LONDON — They’re young, full of ideas — and about to be given the vote. Britain’s government has committed to lowering the voting age from 18 to 16 years — a major extension of the electorate that could have big implications for the outcome of the next race, expected by 2029. It means Brits who are just 12 today are in line to vote in the next general election, which is expected to be a fierce battle between incumbent Keir Starmer and his right-wing challenger Nigel Farage. But what do these young people actually think? In a bid to start pinning down the views of this cohort, POLITICO commissioned pollster More in Common to hold an in-depth focus group, grilling eight youngsters from across the country on everything from social media disinformation to what they would do inside No. 10 Downing Street. To protect those taking part in the study, all names used below are pseudonymous. The group all showed an interest in politics, and had strong views on major topics such as immigration and climate change — but the majority were unaware they would get the chance to vote in 2029.  In a bid to prepare the country for the change, the Electoral Commission has recommended that the school curriculum be reformed to ensure compulsory teaching on democracy and government from an early age. GET YOUR ACT TOGETHER There are few better introductions to the weird world of British politics than prime minister’s questions, the weekly House of Commons clash between Prime Minister Keir Starmer and his Conservative opponent Kemi Badenoch. Our group of 12-13-year-olds was shown a clip of the clash and asked to rate what they saw. They came away distinctly unimpressed. Hanh, 13, from Surrey, said the pair seemed like children winding each other up. “It seems really disrespectful in how they’re talking to each other,” she commented. “It sounds like they’re actually kids bickering … They were just going at each other, which didn’t seem very professional in my opinion.” Sarah, 13, from Trowbridge in the west of England, said the leading politicians were “acting like a pack of wild animals.” | Clive Brunskill/Getty Images Sarah, 13, from Trowbridge in the west of England, said the leading politicians were “acting like a pack of wild animals.” In the clip, the Commons backbenches roar as Tory Leader Kemi Badenoch quips about Starmer’s MPs wanting a new leader for Christmas. In turn, the PM dismisses the Conservative chief’s performance as a “Muppet’s Christmas Carol.” Twelve-year-old Holly, from Lincolnshire, said the pair were being “really aggressive and really harsh on each other, which was definitely rude.” And she said of the PM: “It weren’t really working out for Keir Starmer.” None of the children knew who Badenoch was, but all knew Starmer — even if they didn’t have particularly high opinions of the prime minister, who is tanking in the polls and struggling to get his administration off the ground. Twelve-year-old Alex said the “promises” Starmer had made were just “lies” to get him into No. 10. Sophie, a 12-year-old from Worcester in the West Midlands, was equally withering, saying she thought the PM is doing a “bad job.” “He keeps making all these promises, but he’s probably not even doing any of them,” she added. “He just wants to show off and try to be cool, but he’s not being cool because he’s breaking all the promises. He just wants all the money and the job to make him look really good.” Sarah said: “I think that it’s quite hard to keep all of those promises, and he’s definitely bitten off more than he can chew with the fact that he’s only made those statements because he wants to be voted for and he wants to be in charge.”  While some of the young people referenced broken promises by Starmer, none offered specifics. THE FARAGE FACTOR Although they didn’t know Badenoch as leader of the opposition, the whole room nodded when asked if they knew who Nigel Farage was. Although they didn’t know Badenoch as leader of the opposition, the whole room nodded when asked if they knew who Nigel Farage was. | Dan Kitwood/Getty Images “He’s the leader of the Reform party,” said Alex, whose favorite subject is computing. “He promises lots of things and the opposite of what Starmer wants. Instead of helping immigrants, he wants to kick them out. He wants to lower taxes, wants to stop benefits.” Alex added: “I like him.” Sarah was much less taken. “I’ve heard that he’s the leader of the far right, or he’s part of the far right. I think he’s quite a racist man.” Farage has faced accusations in recent weeks of making racist remarks in his school days. The Reform UK leader replied that he had “never directly racially abused anybody.” Other participants said they’d only heard Farage’s name before. When asked who they would back if they were voting tomorrow, most children shrugged and looked bewildered. Only two of the group could name who they wanted to vote for — both Alex and Sam backed Farage. POLICY WORRIES Politicians have long tried to reach Britain’s youngsters through questionable TikTok videos and cringe memes — but there was much more going on in the minds of this group than simply staring at phones. Climate change, mental health and homelessness were dominant themes of the conversation. Climate change is “dangerous because the polar bears will die,” warned Chris, 13, from Manchester. Sophie, who enjoys horse riding, is worried about habitats being destroyed and animals having to find new homes as a result of climate change, while Sarah is concerned about rising sea levels. Thirteen-year-old Ravi from Liverpool said his main focus was homelessness. “I know [the government is] building houses, but maybe speed the process up and get homeless people off the streets as quick as they can because it’s not nice seeing them on the streets begging,” he said. Sam agreed, saying if he personally made it into No.10, he would make sure “everyone has food, water, all basic survival stuff.” Sarah’s main ask was for better mental health care amid a strained National Health Service. “The NHS is quite busy dealing with mental health, anxiety and things like that,” she said. “Maybe we should try and make an improvement with that so everyone gets a voice and everyone’s heard.” IMMIGRATION DIVISIONS When the conversation moved to the hot-button topic of immigration, views were more sharply divided. Imagining what he’d do in government, Alex said he’d focus on “lowering taxes and stopping illegal immigrants from coming over.” “Because we’re paying France billions just to stop them, but they’re not doing anything,” he said. “And also it’s spending all the tax money on them to give them home meals, stuff like that.” In July, Starmer and France’s Emmanuel Macron unveiled a “one in, one out” pilot program to tackle illegal migration, although it’s enjoyed limited success so far and has generated some embarrassing headlines for the British government. Hanh said she’d been taught at school that it’s important to show empathy, but noted some people are angry about taxes going to support asylum seekers. Chris and Sarah both said asylum seekers are fleeing war, and seemed uneasy at the thought of drawing a hard line. Holly said she wants “racism” — which she believes is tied to conversations about immigration — to end. “I often hear a lot of racism [at school] and prejudice-type stuff … I often hear the N word. People don’t understand how bad that word is and how it can affect people,” she said. “They [migrants] have moved away from something to get safer, and then they get more hate.” Hanh said she is seeing more anti-immigration messages on social media, such as “why are you in my country, get out,” she said. “Then that’s being dragged into school by students who are seeing this … it’s coming into school environment, which is not good for learning.” NEWS SNOOZE Look away now, journalists: The group largely agreed that the news is boring. Some listen in when their parents have the television or radio on, but all said they get most of their news from social media or the odd push alert. Asked why they think the news is so dull, Hanh — who plays field hockey and enjoys art at school — said: “It just looks really boring to look at, there are no cool pictures or any funny things or fun colors. It just doesn’t look like something I’d be interested in.” She said she prefers social media: “With TikTok, you can interact with stuff and look at comments and see other people’s views, [but with the news] you just see evidence and you see all these facts. Sometimes it can be about really disturbing stuff like murder and stuff like that. If it’s going to pop up with that, I don’t really want to watch that.” These children aren’t alone in pointing to social media as their preferred source of news. A 2025 report by communications watchdog Ofcom found that 57 percent of 12-15-year-olds consume news on social media, with TikTok being the most commonly used platform, followed by YouTube and then Instagram. Sophie isn’t convinced that the news is for her. “Sometimes if my parents put it on the TV and it’s about something that’s really bad that’s happened, then I’ll definitely look at it,” she said. “But otherwise, I think it would probably be more for older people because they would like to watch basically whatever’s on the TV because they can’t really be bothered to change the channel.”

French prosecutors have opened a criminal investigation into TikTok for failing to safeguard the mental health of children on its platforms. It’s the first time the protection of minors on social media has led to criminal proceedings, marking a significant escalation in regulators’ push to protect children on the internet. The probe comes after a parliamentary inquiry led by Socialist lawmaker Arthur Delaporte, which presented its findings on Sept. 11. A criminal investigation was opened by the Paris police’s cybercrime unit at the end of October, Delaporte wrote in a press release welcoming the news. “Our commission’s empirical observation is that of an algorithmic trap that, in just a few interactions, increases exposure to harmful, anxiety-inducing, and depressing content,” he previously said. TikTok is regulated as a Very Large Online Platform by the European Commission under the EU’s Digital Services Act. The EU has been investigating TikTok for lapses in the protection of child users. TikTok and the Commission did not immediately respond to POLITICO’s request for comment.

The mastermind of President Donald Trump’s effort to downsize the federal workforce, Russ Vought, promised to use the government shutdown to advance his goal of “shuttering the bureaucracy.” Presented with a layoff plan that would have moved in that direction, officials at the Department of Health and Human Services scaled it way back, POLITICO has learned. It was another example, like several during the layoffs led by Elon Musk’s Department of Government Efficiency this spring, in which Trump’s agency heads have pushed back successfully against top-down cuts they viewed as reckless. POLITICO obtained an HHS document from late September, the shutdown’s eve, that said the department wanted to cut nearly 8,000 jobs, based on guidance from Vought’s budget office. On Oct. 10, HHS only went ahead with 1,760. In the two weeks since, the number has dwindled to 954, as the department has rescinded nearly half of the total, blaming a coding error. The disorganized handling of the layoffs is reminiscent of Musk’s DOGE effort, in which employees were rehired after being fired, sometimes on court orders, sometimes because agency officials objected. In each case, the layoffs rattled agency managers and traumatized employees, as Vought wanted, but haven’t gone nearly as far in downsizing the government as forecast. While the nearly 8,000-person layoff plan this month was largely scuttled by top agency officials who intervened before the cuts could be made, the whiplash manner in which it was proposed and then scaled back shows that the administration is still following the DOGE playbook. “These appear to be leftovers from DOGE. I don’t know anyone — including in the White House — who supports such cuts,” a senior administration official told POLITICO in explaining the pullback from the promised mass layoffs. The official, granted anonymity to discuss confidential matters, pointed to the involvement of a staffer who was part of the DOGE effort in producing the administration document. That document came to its initial tally of 7,885 layoffs at HHS by adding employees who would be furloughed during the shutdown, as well as workers in divisions that would be shuttered if Congress passed Trump’s fiscal 2026 budget proposal. Trump’s May budget plan called for a 25 percent cut to HHS, but lawmakers have rejected it in the appropriations bills now in process. HHS spokesperson Emily Hilliard told POLITICO in a statement that HHS made its layoff list “based upon positions designated as non-essential prior to the Democrat-led government shutdown.” She added: “Due to a recent court order, HHS is not currently taking actions to implement or administer the reduction-in-force notices.” According to the document reviewed by POLITICO, the National Institutes of Health was to take the hardest hit among HHS agencies, 4,545 layoffs, or roughly a quarter of its workforce. It ended up firing no one. A federal judge in San Francisco blocked the firing of 362 of the 954 HHS employees who did receive the October layoff notices. More will be shielded after additional federal employee unions joined the lawsuit on Wednesday. In congressional testimony earlier this year, Health Secretary Robert F. Kennedy Jr. said he had downsized his department’s staff to 62,000 from 82,000 when he took office. He’s nowhere close. An HHS contingency plan produced in advance of the shutdown said the department still employed 79,717. Employees who took a Sept. 30 buyout offer from Musk would bring that lower, though the number who did is unknown because the White House has not released agency-by-agency totals and has stopped publishing agency employment updates. It’s unclear who within the Trump administration came up with the initial plan for the shutdown layoffs. Hilliard did not respond to POLITICO’s question about who within HHS was responsible. Thomas Nagy, the HHS deputy assistant secretary for human resources, has been the one updating the judge, Susan Illston of the U.S. District Court for the Northern District of California, about the layoffs. The experience of the fired 954, whose last work day is scheduled for early December, mirrors the chaos of DOGE’s spring layoffs, in which employees were left wondering whether they still had jobs amidst lawsuits and officials were forced to backtrack and rehire fired workers. In one such instance, Kennedy told a House panel in June that he had appealed directly to Vought to make sure Head Start funding was protected after the early education and health care program was left out of the president’s budget proposal. In another case, HHS fired and then rehired an award-winning Parkinson’s researcher. Kennedy also told senators that he brought back hundreds of staffers at the National Institute for Occupational Safety and Health. That came after West Virginia Republican Sen. Shelley Moore Capito and others protested. Now many HHS employees are having déjà vu. The situation is reminiscent of the experience some former employees of the U.S. Agency for International Development had during the Trump administration dismantling of the foreign aid agency early this year. Some furloughed employees at HHS, for example, didn’t have access to their work emails to receive notices informing them they were laid off this month. “There were individuals who didn’t even know if they were in RIF status until they got the hard copy packet in the mail two days ago,” a laid-off employee at the Centers for Disease Control and Prevention said, using the acronym for “reduction-in-force.” A similar situation played out at HHS’ Office of Population Affairs, where nearly all of the roughly 50 employees were laid off two weeks ago, according to one person with knowledge of the situation speaking anonymously for fear of retribution. The office, which is congressionally mandated, manages hundreds of millions of dollars in funding for family planning and teen pregnancy prevention programs. Three fired employees from the Substance Abuse and Mental Health Services Administration — granted anonymity to provide details about the firings without fear of retribution — said that many of the roughly 170 employees cut from the agency earlier this month are getting physical copies of their termination notices mailed to them because they’re shut out of their email accounts. “DOGE never really left, it just looks different now,” one of the SAMHSA employees said. Amanda Friedman and Sophie Gardner contributed reporting. Tim Röhn is a global reporter at Axel Springer and head of investigations for WELT, POLITICO Germany and Business Insider Germany.

Sweden’s health minister has urged the EU to push ahead with social media restrictions for kids while insisting it be treated as a pressing matter. “We’re losing an entire generation to endless scrolling and harmful content, and we need to do something about it,” Minister Jakob Forssmed told POLITICO, adding that social media use among youth is the “most pressing health issue there is.” His comments follow those of European Commission chief Ursula von der Leyen, who said Europe could adopt a similar approach to Australia. The country is set to ban social media for all users under 16. In her State of the Union address in Strasbourg earlier this week, she pledged to commission a panel of experts to study the impact of the Australian measure and provide recommendations on how Europe should proceed. Forssmed said Europe should move quickly, warning: “We don’t have the time. We need to move forward fast.” Sweden has already compiled research that demonstrates the impact on young people, he said, and the results are clear. “This is a risk for mental health issues. We see it not least when it comes to eating disorders and harmful self-image,” he added. Health authorities in Sweden issued guidelines last year, stating that children under the age of two should not be exposed to any screens and teenagers should have no more than three hours of screen time per day. The government also announced an inquiry into social media use and age restrictions. In Denmark, Minister for Digital Affairs Caroline Stage Olsen also said she would support stronger measures from Brussels and would make it one of the “main priorities” for the Danish presidency of the Council of the EU. “I see three steps on the EU level: mandatory legal requirement for age verification, a ban on harmful and addictive practices for minors and stronger enforcement,” she told POLITICO. Denmark has imposed a ban on smartphones in schools since February, following France’s lead in 2018. A similar ban in Belgium came into effect this month. Five EU countries — Denmark, Greece, France, Italy and Spain — are testing a European Commission age verification app, a new system designed to protect children online. Last year, Ireland’s Department of Health established an online health task force to examine the links between specific types of online activity and physical and mental health harms to children and young people.  It’s also developing a strategic public health response to these harms, which it will bring forward in its final report next month.  Von der Leyen suggested she would wait to decide on EU-wide measures until she had received analysis of the Australian policy. It’s unclear how long European experts will have to do that, given that it comes into force in Australia on Dec. 10, and she wants the panel’s recommendations by year’s end.

Europe spends more on tackling mental health conditions that any other region in the world, but with rates of illness at high levels, it still needs to urgently invest more. That’s one of the warnings from the World Health Organization in two reports released Tuesday — one on governments’ mental health policies and another on mental wellbeing. Together, the reports, which collate rates of mental health conditions and policies from 2021 and 2024, respectively, point to countries playing catch-up as mental health disorders weigh down national health budgets and contribute significantly to disability. Governments in WHO’s Europe region spent $51.76 per capita in 2024 on mental health, far more than any other region globally. The next-highest-spending region is the Americas, with $6.86 per capita. European countries also spend a higher proportion of their overall budget on mental wellbeing, with 4.5 percent compared to the global median figure of 2.1 percent. The 2.1 percent figure is stuck at the same level as in 2017 and 2020, with no evidence of greater spending at any income level, WHO officials told reporters Monday. High-income countries in general greatly outspend lower- and middle income countries on mental health. In all WHO regions, the estimated prevalence of mental disorders has increased since 2001, with the greatest increases taking place in WHO’s Americas region (rising from 15.3 percent to 17.1 percent in 2021) and European region (from 14 percent to 15.4 percent). Globally, there were more than 1 billion people living with a mental health disorder, according to 2021 data. The prevalence of mental health disorders is generally evenly distributed by region, although Europe has lower rates of anxiety disorders than elsewhere in the world, with 3.7 percent of the population compared with 4.4 percent globally. Europe and Southeast Asia both have higher rates of intellectual development disorders than the global rate of 1.2 percent, with 1.8 and 2.7 percent. Underspending on mental health is costing people access to the services they need, the WHO told reporters Monday. Just 9 percent of people with depression, and 40 percent of people with psychosis, get treatment. “Those are the numbers to be worried about,” said Dévora Kestel, a director at the WHO’s department for non-communicable diseases and mental health.

Daniel Harper is a British Iranian multimedia journalist, residing and working in the EU, specializing in migration, women’s rights and human rights. His work has appeared in Euronews, Balkan Insight, GAY Times, Insider, among other publications. After a three-day mourning period, the flags above Austria’s parliament were raised from half-mast, where they’d been lowered following last month’s fatal school shooting in the country’s second city of Graz. The shooting at the high school was the deadliest in the country’s history, leaving 10 dead and several injured. Notably, the assailant had used a shotgun and handgun he’d obtained legally, despite failing a psychological screening for his required military service. According to a small arms survey, Austria is the 14th most armed country in the world, with 30 firearms per 100 inhabitants. Yet, it has often shirked from gun reform — even after the terrorist attack of November 2020, which saw assault rifles fired in central Vienna. So, for the issue to raise to the top of the agenda now, speaks volumes as to just how far this fatal incident has shoved the political dial on the country’s long-standing ambivalence to gun reform. “Nothing we do, including what we have decided today, will bring back the 10 people we lost last Tuesday. But I can promise you one thing: We will learn from this tragedy,” Chancellor Christian Stocker said, echoing that very sentiment a press conference held after the shooting. Question is, will Austria’s government finally be spurred into action? Austria’s hunting culture means gun ownership is deeply engrained in its society. Currently, 130,000 people — roughly 1.4 percent of the population — hold mandatory hunting licenses. And anyone who’s been to Austria can attest to the numerous animal heads and trophy antlers hanging on the walls of pubs and chalets. Moreover, two large weapons manufacturers, Steyr and Glock, are both headquartered in the country. And their lobbying of pro-gun political parties within the conservative faction has helped prevent previous gun reform attempts. “There is a big hunters lobby,” said Professor Roger von Laufenberg, managing director of the Vienna Center for Societal Security explained. “Especially [for] the major political parties. The Conservative Party, for example, has traditionally had a large share of voters [who are] hunters, which is why this was not really perceived as an issue for so long.” The last time gun laws were reformed in any major way in Austria was in 1997, following an EU directive imposing tighter restrictions on gun ownership — a change that, according to a report by the British Journal of Psychology, led to a drop in the rate of firearm suicides and homicides. Decades later, one of the main reforms now being discussed is raising the minimum age to buy firearms from 21 to 25. Other restrictions the chancellor suggested include raising the minimum age to own specific firearms like handguns, having gun permits expire every eight years, strengthening psychological testing and making it mandatory, sharing information across governmental agencies, as well as introducing a four-week waiting period for the delivery of a first weapon. These are all in addition to a suggested expansion of psychological support in schools across the country over the next three years. A woman leaves a candle at a makeshift memorial site near the school where several people died in a school shooting, on June 10, 2025 in Graz, southeastern Austria. | Georg Hochmuth/AFP via Getty Images This is a dramatic shift in how gun reform has been addressed by the government in previous years. Under current laws, anyone over the age of 18 can purchase certain shotguns and rifles without a permit, while other weapons, like hand pistols, require a three-day waiting period and a psychological analysis. The issue of psychological testing is especially a point of focus, as the assailant in the school shooting had passed the test to own a handgun. The process that’s drawing particular criticism is that a person is only tested once in their lifetime and never reassessed. Furthermore, despite the assailant failing his psychological exam for compulsory military service, this information was not shared with other agencies, including the police. Interestingly, just a couple weeks before the Graz shooting, Austria’s Green Party had put forward a proposal aimed at reforming gun laws. But the motion for a resolution was postponed with the votes of Austria’s coalition government. The proposed motion set out much of the same guidelines the chancellor shared with the press — tighter background checks, greater monitoring of private gun sales and a permanent gun ban for those who have restraining orders against them. The difference was that these reforms were specifically aimed at combating violence against women and girls — another problem Austria’s been dealing with for a long time. According to Green member Meri Disoksi, who proposed the reform, “almost one in two perpetrators of violence against women suffers from a mental illness” — hence the greater need for stricter psychological checks. Similarly, an Institute of Conflict Research analysis on femicides in Austria between 2010 to 2020 found that of the women assaulted with a firearm, 62.6 percent died. Even the use of illegal firearms involved with femicides has increased from 2016 to 2020, according to the study. Markus Leinfellner of the right-wing Freedom Party of Austria (FPO) — a party that often blocks gun reform legislation — had criticized the proposal, speaking out against the suggestion of psychological assessments for gun owners every five years, saying it would place a financial burden on gun owners and lead to an increased workload for psychologists. It’s evident just how much the Graz shooting has changed the conversation and forced the issue of gun reform back into play, as even FPO leader Herbert Kickl didn’t come out against the chancellor’s recent proposals. He simply told lawmakers: “I don’t think now is the time to pledge or announce that this or that measure will solve a problem.” Of course, it remains to be seen whether the proposed gun reforms will eventually pass. But with Stocker now promising the country will learn from this tragedy, it seems Austria has been forced to confront the consequences of being a society so intertwined with gun culture after decades of political ambivalence. The shooting in Graz has finally pierced the illusion that legal gun ownership guarantees safety, and the country’s political parties can’t sit on the fence any longer.

EUROPE’S FRONTIER COUNTRIES READY THEIR HOSPITALS FOR WAR From stockpiling trauma kits for mass casualties to kitting out medics with body armor, wartime health planning is no longer hypothetical on NATO’s eastern flank. By GIEDRĖ PESECKYTĖ Illustration by Wayne Brezinka for POLITICO Speeding along Fabriko Street in an ambulance toward Lietavos school, Martyna Veronika Noreikaitė felt unprepared. She could feel her heart pounding. It was a sunny Tuesday morning in mid-May when Noreikaitė was radioed about an explosion in Jonava, a city of 30,000 people in central Lithuania. In her three years as a paramedic, her calls would, on a normal day, involve high blood pressure or chest pains. This was Noreikaitė’s first mass casualty event. As they pulled up to the school, sirens wailing, the building was obscured by smoke. “People were running around, lying on the ground, screaming,” Noreikaitė said, recalling the chaos at the school’s stadium. Police, firefighters and military personnel were already on site. Noreikaitė and her colleague were the first paramedics to arrive.“When you see what happened — the panic, the screams — you don’t know what to do, or where to go. You forget everything. It throws you off balance.” The novelty of such a disaster in a peaceful European state was precisely why the Lithuanian authorities had set up the two-day “Iron Wolf” (“Geležinis Vilkas”) military exercises. The goal was to steel the military, police, firefighters, hospitals and paramedics to operate under exceptional circumstances — as Lithuania braces for the worst-case scenario: an attack on NATO’s eastern flank. Since Russia’s full-scale invasion of Ukraine, the threat of military conflict has loomed large. “When the media reported the war had started in Ukraine, it was terrifying,” Noreikaitė said. “It was frightening at work because we didn’t know if we had enough resources or if we were prepared if it happened here.”  Noreikaitė now feels calmer. She focuses on training and mastering triage protocols. Exercises, like the one in Jonava, help. Indeed, she believes they “should happen more often.” Lithuania is no outlier: All NATO’s eastern flank countries are revisiting crisis response protocols for health-care facilities, organizing training exercises, investing in ballistic helmets and vests, and shifting operating theaters underground. Since the conflict in Ukraine has shattered the illusion that Europe is safe from war. “It’s not a question of if [Russia] will attack,” said Ragnar Vaiknemets, deputy director general of the Estonian Health Board, which oversees preparedness for crises from pandemics to war. “It’s a question about when.” Ukrainian medical personnel transport a wounded soldier to a medical evacuation (Medevac) airplane, in Rzeszow, Poland. | Petter Bernsten/AFP via Getty Images Formerly under Soviet occupation, the countries on Europe’s eastern frontier know only too well how quickly troops can arrive. “We have bad neighbors here: Russia and Belarus,” Daniel Naumovas, Lithuania’s deputy health minister, said at an event in February. His country links NATO to the Baltics via the Suwałki Gap — a narrow, vulnerable corridor seen as one of the likeliest targets of a future Russian attack. While all EU countries are “in the same boat,” some are in the vanguard “where the water is cold,” Naumovas said. “Water is splashing on our face; water of war.” For countries on NATO’s east, war readiness isn’t optional — it’s urgent. “Few EU countries are frontline countries,” said Katarzyna Kacperczyk, undersecretary of state at Poland’s health ministry. “For them the issue is more pertinent.”  Poland has elevated the issue of health security during times of conflict throughout its rotating presidency of the Council of the EU, where Europe’s security has been the central theme. “We cannot prepare a contingency or strategic plan for the military sector or economic sector or energy sector, and exclude the health sector,” Kacperczyk said.  HOSPITALS UNDER FIRE Russia’s invasion of Ukraine has shown that modern conflicts no longer spare health services — or the civilians they serve. Eastern European countries are taking note. Located just 50 kilometers from the EU’s external border with Belarus, Vilnius University Hospital Santaros Clinics is developing underground infrastructure, shelters, helicopter landing sites and autonomous systems that would allow it to function even if electricity or water supplies were cut off. Santaros is not unusual. In Estonia, in addition to body armor for ambulance crews, satellite phones would be distributed to maintain communications if traditional networks fail. Plans are even in place to generate an independent internet network if necessary. European countries average 11.5 intensive care beds per 100,000 population. | Omar Marques/Getty Images Electrical generators are being installed across the health-care system, following Ukraine’s experience with Russian strikes that routinely cut off civilian power. “We know for certain that Russia targets the civilian infrastructure and energy structures, and that means that you cannot have these kinds of situations where the hospital doesn’t work because there are some power plant problems,” Vaiknemets said. Many hospitals in Eastern Europe — relics of the Soviet era — are particularly vulnerable. “We have high buildings, we have large buildings. They are in one complex, one area,” Vaiknemets said. Hospitals are now looking at how to repurpose basements to be operating theaters in case of need. “I can’t imagine working on a top level … of the hospital just waiting to get hit,” he said.  Estonia is procuring mobile medical units — pop-up treatment facilities deployable in emergencies — which should help address the currently limited critical care capacity in Europe. While European countries average 11.5 intensive care beds per 100,000 population, “wartime needs could require three to five times this capacity,” said Bjørn Guldvog, special adviser at the Norwegian Directorate of Health, at a health security event in April. Sustaining a high volume of operations for weeks or months would also be challenging: “Most facilities can sustain maybe 120-150 percent of normal surgical volume for 24 to 48 hours,” he said. Blood and oxygen supplies would also become critical. STOCKPILES AND SUPPLY CHAINS Even the best-prepared hospitals can’t function without medicines, supplies and equipment, and the Baltic countries are stocking up in preparation for mass casualties. Estonia, for example, has allocated €25 million for mass casualty supplies, including orthopedic gear, tourniquets and trauma kits — “the only heavy investment we have made,” Health Minister Riina Sikkut said at an event in February. Stockpiles would ensure that hospitals can run until supplies from allies reach them, Vaiknemets said, adding that NATO is crucial to securing supply routes.  In Latvia, health-care institutions have been required since Covid-19 to maintain a three-month supply of medicines. “I have never thought that I would say thanks to Covid, but thanks to Covid … we found financial resources,” said Agnese Vaļuliene, health ministry state secretary. The country is also working on national stockpiles. But the Baltics are too close to the front lines to keep emergency supplies safe, said Jos Joosten, a medical adviser at the European External Action Service, the EU’s diplomatic corps. As a result, other EU countries must “identify the things that are scarce, that are very difficult to organize, specifically for the small nations,” Joosten said. “And then we should give [up] some sovereignty, give it to the European Union to make decisions” on distributing what is needed. Stockpiles from the Red Cross, national reserves and rescEU, the EU’s emergency service, must all be ready to reach the front line — and civilian patients. “We have to have good crisis plans,” Sikkut said. STAFFING THE WAR EFFORT War readiness goes beyond policy — it needs people. Workforce shortages are a fundamental challenge for the Baltics, where day-to-day health staff are already stretched thin. Estonia, with a population of 1.3 million, has nearly half the health-care workforce per capita of Germany.  A Lithuanian survey found that over a quarter of health workers would likely flee during war, while fewer than 40 percent would stay and a third were unsure. | Mykhailov Dmytro/Global Images Ukraine via Getty Images As a result, patients “from the front lines” cannot expect the same care they would receive in times of peace, Vaiknemets said, which is “the main and underlying principle of our crisis-measure planning.”  But there’s another problem: Not everyone is prepared to stay. When Russia invaded Ukraine, Noreikaitė, like all paramedics, had to sign a declaration saying if war broke out in Lithuania she would stay on and work. “But how it would really be — who would come and who wouldn’t — I don’t know. Personally, I don’t have children or a family yet, so I think I would stay,” she said.  A Lithuanian survey found that over a quarter of health workers would likely flee during war, while fewer than 40 percent would stay and a third were unsure. Estonia anticipates similar patterns: “There are patriots, the first responders, the people that we know without question will stay,” Vaiknemets said. “Of course, there are naysayers that talk about going to Spain straight away.” He said around 50 percent to 60 percent of the population don’t yet know how they would respond. While he’s confident that most doctors and nurses would remain, Estonia’s authorities are working to ease concerns, especially about family safety. “It is very human: If I don’t feel safe, if I don’t have the confidence that my family is safe, I will not do it,” Vaiknemets said. In Latvia, pulmonologist Rūdolfs Vilde said some doctors he spoke to were considering fleeing if war breaks out — especially parents who “don’t see how it would be suitable for them to ditch the children somewhere and be in the hospital in times of military crisis,” he said.  Just a week before the interview, Vilde and his colleagues at Pauls Stradiņš Clinical University Hospital were also asked to sign a document acknowledging they are critical personnel required to report to work if sirens sound.    Vilde himself plans to stay but stressed that he needs more information to feel confident should the worst happen.  “Should I be prepared … to provide some kind of military medicine, or should I be just prepared to come into my regular work and just have a bigger flow of patients?” Vilde asked. “Because those are two very different things and probably both of them would have to function during the wartime.” And Vilde doesn’t mind spending extra hours on top of his doctors’ job for training “because … I see this as a way to keep things the way they are.” A Ukrainian soldier being evacuated to Poland. | Petter Bernsten/AFP via Getty Images “If I want to be able to do my pulmonology job and maybe to try to develop things in Latvia, then there should be Latvian existence, right?” His hospital in Riga has also begun war-training sessions, Vilde said. Other hospitals and countries have begun ramping up war-readiness drills, too. Estonia is reinforcing its system-wide training. Hospitals, ambulance crews and health workers are instructed on how to switch to “crisis mode,” in which they must deal with large influxes of patients and treat wartime injuries — including blast wounds, gunshot trauma, burns, amputations and spinal or head injuries — that are rare in civilian settings. At Lithuania’s Vilnius University Hospital, “evacuation drills and preparedness exercises for receiving a large number of casualties are conducted for hospital staff” alongside the Lithuanian Armed Forces and Riflemen’s Union, hospital chief Tomas Jovaiša said. This year alone, Lithuania is planning seven exercises with the army and over 10 civil-security drills for medical professionals, according to health ministry spokesperson Julijanas Gališanskis. Lithuania is also forming an emergency medical team, and junior doctors last month hosted a forum dedicated to wartime health-care readiness. Some medics travel to Ukraine to learn firsthand how hospitals deal with missile strikes, mass casualties and power outages.  Vaiva Jankienė, a nurse and coordinator at Blue/Yellow Medical, which provides medical care to civilians close to Ukraine’s front line with Russia, has volunteered over 20 times in Ukraine since April 2022 — including in the atrocity-stricken town of Bucha shortly after its liberation. She said the best way to prepare health-care specialists is by volunteering in Ukraine.  She described the scale of injuries and illnesses in Ukraine as “difficult to comprehend” — many wounds are unlike anything seen before, owing to new wartime tactics. “After the drone attacks, the consequences are hard to imagine,” Jankienė said. “Injuries like these,” she sighed, “every single medical professional who saw them said the same thing: We couldn’t have imagined it would look like this.” While a trauma doctor in Lithuania might perform one amputation a year, in Ukraine, entire hospital wards are filled with patients suffering amputations of one, two, three, or even four limbs — plus a range of other severe injuries. “We have very little experience treating such complex, multiple traumas,” she said.  THE REFUGEE SURGE RISK The impact of war wouldn’t stop at national borders. Because of the use of advanced weaponry in Ukraine — including long-range missiles and military drones — the front line is no longer a fixed boundary. Attacks can now reach targets hundreds of kilometers away, endangering hospitals and civilian infrastructure far from combat zones and making evacuation plans essential.  Illustration by Wayne Brezinka for POLITICO As a result, countries further from the front lines must prepare to receive patients and refugees, Joosten said, warning that EU solidarity will be tested. “If Lithuania is overrun, who’s responsible for Lithuanians, because there’s no Lithuania anymore? But the European Union is (still there),” he said.  Joosten urged EU institutions to create funds to handle civilian and military casualties, as well as displaced populations. He added that casualties could be dramatically higher than in Ukraine. “Those 4,000 patients we moved away from Ukraine, that’s nothing, 4,000 in three years,” he said. “Let’s talk about 4,000 in two weeks, and then the next two weeks again, and the next two weeks … the numbers are so different when the real war starts.” No one knows when — or if — war will come. But as Vaiknemets put it: “Crisis never shouts when it’s coming.” That’s why the Poles and the Baltics “have to prepare for the worst,” Vaļuliene said. “But we hope it will not come.”

LONDON — Reform UK is winning over Gen Z women, a demographic that the right-wing populist party has struggled to attract in the past.  The party’s vote share among women aged 18 to 26 shot up in May — jumping from 12 percent to 21 percent after nationwide local elections, according to polling for the More in Common think tank shared with POLITICO. Most of the new recruits seem to have defected from the Conservative Party, according to the data. “In the general election, you could confidently say the median Reform voter is a middle-aged man who voted for Brexit,” said Louis O’Geran, research assistant at More in Common. “The gender gap is narrowing, but also that age distribution is spreading out.”  It’s a striking shift for a party long dogged by accusations it has a problem with women. Leader Nigel Farage has previously dismissed gender disparities in business as a result of men being more willing to “sacrifice family lives” — and once praised controversial far-right influencer Andrew Tate, who was later charged with rape by British prosecutors, as an “important voice” for “emasculated” men. The party’s manifesto includes a pledge to scrap the U.K.’s Equality Act, legislation meant to prohibit discrimination based on gender, disability, race, and more.  Reform is, however, finding clear traction with younger women, some of whom see the party as clearer on its policy aims than the alternatives. Young women point to a dissatisfaction with the opposition Conservatives and the governing Labour party — and “the sense that the two main parties just aren’t working,” O’Geran said. The poll, which is based on an average of four surveys conducted in May of roughly 9,000 adults in Great Britain, reflects a broader increase in Reform’s overall vote share, which moved from 24 percent of the national vote to 29 percent during the same period. “While the increase in support among Gen Z women is really significant, they started on a far lower base than any other age group … the increase is probably part of a wider expansion of Reform’s support following the election,” said O’Geran. JOINING UKIP AT AGE 14 Charlotte Hill, a 25-year-old Reform UK councillor in Derbyshire, joined Farage’s old party UKIP at the age of 14, around the time of the Brexit campaign. In doing so, she took after her father, who was a staunch Leave voter and “played a big part in [her] life lessons,” she told POLITICO. Hill followed Farage’s political journey — and eventually became a Reform UK supporter.  While she studied English literature at university with hopes of becoming a teacher, she felt alienated by the course’s “very Jeremy Corbyn positive and Nigel Farage negative” tone, a reference to the hard-left Labour leader who quit in 2019. Hill said she had grown disenchanted with being “the odd one out” amongst her peers, and changed her course into construction management — a “male-dominated space” where she has “fortunately never had a problem” with discrimination.  What attracts her to Reform is the party’s prowess in communicating its message, and its ability to start “tapping into the younger generation quickly” on social media platforms like TikTok. Farage has 1.2 million followers on TikTok. Prime Minister Keir Starmer and Tory Leader Kemi Badenoch aren’t even on it.  “We look at Labour and Conservatives, and in my opinion, their values are quite similar now,” argued Hill. “You can’t ring fence either party’s values, whereas with Reform, I think you can.” Hill also believes Reform is offering direct policy support for young women. Pointing to Farage’s recent announcement that he wants to scrap a two-child cap on social security benefits, and bring in tax breaks for married people, Hill said Reform would enable women “to stay at home for longer or to go part-time.” SAFETY — AND SCRAPPING DEI  O’Geran notes that Gen Z women diverge from the rest of the population on key issues. Only five percent of those polled named immigration as a top concern — compared to 22 percent among the wider public. Instead, the issues that matter the most to this cohort are the cost of living, jobs, mental health and affordable housing. Still, some of Reform’s female politicians want to link immigration to women’s safety. “Once those illegal immigrants are in the community, that’s when women’s safety becomes a real issue,” Sarah Pochin, a new Reform MP for Runcorn and Helsby, said. “That’s when women feel that they can’t let their children play out on the streets.”  Sarah Pochin (L), Andrea Jenkyns (Centre), Charlotte Hill (R) | Photo-illustration by Aimee Rogers/POLITICO (Source Images from WikiCommons and Reform UK) Andrea Jenkyns, newly elected Lincolnshire mayor, similarly told POLITICO that “especially in coastal areas, young women were saying … that they feared for their safety, because especially on the coast there’s migrant hotels. I think if we’ve got this strong policy on illegal migration and safety, I think that would appeal to people.” Both Reform reps share the idea of people being promoted in the workplace based on ability, and reject diversity initiatives.  “I’m not a feminist, I’m a meritocrat,” said Jenkyns, a former Conservative MP. Although she is neurodiverse and has a son with autism, Jenkyns doesn’t believe laws like the Equality Act are necessary, saying support is “just showing kindness in society.”  “You don’t need policies for that,” she said. “It’s about creating the environment so everyone can thrive,” adding that she would like to see a “more blended learning environment” for neurodiverse people to thrive.  Section 20 of the Equality Act legally requires employers and public bodies to “make reasonable adjustments” for disabled people, including those who are neurodiverse.  POUR MY WINE, PLEASE  Even if it’s making inroads with women, representation remains a sore spot for Farage’s party. Fewer than a quarter of its local election candidates were women, according to data from the University of Exeter’s Election Center. That lags behind the Tories on 30 percent and the Green and Labour parties, both on roughly 40 percent.  But Pochin hopes her win last month, making her Reform’s first female MP, will make women “more interested in Reform.” Just don’t expect her to champion gender quotas anytime soon.  “Women only want meritocracy,” she told POLITICO. “That’s all I ever wanted. I’ve worked in a male-dominated world all my life, and I have never felt at a disadvantage once.”  “I still want a man to pour my glass of wine or whatever it is at night,” she added. “I still want a man to hold a door open for me. I still want a man to say, ‘oh, you look nice,’ when you come down to go out for the evening.” Society, she laments, has lost “the fun and banter” of the workplace. “Of course, we need to protect women. There’s times when it goes wrong or people overstep the mark, but generally speaking, I think we’ve become utterly paranoid.” 

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.

Social media platform TikTok has banned worldwide a popular hashtag linked to weight-loss videos following scrutiny from policymakers in Brussels and Paris. The “SkinnyTok” trend saw TikTok in recent months flooded with videos showing emaciated young women promoting extreme diets and posting weight-loss tips. That grabbed the attention of both the European Commission and the French digital regulator Arcom. “[We] have blocked search results for #skinnytok since it has become linked to unhealthy weight loss content,” TikTok spokesperson Paolo Ganino said in a statement Monday. The move is part of a “regular review” of TikTok’s safety measures “to address evolving risks,” he said. Searching for the hashtag now leads to a link to mental health support. France’s Digital Minister Clara Chappaz on Sunday celebrated what she described as a “collective victory” after nearly two months of lobbying that included support for a public petition and a meeting between Chappaz and TikTok officials in Dublin in early May. Stating that “the fight to protect our children online doesn’t stop there,” Chappaz said: “I won’t give up. Banning social media before 15 is my priority.” The protection of kids online is fast becoming a hot topic in Brussels as countries consider proposals for new EU rules to massively curb children’s social media use. Politicians have jumped on the SkinnyTok example to elevate their concerns. The platform’s responsibilities for guarding against the harmful effects of the SkinnyTok hashtag were a feature of a Friday call between the EU’s Consumer Protection Commissioner Michael McGrath and TikTok CEO Shou Chew, according to a readout. That comes as the EU continues a wider investigation into the platform’s algorithms under the bloc’s content moderation rulebook, the Digital Services Act. “This is a live investigation which will take its course in the normal way but I felt it was important to reiterate the Commission’s strong stance on child protection,” McGrath said following Friday’s call. In 2024 TikTok suspended and later withdrew the TikTok Lite reward program — which rewarded users for screen time — after concerns about its effect on mental health.