DECLARATION OF INTENT ON MULTILATERAL PROCUREMENT OF

MEDICINES

The Minister of Interior and Health of the Kingdom of Denmark,

the Minister of Social Affairs of the Republic of Estonia,

the Minister of Health of the Republic ofLatvia, and

the Minister of Health of the Republic of Lithuania,

hereby jointly referred to as “the Parties”

Considering the shared objective of ensuring timely, equitable and affordable access to safe,

effective and high-quality medicines for their populations;

Recalling the rights and obligations arising from membership of the European Union,

inciuding compliance with Union law on public procurement, competition and the internal

market, as well as the EU pharmaceutical acquis;

Acknowledging that joint activities should respect national competences, responsibilities and

decision-making processes in the organisation and financing of health systems;

Intending to deepen regional cooperation in order to address common challenges, including

shortages ofmedicines and limited market access for small markets;

Have expressed the following common understanding:

Paragraph i - objective

The objective of this Declaration of Intent is to provide a framework for dialogue to explore

cooperation on the multilateral procurement ofmedicines.

Paragraph 2 - principles

The cooperation under this Declaration will be guided by the following principles:

a) Voluntariness — Participation in any joint activity or procedure will be voluntary for each

Party.

b) Equality and mutual respect — Ali parties will have equal standing and will respect each

other’s legal frameworks and national policy choices.

c) Compliance with law — Ali activities will comply with applicable EU and national laws,

inciuding competition and public procurement rules.

d) Transparency and trust — Information will be shared in a transparent manner, subject to

confidentiality requirements and legitimate commercial interests.

e) Solidarity and fairness — Joint actions will, where possible, promote fair ailocation of

beriefits and burdens among the Parties.

Paragraph 3 - scope

The Parties will promote cooperation in the following areas of common interest:

a. Multilateral procurement procedures for seiected medicinal products

b. Information-sharing on procurement and reimbursement practices

c. Measures to prevent and mitigate shortages ofmedicines

d. Any other areas of common interest that may be jointly decided upon by the Parties.

Paragraph 4 — financial arrangements

Each party will bear its own costs related to the implementation ofthis Deciaration

Paragraph 5 — legal nature

This Declaration is a statement of political intent and does not create rights or obligations

under international law or EU law.

This Deciaration does flot affect the right of any party to conduct its own national procurement

procedures or to participate in other forms of cooperation.

This Deciaration is without prejudice to existing or future biiaterai or multilateral agreements

or arrangements in which the parties may take part.

Other parties may be invited to accede to this Deciaration by mutual consent of ali the Parties.

Any party may, at any time, limit its participation in or abstain from any specificjoint activity

without affecting its participation in this Deciaration.

Any party may withdraw from this Deciaration by giving written notice to the other parties.

Signed at Brussels, on 2’ December 2025, in a single original in the English language.

THE MINISTER OF INTERIOR AND

HEALTH OF THE KJNGDOM OF

DENMARK

THE MINISTER OF HEALTH OF

THE REPUBLIC OF LATVIA

THE MINISTER OF SOCIAL

AFFAIRS OF THE REPUBLIC OF

ESTONIA

THE MINISTER OF HEALTH OF

THE REPUBLIC OF LITHUANIA