Listen on * Spotify * Apple Music * Amazon Music Wer regiert die Welt – und was treibt sie an? In unserem regelmäßigen Machthaber-Spezial geht es um die mächtigsten und umstrittensten Politikerinnen und Politiker unserer Zeit. Wir zeigen, wie sie denken, entscheiden – und was das für uns bedeutet. Eine Politikerin oder Politiker, alle zwei Wochen, ein Blick hinter die Kulissen der Macht. Die nächste Folge hört ihr am Dienstag, 30.12.2025. Dann mit einem Porträt der dänischen Ministerpräsidentin Mette Frederiksen. Das Berlin Playbook als Podcast gibt es jeden Morgen ab 5 Uhr. Gordon Repinski und das POLITICO-Team liefern Politik zum Hören – kompakt, international, hintergründig. Für alle Hauptstadt-Profis: Der Berlin Playbook-Newsletter bietet jeden Morgen die wichtigsten Themen und Einordnungen. ⁠Jetzt kostenlos abonnieren.⁠ Mehr von Host und POLITICO Executive Editor Gordon Repinski:Instagram: ⁠@gordon.repinski⁠ | X: ⁠@GordonRepinski⁠. Legal Notice (Belgium) POLITICO SRL Forme sociale: Société à Responsabilité Limitée Siège social: Rue De La Loi 62, 1040 Bruxelles Numéro d’entreprise: 0526.900.436 RPM Bruxelles info@politico.eu www.politico.eu

Disclaimer POLITICAL ADVERTISEMENT * This is sponsored content from AstraZeneca. * The advertisement is linked to public policy debates on the future of cancer care in the EU. More information here. Europe has made huge strides in the fight against cancer.[1] Survival rates have climbed, detection has improved and the continent has become home to some of the world’s most respected research hubs.[2],[3] None of that progress came easy — it was built on years of political attention and cooperation across borders. However, as we look to 2026 and beyond, that progress stands at a crossroads. Budget pressures and tougher global competition threaten to push cancer and health care down the EU agenda. Europe’s Beating Cancer Plan — a flagship initiative aimed at expanding screening, improving early detection and boosting collaboration — is set to expire in 2027, with no clear plan to secure or extend its gains.[4],[5] “My [hope is that we can continue] the work started with Europe’s Beating Cancer Plan and make it sustainable… [and] build on the lessons learned, [for other disease areas] ” says Antonella Cardone, CEO of Cancer Patients Europe. A new era in cancer treatment Concern about the lapsing initiative is compounded by two significant shifts in health care: declining investment and increasing scientific advancement. Firstly, Europe has seen the increased adoption of cost-containment policies by some member states. Under-investment in Europe in cancer medicines has been a challenge — specifically with late and uneven funding, and at lower levels than international peers such as the US — potentially leaving patients with slower and more limited access to life-saving therapies.[6],[7],[8] Meanwhile, the U.S., which pays on average double for medicines per capita than the EU,[9] is actively working to rebalance its relationship with pharmaceuticals to secure better pricing (“fair market value”) through policies across consecutive administrations.[10] All the while, China is rapidly scaling investment in biotech and clinical research, determined to capture the trials, talent, and capital that once flowed naturally to Europe.[11] The rebalancing of health and life-science investment can have significant consequences. If Europe does not stay attractive for life-sciences investment, the impact will extend beyond cancer patient outcomes. Jobs, tax revenues, advanced manufacturing, and Europe’s leadership in strategic industries are all at stake.[12] Secondly, medical science has never looked more promising.[7] Artificial intelligence is accelerating drug discovery, clinical trials, and diagnostics, and the number of approved medicines for patients across Europe has jumped from an average of one per year between 1995 and 2000 to 14 per year between 2021 and 2024.[13],[14],[15], [7] Digital health tools and innovative medtech startups are multiplying, increasing competitiveness and lowering costs — guiding care toward a future that is more personalized and precise.[16],[17] Europe stands at the threshold of a new era in cancer treatment. But if policymakers ease up now, progress could stall — and other regions, especially the U.S. and China, are more than ready to widen the innovation gap. Recognizing the strategic investment Health spending is generally treated as a budget item to be contained. Yet investment in cancer care has been one of Europe’s smartest economic bets.[18],[19] The sector anchors millions of high-skilled jobs (it employs around 29 million people in the EU[11]) and attracts global life sciences investment. According to the European Commission, the sector contributes nearly €1.5 trillion to the EU economy.[12] Studies from the Institute of Health Economics confirm that money put into research directly translates into better survival outcomes.[20] The same report shows that although the overall spend on cancer is increasing, the cost per patient has actually decreased since 1995, suggesting that innovative treatments are increasing efficiency.[20] Those gains matter not only to patients and families, but to Europe’s long-term stability: healthier populations mean fewer costs down the line, stronger productivity, and more sustainable public finances.[20] Fixing Europe’s access gap Cancer medicines bring transformative value — to patients, to society and to the wider economy. [21] However, even as oncology therapies advance, patients across Europe are not benefiting equally. EFPIA’s 2024 Patients W.A.I.T. indicator shows that, on average, just 46 percent of innovative medicines approved between 2020 and 2023 were available to patients in 2024.[22] On average, it takes 578 days for a new oncology medicine to reach European patients, and only 29 percent of drugs are fully available in all member states.[23] This is not caused by a lack of breakthrough medicines, but by national policy mechanisms that undervalue innovation. OECD and the Institute for Health Economics data show that divergent HTA requirements, rigid cost-effectiveness thresholds, price-volume clawbacks, ad hoc taxes on pharmaceutical revenues and slow national reimbursement decisions collectively suppress timely access to new cancer medicines across the EU.[24] These disparities cut against Europe’s long-standing reputation as a collection of societies that values equitable, high-quality care for all of its citizens. It risks eroding one of the EU’s defining strengths: the commitment to fairness and collective progress. Cancer policy solutions for the EU Although this is ultimately a matter for member states, embedding cancer as a permanent EU priority — backed by funding, coordination, and accountability — could give national systems the incentives and strategic direction to buck these trends. These actions will reassure pharmaceutical companies that Europe is serious about attracting clinical trials and the launch of new medicines, ensuring that its citizens, societies and economies enjoy the benefits this brings. Europe’s Beating Cancer Plan delivered progress, but its expiry presents a pivotal moment. 2026 and beyond bring a significant opportunity for the EU to build on this by ensuring that member states implement National Cancer Control Plans and have clear targets and accountability on their national performance, including on investment and access. To do this, EU policymakers should consider three actions as an immediate priority with lasting impact: * Embed cancer and investment within EU governance. Build it into the European Semester on health with mandatory indicators, regular reviews, and accountability frameworks to ensure continuity. This model worked well during Covid-19 and should be adapted for non-communicable diseases starting with cancer as a pilot. * Secure stable and sufficient funding. The Multiannual Financial Framework must ensure adequate funding for health and cancer to encourage coordinated initiatives across member states. * Strengthen EU-level coordination. Ensure that pan-EU structures such as the Comprehensive Cancer Centres and Cancer Mission Hubs are adequately funded and empowered. These are the building blocks of a lasting European commitment to cancer. With action, Europe can secure a sustainable foundation for patients, resilience and continued scientific excellence. -------------------------------------------------------------------------------- [1] European Commission, OECD/European Observatory on Health Systems and Policies. 2023. State of Health in the EU: Synthesis Report 2023. Available at: https://health.ec.europa.eu/system/files/2023-12/state_2023_synthesis-report_en.pdf [Accessed December 2025] [2] Efpia. 2025. Cancer care 2025: an overview of cancer outcomes data across Europe. Available at: https://www.efpia.eu/news-events/the-efpia-view/statements-press-releases/ihe-cancer-comparator-report-2025/ [Accessed December 2025] [3] Cancer Core Europe. 2024. Cancer Core Europe: Advancing Cancer Care Through Collaboration. Available at: https://www.cancercoreeurope.eu/cce-advancing-cancer-care-collaboration/ [Accessed December 2025] [4] European Commission. 2021. Europe’s Beating Cancer Plan. Available at:https://health.ec.europa.eu/system/files/2022-02/eu_cancer-plan_en_0.pdf [Accessed December 2025] [5] European Parliament. 2025. Europe’s Beating Cancer Plan: Implementation findings. https://www.europarl.europa.eu/RegData/etudes/STUD/2025/765809/EPRS_STU(2025)765809_EN.pdf [Accessed December 2025] [6] Hofmarcher, T., et al. 2024. Access to Oncology Medicines in EU and OECD Countries (OECD Health Working Papers, No.170). OECD Publishing. Available at: https://www.oecd.org/content/dam/oecd/en/publications/reports/2024/09/access-to-oncology-medicines-in-eu-and-oecd-countries_6cf189fe/c263c014-en.pdf [Accessed December 2025] [7] Manzano, A., et al. 2025. Comparator Report on Cancer in Europe 2025 – Disease Burden, Costs and Access to Medicines and Molecular Diagnostics (IHE). Available at: https://ihe.se/app/uploads/2025/03/IHE-REPORT-2025_2_.pdf [Accessed December 2025] [8] Efpia. [no date]. Europe’s choice. Available at: https://www.efpia.eu/europes-choice/ [Accessed December 2025] [9] OECD. 2024. Prescription Drug Expenditure per Capita. https://data-explorer.oecd.org/vis?lc=en&pg=0&snb=1&vw=tb&df[ds]=dsDisseminateFinalDMZ&df[id]=DSD_SHA%40DF_SHA&df[ag]=OECD.ELS.HD&df[vs]=&pd=2015%2C&dq=.A.EXP_HEALTH.USD_PPP_PS%2BPT_EXP_HLTH._T..HC51%2BHC3.._T…&to[TIME_PERIOD]=false&lb=bt [Accessed December 2025] [10] The White House. 2025. Delivering most favored-nation prescription drug pricing to American patients. Available at: https://www.whitehouse.gov/presidential-actions/2025/05/delivering-most-favored-nation-prescription-drug-pricing-to-american-patients/ [Accessed December 2025] [11] Eleanor Olcott, Haohsiang Ko and William Sandlund. 2025. The relentless rise of China’s Biotechs. Financial Times. Available at: https://www.ft.com/content/c0a1b15b-84ee-4549-85eb-ed3341112ce5 [Accessed December 2025] [12] European Commission, Directorate-General for Communication. 2025. Making Europe a Global Leader in Life Sciences. Available at: https://commission.europa.eu/news-and-media/news/making-europe-global-leader-life-sciences-2025-07-02_en [Accessed December 2025] [13] Financial Times. 2025. How AI is reshaping drug discovery. Available at: https://www.ft.com/content/8c8f3c10-9c26-4e27-bc1a-b7c3defb3d95 [Accessed December 2025] [14] Seedblink. 2025. Europe’s HealthTech investment landscape in 2025: A deep dive. https://seedblink.com/blog/2025-05-30-europes-healthtech-investment-landscape-in-2025-a-deep-dive [15] European Commission. [No date]. Artificial Intelligence in healthcare. Available at: https://health.ec.europa.eu/ehealth-digital-health-and-care/artificial-intelligence-healthcare_en [Accessed December 2025] [16] Codina, O. 2025. Code meets care: 20 European HealthTech startups to watch in 2025 and beyond. EU-Startups. Available at: https://www.eu-startups.com/2025/06/code-meets-care-20-european-healthtech-startups-to-watch-in-2025-and-beyond [Accessed December 2025] [17] Protogiros et al. 2025. Achieving digital transformation in cancer care across Europe: Practical recommendations from the TRANSiTION project. Journal of Cancer Policy. Available at: https://www.sciencedirect.com/science/article/pii/S2213538325000281 [Accessed December 2025] [18] R-Health Consult. [no date]. The case for investing in a healthier future for the European Union. EFPIA. Available at: https://www.efpia.eu/media/xpkbiap5/the-case-for-investing-in-a-healthier-future-for-the-european-union.pdf [Accessed December 2025] [19] Pousette A., Hofmarcher T. 2024.Tackling inequalities in cancer care in the European Union. Available at: https://ihe.se/en/rapport/tackling-inequalities-in-cancer-care-in-the-european-union-2/ [Accessed December 2025] [20] Efpia. 2025. Comparator Report Cancer in Europe 2025. Available at: https://www.efpia.eu/media/0fbdi3hh/infographic-comparator-report-cancer-in-europe.pdf [Accessed December 2025] [21] Garau, E. et al. 2025. The Transformative Value of Cancer Medicines in Europe. Dolon Ltd. Available at: https://dolon.com/wp-content/uploads/2025/09/EOP_Investment-Value-of-Oncology-Medicines-White-Paper_2025-09-19-vF.pdf?x16809 [Accessed December 2025] [22] IQVIA. 2025. EFPIA Patients W.A.I.T. Indicator 2024 Survey. Available at: https://www.efpia.eu/media/oeganukm/efpia-patients-wait-indicator-2024-final-110425.pdf [Accessed December 2025] [23] Visentin M. 2025. Improving equitable access to medicines in Europe must remain a priority. The Parliament. Available at: https://www.theparliamentmagazine.eu/partner/article/improving-equitable-access-to-medicines-in-europe-must-remain-a-priority [Accessed December 2025] [24] Hofmarcher, T. et al. 2025. Access to novel cancer medicines in Europe: inequities across countries and their drivers. ESMO Open. Available at: https://www.esmoopen.com/action/showPdf?pii=S2059-7029%2825%2901679-5 [Accessed December 2025]

Listen on * Spotify * Apple Music * Amazon Music Friedrich Merz trifft den türkischen Präsidenten Recep Tayyip Erdoğan – und das vor dem Hintergrund massiver innenpolitischer Spannungen in der Türkei: Ein neuer Haftbefehl gegen Oppositionsführer Ekrem İmamoğlu, staatliche Eingriffe in die Pressefreiheit und wachsendes Misstrauen gegenüber Deutschland. Gemeinsam mit Deniz Yücel analysiert Rixa Fürsen, was die Reise des Kanzlers bedeutet – politisch, wirtschaftlich und strategisch. Das Berlin Playbook als Podcast gibt es morgens um 5 Uhr. Gordon Repinski und das POLITICO-Team bringen euch jeden Morgen auf den neuesten Stand in Sachen Politik — kompakt, europäisch, hintergründig. Und für alle Hauptstadt-Profis: Unser Berlin Playbook-Newsletter liefert jeden Morgen die wichtigsten Themen und Einordnungen. Hier gibt es alle Informationen und das kostenlose Playbook-Abo. Mehr von Berlin Playbook-Host und Executive Editor von POLITICO in Deutschland, Gordon Repinski, gibt es auch hier:   Instagram: @gordon.repinski | X: @GordonRepinski.

MADRID — Europe’s far-right leaders huddled in Madrid on Saturday as a show of force following Donald Trump’s reelection. Boasting about a new era of conservative governments in Europe under the motto “Make Europe Great Again,” the Patriots for Europe party, the third-largest EU political family, held its first rally since its inception after last summer’s EU election. On the menu? Scrapping green policy, battling Islam, taking down Brussels EU governance, migration, opposing gender and family diversity, and fighting “population replacement.” “Our friend Trump, the Trump tornado, has changed the world in just a couple of weeks. An era has ended. Today, everyone sees that we are the future,” crowed Hungarian Prime Minister Viktor Orbán, the most senior of the leaders at the really in the Spanish capital. “We’re facing a global tipping point,” said France’s Marine Le Pen, while celebrating that, since Trump’s inauguration, European Commission President Ursula von der Leyen “has all but disappeared from the screens.” The guests, mostly Vox’s most loyal supporters and political muscle from across Spain, descended on Madrid Airport’s Marriott Conference Center to fill a 2,000-seat auditorium, armed their Dior scarfs and Barbour jackets. They came to listen to leaders including Orbán, Le Pen, the Netherlands’ Geert Wilders, Italy’s Matteo Salvini, Czechia’s Andrej Babiš and Austria’s Herbert Kickl, who joined via video link as he finalizes negotiations in Vienna to become Austria’s new chancellor. One after the other, the leaders vowed to “reconquer” Europe’s governments from Socialist, liberal and center-right forces — building an explicit parallel to Spain’s “Reconquista,” when Christian kingdoms reconquered the Iberian Peninsula from Muslim rulers in the Middle Ages. Following his landslide victory in Austria, Kickl argued that “people everywhere are rising against the impositions of the EU centralists and left-wing ideologies,” and promised a new model of European cooperation based on national sovereignty. GREEN DEAL AND IMMIGRATION The leaders agreed the EU and the European Commission president are the source of Europe’s social and economic malaise. “The Green Deal is dead,” said Czechia’s Babiš, former prime minister and leader of ANO, currently topping the polls. “Brussels is leading us down a road that brings us to [economic] blackout and economic collapse,” he added. “Energy policy is a fiasco, dragging our economies down. … Industrialists are openly rebelling against absurd and suicidal dictates,” said Le Pen. The European migration pact also was in the spotlight, with all leaders at the rally blaming Brussels for incoming migrants. “People have had enough of illegal immigration. And I ask you, do you have enough of crime in Spain? Do you have a lot of Islamic immigration in Spain? Do you have enough of woke insanity?” asked Dutch far-right leader Wilders, whose PVV party has been in government since May last year. “Yes!” cheered the crowd as they repeated “Viva España.” “You were the first who rolled back Islam and restored the rich heritage of Christianity in your country,” Wilders said. “That’s why we are great admirers of Spain.” All the leaders at the rally also echoed a rejection of gender and sexual diversity, including repeated celebrations of Trump’s two-gender only policy.  “We will defend Christianity and traditional values. … We will defend traditional and normal family: mother, father and many children,” said Krzysztof Bosak, leader of Poland’s Konfederacja. LOOKING FOR ALLIES But the Patriots for Europe are well aware they will not get far in Brussels’ democratic structures without other allies, as they currently are the third force in the European Parliament with 86 seats, and, for now, only hold one head of government out of 27. Le Pen argued that, despite Italian Prime Minister Giorgia Meloni belonging to another political party, the European Conservatives and Reformists (ECR), “there are a number of issues we can all agree on.” “And the issue of the day is: Are we or are we not going to stop with this Green Deal nonsense?” Le Pen said, arguing that the ECR will team up with them, but also with certain members of the center-right European People’s Party (EPP). The EPP, the biggest European party holding the most leadership positions, has been flirting with the groups to its right, having voted alongside the Patriots to water down the EU’s deforestation regulation. However, they have for now stuck to their alliance with Socialists and Democrats and liberals. “You must finally choose,” said Italy’s Deputy Prime Minister Matteo Salvini: “We ask you for the vision and courage to stop collaborating with the socialists and the left in Brussels. … The EPP must choose between a disastrous past and a future of change.” At the same time, leader of Spain’s Vox party and the president of the Patriots, Santiago Abascal, said: “We have to reach out permanently to our allies in Europe,” wishing Alternative for Germany’s Alice Weidel, from the Europe of Sovereign Nations (ESN) group, success in the upcoming German election. “We have to know how to put aside our differences and live with them without that impeding constant cooperation in the face of common enemies,” Abascal said. Prior to the rally, leaders on Friday met behind closed doors followed by a gala dinner with special guest Kevin Roberts, president of the Heritage Foundation, a leading U.S. Republican-linked conservative think tank.

John Kampfner is a British author, broadcaster and commentator. His latest book is “In Search of Berlin,” published by Atlantic. He is a regular POLITICO columnist. Nobody in Europe showers German Chancellor Olaf Scholz with compliments. So, when Joe Biden turned to the German leader during his first and last presidential visit to Berlin earlier this month, and said “thank you, thank you, thank you,” the chancellor couldn’t help but flash a broad grin. With Germany’s economy stuttering in a second year of recession and his coalition government teetering on the brink, Scholz is in need of friends wherever he can find them. Very soon he may have former U.S. President Donald Trump — who’s no friend of Germany — to grapple with. And due to several disputes, some of which it has deliberately engineered, Berlin now has precious few allies in Europe. One political figure who might have smiled at Scholz would be former British Prime Minister Margaret Thatcher, who spent years picking fights with Brussels to make a point, even if she knew she wouldn’t prevail. Win or fail, what mattered most for Thatcher in her political fights with Europe was the political standing it brought back home — and that seems to be Scholz’s tactic too. The leader of the Continent’s most powerful economy and of the country once regarded as the most collaborative in Europe, Scholz now seems to view the bloc as a problem to be managed. Meanwhile, European institutions and member countries seem to regard him, in their turn, as a problem to be managed too. Of course, some might argue that Germany’s actions were never quite as generous as its words. For this, they’d point to the 2008 financial crash and subsequent debt crisis, and suggest that Berlin saw its EU partners as export fodder required to toe its strict fiscal line. Indeed, halcyon moments where individual nations relegated their interests in favor of a common good are mythical. Mercantilism has always played a major part in these relationships. But the difference between then and now is that Germany is no longer trying to minimize the differences. Take these recent examples: Germany was one of only five EU members to reject the imposition of tariffs on Chinese electric vehicles. Scholz came under sustained pressure from German carmakers — which rely on China for sales — and yet he decided to vote alongside the likes of serial rebels Hungary and Slovakia, knowing the European Commission would press ahead regardless. But why go against the European mainstream, even when you know you’re going to lose? Then, in March, the EU backed a law that would require companies to audit their supply chains despite an abstention from the German government — or rather, from the smallest of its three coalition partners, the Free Democrats. With Germany’s economy stuttering in a second year of recession and his coalition government teetering on the brink, Olaf Scholz is in need of friends wherever he can find them. | Hannibal Hanschke/Getty Images And finally, while Germany has long argued for greater fiscal and monetary unity within the EU, as well as for free market principles to be more rigorously embedded, Scholz voiced opposition to Italian bank UniCredit’s plan to merge with Commerzbank — a move that perplexed EU and corporate leaders alike. This isn’t the German behavior of yesteryear. And there have been other iterations of it as well. Scholz is different to his predecessors in both tone and substance. For one, he doesn’t work the room. On entering summit meetings, he sits down, puts on his translation headphones and speaks only to deliver his position. Then, there’s the most visible — and symbolically important — demonstration of what’s been coming across as a “Germany First” approach: The government’s unilateral decision to impose checks on its remaining open borders. While controls had been operating on Germany’s eastern frontiers with the Czech Republic, Poland and Austria for some time now, in the middle of September, these checks were also applied to the country’s borders with France, the Netherlands, Belgium and Denmark at short notice. And although the government insisted these changes were limited to six months, the expectation is that they’ll be renewed. Schengen RIP, or so it seems. With that, it looks as though everyone’s doing their own thing on migration now. Italian Prime Minister Giorgia Meloni — regarded in Brussels as one of Europe’s most powerful figures — has set the tone with her Albania deal. The right-wing coalition in the Netherlands is seeking to opt out from EU-wide migration rules. Meanwhile, Finland and Poland, both facing Kremlin-coordinated immigration waves along their borders with Russia and Belarus, are striking out on their own too. Germany thus isn’t going out on a limb per se. But what is so different from a decade or two ago is that it isn’t trying to lead either. The EU has traveled far since its optimistic, federalist era of old. Each country is now fighting for scraps and pursuing its own agenda, compounding the many challenges facing Commission President Ursula von der Leyen as she begins her second term and is increasingly at odds with national governments. But even if there’s little goodwill or vision, there’s still an acute need for the big players to come together. Not just to fight fires, but to address Europe’s structural problems — both present and future. And that was the message from former European Central Bank President Mario Draghi in his recent blueprint on competitiveness, which was commissioned by von der Leyen. “We have reached the point where, without action, we will have to either compromise our welfare, our environment or our freedom,” Draghi declared. The message is a familiar one coming from Brussels: Either integrate, or die as a global force. It seems, however, we’re headed in the opposite direction — and Germany is part of the reason for that.