coverage is down 2.7 percentage points as of the 2024-2025 school year, from a peak of 95.2 percent prior to the pandemic, according to CDC data. That drop occurred before Kennedy became health secretary. Kennedy and his advisers blame it on distrust engendered by Covid vaccine mandates imposed by states and President Joe Biden. But Kennedy led an anti-vaccine movement for years before joining the Trump administration, linking shots to autism and other conditions despite scientific evidence to the contrary, and he has continued to question vaccine safety as secretary. In some EU nations, vaccines aren’t compulsory for school entry. Swedish law guarantees the right to education and promotes close consultation between providers and patients. Some governments fear mandates could push away vaccine-hesitant parents who want to talk the recommended shots over with their doctor before giving the vaccines to their children, Rubin explained. In the U.S., states, which have the authority to implement vaccine mandates for school entry, rely on the CDC’s guidance to decide which to require. Vaccine skeptics have pushed the agency to relax some of its recommendations with an eye toward making it easier for American parents to opt out of routine shots. Scandinavian nations maintain high vaccine uptake without mandates thanks to “high trust” in public health systems, Rubin said. In Sweden, she added, nurses typically vaccinate young children at local clinics and provide care for them until they reach school age, which helps build trust among parents. CHICKENPOX Another example of where the U.S. and Europe differ is the chickenpox vaccine. The U.S. was the first country to begin universal vaccination against the common childhood illness in 1995; meanwhile, 13 EU nations broadly recommend the shot. Denmark doesn’t officially track chickenpox — the vaccine isn’t included on its schedule — but estimates 60,000 cases annually in its population of 6 million. The vastly larger U.S. sees fewer than 150,000 cases per year, according to the CDC. Many European countries perceive chickenpox as a benign disease, Van Damme said. “If you have a limited budget for prevention, you will spend usually the money in other preventative interventions, other vaccines than varicella,” he said, referring to the scientific term for chickenpox. But there’s another risk if countries decide to recommend chickenpox vaccination, he explained. If the vaccination level is low, people remain susceptible to the disease, which poses serious risks to unborn babies. If it’s contracted in early pregnancy, chickenpox could trigger congenital varicella syndrome, a rare disorder that causes birth defects. If children aren’t vaccinated against chickenpox, almost all would get the disease by age 10, Van Damme explained. If countries opt for vaccination, they have to ensure robust uptake: vaccinate virtually all children by 10, or risk having big pockets of unvaccinated kids who could contract higher-risk infections later. Europe’s stance toward chickenpox could change soon. Several countries are calculating that widely offering chickenpox vaccines would provide both public health and economic benefits. Britain is adding the shot to its childhood schedule next month. Sweden is expected to green-light it as part of its national program in the coming months. While the public doesn’t see it as a serious disease, pediatricians who see serious cases of chickenpox are advocating for the vaccine, Rubin told POLITICO. “It is very contagious,” she said. “It fulfills all our criteria.” The U.K. change comes after its vaccine advisory committee reviewed new data on disease burden and cost-effectiveness — including a 2022 CDC study of the U.S. program’s first 25 years that also examined the vaccine’s impact on shingles, a painful rash that can occur when the chickenpox virus reactivates years later. Scientists had theorized for years that limiting the virus’ circulation among children could increase the incidence of shingles in older adults by eliminating the “booster” effect of natural exposure, but the U.S. study found that real-world evidence didn’t support that hypothesis.

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

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

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

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

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

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

The European Commission president’s big set-piece speech of the year is upon us. The State of the Union address is where Ursula von der Leyen sets out her vision for the year ahead, and it promises to be a very challenging 12 months, for her and for Europe. So we tapped into the POLITICO newsroom’s deep knowledge of the political and policy realms and have attempted to preempt her speech by writing our own version. This is what we think she’ll say. Remember, this is not the actual State of the Union but our version of it. As it says on all speeches sent to journalists ahead of time, “please check against delivery.” Madam President, Honorable members, My fellow Europeans, This comes at a pivotal moment for Europe. We live in a world that presents many challenges for our Union; challenges that we as Europeans will have to face together. It is also a time for Europeans to decide which kind of future they wish to embrace; one of unity, one of strength, one of making our continent a better, more secure place; or one of conflict and dissent, in which we let external forces dictate the direction of our lives. There are people out there who want to destroy Europe; who side not with those of us who want a peaceful, prosperous Europe, but with our enemies. I know which path I will choose. And I believe, as I am sure you do too, that the people of Europe will take the right road. That is why, as we reflect on the State of our Union, we must acknowledge the advances we have made but also build the foundations of a more stable Europe, one that is less reliant on others in critical areas. UKRAINE AND DEFENSE Mesdames et Messieurs, les députés, Russia’s brutal war against Ukraine has presented us with challenges not seen since World War Two. As a result, we must take greater responsibility for our own security. That means investing in robust defense, safeguarding our people, and ensuring we have the resources to act when needed.  The EU’s likely message to Ukraine? We are at your side. | Olivier Hoslet/EPA Investing in European defense means investing in peace and long-term stability for current and future generations. It also means boosting technological innovation, supporting European competitiveness, promoting regional development, and powering economic growth.   Our ReArm Europe plan gives member states greater flexibility to spend more on defense while ensuring that the European defense industry can produce at speed and volume. It will also allow the rapid deployment of troops and assets across the EU. Red tape needs to be slashed to reach these aims. In a first step to simplify regulations, the Commission has already proposed a Defence Readiness Omnibus that will help untangle investment rules. However, simply spending more is not enough. Member states need to spend better, work together, and prioritize European companies. The EU will support this by helping coordinate investments and making sure that defense equipment is ‘Made in Europe’.  Yet the challenges caused by Russia are great and varied, including the threats caused by hybrid warfare attacking European infrastructure, and the increasing spread of disinformation online. We already have plans for an early-warning system and rapid response teams to help hospitals fight off cyberattacks. We can only overcome these problems by working together and, rest assured, Europe will also maintain diplomatic and, in particular, economic pressure on Russia. This week we will publish the 19th package of sanctions, as we tighten the net on those who do business with Russia. Working with our partners in the U.S., we are continuing to limit Russia’s potential and showing Vladimir Putin that we are serious about bringing an end to this war. Because a predator such as Putin can only be kept in check through strong deterrence. Our boost to defense is not just for our own security but for that of our allies and neighbors, and those who share our European values and wish to join the bloc. That is why our message to Ukraine is clear: Your future is in the European Union and we have been, and will continue to be, at your side every step of the way. REVIVING THE EUROPEAN ECONOMY Meine Damen und Herren Abgeordnete, As we look to advance our goals to boost European competitiveness, we have strong foundations such as our potential to unleash vast resources and latent technological and industrial power. I asked Mario Draghi to deliver a report on how to revive the European economy. One year ago, he delivered that report and we have been delivering on his recommendations. The year since the publication of Mario Draghi’s report has been all about cutting red tape and … boosting European competitiveness. | Olivier Hoslet/EPA As part of the Commission’s plans for the next multiannual financial framework — an ambitious and dynamic budget that will help us meet the challenges of the future — we created a €409 billion cash pot to fund Europe’s industrial revival, allowing European firms to rapidly scale up and cut red tape when accessing EU funds. And after a very clear signal from the European business sector that there is too much complexity in EU regulation, we launched the Omnibus Package to simplify legislation for sustainable finance, due diligence and taxonomy rules, and save companies €37 billion a year by 2029.   Mr. Draghi also recommended a single market for investment in the EU, and we have pushed forward plans for a Savings and Investments Union that would integrate supervision of capital markets and break down national barriers for the likes of stock exchanges and clearinghouses. The other major challenge we face is trade. The Commission has taken steps to deepen partnerships with trusted allies, partners and friends, which is an essential step in today’s uncertain geopolitical climate. We have in recent weeks secured trade deals with the United States as well as with Mexico and the Mercosur bloc of Latin American countries. I urge everyone in this House who believes in making our Union stronger to support these trade deals as they, and others, will help businesses across the continent, opening up our markets and diversifying our exports. The Mercosur deal alone opens up a market of over 280 million people for European exports, while the U.S. trade deal saves trade flows, saves jobs in Europe and opens up a new chapter in EU-U.S. relations. MIGRATION Señoras y señores diputados, Europe remains a place of safe refuge for those fleeing conflict and climate change. But I am of the firm belief that migration needs to be managed. That is why, after the launch of the Migration and Asylum Pact, we created a plan to streamline deportations, toughen penalties for rejected migrants who do not leave the bloc, and create hubs in countries outside the EU to house people awaiting deportation. Migration is often exploited by populists for political gain. But we want to create a system that supports those with a genuine asylum claim while making clear the rules on forced returns, and incentivizing voluntary returns. We also want to continue attracting talent from across the globe in areas where Europe is a world leader, such as in the life sciences and biotech spheres. Migration is a key issue for European citizens, but there are others. The latest Eurobarometer survey shows that the No. 1 issue Europeans want the EU institutions to resolve is the cost of living crisis. Across the continent, families are struggling to pay for homes, and this Commission is determined to do everything in its power to ease the pressure they are facing.  Migration is a key issue for European citizens. | Gene Medi/NurPhoto via Getty Images Early next year, we will present Europe’s first-ever European Affordable Housing Plan, which will aim to accelerate the construction of new homes, the renovation of existing buildings, and ensure no one sleeps on the streets by 2030. To do so, we will move to put in new measures to limit speculation, introduce regulations for short-term rentals in stressed housing markets, and cut red tape to boost public and private investments in the construction of new homes. People are also concerned about their energy bills and, here, the Commission is taking action. We must never forget Putin’s deliberate use of gas as a weapon, and that is why the EU will phase out Russian gas by 2027 thanks to the REPowerEU roadmap. As part of our deal with Washington, we will increase our energy imports from the U.S. over the next three years, a plan that is fully compatible with our medium- and long-term policy to diversify our energy sources and part of our commitment to the green agenda that so many in this House, myself included, fully support. That is why we have drawn up the Grids Package, which will come out later this year and aims to turbocharge investment in power networks, which is the key bottleneck in the uptake of more renewables. ARTIFICIAL INTELLIGENCE Signore e signori, deputati, The time is coming when artificial intelligence will match human thinking. That is why this week we published a report looking at the challenges and opportunities of AI. In Europe, we must take a leading role in shaping high-impact technologies. We will make sure there is smart yet strategic regulation while creating the right incentives, including funding and investment, to prevent AI and other technologies from becoming destabilizing forces. But we must not forget our traditional industries. The automotive sector is a critical pillar of the European economy, supporting more than 13 million jobs. The industry is facing increased competition from those who have benefited from unfair subsidies, and we have taken big steps to ensure this critical sector remains competitive and made in Europe. With our Automotive Action Plan, we set a strong course for building European batteries and ensuring our companies are the technological leaders in autonomous driving. At the same time, we have made big strides in maintaining our climate goals while giving our companies the necessary flexibility to stay competitive. THE EU BUDGET Panie i panowie, posłowie, We want a stronger European Union, stronger member states, and stronger regional and city governments, and we will work with local leaders — those closest to Europe’s citizens — to ensure they get the funds they need.  Cohesion Funds have helped build our Union with bridges and railways, public sports halls and libraries. Our cohesion policy is a central pillar of the European Union, and we will ensure that it continues to bridge gaps between regions, while also earmarking funds for the cities in which nearly three-quarters of all Europeans live. But we also want to protect and promote one of the most important elements of Europe, its agriculture and farmers. With our budget proposal we are safeguarding direct payments to farmers, boosting the funding available to rural communities, and giving more money to national governments to spend on agriculture. Farmers are essential to Europe, and what matters to Europeans matters to Europe. We need a continent that is united, safe and prosperous. I believe we can rise to the challenge. Long live Europe. Thanks to Victor Jack, Sam Clark, Max Griera, Pieter Haeck, Jordyn Dahl, Aitor Hernández-Morales and Helen Collis.