Pöördumine

Brussels, 12 December 2025

Call to EU Member States to safeguard support for health & civil society action under the 2026 EU4Health Work Programme and the 2028–2034 Multiannual Financial Framework

We, 38 health and patient advocacy organisations active across the European region and united under the EU4Health Civil Society Alliance, are writing ahead of two key moments that will shape the future of health in Europe, and where Member States support is essential: the upcoming EU4Health Steering Group meeting; and the European Council meeting on 18–19 December, where discussions on the next Multiannual Financial Framework (MFF) 2028–2034 are expected.

We urge EU Member States to ensure that the EU4Health 2026 Work Programme reinstates operating support for civil society organisations (CSOs), and that the next MFF dedicates a robust and sustained budget to health, including a strong civil society component.

2025 has been an extremely difficult year for health CSOs, as the political decision to remove operating grants, communicated in July 2025 after months of delay, has led to the closure of at least two of our member organisations and forced many more to significantly reduce their activities and make staff redundant. We are extremely concerned that the lack of financial support for civil society’s involvement in EU health policymaking reflects a weakening of democratic processes, and we warn against institutionalising this dangerous precedent.

Funding health and civil society is cost-effective, adds value, and supports equity

As confirmed by the recent evidence produced in support to the interim evaluation of EU4Health (2021–2024), it is clear that the programme is cost-effective. Investments in preparedness for health crises generate substantial returns estimated between €9 billion and €27.5 billion, while investments in health promotion and disease prevention deliver additional returns, estimated up to €3.5 billion over time. The evaluation also shows that the EU4Health model delivers real EU added value, fostering cross-border cooperation and transnational initiatives that tackle systemic health challenges more efficiently than individual countries acting alone. This is especially meaningful for smaller or resource-constrained Member States. Since 2021, the programme has become even more relevant, not only in responding to the aftermath of COVID- 19 but also to growing, shared global challenges.

According to the same report, CSOs have proven to be vital partners in achieving the EU4Health Programme’s objectives, amplifying its impact across Europe. By supporting CSOs whose missions align with EU4Health priorities, these grants have enhanced policy coherence and facilitated the inclusion of citizens’ voices in EU health policymaking. Thanks to these grants, health CSOs have, for example, promoted physical activity across Europe, expanded access to care for patients with chronic and rare diseases, and responded swiftly to emergencies like the displacement of families during the war in Ukraine. In addition, CSOs have played a decisive role in building capacity, sharing knowledge through international networks, and driving innovation in public health interventions. While technical and financial hurdles, such as complex administrative requirements and high co-funding obligations, still limit the participation of smaller organisations, the evidence clearly shows the value of sustained and simplified support for CSOs under the EU4Health framework.

Brussels, 12 December 2025

In light of this proven value and impact, it is crucial to safeguard operating grants and a strong Health Programme that enables CSOs to contribute to stronger, more equitable and people-centred healthcare systems.

We identify two key milestones to reinforce EU health policy and ensure its long-term effectiveness, where Member States’ support and leadership are indispensable.

Call for the reinstatement of operating grants for civil society under the EU4Health 2026 Work Programme

Operating grants are the only instrument that ensure stable, predictable, multi-annual support to organisations that work directly with and for Europe’s communities, including the most vulnerable and marginalised. Without these grants, many organisations cannot maintain continuity, expertise, or the capacity to contribute meaningfully to EU policy objectives.

We therefore urge EU Member States to actively support the reinstatement of operating grants in the 2026 EU4Health Work Programme, recognising their essential contribution to the programme’s effectiveness and to health democracy.

Support a substantial, sustained health and civil-society budget in the next MFF (2028–2034)

The MFF will determine the scale of EU ambition for health in the years ahead. While the current EU4Health programme has delivered substantial added value, the interim evaluation also reveals areas where investment has been insufficient, particularly in prevention, mental health, antimicrobial resistance, climate-related health risks, and non-communicable diseases.

We are concerned that in the current proposal, health does not have a standalone window, thereby risking becoming the “adjustment variable” whenever other priorities arise. A strong, future-proof MFF must provide a robust and stable EU health budget that expands action across the healthcare continuum, from prevention to access to health services, with equity and solidarity at the core. In this context, ensuring dedicated and predictable long-term funding for health CSOs, building on the operating grant model that allows organisations to deliver sustained impact, is of utmost priority. We count on Member States support to ensure that these essential elements are upheld.

Investing in health and civil society is indispensable to secure Europe’s resilience, social cohesion, competitiveness and future. The EU4Health Civil Society Alliance stands ready to support all member states in shaping a robust, forward-looking EU4Health 2026 Work Programme, and an MFF 2028–2034 that deliver for all people.

Signatories:

1. European Public Health Alliance (EPHA) 2. European Patients’ Forum (EPF) 3. Alzheimer Europe 4. EURORDIS Rare Diseases Europe

Brussels, 12 December 2025

5. European Public Health Association (EUPHA) 6. AIDS Action Europe 7. Association of European Cancer Leagues (ECL) 8. Association of European Coeliac Societies (AOECS) 9. Childhood Cancer International Europe 10. Correlation - European Harm Reduction Network (C-EHRN) 11. Digestive Cancers Europe 12. EUROCAM 13. EuroHealthNet 14. European AIDS Treatment Group (EATG) 15. European Alcohol Policy Alliance (Eurocare) 16. European Association for Palliative Care (EAPC) 17. European Central Council of Homeopaths (ECCH) 18. European Federation of Allergy and Airways Diseases Patients' Associations (EFA) 19. European Federation of Neurological Associations (EFNA) 20. European Heart Network (EHN) 21. European Health Management Association (EHMA) 22. European Kidney Health Alliance (EKHA) 23. European Liver Patients’ Association (ELPA) 24. European Network for Smoking and Tobacco Prevention (ENSP) 25. European Respiratory Society (ERS) 26. Fertility Europe 27. Health Action International (HAI) 28. Infectious Disease Alliance (IDA) 29. International Diabetes Federation (Europe) 30. International Federation of Anthroposophical Medical Associations (IVAA) 31. International Sport and Culture Association 32. Mental Health Europe (MHE) 33. Psychedelic Access and Research European Alliance (PAREA) 34. Salud por Derecho 35. SIOPE – European Society for Paediatric Oncology 36. Smoke Free Partnership (SFP) 37. TB Europe Coalition (TBEC) 38. Wemos

Brussels, 12 December 2025

Brussels, 12 December 2025

Call to EU Member States to safeguard support for health & civil society action under the 2026 EU4Health Work Programme and the 2028–2034 Multiannual Financial Framework

We, 38 health and patient advocacy organisations active across the European region and united under the EU4Health Civil Society Alliance, are writing ahead of two key moments that will shape the future of health in Europe, and where Member States support is essential: the upcoming EU4Health Steering Group meeting; and the European Council meeting on 18–19 December, where discussions on the next Multiannual Financial Framework (MFF) 2028–2034 are expected.

We urge EU Member States to ensure that the EU4Health 2026 Work Programme reinstates operating support for civil society organisations (CSOs), and that the next MFF dedicates a robust and sustained budget to health, including a strong civil society component.

2025 has been an extremely difficult year for health CSOs, as the political decision to remove operating grants, communicated in July 2025 after months of delay, has led to the closure of at least two of our member organisations and forced many more to significantly reduce their activities and make staff redundant. We are extremely concerned that the lack of financial support for civil society’s involvement in EU health policymaking reflects a weakening of democratic processes, and we warn against institutionalising this dangerous precedent.

Funding health and civil society is cost-effective, adds value, and supports equity

As confirmed by the recent evidence produced in support to the interim evaluation of EU4Health (2021–2024), it is clear that the programme is cost-effective. Investments in preparedness for health crises generate substantial returns estimated between €9 billion and €27.5 billion, while investments in health promotion and disease prevention deliver additional returns, estimated up to €3.5 billion over time. The evaluation also shows that the EU4Health model delivers real EU added value, fostering cross-border cooperation and transnational initiatives that tackle systemic health challenges more efficiently than individual countries acting alone. This is especially meaningful for smaller or resource-constrained Member States. Since 2021, the programme has become even more relevant, not only in responding to the aftermath of COVID- 19 but also to growing, shared global challenges.

According to the same report, CSOs have proven to be vital partners in achieving the EU4Health Programme’s objectives, amplifying its impact across Europe. By supporting CSOs whose missions align with EU4Health priorities, these grants have enhanced policy coherence and facilitated the inclusion of citizens’ voices in EU health policymaking. Thanks to these grants, health CSOs have, for example, promoted physical activity across Europe, expanded access to care for patients with chronic and rare diseases, and responded swiftly to emergencies like the displacement of families during the war in Ukraine. In addition, CSOs have played a decisive role in building capacity, sharing knowledge through international networks, and driving innovation in public health interventions. While technical and financial hurdles, such as complex administrative requirements and high co-funding obligations, still limit the participation of smaller organisations, the evidence clearly shows the value of sustained and simplified support for CSOs under the EU4Health framework.

Brussels, 12 December 2025

In light of this proven value and impact, it is crucial to safeguard operating grants and a strong Health Programme that enables CSOs to contribute to stronger, more equitable and people-centred healthcare systems.

We identify two key milestones to reinforce EU health policy and ensure its long-term effectiveness, where Member States’ support and leadership are indispensable.

Call for the reinstatement of operating grants for civil society under the EU4Health 2026 Work Programme

Operating grants are the only instrument that ensure stable, predictable, multi-annual support to organisations that work directly with and for Europe’s communities, including the most vulnerable and marginalised. Without these grants, many organisations cannot maintain continuity, expertise, or the capacity to contribute meaningfully to EU policy objectives.

We therefore urge EU Member States to actively support the reinstatement of operating grants in the 2026 EU4Health Work Programme, recognising their essential contribution to the programme’s effectiveness and to health democracy.

Support a substantial, sustained health and civil-society budget in the next MFF (2028–2034)

The MFF will determine the scale of EU ambition for health in the years ahead. While the current EU4Health programme has delivered substantial added value, the interim evaluation also reveals areas where investment has been insufficient, particularly in prevention, mental health, antimicrobial resistance, climate-related health risks, and non-communicable diseases.

We are concerned that in the current proposal, health does not have a standalone window, thereby risking becoming the “adjustment variable” whenever other priorities arise. A strong, future-proof MFF must provide a robust and stable EU health budget that expands action across the healthcare continuum, from prevention to access to health services, with equity and solidarity at the core. In this context, ensuring dedicated and predictable long-term funding for health CSOs, building on the operating grant model that allows organisations to deliver sustained impact, is of utmost priority. We count on Member States support to ensure that these essential elements are upheld.

Investing in health and civil society is indispensable to secure Europe’s resilience, social cohesion, competitiveness and future. The EU4Health Civil Society Alliance stands ready to support all member states in shaping a robust, forward-looking EU4Health 2026 Work Programme, and an MFF 2028–2034 that deliver for all people.

Signatories:

1. European Public Health Alliance (EPHA) 2. European Patients’ Forum (EPF) 3. Alzheimer Europe 4. EURORDIS Rare Diseases Europe

Brussels, 12 December 2025

5. European Public Health Association (EUPHA) 6. AIDS Action Europe 7. Association of European Cancer Leagues (ECL) 8. Association of European Coeliac Societies (AOECS) 9. Childhood Cancer International Europe 10. Correlation - European Harm Reduction Network (C-EHRN) 11. Digestive Cancers Europe 12. EUROCAM 13. EuroHealthNet 14. European AIDS Treatment Group (EATG) 15. European Alcohol Policy Alliance (Eurocare) 16. European Association for Palliative Care (EAPC) 17. European Central Council of Homeopaths (ECCH) 18. European Federation of Allergy and Airways Diseases Patients' Associations (EFA) 19. European Federation of Neurological Associations (EFNA) 20. European Heart Network (EHN) 21. European Health Management Association (EHMA) 22. European Kidney Health Alliance (EKHA) 23. European Liver Patients’ Association (ELPA) 24. European Network for Smoking and Tobacco Prevention (ENSP) 25. European Respiratory Society (ERS) 26. Fertility Europe 27. Health Action International (HAI) 28. Infectious Disease Alliance (IDA) 29. International Diabetes Federation (Europe) 30. International Federation of Anthroposophical Medical Associations (IVAA) 31. International Sport and Culture Association 32. Mental Health Europe (MHE) 33. Psychedelic Access and Research European Alliance (PAREA) 34. Salud por Derecho 35. SIOPE – European Society for Paediatric Oncology 36. Smoke Free Partnership (SFP) 37. TB Europe Coalition (TBEC) 38. Wemos

Brussels, 12 December 2025