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

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

CHIATURA, Georgia — Giorgi Neparidze, a middle-aged man from near the town of Chiatura in western Georgia, still has marks on his lips from where he sewed his mouth shut during a hunger strike last year. He says Georgian Manganese, a mining company with close links to the government, has wrought environmental devastation around his home and has ignored the rights of its workers. He is seeking compensation.  Europe, which imports Georgia’s manganese, is partly to blame for the black rivers and collapsing houses in Chiatura district, Neparidze says. The former miner-turned-environmental and civil rights activist claims that in one village, Shukruti, toxic dust from the pits is making people unwell. Filthy black water, laced with heavy metals, periodically spurts out of pumps there. Houses are collapsing as the tunnels underneath them cave in.  Manganese, a black metal traditionally used to reinforce steel, is crucial for Europe’s green energy transition as it is used in both wind turbines and electric car batteries. The metal is also vital for military gear like armor and guns. In 2022, the European Union bought 20,000 metric tons of manganese alloys from Georgia — almost 3 percent of its total supply. A year later the bloc added manganese to its list of critical minerals. But Chiaturans say their lives are being ruined so that Western Europeans can breathe cleaner air. “We are sacrificed so that others can have better lives,” Neparidze says. “There are only 40,000 people in Chiatura. They might feel ill or live in bad conditions but they are sacrificed so that millions of Europeans can have a cleaner environment.” Neparidze says cancer rates in the region are unusually high. Doctors at a hospital in Chiatura back up the observation, but no official study has linked the illnesses to the mines. An aerial view of Chiatura with the polluted Kvirila River running through the town | Olivia Acland Hope that things will improve appears dim. European companies often don’t know where their manganese is sourced from. As ANEV, Italy’s wind energy association, confirms: “There is no specific obligation to trace all metals used in steel production.”  Last year the EU enacted a law that was meant to change that. The Corporate Sustainability Due Diligence Directive obliges companies to run closer checks on their supply chains and clamp down on any human rights violations, poor working conditions and environmental damage.  But barely a year after it took effect, the European Commission proposed a major weakening of the law in a move to reduce red tape for the bloc’s sluggish industry. EU member countries, motivated by this deregulation agenda, are now pushing for even deeper cuts, while French President Emmanuel Macron and German Chancellor Friedrich Merz want to get rid of the law altogether.  Meanwhile, Europe’s appetite for mined raw materials like manganese, lithium, rare earths, copper and nickel is expected to skyrocket to meet the needs of the clean energy transition and rearmament. Many of these resources are in poorly regulated and often politically repressive jurisdictions, from the Democratic Republic of Congo to Indonesia and Georgia. Weakening the EU supply chain law will have consequences for communities like Neparidze’s. “Only an empty shell of the directive remains,” says Anna Cavazzini, a member of the European Parliament’s Green Party, adding that the legislature caved to pressure from businesses seeking to reduce their costs. “Now is not the time to abandon the defense of human rights and give corporations a free hand,” she says.  A resident of Chiatura standing on a collapsed house following a mining-related landslide in Itkhvisi village. | Olivia Acland As Georgia’s government pivots toward Russia and stifles dissent, life is becoming increasingly dangerous for activists in Chiatura. On April 29, four activists including Neparidze were arrested for allegedly assaulting a mine executive. A statement put out by Chiatura Management Company, the firm in charge of staffing Georgian Manganese’s underground operations, says that Tengiz Koberidze, manager of the Shukruti mine, was “verbally abused and pelted with stones.” Supporters call it a staged provocation in which Koberidze tried to incite violence, and say it’s part of a broader campaign to silence resistance. If convicted they face up to six years behind bars. Koberidze did not respond to requests for comment. Chiatura residents are protesting over two overlapping issues. On one side, miners are demanding safer working conditions underground, where tunnel collapses have long been a risk, along with higher wages and paid sick leave. When the mine was temporarily shut in October 2024, they were promised 60 percent of their salaries, but many say those payments never materialized. Workers are also raising concerns about mining pollution in the region. “The company doesn’t raise wages, doesn’t improve safety, and continues to destroy the natural environment. Its profits come not just from extracting resources, but from exploiting both workers and the land,” says one miner, David Chinchaladze. Georgian Manganese did not respond to interview requests or written questions. Officials at Georgia’s Ministry of Mines and the government’s Environment Protection and Natural Resources Department did not respond to requests for comment. A collapsing building in Shukruti. | Olivia Acland.  The second group of protesters comes from the village of Shukruti, which sits directly above the mining tunnels. Their homes are cracking and sinking into the ground. In 2020, Georgian Manganese pledged to pay between 700,000 and 1 million Georgian lari ($252,000 to $360,000) annually in damages — a sum that was meant to be distributed among residents. But while the company insists the money has been paid, locals — backed by watchdog NGO Social Justice — say otherwise. According to them, fewer than 5 percent of Shukruti’s residents have received any compensation.  Their protest has intensified in the last year, with workers now blocking the roads and Shukruti residents barring entry to the mines. But the risks are intensifying too. Since suspending EU accession talks last year amid deteriorating relations with the bloc, Georgia’s ruling party has shuttered independent media, arrested protestors and amplified propaganda. The country’s democracy is “backsliding,” says Irakli Kavtaradze, head of the foreign department of the largest opposition political party, United National Movement. Their tactics “sound like they come from a playbook that is written in the Kremlin,” he adds. ‘KREMLIN PLAYBOOK’ In the capital Tbilisi, around 200 kilometers east of Chiatura, protesters have taken to the streets every night since April 2, 2024 when the government unveiled a Kremlin-style “foreign agents” law aimed at muzzling civil society.  Many demonstrators wear sunglasses, scarfs and masks to shield their identities from street cameras, wary of state retaliation.  A scene from the 336th day of protests in Tbilisi in April 2025. | Olivia Acland. Their protests swelled in October last year after the government announced it would suspend talks to join the EU. For Georgians, the stakes are high: Russia already occupies 20 percent of the country after its 2008 invasion, and people fear that a more profound drift from the EU could open the door to further aggression. When POLITICO visited in April, a crowd strode down Rustaveli Avenue, the city’s main artery. Some carried EU flags while others passed around a loudspeaker, taking it in turns to voice defiant chants. “Fire to the oligarchy!” one young woman yelled, the crowd echoing her call. “Power lies in unity with the EU!” another shouted. They also called out support for protestors in Chiatura, whose fight has become something of a cause célèbre across the country: “Solidarity to Chiatura! Natural resources belong to the people!”  The fight in Chiatura is a microcosm of the country’s broader struggle: The activists are not just taking on a mining company but a corporate giant backed by oligarchs and the ruling elites.  Georgian Manganese’s parent company, Georgian American Alloys, is registered in Luxembourg and counts Ukrainian oligarch Ihor Kolomoisky as a shareholder. He is in custody in Kyiv over allegations that he hired a gang to kill a lawyer who threatened his business interests in 2003. Kolomoisky has also been sanctioned by the United States for his alleged involvement in siphoning billions out of PrivatBank, Ukraine’s largest bank.  Giorgi Kapanadze — a businessman closely connected with the ruling Georgian Dream party of Bidzina Ivanishvili — is listed as general manager of Georgian American Alloys.  Until recently, Kapanadze owned Rustavi TV, a channel notorious for airing pro-government propaganda. The European Parliament has called on the EU to hit Kapanadze with sanctions, accusing him of propping up the country’s repressive regime. Kolomoisky and Kapanadze did not respond to POLITICO’s requests for comment. The government swooped in to help Georgian Manganese in 2016 when a Georgian court fined it $82 million for environmental destruction in the region. The state placed it under “special management” and wrote off the fine. A new government-appointed manager was tasked, on paper, with cleaning up the mess. He was supposed to oversee a cleanup of the rivers that flow past the mines, among other promises. Manganese mining pit in Chiatura region, Georgia. | Olivia Acland But POLITICO’s own tests based on four samples taken in April 2025 from the Kvirila River, which runs through Chiatura, as well as its tributary, the Bogiristiskali, which were examined in a U.K. licensed laboratory, show the manganese levels in both rivers are over 10 times the legal limit. Iron levels are also higher than legally permitted. Locals use the polluted water to irrigate their crops. Fishermen are also pulling in increasingly empty nets as the heavy metals kill off aquatic life, according to local testimonies. The water from the Kvirila River flows out into the Black Sea, home to endangered dolphins, sturgeons, turtles and sharks.  A 2022 analysis by the Georgian NGO Green Policy found even worse results, with manganese in the Kvirila River averaging 42 times the legal limit. The group also detected excessive levels of iron and lead. Chronic manganese exposure can lead to irreversible neurological damage — a Parkinson’s-like condition known as manganism — as well as liver, kidney and reproductive harm. Lead and iron are linked to organ failure, cancer and cardiovascular disease. On Georgian Manganese’s website, the company concedes that “pollution of the Kvirila River” is one of the region’s “ecological challenges,” attributing it to runoff from manganese processing. It claims to have installed German-standard purification filters and claims that “neither polluted nor purified water” currently enters the river. Protesters like Neparidze aren’t convinced. They claim the filtration system is turned on only when inspectors arrive and that for the rest of the time, untreated wastewater is dumped straight into the rivers. BLOCKING EXPORTS Their protests having reaped few results, Chiaturans are taking increasingly extreme measures to make their voices heard.  Gocha Kupatadze, a retired 67-year-old miner, spends his nights in a tarpaulin shelter beside an underground mine, where he complains that rats crawl over him. “This black gold became the black plague for us,” he says. “We have no choice but to protest.” Kupatadze’s job is to ensure that manganese does not leave the mine. Alongside other protesters he has padlocked the gate to the generator that powers the mine’s ventilation system, making it impossible for anyone to work there. Kupatadze says he is only resorting to such drastic measures because conditions in his village, Shukruti, have become unlivable. His family home, built in 1958, is now crumbling, with cracks in the walls as the ground beneath it collapses from years of mining. The vines that once sustained his family’s wine-making traditions have long since withered and died. Gocha Kupatadze, an activist sleeping in a tarpaulin tent outside a mine. | Olivia Acland. For over a year, protesters across the region have intermittently blocked mine entrances as well as main roads, determined to stop the valuable ore from leaving Chiatura. In some ways it has worked: Seven months ago, Chiatura Management Company, the firm in charge of staffing Georgian Manganese’s underground operations, announced it would pause production.  “Due to the financial crisis that arose from the radical protests by the people of Shukruti village, the production process in Chiatura has been completely halted,” it read. Yet to the people of Chiatura, this feels more like a punishment than a triumph.  Manganese has been extracted from the area since 1879 and many residents rely on the mines for their livelihoods. The region bears all the hallmarks of a mining town that thrived during the Soviet Union when conditions in the mines were much better, according to residents. Today, rusted cable cars sway above concrete buildings that house washing stations and aging machinery.   While locals had sought compensation for the damage to their homes, they now just find themselves out of work.  Soviet-era buildings and mining infrastructure around Chiatura. | Olivia Acland.  Making matters worse, Georgian Manganese, licensed to mine 16,430 hectares until 2046, is now sourcing much of its ore from open pits instead of underground mines. These are more dangerous to the communities around them: Machines rip open the hillsides to expose shallow craters, while families living next to the pits say toxic dust drifts off them into their gardens and houses.  MORE PITS The village of Zodi is perched on a plateau surrounded by gently undulating hills, 10 kilometers from Chiatura. Many of its residents rely on farming, and cows roam across its open fields. “It is a beautiful village with a unique microclimate which is great for wine-making,” says Kote Abdushelishvili, a 36-year-old filmmaker from Zodi.  Mining officials say the village sits on manganese reserves. In 2023, caterpillar trucks rolled into Zodi and began ripping up the earth. Villagers, including Abdushelishvili, chased them out. “We stopped them,” he says, “We said if you want to go on, you will have to kill us first.” A padlocked gate to the mine’s ventilation system. | Olivia Acland Abdushelishvili later went to Georgian Manganese’s Chiatura office to demand a meeting with the state-appointed special manager. When he was turned away, he shouted up to the window: “You can attack us, you can kill us, we will not stop.” Two days later, as Abdushelishvili strolled through a quiet neighborhood in Tbilisi, masked men jumped out of a car, slammed him to the pavement and beat him up. Despite the fierce resistance in Chiatura, Georgian Manganese continues to send its metal to European markets. In the first two months of 2025, the EU imported 6,000 metric tons of manganese from Georgia. With the bloc facing mounting pressures — from the climate crisis to new defense demands — its hunger for manganese is set to grow. As the EU weakens its corporate accountability demands and Georgia drifts further into authoritarianism, the voices of Chiatura’s people are growing even fainter.  “We are not asking for something unreasonable,” says activist Tengiz Gvelesiani, who was recently detained in Chiatura along with Neparidze, “We are asking for healthy lives, a good working environment and fresh air.” Georgian Manganese did not respond to requests for comment. This article was developed with the support of Journalismfund Europe.

BRUSSELS — Climate change supercharged last week’s European heat wave and tripled the death toll, a group of scientists said Wednesday.  Extreme temperatures baked large swaths of the continent in late June and early July, exposing millions of Europeans to dangerous levels of heat.  Looking at 12 European cities, the researchers found that in 11 of them, heat waves of the type that peaked last week would have been significantly less intense — between 2 to 4 degrees Celsius cooler — in a world without man-made global warming.  This climate-induced change in temperatures, the scientists said, led to a surge in excess deaths in those cities. Of the 2,300 additional fatalities linked to high temperatures, around 1,500 of them can be attributed to global warming, they estimated.  “Climate change is an absolute game changer when it comes to extreme heat,” said Friederike Otto, a climate scientist at Imperial College London, which co-led the research.  A construction worker in Italy and a street cleaner in Spain were among those thought to have died of heat stroke last week. But most heat-related deaths, particularly among the elderly, go unreported. The scientists said the vast majority of deaths they analyzed occurred among Europeans aged 65 or older.  As a result, heat is often dubbed a “silent killer,” though it’s no less deadly than other climate-related disasters. The scientists noted that last week’s heat wave killed more people than devastating flood events in recent years, which resulted in several hundred deaths.  “Our study is only a snapshot of the true death toll linked to climate change-driven temperatures across Europe, which may have reached into the tens of thousands,” said Garyfallos Konstantinoudis, also a climate specialist at Imperial College London. Global warming, driven by burning fossil fuels such as coal, oil and natural gas, is increasing the severity and frequency of heat waves in Europe and worldwide. An aging population also makes Europe more vulnerable to the health effects of extreme temperatures.  The European Environment Agency has warned that heat-related deaths are expected to increase tenfold if the planet warms 1.5 C, and thirtyfold at 3 C. The planet is already 1.3 C hotter than in preindustrial times and on track to warm 2.7 C this century.  THE TOLL OF EXTREME HEAT The rapid analysis published Wednesday — which uses methods considered scientifically reliable but has not undergone peer review  — was led by researchers at Imperial College London and the London School of Hygiene & Tropical Medicine.  The scientists looked at deaths in Milan (where they estimated 317 fatalities were due to changes in the climate), Barcelona (286), Paris (235), London (171), Rome (164), Madrid (108), Athens (96), Budapest (47), Zagreb (31), Frankfurt (21), Lisbon (also 21) and the Sardinian city of Sassari (six) between June 23 and July 2.  “These numbers represent real people that have lost their lives in the last days due to the extreme heat. Two-thirds of these would not have died were it not for climate change,” said Otto.  Last week’s heat also drove up wildfire risk across Europe, with fires still raging in many parts of the continent. The analysis does not include deaths linked to fire or smoke. In Spain, for example, two farmers were killed trying to flee encroaching flames last week.  The Spanish government separately monitors heat-related excess deaths and found that between June 21 and July 2, more than 450 people died due to extreme temperatures — 73 percent more than in the same period in 2022, which saw record numbers of deaths.  WESTERN EUROPE’S HOTTEST JUNE The EU’s Copernicus climate monitoring service, meanwhile, said Wednesday morning that last month was the third-hottest June on record worldwide.  For Europe, it was the fifth-warmest June, though the western part of the continent saw its hottest June on record, the scientists said — just above the 2003 record, which was followed by a summer marked by deadly heat.  The temperatures in Europe are further amplified by what Copernicus terms an “exceptional” marine heat wave in the Mediterranean Sea. The water surface temperatures have hit their highest level on record, not just for June but for any month.  “June 2025 saw an exceptional heat wave impact large parts of western Europe, with much of the region experiencing very strong heat stress. This heatwave was made more intense by record sea surface temperatures in the western Mediterranean,” said Samantha Burgess, strategic climate lead at the European Centre for Medium-Range Weather Forecasts.  “In a warming world, heat waves are likely to become more frequent, more intense and impact more people across Europe,” she added.  Cory Bennett contributed to this report. 

Chronic diseases such as cancer, cardiovascular disease, diabetes and mental and neurological conditions are on the rise. New research shows that these non-communicable diseases (NCDs) are responsible for 75 percent of deaths worldwide. Today, one in three people around the world live with a NCD. In addition to the huge impact these diseases have on individuals, they place enormous strain on health systems and reduce economic productivity. So much so, that it is estimated these diseases cost economies globally $2 trillion every year.   > Today, one in three people around the world live with a NCD. In addition to > the huge impact these diseases have on individuals, they place enormous strain > on health systems and reduce economic productivity. The underrecognized link between chronic diseases and vaccine preventable illnesses  It is well understood that prevention is better than the cure, and immunization campaigns are at the heart of robust, preventative healthcare. But it is often thought that vaccines are only relevant in preventing infectious disease, and the role they play in protecting people with chronic diseases as well as preventing those conditions in the first place is less understood.  It’s been encouraging to see that under the Hungarian presidency, the European Council has urged more robust efforts to prevent cardiovascular diseases — explicitly recognizing that vaccines against influenza, pneumococcal infections, SARS-CoV-2 and respiratory syncytial virus (RSV) offer crucial protection for patients living with cardiovascular diseases. The presidency has also called for action to integrate systematic vaccination alongside screening, treatment and rehabilitation into cardiovascular health action framework.  Later this year, the UN will discuss a new political declaration aimed at tackling the rise of NCDs, providing a key opportunity to maximize the benefits from vaccines and ensuring adult immunization is at the core of essential NCD prevention and management. This will not only help reduce the burden of these diseases on individuals and healthcare systems while supporting economic growth, but it will also help build better health for future generations.  > Later this year, the UN will discuss a new political declaration aimed at > tackling the rise of NCDs, providing a key opportunity to maximize the > benefits from vaccines and ensuring adult immunization is at the core of > essential NCD prevention and management. Embedding adult immunization into NCD care pathways  Adult immunization offers a cost-effective way to protect people living with NCDs, particularly against common respiratory infections like COVID-19, influenza, pneumococcal disease and RSV. These infections can worsen chronic conditions, trigger complications and lead to preventable hospitalizations and death. For example, people living with diabetes are twice as likely to die from influenza than people with no underlying condition.  Immunizing people living with NCDs against respiratory diseases is a practical, evidence-based way to strengthen prevention, protect the vulnerable, and reduce the strain on health systems both in the short term during seasonal infection peaks and over the longer term as populations age and NCDs rise. Adult immunization programs also support productivity by enabling people to stay in education or employment for much longer.   For people living with cardiovascular disease, the flu vaccine may reduce the risk of death from stroke by 50 percent and from heart attack by 45 percent. For people living with a chronic respiratory disease — such as asthma or chronic obstructive pulmonary disease (COPD) — the COVID-19 vaccine can reduce the risk of hospitalization due to infection by around 80 percent.  Despite this, vaccine policies for adults with chronic illnesses remain limited, and when available they are not equitably implemented. Data shows that 58 percent of the World Health Organization’s member states report vaccination against flu for adults with chronic conditions, and only 23 percent against pneumococcal disease. The findings show persistent gaps in adult vaccination programs, with awareness and uptake remaining low in many parts of the world. This can also be observed in Europe, where meeting the target of 75 percent of people having had a flu vaccine has proven challenging. In 2022 half of people aged 65 years and over in the EU were vaccinated against influenza, with another global report showing that adult influenza vaccination rates ranged from a low of 6 percent to a high of 86 percent, highlighting huge disparities between countries. This is not just about statistics. It is about real people and their families. It is about missed opportunities to protect those most at risk.   Lowering the risks of developing cancer and dementia  Vaccines also play a critical role in lowering the risk of developing cancer. This is because some cancers are caused by viruses. By preventing these viral infections, vaccines can halt the rise in some types of cancer. For instance, the human papillomavirus (HPV) vaccine is highly effective in preventing HPV-related cancers. It has the potential to eliminate cervical cancer in certain countries during our lifetime and radically reduce the burden of other HPV-related cancers. Similarly, improving access to and uptake of highly effective vaccines against Hepatitis B is critical to reducing liver cancer. Together, vaccination against HPV and Hepatitis B could prevent over one million cancer cases worldwide every year.  > Together, vaccination against HPV and Hepatitis B could prevent over one > million cancer cases worldwide every year. In addition, emerging research suggests that vaccines, by helping to prevent infections and reducing inflammation, can help protect the brain from long-term damage, potentially lowering the risk of dementia. A recent study performed using the electronic health records of 280,0000 people in Wales demonstrated a 20 percent relative reduction of dementia risk after shingles vaccination. This finding highlights the importance of real-world evidence for understanding the full value of immunization, and how it prevents NCDs and promotes healthy aging.   Opportunity for action   This year, the UN will consider a political declaration aimed at addressing the rising number of people around the world living with NCDs. This presents a real opportunity to place vaccination at the heart of efforts to do so.   Recognizing the role of immunization as a central pillar of NCD prevention and management would be a significant step forward. To deploy lifelong routine immunization programs as fundamental components of NCD management, policy- and decision-makers should look to deliver decisive action across four policy priorities.  > Recognizing the role of immunization as a central pillar of NCD prevention and > management would be a significant step forward. Firstly, we must ensure that adult immunization is at the core of essential NCD care in health care systems all over the world. That includes immunization against respiratory infections in national strategies and access through innovative outreach and delivery models.   Secondly, this should include expanded access to vaccines for people living with NCDs. This can help prevent complications, reduce hospitalizations and support system resilience, and enable more efficient use of existing prevention budgets.   Thirdly, we need to build awareness of the importance of immunization among people living with NCDs, by providing clear, trusted information and equipping healthcare professionals with the right knowledge and skills to communicate effectively about vaccines.   And, finally, we must make sure there is a system to capture what is going well and what can be improved, by tracking immunization coverage for people living with NCDs so that there is clear accountability for driving further progress.   Investing in social and economic resilience  Integrating routine adult immunization into NCD prevention and management offers a cost-effective opportunity to bend the curve on NCDs, helping people stay healthier for longer, alleviating pressure on healthcare systems, and delivering substantial economic benefits.  Data shows that adult vaccination programs deliver socio-economic benefits of up to 19 times the initial investment through benefits to individuals, health care systems and wider society. As countries confront rising rates of chronic disease, aging populations, workforce shortages and increasingly constrained budgets, investing in prevention today is not just good health policy — it’s smart economics.

Qatar’s prime minister defended gifting a luxury jet to U.S. President Donald Trump, saying the controversial offering did not amount to “bribery” and would be given “very legally.” Trump announced this month that the Gulf nation had offered to give him a Boeing 747-8 jet, once owned by Qatar’s royal family, to be used as Air Force One, the president’s official plane. Valued at $400 million, the “palace in the sky,” as it has been called, would be one of the most expensive gifts from a foreign government to an American president in history. “It’s a great gesture from Qatar,” Trump told reporters last week. “I would never be one to turn down that kind of an offer. I mean, I could be a stupid person and say, ‘No, we don’t want a free, very expensive airplane.’” Democrats quickly denounced the deal over ethical, security and even constitutional concerns, with some Republicans and stalwart MAGA allies, such as Missouri Senator Josh Hawley, also voicing their trepidation. But the donation is totally above board, Qatari Prime Minister Sheikh Mohammed bin Abdulrahman Al-Thani stressed Tuesday, calling it “a normal thing that happens between allies.” “I don’t know why people consider it as bribery or Qatar trying to buy influence with this administration,” he said at the Qatar Economic Forum. “There was a lot of controversy that’s been created out of this, what I call an exchange between two countries,” he added. “The plane story is a Ministry of Defense to Department of Defense transaction which is basically done with full transparency and very legally.” The Trump administration has long sought to replace the aging Air Force One fleet, a pair of Boeing 747-200B aircraft, which have been in the skies since 1990. Boeing is currently modifying two newer Boeing 747 jets to meet the requirements needed for the planes to serve as Air Force One at a cost of billions, but the project’s completion date has been pushed out to 2027, leading Trump to voice his frustration. “We’re very disappointed that it’s taking Boeing so long to build a new Air Force One,” he complained last week. Even if Trump accepts the Qatari jumbo jet — which he has pledged to donate to his presidential library at the end of his term — it would take years and cost hundreds of millions to modify it so that it can serve as the president’s plane.

‘PARKINSON’S IS A MAN-MADE DISEASE’ Europe’s flawed oversight of pesticides may be fueling a silent epidemic, warns Dutch neurologist Bas Bloem. His fight for reform pits him against industry, regulators — and time. Text and photos by BARTOSZ BRZEZIŃSKI in Nijmegen, Netherlands Illustration by Laura Scott for POLITICO In the summer of 1982, seven heroin users were admitted to a California hospital paralyzed and mute. They were in their 20s, otherwise healthy — until a synthetic drug they had manufactured in makeshift labs left them frozen inside their own bodies. Doctors quickly discovered the cause: MPTP, a neurotoxic contaminant that had destroyed a small but critical part of the brain, the substantia nigra, which controls movement. The patients had developed symptoms of late-stage Parkinson’s, almost overnight. The cases shocked neurologists. Until then, Parkinson’s was thought to be a disease of aging, its origins slow and mysterious. But here was proof that a single chemical could reproduce the same devastating outcome. And more disturbing still: MPTP turned out to be chemically similar to paraquat, a widely used weedkiller that, for decades, had been sprayed on farms across the United States and Europe. Advertisement While medication helped some regain movement, the damage was permanent — the seven patients never fully recovered. For a young Dutch doctor named Bas Bloem, the story would become formative. In 1989, shortly after finishing medical school, Bloem traveled to the United States to work with William Langston, the neurologist who had uncovered the MPTP-Parkinson’s link. What he saw there reshaped his understanding of the disease — and its causes. “It was like a lightning bolt,” Bloem tells me. “A single chemical had replicated the entire disease. Parkinson’s wasn’t just bad luck. It could be caused.” THE MAKING OF A MAN-MADE DISEASE Today, at 58, Bloem leads a globally recognized clinic and research team from his base at the Radboud University Medical Center in Nijmegen, a medieval Dutch city near the German border. It treats hundreds of patients each year, while the team pioneers studies on early diagnosis and prevention. The hallway outside Bloem’s office was not hectic on my recent visit, but populated — patients moving slowly, deliberately, some with walkers, others with a caregiver’s arm under their own. One is hunched forward in a rigid, deliberate shuffle; another pauses silently by the stairs, his face slack, not absent — just suspended, as if every gesture had become too costly. On its busiest days, the clinic sees over 60 patients. “And more are coming,” Bloem says. Bloem’s presence is both charismatic and kinetic: tall — just over 2 meters, he says with a grin — with a habit of walking while talking, and a white coat lined with color-coded pens. His long, silver-gray hair is swept back, a few strands escaping as he paces the room. Patients paint portraits of him, write poems about him. His team calls him “the physician who never stops moving.” Unlike many researchers of his stature, Bloem doesn’t stay behind the scenes. He speaks at international conferences, consults with policymakers, and states his case to the public as well as to the scientific world. His work spans both care and cause — from promoting movement and personalized treatment to sounding the alarm about what might be triggering the disease in the first place. Alongside his focus on exercise and prevention, he’s become one of the most outspoken voices on the environmental drivers of Parkinson’s — and what he sees as a growing failure to confront their long-term impact on the human brain. Advertisement “Parkinson’s is a man-made disease,” he says. “And the tragedy is that we’re not even trying to prevent it.” When the English surgeon James Parkinson first described the “shaking palsy” in 1817, it was considered a medical curiosity — a rare affliction of aging men. Two centuries later, Parkinson’s disease has more than doubled globally over the past 20 years, and is expected to double again in the next 20. It is now one of the fastest-growing neurological disorders in the world, outpacing stroke and multiple sclerosis. The disease causes the progressive death of dopamine-producing neurons and gradually robs people of movement, speech and, eventually, cognition. There is no cure. Age and genetic predisposition play a role. But Bloem and the wider neurological community contend that those two factors alone cannot explain the steep rise in cases. In a 2024 paper co-authored with U.S. neurologist Ray Dorsey, Bloem wrote that Parkinson’s is “predominantly an environmental disease” — a condition shaped less by genetics and more by prolonged exposure to toxicants like air pollution, industrial solvents and, above all, pesticides. Most of the patients who pass through Bloem’s clinic aren’t farmers themselves, but many live in rural areas where pesticide use is widespread. Over time, he began to notice a pattern: Parkinson’s seemed to crop up more often in regions dominated by intensive agriculture. “Parkinson’s was a very rare disease until the early 20th century,” Bloem says. “Then with the agricultural revolution, chemical revolution, and the explosion of pesticide use, rates started to climb.” Europe, to its credit, has acted on some of the science. Paraquat — the herbicide chemically similar to MPTP — was finally banned in 2007, although only after Sweden took the European Commission to court for ignoring the evidence of its neurotoxicity. Other pesticides with known links to Parkinson’s, such as rotenone and maneb, are no longer approved. Advertisement But that’s not the case elsewhere. Paraquat is still manufactured in the United Kingdom and China, sprayed across farms in the United States, New Zealand and Australia, and exported to parts of Africa and Latin America — regions where Parkinson’s rates are now rising sharply. Once the second-most widely sold herbicide in the world — after glyphosate — paraquat helped drive major profits for its maker, Swiss-based and Chinese-owned company Syngenta. But its commercial peak has long passed, and the chemical now accounts for only a small fraction of the company’s overall business. In the U.S., Syngenta faces thousands of lawsuits from people who say the chemical gave them Parkinson’s. Similar cases are moving ahead in Canada. Syngenta has consistently denied any link between paraquat and Parkinson’s, pointing to regulatory reviews in the U.S., Australia and Japan that found no evidence of causality.  The company told POLITICO that comparisons to MPTP have been repeatedly challenged, citing a 2024 Australian review which concluded that paraquat does not act through the same neurotoxic mechanism. There is strong evidence, the company said in a written response running to more than three pages, that paraquat does not cause neurotoxic effects via the routes most relevant to human exposure — ingestion, skin contact or inhalation. “Paraquat is safe when used as directed,” Syngenta said. Still, for Bloem, even Europe’s bans are no cause for comfort. “The chemicals we banned? Those were the obvious ones,” Bloem says. “What we’re using now might be just as dangerous. We simply haven’t been asking the right questions.” A CHEMICAL EUROPE CAN’T QUIT Among the chemicals still in use, none has drawn more scrutiny — or survived more court battles — than glyphosate. It’s the most widely used herbicide on the planet. You can find traces of it in farmland, forests, rivers, raindrops and even in tree canopies deep inside Europe’s nature reserves. It’s in household dust, animal feed, supermarket produce. In one U.S. study, it showed up in 80 percent of urine samples taken from the general public. For years, glyphosate, sold under the Roundup brand, has been at the center of an international legal and regulatory storm. In the United States, Bayer — which acquired Monsanto, Roundup’s original maker — has paid out more than $10 billion to settle lawsuits linking glyphosate to non-Hodgkin’s lymphoma.  Advertisement Glyphosate is now off-patent and manufactured by numerous companies worldwide. But Bayer remains its top seller — achieving an estimated €2.6 billion in glyphosate-related sales in 2024, even as market competition and legal pressures cut into profits. In Europe, lobbyists for the agricultural and chemical sectors have fought hard to preserve its use, warning that banning glyphosate would devastate farming productivity. National authorities remain split. France has tried to phase it out. Germany has promised a full ban — but never delivered. In 2023 — despite mounting concerns, gaps in safety data and political pressure — the European Union reauthorized it for another 10 years. While most of the debate around glyphosate has centered on cancer, some studies have found possible links to reproductive harm, developmental disorders, endocrine disruption and even childhood cancers. Glyphosate has never been definitively linked to Parkinson’s. Bayer told POLITICO in a written response that no regulatory review has ever concluded any of its products are associated with the disease, and pointed to the U.S.-based Agricultural Health Study, which followed nearly 40,000 pesticide applicators and found no statistically significant association between glyphosate and the disease. Bayer said glyphosate is one of the most extensively studied herbicides in the world, with no regulator identifying it as neurotoxic or carcinogenic. But Bloem argues that the absence of a proven link says more about how we regulate risk than how safe the chemical actually is. Unlike paraquat, which causes immediate oxidative stress and has been associated with Parkinson’s in both lab and epidemiological studies, glyphosate’s potential harms are more indirect — operating through inflammation, microbiome disruption or mitochondrial dysfunction, all mechanisms known to contribute to the death of dopamine-producing neurons. But this makes them harder to detect in traditional toxicology tests, and easier to dismiss. “The problem isn’t that we know nothing,” Bloem says. “It’s that we’re not measuring the kind of damage Parkinson’s causes.” Responding, Bayer pointed to paraquat as one of only two agricultural chemicals that studies have linked directly to the development of Parkinson’s disease — even as Syngenta, its manufacturer, maintains there is no proven connection. Advertisement The EU’s current pesticide evaluation framework, like that of many other regulatory systems, focuses primarily on acute toxicity — short-term signs of poisoning like seizures, sudden organ damage or death. Manufacturers submit safety data, much of it based on animal studies looking for visible behavioral changes. But unlike for the heroin users in California, who were exposed to an unusually potent toxin, Parkinson’s doesn’t announce itself with dramatic symptoms in the short term. It creeps in as neurons die off, often over decades. “We wait for a mouse to walk funny,” Bloem says. “But in Parkinson’s, the damage is already done by the time symptoms appear.” The regulatory tests also isolate individual chemicals, rarely examining how they interact in the real world. But a 2020 study in Japan showed how dangerous that assumption may be. When rodents were exposed to glyphosate and MPTP — the very compound that mimicked Parkinson’s in the California heroin cases — the combination caused dramatically more brain cell loss than either substance alone. “That’s the nightmare scenario,” Bloem says. “And we’re not testing for it.” Even when data does exist, it doesn’t always reach regulators. Internal company documents released in court suggest Syngenta knew for decades that paraquat could harm the brain — a charge the company denies, insisting there is no proven link. More recently, Bayer and Syngenta have faced criticism for failing to share brain toxicity studies with EU authorities in the past — data they had disclosed to U.S. regulators. In one case, Syngenta failed to disclose studies on the pesticide abamectin. The Commission and the EU’s food and chemical agencies have called this a clear breach. Bloem sees a deeper issue. “Why should we assume these companies are the best stewards of public health?” he asked. “They’re making billions off these chemicals.”  Syngenta said that none of the withheld studies related to Parkinson’s disease and that it has since submitted all required studies under EU transparency rules. The company added that it is “fully aligned with the new requirements for disclosure of safety data.” Some governments are already responding to the links between Parkinson’s and farming. France, Italy and Germany now officially recognize Parkinson’s as a possible occupational disease linked to pesticide exposure — a step that entitles some affected farmworkers to compensation. But even that recognition, Bloem argues, hasn’t forced the broader system to catch up. WHERE SCIENCE STOPS, POLITICS BEGINS Bloem’s mistrust leads straight to the institutions meant to protect public health — and to people like Bernhard Url, the man who has spent the past decade running one of the most important among them.  Url is the outgoing executive director of the European Food Safety Authority, or EFSA — the EU’s scientific watchdog on food and chemical risks, based in Parma, Italy. The agency has come under scrutiny in the past over its reliance on company-submitted studies. Url doesn’t deny that structure, but says the process is now more transparent and scientifically rigorous. I met Url while he was on a visit to Brussels, during his final months as EFSA’s executive director. Austrian by nationality and a veterinarian by training, he speaks precisely, choosing his words with care. If Bloem is kinetic and outwardly urgent, Url is more reserved — a scientist still operating within the machinery Bloem wants to reform. Advertisement Still, Url didn’t dispute the core of the critique. “There are areas we don’t yet take into consideration,” he told me, pointing to emerging science around microbiome disruption, chemical synergy and chronic low-dose exposure. He didn’t name Parkinson’s, but the implications were clear. “We’re playing catch-up,” he admitted. Part of the problem, he suggested, is structural. The agency relies on a system built around predefined methods and industry-supplied data. “We assess risk based on what we’re given, and what the framework allows us to assess,” Url said. “But science evolves faster than legislation. That’s always the tension.” EFSA also works under constraints that its pharmaceutical counterpart, the European Medicines Agency, does not. “EMA distributes money to national agencies,” Url said. “We don’t. There’s less integration, less shared work. We rely on member states volunteering experts. We’re not in the same league.” A pesticide-free farm in in Gavorrano, Italy. | Alberto Pizzoli/AFP via Getty Images Url didn’t sound defensive. If anything, he sounded like someone who’s been pushing against institutional gravity for a long time. He described EFSA as an agency charged with assessing a food system worth trillions — but working with limited scientific resources, and within a regulatory model that was never designed to capture the risks of chronic diseases like Parkinson’s. “We don’t get the support we need to coordinate across Europe,” he said. “Compared to the economic importance of the whole agri-food industry … it’s breadcrumbs.” But he drew a sharp line when it came to responsibility. “The question of what’s safe enough — that’s not ours to answer,” he said. “That’s a political decision.” EFSA can flag a risk. It’s up to governments to decide whether that risk is acceptable. Advertisement It was a careful way of saying what Bloem had said more bluntly: Science may illuminate the path, but policy chooses where — and whether — to walk it. And in a food system shaped by powerful interests, that choice is rarely made in a vacuum. “There are gaps,” Url said, “and we’ve said that.” But gaps in science don’t always lead to action. Especially when the cost of precaution is seen as an economic threat. THE DOCTOR WHO WON’T SLOW DOWN Evidence from the field is becoming harder to ignore. In France, a nationwide study found that Parkinson’s rates were significantly higher in vineyard regions that rely heavily on fungicides. Another study found that areas with higher agricultural pesticide use — often measured by regional spending — tend to have higher rates of Parkinson’s, suggesting a dose-response relationship. In Canada and the U.S., maps of Parkinson’s clusters track closely with areas of intensive agriculture. The Netherlands has yet to produce comparable data. But Bloem believes it’s only a matter of time. “If we mapped Parkinson’s here, we’d find the same patterns,” he says. “We just haven’t looked yet.” In fact, early signs are already emerging. The Netherlands, known for having one of the highest pesticide use rates in Europe, has seen a 30 percent rise in Parkinson’s cases over the past decade — a slower increase than in some other regions of the world, but still notable, Bloem says. In farming regions like the Betuwe, on the lower reaches of the Rhine River, physiotherapists have reported striking local clusters. One village near Arnhem counted over a dozen cases. “I don’t know of a single farmer who’s doing things purposely wrong,” Bloem says. “They’re just following the rules. The problem is, the rules are wrong.” To Bloem, reversing the epidemic means shifting the regulatory mindset from reaction to prevention. That means requiring long-term neurotoxicity studies, testing chemical combinations, accounting for real-world exposure, genetic predisposition and the kind of brain damage Parkinson’s causes — and critically, making manufacturers prove safety, rather than scientists having to prove harm. “We don’t ban parachutes after they fail,” Bloem says. “But that’s what we do with chemicals. We wait until people are sick.” Advertisement His team is also studying prevention-focused interventions — including exercise, diet and stress reduction — in people already diagnosed with Parkinson’s, in one of the most comprehensive trials of its kind. Still, Bloem is realistic about the limits of individual action. “You can’t exercise your way out of pesticide exposure,” he says. “We need upstream change.” Bloem has seen it before — the same pattern playing out in slow motion. “Asbestos,” he says “Lead in gasoline. Tobacco. Every time, we acted decades after the damage was done.” The science existed. The evidence had accumulated. But the decision to intervene always lagged. “It’s not that we don’t know enough,” he adds. “It’s that the system is not built to listen when the answers are inconvenient.” The clinic has grown quiet. Most of the staff have left for the day, the corridors are still. Bloem gathers his things, but he’s not finished yet. One more phone call to make — something he’ll take, as always, while walking. As we stand up to go into the hallway, he pauses. “If we don’t fix this now,” he says, “we’re going to look back in 50 years and ask: ‘What the hell were we thinking?’” He slips on a pair of black headphones, nods goodbye and turns toward the exit. Outside, he’s already striding across the Radboud campus, talking into the cold evening air — still moving, still making calls, still trying to bend a stubborn system toward change. Graphics by Lucia Mackenzie.

These are difficult times for Europe. They are times that compel us to focus on policies that guarantee our autonomy and sovereignty. The plan to finance European rearmament announced recently by the European Commission shows the even greater need for a united, sovereign and autonomous Europe. And energy is an absolutely essential piece of this puzzle. The EU needs more energy independence, a reality we have known for a long time but that has been manifesting itself in stark relief since 2022, the Russian invasion of Ukraine, and even more so in recent weeks. This geopolitical premise, immovable in the current situation, is also seen in every region of the EU. I’m writing from a small area in the north of Extremadura, Campo Arañuelo, almost halfway between Madrid and Lisbon. The Almaraz nuclear power plant is located here. Almaraz has two reactors that supply 7 percent of all the energy produced in Spain. In addition to being the mayor of one of the villages in the area, I direct a platform, ‘Sí a Almaraz, Sí al futuro’, created less than three months ago to work toward extending the useful life of the Almaraz nuclear power plant, which provides about 3,000 jobs, both direct and indirect. We have no time to lose. According to a 2020 order from the Spanish Ministry of Ecological Transition, led then by Teresa Ribera, Almaraz will have to close its doors permanently in 2028, and the first steps toward its dismantling would begin this year. Almaraz would be the first power plant to fall on a schedule to close all Spanish nuclear power plants, ending in 2035. Sí a Almaraz, Sí al futuro is succeeding in mobilizing more and more people and organizations, both in Extremadura and in Spain. Our region, Extremadura, historically pushed aside when it comes to the interests of other richer or more populated Spanish regions, is no longer willing to let itself be sacrificed for the interests of others. We no longer believe in grand plans that never come true. And it’s very clear to us that if Almaraz is closed, the process of depopulation and aging in Extremadura will just be exacerbated. It is estimated that 30% of the population in Extremadura will be over 65 years of age by 2037 compared with 21% today, with a fall in the total population of around 5%. But this struggle is not only ours. We are not only defending our jobs. That Almaraz continues is as necessary for all of Spain as it is for Europe. This is why next week a delegation from the platform, made up of mayors and representatives from civil society, will work in Brussels with representatives of the Europeans Commission and Parliament to help them understand the depth of what is at stake. To be competitive and independent, Europe needs a mature energy production system. This must have reasonable taxation, decreasing costs, be cheap, stable, meet safety standards and respect the environment, not emitting CO2. In the current geopolitical situation, and with the current technological development of solutions to store renewable energies, this European energy mix must include nuclear energy no matter what. Of course, the platform is a strong supporter of renewable energies, in which Spain and Extremadura are very well positioned, and believes that both production sources are not only compatible but are also mutually complementary. But with current technological development, it simply isn’t responsible to defend replacing the solid power of nuclear with the intermittent power of renewables. > with current technological development, it simply isn’t responsible to defend > replacing the solid power of nuclear with the intermittent power of > renewables. It is also a question of economic competitiveness. As both the Letta and Draghi reports repeatedly warn, without a stable energy supply at a competitive price, European industries – including the defense industries – will not be able to survive in a hostile foreign market, against competitors sometimes ‘doped up’ by their governments or regimes. We have been promised new industries that would replace the Almaraz power plant as a driving economic force in the region. But it’s very clear to us that no new industry is willing to invest in an area without the assurance of a stable energy supply. And Extremadura needs investments. Our GDP per capita is less than 75 percent of the EU average, so we are recipients of ERDF funds and the European Social Fund Plus, whose objectives are to reduce regional inequalities. With this data, closing Almaraz would deepen our discrimination. > without a stable energy supply at a competitive price, European industries – > including the defense industries – will not be able to survive in a hostile > foreign market(…) For all these reasons, we will not rest until the decision the Spanish government formalized between 2019 and 2020 is reversed, as now is a very different context. Europe needs to know what is happening, and there are many things that the Spanish government must reflect on. Why are the overwhelming majority of countries backing nuclear energy? France, the United Kingdom, Italy, Japan, Germany, Belgium. The Belgian case, with authorization from the European Commission for state aid, is symptomatic, as it shows that nuclear policy in EU countries is not merely a national issue but is subject to approval from and supervision by Brussels, which reinforces the union’s role in energy planning. In Spain, Almaraz’s proprietors are not asking for any type of aid or subsidy, but rather a reduction in the tax burden they have to bear, which is much higher than in other comparable countries. And the facility, which began operating in 1981, is more than ready to work, at least, until the age of 60. This has been corroborated by recent technical inspections and its excellent rating in tests by the World Association of Nuclear Operators (WANO). It is therefore time, once and for all, for the Spanish government to sit down to negotiate with the proprietary companies and agree on a continuance that, ensuring the economic profitability of the plants, will turn around a closure plan that was designed in a very different scenario. We have to understand that the situation has change and react accordingly. We won’t let the Almaraz power plant close. Let’s not mutilate, all on our own, our energy sovereignty.

LONDON — The British government stressed that the United States remains a “reliable ally,” amid questions in London about the future of the country’s jointly-maintained nuclear deterrent under Donald Trump. “The U.K. has a long standing, close relationship with the U.S. on all defense nuclear issues,” Prime Minister Keir Starmer’s spokesperson told reporters Thursday. “Long-term arrangements provide the cooperation and collaboration which has been and continues to be a considerable mutual benefit to both nations,” they added. The comments come after defense analysts told the Times of London that Trump’s sharp pivot away from Europe, as he tries to end the Ukraine war, called into question the future of the U.K.’s £3 billion-a-year Trident program, which relies heavily on U.S. cooperation to keep running. Britain has operational control over its Trident nuclear arsenal. But the missiles, loaded on to four nuclear submarines, are U.S. manufactured, and jointly-maintained by the U.K. and U.S. They are subject to periodic refurbishing by the U.S. It has prompted some experts in London to warn that, as Trump’s administration places curbs on intelligence-sharing with Ukraine and pulls back from European security, the U.K. may need to make contingency plans. Nicholas Drummond, a defense industry analyst, told the Times it was “extremely unlikely” the U.S. would cut off U.K. access to Trident missiles, because such a move would mark a “strategic betrayal on a grand scale that would damage him and America.” But he warned: “When it comes to support and maintenance, I would say that we are largely dependent on the U.S. for parts and technical assistance. If this was withdrawn, it would also weaken our deterrent.” He said any refusal by the U.S. to supply Trident missiles in the future would be a “terrifying thought,” and added: “Anyone who suggested this a year ago would have been dismissed as an idiot. Now it is a scenario that we need to plan for.” Britain is already working on a replacement for the aging fleet of Trident-armed Vanguard submarines, with MPs in 2016 voting to renew the program and press ahead with newer so-called “Dreadnought”-class ballistic missile submarines over the coming years. Defense suppliers Rolls Royce and BAE Systems are working on that project. Asked what would happen with Trident in the event of an unreliable United States, Starmer’s spokesperson said Monday: “The prime minister has been absolutely clear. The U.S. is a reliable ally. It’s our closest ally on defense and security and that relationship endures and continues to do so.” The spokesperson added: “Obviously, the prime minister sees the U.K.’s national security as a primary function of his role as prime minister. “But I repeat: Our relationship with the U.S. on defense, security and intelligence remains inextricably entwined, and we have a long-standing close relationship with them, facing back many, many years.” Noah Keate contributed to this report.

Europeans face “lifelong health crises” as the region grapples with a growing mental health crisis among young people, stagnating immunization coverage and high rates of chronic diseases such as obesity and heart disease, according to a World Health Organization report published Tuesday. At the same time, health systems are not ready for future health emergencies, strained under the growing threat of climate change and facing an aging population amid ongoing workforce shortages.   The WHO’s European Health Report, published every three years, looks at the state of health across the European region, which includes 53 countries in Europe, the Caucasus and Central Asia. It found that one in six people in the region die before their 70th birthday from non-communicable diseases (NCDs), such as cardiovascular diseases, cancer, diabetes or chronic respiratory diseases.  “The entire region must confront the root causes of chronic disease, from tobacco and alcohol use to poor access to healthy and nutritious food, to air pollution, to a lack of physical activity,” said WHO Regional Director for Europe Hans Henri Kluge in a statement. The European region has the world’s highest alcohol intake, averaging 8.8 liters of pure alcohol per adult per year, with the EU recording the highest intake. Tobacco use remains “unacceptably high” at 25.3 percent and obesity, currently affecting a quarter of adults, is rising.   The report also found that infant mortality, though overall low in the region, varies greatly among countries and nearly 76,000 children die before their fifth birthday every year, usually due to preterm birth complications, birth asphyxia, congenital heart anomalies, lower respiratory infections, neonatal sepsis or other infections. On top of this, routine vaccination rates are stagnating, which is leading to a resurgence of preventable diseases. For example, measles cases across 41 WHO Europe member countries saw a 30-fold increase in 2023 compared with the previous year, with 58,000 measles cases. Poor mental health is also a growing trend among children and teenagers. One in five teenagers in the region grapples with a mental health condition, with suicide being the leading cause of death among 15 to 29-year-olds. Cyberbullying has also become a significant concern, affecting 15 percent of adolescents. Unhealthy lifestyles are also a worrying trend, according to the report, with nearly one in three school-aged children overweight and one in eight living with obesity. And about 11 percent of teenagers used some form of tobacco products in 2022, including e-cigarettes. The report shows “health linkages across the entire life cycle,” Kluge said. “A healthy child is more likely to grow into a healthy adolescent, a healthy adult and a healthy older person. This couldn’t be more crucial because for the first time ever, there are more people aged over 65 years than under 15 years in the European Region.”