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The access to medicines debate in Europe is at a critical juncture. With the pandemic, all issues, old and new, suddenly find a place on the agenda. They range from the prices of medicines, the flexibility of regulatory standards, the quality of innovation, all the way to the resilience of supply chain and the role of intellectual property. The implementation of the landmark EU Pharmaceutical Strategy is rightly prioritized under the EU4Health programme, but with its long list of actions and initiatives, and with (only) two years for effective legislative work ahead of us, the management of the pandemic adds to the hefty workload of officials in Brussels and the capitals.

Such a challenging environment pushes us past the point of generic, high-level statements, and makes operational, technical proposals a clear must for advancing the debate for the benefit of Europe’s public health. At the same time, such an environment makes industry’s disproportionate influence only more obvious, and creating a level playing field becomes an urgent prerequisite to address the asymmetry of powers. Levelling up, securing a robust and healthy civil society, and equipping it with the means to co-create and co-shape the policies that impact public health, will proof instrumental. This will result in increased legitimacy, broader ownership of the outcomes, and will dispel mistrust and bias.

As health and pharmaceutical policies headline the EU’s agenda, the demand for input from organisations like EPHA is higher than ever before. This demand, however, is in stark contrast with the challenges that civil society face, increasingly lacking means to provide input, and pressured by the existential concerns resulting from the new funding mechanisms under the EU4Health programme. For civil society to remain independent, build expertise, be a reliable and constructive partner, the European Commission needs to ensure its sufficient funding. This will result in comprehensive, balanced solutions, truly driven by public health needs.

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