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

LONDON — A mutated influenza strain is spreading early in Europe this winter, but some experts warn talk of a “superflu” is misleading, erodes public trust and distracts from the underlying problems of the National Health Service. The new strain has triggered dramatic headlines in the U.K., where health leaders are warning of a “worst-case scenario” for the country’s NHS. Health Secretary Wes Streeting described it as a “tidal wave of flu tearing through our hospitals” and labelled it a “challenge unlike any [the NHS] has seen since the pandemic.” While hospital admissions have been rising sharply due to the early arrival of flu season, there is currently no evidence that this season’s variant is more deadly or transmissible, experts at the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) told POLITICO. Neither does the data suggest hospital admissions will peak higher than previous years — although this is possible — just that they’re a few weeks early. But some experts in the U.K. have criticized the government’s “superflu” narrative, suggesting it’s being used as leverage in talks on doctor pay and conditions ahead of a looming strike. Prime Minister Keir Starmer wrote in The Guardian Friday it was “beyond belief” doctors would consider striking in these “potentially dire” circumstances, citing “a superflu epidemic.” The British Medical Association (BMA), the union representing resident doctors due to go on strike Wednesday, claimed it was “irresponsible to portray the current winter flu crisis as unprecedented” given that rates of infection and hospitalization were “comparable to most years,” a spokesperson told POLITICO. Mathematician Christina Pagel, a professor at University College London, said the “superflu” line was based on the “highly misleading use of statistics” and had more to do with the impending doctors’ strike than real trends. When contacted by POLITICO, the U.K. government stood by its health leaders’ warnings of the current flu season, in which they described it as an “unprecedented wave of super flu.” They said staff were being “pushed to the limit.” The government also pointed to stats showing the NHS is under pressure. A DHSC spokesperson told POLITICO the government had offered the BMA an extended mandate so they could strike in January instead, but the union rejected it. The BMA told POLITICO the extension included “several restrictive conditions.” THE IMPORTANCE OF TRUST The government and NHS bosses have warned the heavy burden on hospitals in December could set the health system up for a very severe winter. NHS statistics published last week show an average of 2,660 patients in hospital with flu per day, a record for this time of year, while the Health Foundation has said the NHS could face “major pressures” if cases continue to climb rapidly in the weeks ahead. Yet, while NHS staff are stretched, Pagel and others argue this year is largely consistent with previous severe flu seasons. However, without being clear about this with the public, some experts are concerned the government’s messaging could do more harm than good. “One of the real issues we have with governments everywhere is trust,” Martin McKee, professor of public health at the London School of Hygiene and Tropical Medicine, told POLITICO. While NHS staff are stretched, experts argue this year is largely consistent with previous severe flu seasons. | Geography Photos/Getty Images “The difficulty is we’ve seen them do all sorts of things for all sorts of motives. That then becomes a problem whenever they are saying something accurate,” McKee said, adding that the government should be more careful in its flu messaging given the declining trust in science. POLITICO put these concerns over trust in science to DHSC, but the department did not respond by the time of publication. A spokesperson for government-sponsored NHS England told POLITICO: “The NHS is not misleading the public — this is the earliest flu season we have seen in recent years with the latest data showing the numbers of patients in hospital with flu is extremely high for this time of year.” The NHS is struggling as it often does in winter, with a spike in delayed discharges — people who are ready to leave hospital but have nowhere to go — posing an extra challenge for hospitals, The Guardian reported Sunday. Hospital admissions for flu per 100,000 rose 23 percent in last week’s data, compared to 69 percent the previous week, but this doesn’t rule out another surge in the weeks ahead. McKee said the NHS was paying the price for chronic underinvestment. “We almost seem surprised that it’s arrived,” he said of the current flu wave, citing a “massive shortage” in beds, IT equipment and scanners.  WHAT THE EXPERTS SAY There is no reason to think the current flu strain (H3N2 sub-clade K) causes more severe disease than other types of flu, Hans Kluge, head of the World Health Organization’s Europe office, told POLITICO. Nor is there any solid evidence that it is more transmissible, said Edoardo Colzani, a flu expert at the European Centre for Disease Prevention and Control. It’s possible the lower level of immunity to this strain could lead to more cases “but this is still speculative at this stage,” Colzani said. “The epidemiological situation at the moment [in the EU] does not seem worse than in previous years apart from the fact that it is two-to-three weeks earlier,” Colzani said. Kluge said it was “about 4 weeks earlier than usual,” which “is not out of the ordinary” and trending similar to the 2022–2023 influenza season. There were some concerns the available flu vaccine might not be a “perfect match” for the current strain, Kluge said, but early data from the U.K. suggests it provides “meaningful protection” and may prevent severe disease and death, especially among vulnerable groups. “We [could] end up having a much bigger wave than usual but we have no evidence,” Pagel said, adding she thought it was “most likely” to peak “in a couple of weeks.” But the available data can’t tell us whether it will be a normal wave that starts and ends early, or an especially bad season, she added.  “We don’t know when it will turn the corner but the actual shape of the wave doesn’t look that different from previous years,” McKee said. The NHS has previously warned of the risk of a “long and drawn-out flu season” due to the early start. According to the WHO, some countries in the southern hemisphere had unusually long flu seasons this year.  “Based on previous trends, this season is expected to peak in late December or early January,” Kluge said. The advice from EU and U.K. authorities remains the same — get a flu vaccine as soon as possible, especially for those in a vulnerable group.

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

Today, as the world reaches a critical juncture in the fight against HIV/AIDS, tuberculosis (TB) and malaria, the EU must choose: match scientific breakthroughs with political will and investment or retreat, putting two decades of hard-won progress at risk. Having saved over 70 million lives, the Global Fund to Fight AIDS, Tuberculosis, and Malaria (the Global Fund) has proven what smart, sustained investment can achieve.  But the impact of its work — the lives protected, the life expectancy prolonged, the systems strengthened, the innovations deployed — is now under threat due to declining international funding.  > The real question is no longer whether the EU can afford to invest in the > Global Fund, but whether it can afford to let these hard-won gains unravel. The real question is no longer whether the EU can afford to invest in the Global Fund, but whether it can afford to let these hard-won gains unravel. Declining international funding, climate change, conflict and drug resistance are reversing decades of progress. HIV prevention is hampered by rising criminalization and attacks on key populations, with 1.3 million new infections in 2024 — far above targets. TB remains the deadliest infectious disease, worsened by spreading multidrug resistance, even in Europe. Malaria faces growing resistance to insecticides and drugs, as well as the impacts of extreme weather. Without urgent action and sustained investment, these threats could result in a dangerous resurgence of all three diseases. The stakes could not be higher  The Global Fund’s latest results reveal extraordinary progress. In 2024 alone: * 25.6 million people received lifesaving antiretroviral therapy, yet 630,000 still died of AIDS-related causes; * 7.4 million people were treated for TB, with innovations like AI-powered diagnostics reaching frontline workers in Ukraine; and * malaria deaths, primarily among African children under five, have been halved over two decades, with 2.2 billion mosquito nets distributed and ten countries eliminating malaria since 2020. Yet one child still dies every minute from this treatable disease.  What makes this moment unprecedented is not just the scale of the challenge, but the scale of the opportunity. Thanks to extraordinary scientific breakthroughs, we now have the tools to turn the tide:  * lenacapavir, a long-acting antiretroviral, offers new hope for the possibility of HIV-free generations; * dual active ingredient mosquito nets combine physical protection with intelligent vector control, transforming malaria prevention; and  * AI-driven TB screening and diagnostics are revolutionizing early detection and treatment, even in the most fragile settings. Some of these breakthroughs reflect Europe’s continued research and development and the private sector’s leadership in global health. BASF’s dual-active-ingredient mosquito nets, recently distributed by the millions in Nigeria, are redefining malaria prevention by combining physical protection with intelligent vector control. Delft Imaging’s ultra-portable digital X-ray devices are enabling TB screening in remote and fragile settings, while Siemens Healthineers is helping deploy cutting-edge AI software to support TB triage and diagnosis.  But they must be deployed widely and equitably to reach those who need them most. That is precisely what the Global Fund enables: equitable access to cutting-edge solutions, delivered through community-led systems that reach those most often left behind. A defining moment for EU Leadership The EU has a unique chance to turn this crisis into an opportunity. The upcoming G20 summit and the Global Fund’s replenishment are pivotal moments.  President Ursula von der Leyen and Commissioner Síkela can send a clear, unequivocal signal: Europe will not stop at “almost”. It will lead until the world is free of AIDS, tuberculosis and malaria.  The Global Fund is a unique partnership that combines financial resources with technical expertise, community engagement and inclusive governance. It reaches those often left behind — those criminalized, marginalized or excluded from health systems.  > Even in Ukraine, amid the devastation of war, the Global Fund partnership has > ensured continuity of HIV and TB services — proof that smart investments > deliver impact, even in crisis. Its model of country ownership and transparency aligns with Africa’s agenda for health sovereignty and with the EU’s commitment to equity and human rights. Even in Ukraine, amid the devastation of war, the Global Fund partnership has ensured continuity of HIV and TB services — proof that smart investments deliver impact, even in crisis. The cost of inaction Some may point to constraints in the Multiannual Financial Framework. But history shows that the EU has consistently stepped up, even in difficult fiscal times. The instruments exist. What’s needed now is leadership to use them. Failure to act would unravel decades of progress. Resurgent epidemics would claim lives, destabilize economies and undermine global health security. The cost of inaction far exceeds the price of investment. For the EU, the risks are strategic as well as moral. Stepping back now would erode the EU’s credibility as champion of human rights and global responsibility. It would send the wrong message, at precisely the wrong time.  Ukraine demonstrates what is at stake: with Global Fund support, millions continue to receive HIV and TB services despite war. Cutting funding now would risk lives not only in Africa and Asia, but also in Europe’s own neighborhood. A call to action Ultimately, this isn’t a question of affordability, but one of foresight. Can the EU afford for the Global Fund not to be fully financed? The answer, for us, is a resounding no. We therefore urge the European Commission to announce a bold, multi-year financial commitment to the Global Fund at the G20.  This pledge would reaffirm the EU’s values and inspire other Team Europe partners to follow suit. It would also support ongoing reforms to further enhance the Global Fund’s efficiency, transparency and inclusivity. > Ultimately, this isn’t a question of affordability, but one of foresight. Can > the EU afford for the Global Fund not to be fully financed? The answer, for > us, is a resounding no. This is more than a funding decision. It is a moment to define the kind of world we choose to build: one where preventable diseases no longer claim lives, where health equity is a reality and where solidarity triumphs over short-termism. Now is the time to reaffirm Europe’s leadership. To prove that when it comes to global health, we will never stop until the fight is won.

BRUSSELS — An adviser to U.S. Health Secretary Robert F. Kennedy Jr. lauded Europe’s data on Covid-19 vaccines in front of European Parliament lawmakers on Wednesday. Robert W. Malone, one of RFK Jr.’s newly selected vaccine advisers to the U.S. Centers for Disease Control and Prevention, said the United States can’t gather and analyze data as well as Europe does it, name-checking the Nordics and the U.K. especially for their systems. “One of the consequences is we can’t do, frankly, as good a job as you can do in epidemiology, which may be part of the reason why in some nation states, we’re getting better data on the Covid harms from Europe, the U.K., than we’re getting from the United States,” Malone said. That’s because, among other things, “we don’t have socialized medicine the same way you do, and we have barriers to ensure patient confidentiality,” he told right-wing MEPs gathered in the Parliament to launch the Make Europe Healthy Again (MEHA) movement with the Patriots for Europe group. Under RFK Jr., the U.S. has tried to reign in who can receive Covid-19 shots, which until recently were offered to everyone over 6 months of age at least once a year.   Europe diverged from American Covid-19 shot recommendations during the pandemic, restricting eligibility to those who would be at greatest risk from catching the virus as well as weighing the possible side effects. Younger men and teenagers, for example, appeared more susceptible to a rare heart condition after vaccination. RFK Jr., who has campaigned against the use of certain vaccines, has cited Europe’s approach to Covid-19 vaccination in his attempts to restrict who in the U.S. should receive it. He has also pushed for pregnant women to avoid using paracetamol (Tylenol), linking its use to increasing rates of autism in the U.S., under his Make America Health Again (MAHA) campaign.

France has recorded nearly 400 locally-acquired cases of chikungunya this summer, a sharp increase from last year, French health authorities announced Wednesday. As of Sept. 8, there have been 382 cases of chikungunya from infected mosquitoes biting people in mainland France, including 81 from the past week alone, in addition to 966 imported cases. The country also reported 21 cases of locally-acquired dengue and 894 imported cases. It’s a stark increase in the number of chikungunya cases from mosquitoes in the country compared to last year, when only one such case was reported in France. Chikungunya can cause flu-like symptoms, such as high fever, headache, nausea, rash, and muscle and joint pain. Most people recover, although 30 to 40 percent of those affected develop chronic arthritis. Tiger mosquitoes are increasingly spreading across Europe as climate change makes environmental conditions more habitable, raising the risk that vector-borne diseases once limited to the tropics become endemic across the continent.

Estonia’s social affairs minister lambasted the World Health Organization’s Europe chief for meeting with Russia’s foreign minister when the former Soviet country has frequently attacked Ukraine’s health facilities. Karmen Joller, who is also a doctor, said she is “profoundly dismayed” at WHO’s Hans Kluge meeting with Sergey Lavrov, given that Russia has “systematically violated international humanitarian law,” including more than 1,700 attacks on health care facilities, she posted on X. While she noted that Kluge pressed Lavrov on the “urgent need to ensure full respect for international humanitarian principles — including the obligation of all parties to refrain from attacks on health care facilities,” she questioned: “But does anyone genuinely believe that Russia is unaware of these obligations — or that its repeated violations are anything but deliberate?” According to Joller, Kluge’s Russia visit “risks legitimizing a regime that deliberately targets the very values WHO is meant to defend.” Joller was reacting to a post from Kluge, who is regional director of WHO Europe, pictured shaking hands with Lavrov alongside a list of the topics they had discussed: from the pandemic deal to HIV prevention, as well as the obligation not to attack health care facilities. In a separate post Kluge shared that he’d also chaired a meeting on HIV in Moscow, alongside the country’s Deputy Health Minister Andrey Plutnitskiy. Kluge defended his visit to Russia, telling POLITICO the objective of his mission was, “among other things, to advocate for the protection of health care facilities and the upholding of humanitarian principles in all contexts.” He told Russian officials that health care facilities and workers must never be targets. Kluge also said WHO remains “deeply committed to supporting Ukraine’s health system and its people,” and has visited the country five times since the 2022 full-scale Russian invasion, speaking frankly about the devastating attacks on health. With Russia accounting for more than 50 percent of all new HIV cases in the WHO European region, Kluge said it was his “duty” to stand up for the most marginalized — including the LGBTQI community, sex workers, migrants, people who use drugs, and the homeless — in chairing the HIV meeting. Open and constructive engagement with all 53 European member countries “is the only path to securing regional health security and, ultimately, to protecting lives,” Kluge said. “My visit to the Russian Federation was guided by this imperative.”

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.

Europe’s drugs agency is warning about the growing threat of synthetic cathinones, lab-made drugs also known as “bath salts,” which are increasingly being imported and produced on the continent. In its new edition of the European Drug Report, published Thursday, the European Union Drugs Agency (EUDA) warns about emerging threats in a “constantly evolving” European drug market, which include the growing availability of cocaine, new synthetic opioids and the diversification of the synthetic stimulants market beyond the more common amphetamine and methamphetamine. “The rise of highly potent substances and more complex patterns of drug use is placing health and security systems under strain,” EUDA Executive Director Alexis Goosdeel said in a statement. “This calls for a general overhaul of our approach and a shift from monitoring the situation to actively assessing and strengthening our preparedness.” There have been “unprecedented imports and seizures” of synthetic cathinones in 2023, the EUDA writes, and the more widespread availability and use of these substances raise “concerns about increased health and social problems.” “Bath salts” pose similar health risks to other stimulant drugs such as amphetamine and methamphetamine — known as speed and meth. These include overdoses, acute and chronic mental health problems and spread of infectious diseases. But synthetic cathinones can contain higher potency substances that might have different and more severe health risks, the agency warns. Poland stands out as a production hub for the drug in Europe. In 2023, authorities dismantled 53 synthetic cathinone production sites across the continent — compared to 29 in 2022. Forty of them were in Poland. “This is one illustration of the significant intensification of drug production in Europe,” the EUDA said. The quantity of synthetic cathinone seized in Europe has been rising over the past few years, going from 3.3 metric tons in 2020 to 26.5 metric tons in 2022. In 2023, the number went up to 37 tons, according to the report. Already in 2024, the agency had warned that production of “bath salts” was growing in parts of Europe and there were “signs” that a small number of synthetic cathinones were “becoming established” in stimulant markets on the continent. The drug was traditionally largely imported from China, but now there have been growing imports from India, coming into Europe primarily through the Netherlands. SYNTHETIC OPIOIDS AND COCAINE In the report, which looks at data from 29 countries (the 27 EU members, Turkey and Norway), the agency also highlighted the threat posed by the emergence of new synthetic opioids, which feature particularly in the Baltic countries. These drugs are highly potent and a small amount can pose elevated life-threatening poisoning risks. In particular, nitazene opioids have recently entered the European drug market and their availability is increasing. Drug-induced deaths went up, from 7,100 in 2022 to 7,500 in 2023, mostly caused by a combination of opioids and other substances. Cocaine is the second most commonly used illicit drug in Europe — after cannabis — and the most commonly consumed illicit stimulant drug, used by around 4.6 million European adults in the last year. The EUDA is warning that the availability of cocaine is continuing to increase, in the form of both cocaine powder and crack cocaine, an increase which is “having a growing negative impact on public health in Europe.” Cocaine residues in wastewater also increased in several cities, which “suggests that as cocaine has become increasingly available, so too has its geographical and social distribution,” it said. EU countries also seized record quantities of cocaine for the seventh consecutive year, amounting to a 418 metric tons in 2023, compared to 323 metric tons in 2022. Nearly three-quarters of the total quantity taken was seized in Belgium, Spain and the Netherlands.

French regions are waging war against tiger mosquitoes as the country records rising cases of tropical diseases such as dengue, zika and chikungunya. Since Jan. 1, France has already seen 1,123 imported cases of dengue, 728 imported cases of chikungunya and four imported cases of zika. In May alone, French health authorities said they recorded 225 cases of chikungunya, 152 cases of dengue and one case of zika — also all imported. The numbers raise alarm for health authorities, who are warning people to watch out for tiger mosquitoes, the insects most responsible for carrying and spreading the diseases. While a person infected with dengue or chikungunya cannot pass the virus to another person, they can infect other mosquitoes which can further spread the disease. Zika can be transmitted from an infected person through sexual intercourse. The southeastern region of Auvergne-Rhône-Alpes — which was the second most affected French region in 2024 and already recorded 68 cases of chikungunya and dengue in May — has issued recommendations to help eradicate the mosquitoes, which have spread to over one quarter of the municipalities in the region. They urge people to store, empty or cover containers that could accumulate water, which can serve as breeding sites for mosquitoes, and take precautions against mosquito bites, especially when traveling. They’re also sending a plea to mayors and other local officials to take action to control the spread of mosquitoes. It’s not just France: Belgium’s public health institute warned that tiger mosquitoes had been found in twice as many locations in 2023 compared with the previous year. The Flemish Department of Public Health also launched a new campaign to minimize the spread of the tiger mosquitoes earlier this month, urging people to play their part to stop the invasive insect from breeding. Tiger mosquitoes are increasingly spreading across Europe as climate change makes environmental conditions more habitable, raising the risk that vector-borne diseases once limited to the tropics become endemic across the continent.