BRUSSELS — Hope for the best, prepare for the worst.

The European Commission updated its approach to dealing with climate change along those lines on Tuesday with a package aimed at improving the bloc’s response to mounting disasters such as extreme heat, supercharged storms and worsening wildfires. 

Unveiling its first-ever law to boost the bloc’s resilience to global warming, the EU executive conceded that merely slashing planet-warming emissions is insufficient as climate extremes wreak havoc across the continent. 

“There is no alternative to continue to cut emissions more forcefully and to move full-frontal into clean energy,” Climate Commissioner Wopke Hoekstra told reporters. “But at the same time, we do have to acknowledge that the problems we’re facing have morphed into something that is so large that just doing that alone unfortunately no longer is good enough.” 

The Commission’s proposed Climate Resilience Law asks governments to draft plans to prepare for a world that’s 2 degrees Celsius hotter in 2050 and 3C hotter by the end of the century, aligning with the United Nations’ latest projections that current global climate policies can only limit warming to 2.8C. 

The same U.N. report also warned that the world can no longer limit warming to 1.5C, the lower bound of the Paris Agreement’s dual goals, and that steep emissions cuts are needed to achieve the best-case scenario of halting the rise in global temperatures at 1.8C. 

The Commission insisted that Tuesday’s package did not amount to Brussels resigning itself to catastrophic levels of warming. 

“Let me just be crystal-clear on the 1.5C, that remains our goal,” said Hoekstra. “At the same time, it would be unwise not to prepare for… the current trajectory the world is on.” 

Regulation for the deregulation era

Under the proposed law, governments are “encouraged” to take the 3C scenario into account when designing policies, budgets and investments. 

Countries will have to carry out national climate risk assessments every five years starting in 2029, and subsequently draw up climate-proofing plans by the end of 2030. These strategies should also indicate which public authorities are in charge of managing certain climate risks to avoid inaction and finger-pointing among ministries and agencies.  

The fairly light-touch legislation reflects the prevailing mood in the EU. Brussels itself has committed to a deregulation agenda, and national governments have called for fewer rules, not more, particularly where climate and the environment are concerned. 

Efforts to improve resilience to weather extremes, such as flood prevention or urban greening, are also largely a national and even local responsibility, with the EU holding limited powers. 

Even the limited rules proposed on Tuesday are already raising eyebrows. 

“I strongly support a clearer allocation of responsibilities,” said Peter Liese, the lead climate lawmaker of the center-right European People’s Party. But, he added, “we need to examine whether the plans, in the form proposed by the Commission, are necessary. Plans alone do not protect people and could tie up resources unnecessarily if we do not design them pragmatically.” 

Others argued the law was too limited. “The danger is a framework that tells us exactly how exposed we are and then commits us to nothing,” said Greens-affiliated lawmaker Kai Tegethoff. “Europe needs binding resilience targets and clear, measurable goals for the sectors most at risk.”

The Commission, for its part, has sought to appeal to governments’ concerns over the EU’s economic competitiveness by emphasizing the wealth-destroying threat of climate disasters and the business potential of climate-proofing technologies. 

“Some may say resilience is expensive. But the right question is, what is the real cost of being unprepared,” said Teresa Ribera, the Commission’s executive vice president in charge of the green transition. Both she and Hoekstra cited data showing the impact of heat on GDP as an example. “Europe cannot be competitive without being resilient,” she added. 

In the wider package presented Tuesday, the Commission also highlighted the emerging market for climate technologies such as drought-resilient crops and cooling solutions, casting European industry as a front-runner in that sector. 

As the EU is currently negotiating its next long-term budget, the package does not come with any funding attached, despite financing often acting as the biggest barrier to climate-proofing efforts. The bloc needs to invest around €70 billion a year by 2050 to adapt to a warmer world but currently only spends €29 billion. 

More where that came from

While presenting new obligations for governments, the Commission also promised to push ahead with work in Brussels. 

The European Environment Agency will draw up bloc-wide climate risk assessments, with the next one due in June 2028, and the Commission will present an EU “strategic plan on climate resilience” by the end of September 2028. 

Progress will be assessed regularly based on four criteria — climate-related deaths, economic losses attributable to global warming, the share of uninsured losses, and related fiscal costs. The Commission’s Eurostat agency will start compiling EU-wide statistics on climate-related deaths and economic losses by the end of 2030, according to the regulation. 

Beyond the legislative efforts, the EU executive also presented a wider package that includes several digital tools, including a “climate viewer” that converts the new warming scenario into local projections policymakers can use.

The Commission also vowed to take into account the new 3C warming scenario in all its future policy proposals. Further steps, including a heat wave action plan and a climate insurance alliance, are planned for next year, it said. 

“I wouldn’t say that we’re nearly done,” said Hoekstra. “Much of this is going to be work in progress.” And if climate change continues getting worse, he added, “this package might well need to be beefed up.” 

European lawmakers have held four times as many meetings with tobacco and nicotine lobbyists in the past two years compared with the entire previous parliamentary term, according to data analyzed by POLITICO.

Since this Parliament took office in the summer of 2024, more than 400 meetings have been declared, compared with about 100 in the 2019-2024 term, according to data collected by the Smoke Free Partnership, a coalition of NGOs, from the Transparency Register. European lawmakers are required to publicly disclose their meetings on the register.  

Meanwhile, most meetings this term were with right-leaning MEPs. Some 75% were with lawmakers from the center-right European People’s Party, the right-wing European Conservatives and Reformists and the far-right Patriots for Europe groups.

Meetings with tobacco and nicotine groups have ramped up this term as the EU seeks to overhaul several key pieces of tobacco and nicotine legislation. The EU has also proposed measures this session to curb heart disease and cancer, plans that also affect the sector.

Some MEPs have called out the tobacco industry’s access to lawmakers as they negotiate measures to prevent addiction and disease caused by the sector’s products, such as in a cardiovascular disease strategy report and cancer plan. 

“I find it scandalous and shocking that there are more meetings with the tobacco industry than the NGOs and the associations that advocate for stop smoking,” Tilly Metz, a lawmaker with the Greens/European Free Alliance, said.

“When you are working on health files, it is completely incompatible to regularly meet with the tobacco industry,” she said. Metz referenced the World Health Organization’s tobacco control treaty, which says policymakers should meet with tobacco lobbyists only when strictly necessary to discuss the sector’s regulation. 

The tobacco industry and MEPs who regularly meet with industry say they have done nothing wrong.

British American Tobacco’s head of fiscal affairs, Simon Trussler, said that like any other business in Europe, it had legitimate experiences and arguments to put forward “because we see what’s going on on the ground.”

Marlboro manufacturer Philip Morris International, whose meetings accounted for the most of any tobacco company, pointed out its contribution to the European economy and that the firm is “undergoing a deep transformation towards a smoke-free future.” 

“We are proud to contribute to the democratic dialogue and to engage with any MEP, from any political group, who is open to discuss on the basis of science and facts and our determination to be part of the solution,” said the company, which also sells nicotine pouches, vapes and heated tobacco products.

Global treaty debate

One concern raised by Metz and other MEPs is whether World Health Organization tobacco control rules are being followed correctly.

The WHO Framework Convention on Tobacco Control stipulates that public health policies need to be protected against industry’s commercial interests. It doesn’t ban lobbying, but guidelines to implement the treaty say that policymakers should limit interactions with the sector to what is strictly necessary for the purposes of regulating it, and ensure transparency of those meetings. 

Industry maintains it operates within the rules and presents its perspective transparently. The sector also points to a 2022 European Court of Justice judgment stating that the treaty doesn’t prohibit industry participation in implementing tobacco control; it is “intended solely to prevent the tobacco control policies of the parties to the convention from being influenced by that industry’s interests.”

In addition, the sector argues that the WHO framework doesn’t cover tobacco-free nicotine products. These products are especially in the firing line for stricter regulations as Europe seeks to overhaul tobacco products and advertising rules, as well as EU minimum taxes.

BAT’s Trussler said the company complied with all regulations and was transparent in how it did so. The WHO’s framework on tobacco control has been “misquoted and misunderstood,” Trussler claimed. 

The company also argued that the FCTC’s scope is limited to products made from tobacco leaf.

That’s not the position of the World Health Organization. Kristina Mauer-Stender, WHO Europe’s regional adviser on tobacco control, pointed out the scope of the treaty “extends beyond reducing tobacco consumption.”

Article 5.2(b) requires parties to adopt and implement effective legislative and other measures “for preventing and reducing tobacco consumption, nicotine addiction and exposure to tobacco smoke,” she said. “Therefore, preventing nicotine addiction is an explicit objective of the Convention’s implementation, rather than merely an indirect consideration.”

The Conference of the Parties’ decisions have also progressively addressed novel and emerging tobacco and nicotine products, she added.

Clusters

The data comes following criticism that the European People’s Party watered down language on tobacco in a non-binding cardiovascular disease report this summer. 

EPP lawmakers suggested changing the wording around nicotine having the “same” regulation as tobacco to instead having “appropriate rules.” This was supported by two MEPs who had held the third most meetings with industry — Jessica Polfjärd and Elena Nevado del Campo.

The final report adopted by the European Parliament reflected the proposal. 

Socialists and Democrats MEP Romana Jerković, who led the report in the health committee, said at the time she wished it could have been more ambitious on tobacco. 

Lobbying has also intensified as the European Commission prepares to release several updated regulations on tobacco and nicotine products.

The Smoke Free Partnership says spikes in meetings cluster around key policy initiatives, such as the tax directive. “While meetings alone cannot prove direct influence on decisions, they highlight the industry’s opportunities to shape the legislative debate,” Director Erin Roman said. 

However, transparency around industry meetings was not sufficient, Roman said, adding that meetings should only be “strictly necessary for effective regulation.”

To another Socialists and Democrats MEP, the lobbying has gone too far.

“Amendments weakening new tobacco products rules in a plan to fight Europe’s biggest killer didn’t come from nowhere: the groups meeting the industry most are the ones watering down the rules,” Spain’s Nicolás González Casares said.

Political trends

MEPs who have met with industry the most this parliamentary term mostly hail from the right. 

Patriots MEP Auke Zijlstra held the most meetings with 14, followed by ECR’s Pietro Fiocchi with nine. The EPP’s Michalis Hadjipantela, Elena Nevado del Campo and Jessica Polfjärd all declared eight.

Zijlstra said he always spoke with any industry when a legislative proposal was on the table that would impact them. 

“I do not think that I had too many meetings regarding tobacco and nicotine legislation. Taking an interest in the field is an absolute part of the job, and I don’t understand MEPs who have an opinion without,” he added.

He also denied the industry was overrepresented in meetings with lawmakers, saying, “There are a lot of consumers out there.” He encouraged NGOs to ask for more meetings to explain their point of view. 

The Smoke Free Partnership said it had faced “significant pressure” on its resources due to the withdrawal of EU operating grants last year. “We have continued engaging with policymakers and coordinating independent public health expertise, but reduced funding means difficult choices about what activities can be prioritized,” it said, adding there was an imbalance between industry’s resources. 

A spokesperson for Hadjipantela said he engages with a broad range of stakeholders as he’s a member of six committees. He “remains fully independent in his assessments and decisions,” the spokesperson said, adding: “Meeting with a stakeholder does not imply endorsement of their views or interests.”

Meanwhile, Nevado Del Campo said her meetings with tobacco representatives were because of the large number of tobacco producers in her region, and she had a duty to listen to the sector as it was a large employer. She also met with groups on the other side of the debate. “My commitment is with a healthy Europe and, at the same time, to those farmers who get up every day to work the fields of Extremadura and boost our regional economy.”

Fiocchi and Polfjärd did not respond to requests for comment by the time of publication. 

Topics and countries

A large number of meetings covered the tobacco taxation directive, which is currently making its way through the Council of the EU. The directive will put minimum taxes on nicotine and tobacco products and expand the definition of what is covered. 

Other topics discussed and declared included tobacco products and advertising directives, as well as “harm reduction.” The Commission is currently drafting revisions of the products and advertising rules.

Lawmakers declared at least 178 meetings with Philip Morris International representatives — far more than any other tobacco manufacturer. Second was British American Tobacco with 60. 

Further data shared with POLITICO by Transparency International EU shows that PMI ranked fourth behind Meta, Google and Apple as companies that had met the most MEPs and their assistants. A POLITICO investigation last year revealed PMI also successfully lobbied the European Commission. 

The Transparency Register data also shows which countries are more willing to listen to tobacco lobbyists.

MEPs from Italy, the bloc’s leading tobacco leaf producer, met with the industry far more than other nationalities — more than one in five declared meetings of tobacco industry representatives in the Parliament involved an Italian lawmaker.

This was in part driven by Italian company Manifatture Sigaro Toscano meeting exclusively with Italian MEPs. Just under half of BAT’s meetings were with Italian MEPs. The country was also well represented in meetings with PMI, although German lawmakers declared having met the company slightly more.

The dataset, which relies on lawmakers’ declarations of their meetings, likely offers a conservative snapshot of tobacco lobbying in Parliament. POLITICO removed declarations with insufficient information, but also added meetings declared more recently.

Large tobacco companies are broadly working to migrate consumers onto nicotine products under what they describe as a “harm reduction” approach. They argue nicotine and smoke-free products are better alternatives to smoking tobacco and so need to be enticing enough for people to use over cigarettes. 

Proponents dispute this, saying people don’t need to be exposed to addictive products. They also point to the high use of nicotine pouches and products among young people, who otherwise weren’t smoking. 

At least 28 meetings in the dataset referenced public health measures, rather than tobacco regulation or taxation, although this is likely non-exhaustive, as a large number of self-declared descriptions remain vague. Two meetings explicitly mentioned cardiovascular diseases. 

Greens MEP Metz was part of a group of lawmakers who pushed to restrict tobacco lobbyists’ access to EU lawmakers and accused the Parliament of failing to live up to its obligations under the WHO tobacco control treaty. But this push failed earlier this year. 

Metz said she will “continue to fight” for Parliament to fully respect the framework controlling tobacco.

People in Belgium will be able to smoke at restaurant terraces for a little while longer after the government announced it would be delaying its outdoor ban planned for early 2027.  

The federal government planned to prohibit smoking outside cafés and eateries as a public health measure from Jan. 1 , spearheaded by social democrat Health Minister Frank Vandenbroucke.

But Belgium’s Council of State, its supreme administrative court, “has asked us to adjust some measures, and we are working on this,” a statement from Vandenbroucke’s cabinet, shared with local media outlet VRT, said.  

The minister’s move initially prompted backlash from the Belgian hospitality sector; the statement added the postponement would allow enough time for venues to adjust to the new rules.   

Several other EU countries are moving forward with similar bans — albeit with different success rates. France recently introduced a smoking ban on beaches, gardens and near schools.  

Spain, meanwhile, approved a draft bill in July that would extend the ban to outdoor terraces and other public spaces, including restrictions on e-cigarettes — but which faces pushback from restaurant owners. 

Belgium introduced a slate of new anti-smoking laws last year, including curbs on smoking in airport rooms and a ban on flavored vapes, aiming to achieve a “smoke-free generation” by 2040. Outdoor smoking bans are one of many measures advocated by the World Health Organization (WHO).  

According to the Belgian Cancer Foundation, nearly a quarter of Belgians smoke and 19% do so daily. 

It is unclear how long Belgium will postpone its outdoor smoking ban. Once published, the country’s national parliament still has to approve the Council of State’s amendments.

BRUSSELS — Extreme heat killed more than 50,000 Europeans this summer. Climate change was responsible for two-thirds of the death toll. 

Those are the stark findings from two new peer-reviewed studies in the academic journal Nature Health, marking the first comprehensive assessment of fatalities during this year’s record-breaking heat waves. 

The figures come from around 850 cities across Europe, meaning the full death toll, including rural areas, is higher still. The scientists also found that this summer was the deadliest so far this century, far outstripping previous records. 

“I think we can be quite confident in stating that the summer of 2026 is likely to have been the worst on record for heat-related mortality across much of Europe,” said study lead author Clair Barnes, an extreme weather researcher at Imperial College London. 

“These numbers are a stark reminder that our hotter, more extreme summers are having an increasingly severe impact on public health. Behind these statistics are real people whose lives were lost and real families who grieve for them,” she added. 

Scientists from Imperial College and the London School of Hygiene & Tropical Medicine examined 854 cities in the European Union, the United Kingdom, Norway and Switzerland, home to about 40% of the 30 countries’ population. 

The first study, published earlier this month, looked at climate-linked mortality between 2000 and 2025, while the second study, released on Friday, focused on 2026.

Both papers estimated heat-related excess deaths by analyzing temperature records and historical heat-mortality models, a method the researchers say has consistently produced results mirroring official statistics later released by governments. 

To isolate the role of climate change, the scientists then compared the actual weather seen in these cities to a temperature model representing a world without global warming. 

They found that more than 50,000 heat-related excess deaths occurred in those cities this summer, with around 32,000 attributable to climate change driving up temperatures. 

The studies also showed how exceptionally deadly this year’s summer proved. Between 2000 and 2025, the first paper found a total of 430,000 heat-related deaths, with around half caused by climate change. The 2026 figures eclipsed the previous records of 29,000 deaths in 2022 and 28,000 in 2003.

Almost a third of this summer’s heat-related deaths occurred during Europe’s late June heat wave that smashed several temperature records. 

And while the elderly were the worst-affected population group, the death toll of this summer included around 6,000 people under the age of 65. 

“The burden was greater among older adults. People aged 85 and over accounted for roughly half of the estimated deaths,” said Garyfallos Konstantinoudis, study co-author and assistant professor at Imperial College. 

“However, heat-related mortality was not limited to the older populations,” he added. “Even among younger adults, people aged between 20 and 44, we estimated more than 800 excess deaths.” 

France has reported the first ever human case of Shamonda virus, a disease that had so far only affected animals, in a patient that died in early October.

The patient was severely immunocompromized and had been receiving treatment for a serious illness that made them more susceptible to infection and complications, the country’s agriculture, food and health authorities said Thursday.

Brain complications observed in the patient before their death “would most likely be linked to the infection with the Shamonda virus,” the authorities said.

They added that this is “an exceptional case in a highly immunocompromized patient,” and that there is “no health risk for the general population.”

Health authorities have highlighted the potential of zoonotic spillover — or the jump of diseases from animals to humans — being behind the next pandemic. Currently, over 60% of emerging infectious disease threats are of zoonotic origin, including Covid-19 and Ebola. As diseases adapt and jump from wild animals to pets to humans, their potential for pandemic threats evolves too. For this reason, scientists have been on high alert for the bird flu.

The Shamonda virus, which spreads between animals through bites from infected midges, was detected in European farm animals for the first time this year. It had previously been found only in countries outside Europe, predominantly in Africa. It is mainly observed in cattle, but there have been cases of infections in horses, sheep, goats and an alpaca.

Since the summer, the virus has been detected in farm animals in Austria, Belgium, France, Germany, Ireland, Italy, Liechtenstein, Luxembourg, the Netherlands, Portugal, Spain and Switzerland, the European Centre for Disease Prevention and Control said. In cattle, its symptoms include fever, diarrhea, lethargy, reduced milk production and mild respiratory signs.

It’s still not clear whether  the virus caused or contributed to the patient’s death and how the infection was acquired, the ECDC said. French authorities said they believe the patient might have been infected by a midge bite while in eastern France, an area where the virus has been circulating in animals since the spring.

The ECDC said it is “carefully monitoring the situation” and is in touch with French authorities and European partners to “investigate the potential public health implications of this first human infection.”

Nigeria has become the fifth country to detect the rapidly-spreading Ebola strain, with its first confirmed case in a woman who traveled from Uganda.

The patient started showing symptoms on Oct. 7, four days after her arrival in the Western African country. She was later admitted to a private hospital in the capital Abuja, where laboratory testing confirmed the Ebola diagnosis, the country’s health minister and the World Health Organization said Tuesday. She is currently in isolation and receiving medical care.

Nigeria’s health ministry and disease agency are working with the WHO and Africa Centres for Disease Control and Prevention to “contain that infection and prevent its further spread.”

The case underscores the difficulty in stopping the spread of the highly-infectious disease. The Democratic Republic of the Congo, the epicenter of the outbreak, is currently grappling with the fastest-growing and deadliest Ebola outbreak in the country’s history, caused by the Bundibugyo strain for which there are no approved vaccines or treatments. As of Oct. 19, Congo reported 9,552 confirmed cases, including 4,602 related deaths. 

In Nigeria, where there is a more established private health care market and less reliance on international aid for services, health authorities are working to track down and monitor people who may have been exposed, with 44 close contacts already identified.

“There is no need for panic,” the health ministry wrote on social media. “What matters is staying informed, practising good hand hygiene, knowing the symptoms and seeking guidance from public health authorities if you suspect exposure.”

The disease has also recently spread to Kenya, in Eastern Africa, with nine confirmed cases all linked to a man who traveled from Congo to Uganda before taking a flight to Kenya. He died at a hospital in Nairobi after testing positive for Ebola on Oct. 5.

Jean Kaseya, director-general of Africa CDC, told Devex last week this case illustrated the difficulties in contact tracing. Health authorities were still trying to ascertain who was on his flight, and if they had made onward travel, he said.

The WHO has urged “all countries in the region to sustain a high level of readiness as the outbreak in the Democratic Republic of the Congo continues to evolve.”

The U.N. health agency, which first declared the outbreak in Congo on May 15, also advised against any restriction of travel to, or trade with, affected countries.

As Europe plans its response to the neurological disease burden, a fundamental measurement gap is being overlooked — and the cost of ignoring it is being felt.

A briefing requested earlier this year by the European Parliament’s Committee on Public Health (SANT) put it plainly: neurological diseases are one of Europe’s most urgent and rapidly expanding health, social and economic challenges. Published in February 2026, it calls for a coordinated European plan linking prevention, early diagnosis, research and innovation.¹ But before Europe considers what that plan should look like, a foundational question demands attention: are we measuring the right things?

Multiple sclerosis (MS), a chronic, progressive disease of the central nervous system that disrupts communication between the brain and the body, offers a revealing case study. Consider a woman in her mid-30s, working, raising a family, managing what her neurologist calls “stable” MS. She has not slept properly in years, her memory has been slipping and she is cutting her hours at work. Her last clinical note reads: “No change.” On paper, she is stable, but in reality she is anything but.

Her story is not unusual. According to research commissioned by Sanofi^*, the gap between what health systems measure and what people with MS experience may be costing individuals, families and economies more than we realize.³

The stakes for Europe

Over 3 million people globally live with MS and Europe has the highest prevalence, at 133 per 100,000 people.^2,3 The condition strikes primarily during prime working years, meaning hundreds of thousands of people are navigating a progressive, unpredictable disease at precisely the point when inadequate support is felt most acutely.³

That support begins with measurement. And right now, the tools used to assess MS in clinical practice do not fully capture what people with the disease experience.³

The consequences extend far beyond the clinic: 82 percent of people with severe MS rely on unpaid family caregiving, yet this burden rarely appears in standard health data or policy design.³ When the full impact of disease is not measured, health systems can underestimate need, delay support, and overlook the wider effects on work, welfare and family life.³

The measurement gap

The Expanded Disability Status Scale (EDSS), the primary tool used to measure MS disability, was developed in 1983 to assess walking ability. We now know that MS affects far more than mobility. Fatigue affects 94 percent of people with MS, while 75 percent report cognitive difficulties, but both are absent in the EDSS assessment.³ In a field where clinical consensus is rare, seven in ten neurologists agree: a more comprehensive approach is needed.³

Growing recognition of smouldering neuroinflammation has made the need for new methods of quantifying MS progression increasingly urgent. This slow, chronic disease activity can persist even when a patient appears clinically stable, with effects that are subtle, cumulative and easy to miss until significant damage has already occurred.⁴

This is why Sanofi initiated the development of the Smouldering Associated Worsening (SAW) Index⁺. The SAW Index Study — led by an international steering committee of leading MS clinicians, researchers and patient advocates — is due to complete in 2027. Based on hundreds of hours of in-depth qualitative research with people with MS, the goal of the SAW Index is to provide neurologists with a comprehensive measurement framework that bridges the gap between lived experience and what clinical tools are currently able to detect.

According to the European Multiple Sclerosis Platform, people with MS experience an average of 14 symptoms within the first five years of diagnosis, with fatigue, sensory problems, sleep disturbances, cognitive impairment and balance problems among the most common.⁵ These are precisely the experiences the SAW Index is designed to surface, replacing static labels like “moderately affected” with measurement metrics grounded in the experience and words of people with MS.

The cost of this gap

These aspects of MS can be challenging to quantify and are associated with substantial societal and economic burdens. Lifetime productivity loss per person with MS ranges from €394,000 in France to €668,000 in Germany.³ The cost profile shifts significantly as the disease progresses: in mild MS, direct healthcare costs dominate; in severe MS, indirect costs become the primary driver.³ Indeed, lost wages, absenteeism, early retirement, disability payments and the growing burden on unpaid carers outweigh medical costs in many countries, placing growing long-term pressure on social insurance and disability systems.³

Early identification of progression could change that trajectory, extending years of employment, preserving household income, and reducing long-term dependence on disability and social benefits.^3,6 That is a cost-avoidance opportunity current measurement frameworks are missing.

Progress in motion

There is no single fix, but there is momentum.

MS care has advanced significantly in recent decades: diagnosis is happening earlier, treatment options have expanded and the focus is shifting from relapse control alone to slowing long-term disability progression.⁷ Furthermore, there is growing recognition of the importance of cognition, mental health, rehabilitation and the day-to-day realities that shape whether people living with MS can remain independent and active.⁸

The challenge now is to ensure policy keeps pace with that progress, and better measurement is part of the answer. If Europe wants health spending to deliver lasting value, it should see these improvements not as costs to be managed, but as investments in independence, participation, productivity and more sustainable health systems.

Time to act

The European Parliament’s SANT Committee has called for a fully funded European neurological health plan — one with the scale and ambition of Europe’s Beating Cancer Plan, aligning health, research and societal action in a unified framework.¹ MS offers a clear and immediate test case for what that ambition looks like in practice.

But ambitious plans require accurate data. If Europe is serious about a coordinated response to neurological disease, getting measurement right is not a secondary concern; it is the foundation on which everything else depends.

The people living with MS across the continent cannot wait for the tools that measure their disease to catch up with the science that understands it. Neither should policymakers.

^*Research commissioned by Sanofi. All editorial control retained by Economist Impact.
⁺Sanofi initiated and funds the SAW Index Study.

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References

1. European Parliament. Strengthening Brain Health: Policy Recommendations to Tackle the Rising Burden of Neurological Diseases. Available at: https://www.europarl.europa.eu/telastatic/cmsdata/302850/Briefing_Strengthening%20Brain%20Health_EN.pdf. Accessed: September 2026
2. MS International Federation. MS Atlas. Available at: https://atlasofms.org/map/global/epidemiology/number-of-people-with-ms. Accessed: September 2026
3. Economist Impact. Measuring what matters: Bridging the gap between disability impact and economic burden in multiple sclerosis. Available at: https://impact.economist.com/health-society/measuring-what-matters. Accessed: September 2026
4. Scalfari, A, et al. (2024) Smouldering-Associated Worsening in Multiple Sclerosis: An International Consensus Statement on Definition, Biology, Clinical Implications, and Future Directions. Ann Neurol 2024;00:1. DOI: 10.1002/ana.27034.
5. European Multiple Sclerosis Platform. (n.d.). Impact of multiple sclerosis symptoms (IMSS) [Fact sheet]. Accessed: October 2026
6. Cicely Dudley, Victoria Donnaloja and Karen Steadman. A guide for Health Care Professionals to have Conversations on Work with People with Multiple Sclerosis. Available at: https://emsp.org/wp-content/uploads/2017/02/Ready-for-Work-Employment-Guide.pdf. Accessed: September 2026
7. Montague T, Drummond J, Ng K, Parratt J. Advancements in multiple sclerosis. Intern Med J. 2025 Jun;55(6):895-904. DOI: 10.1111/imj.70023.
8. Giovannoni G, et al. MS care: integrating advanced therapies and holistic management. Front Neurol. 2024 Jan 30;14:1286122. doi: 10.3389/fneur.2023    

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Disclaimer

POLITICAL ADVERTISEMENT

• The sponsor is Sanofi.
• The political advertisement is linked to driving action in how neurological disease is measured in the EU (using MS as a case study) and driving action around the briefing requested by the SANT committee aimed at strengthening brain health (Policy Recommendations to Tackle the Rising Burden of Neurological Diseases).

More information here.