Making water the engine for climate action

Much progress has been made on water security over recent decades, yet for the first time in human history, our collective actions have pushed the global water cycle out of balance. Water is life: it is essential for health, food, energy, socioeconomic development, nature and livable cities. It is hardly surprising that the climate and biodiversity crises are also a water crisis, where one reinforces the other. Already, a staggering four billion people suffer from water scarcity  for at least one month a year and two billion people lack access to safely-managed drinking water. By 2030, global water demand will exceed availability by 40 percent. By 2050, climate-driven water scarcity could impact the economic growth of some regions by up to 6 percent of their Gross Domestic Product per year.

Meike van Ginneken, Water Envoy of the Kingdom of the Netherlands

Right now, the world’s first Global Stocktake is assessing the progress being made toward the goals of the Paris Agreement and global leaders are convening at COP28 in Dubai to agree on a way forward. We have a critical opportunity to catalyze global ambition and recognize that water is how climate change manifests itself. While wealthier, more resilient nations may be able to manage the devastating impacts of climate change, these same challenges are disastrous for lesser developed, more vulnerable communities.

Rainfall, the source of all freshwater, is becoming more erratic. Changes in precipitation, evaporation and soil moisture are creating severe food insecurity. Droughts trap farmers in poverty, as the majority of cultivated land is rain-fed. Extreme drought reduces growth in developing countries by about 0.85 percentage points. Melting glaciers, sea-level rise and saltwater intrusion jeopardize freshwater supplies. Floods destroy infrastructure, damage homes and disrupt livelihoods. The 2022 Pakistan floods affected 33 million people and more than 1,730 lost their lives, while 2023 saw devastating floods in Libya among other places.  

Now more than ever, it is urgent that we work together to make water the engine of climate action. Already, many countries are investing in technology and climate-resilient water infrastructure. Yet, we need more than technology and engineering to adapt to a changing climate. To advance global water action, we must radically change the way we understand, value and manage water with an emphasis on two necessary measures.

First, we need to make water availability central to our economic planning and decision-making. We need to rethink where and how we grow our food, where we build our cities, and where we plan our industries. We cannot continue to grow thirsty crops in drylands or drain wetlands and cut down forests to raise our cattle. In a changing climate, water availability needs to guide where we undertake economic activity.

In a changing climate, water availability needs to guide where we undertake economic activity.  

Second, we must restore and protect natural freshwater stocks, our buffers against extreme climate events. Natural freshwater storage is how we save water for dry periods and freshwater storage capacity is how we store rainwater to mitigate floods. 99 percent of freshwater storage is in nature. We need to halt the decline of groundwater, wetlands and floodplains. But our challenge is not only about surface and groundwater bodies, or blue water. We also need to preserve and restore our green water stocks, or the water that remains in the soil after rainfall. To reduce the decline of blue water and preserve green water, we need to implement water-friendly crop-management practices and incorporate key stakeholders, such as farmers, into the decision-making process.

Addressing the urgency of the global water crisis goes beyond the water sector. It requires transformative changes at every level of society. National climate plans such as Nationally Determined Contributions (NDCs) and National Adaptation Plans are key instruments to make water an organizing principle to spatial, economic and investment planning. Much like the Netherlands did earlier this year when the Dutch parliament adopted a policy that makes water and soil guiding principles in all our spatial planning decisions. Right now, about 90 percent of all countries’ NDCs prioritize action on water for adaptation. NDCs and National Adaptation Plans are drivers of integrated planning and have the potential to unlock vast investments, yet including targets for water is only a first step.

To drive global action, the Netherlands and the Republic of Tajikistan co-hosted the United Nations 2023 Water Conference, bringing the world together for a bold Water Action Agenda to accelerate change across sectors and deliver on the water actions in the 2030 Agenda for Sustainable Development and the Paris Agreement. To elevate the agenda’s emphasis on accelerating implementation and improved impact, the Netherlands is contributing an additional €5 million to the NDC Partnership to support countries to mitigate the impacts of climate change, reduce water-related climate vulnerability and increase public and private investments targeting water-nexus opportunities. As a global coalition of over 200 countries and international institutions, the NDC Partnership is uniquely positioned to support countries to enhance the integration of water in formulating, updating, financing and implementing countries’ NDCs.

One example showcasing the importance of incorporating water management into national planning comes from former NDC Partnership co-chair and climate leader, Jamaica. Jamaica’s National Water Commission (NWC), one of the largest electricity consumers in the country, mobilized technical assistance to develop an integrated energy efficiency and renewables program to reduce its energy intensity, building up the resilience of the network, while helping reduce the country’s greenhouse gas emissions. With additional support from the Netherlands, the International Renewable Energy Agency (IRENA) and the United Nations Development Programme (UNDP), together with Global Water Partnership (GWP)-Caribbean, the government of Jamaica will ensure the National Water Commission is well equipped for the future. Implementation of climate commitments and the requisite financing to do so are key to ensuring targets like these are met.

Water has the power to connect. The Netherlands is reaching out to the world.

Water has the power to connect. The Netherlands is reaching out to the world. We are committed to providing political leadership and deploying our know-how for a more water-secure world. As we look towards the outcomes of the Global Stocktake and COP28, it is essential that we make water the engine of climate action. 



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AWS digital sovereignty pledge: A new, independent sovereign cloud in Europe

From day one, Amazon Web Services (AWS) has believed it is essential that customers have control over their data, and choices for how they secure and manage that data in the cloud. Last year, we introduced the AWS Digital Sovereignty Pledge, our commitment to offering AWS customers the most advanced set of sovereignty controls and features available in the cloud.

AWS offers the largest and most comprehensive cloud infrastructure globally. Our approach from the beginning has been to make AWS sovereign-by-design. We built data protection features and controls in the AWS cloud with input from financial services, health care and government customers — who are among the most security- and data privacy-conscious organizations in the world. This has led to innovations like the AWS Nitro System, which powers all our modern Amazon Elastic Compute Cloud (Amazon EC2) instances and provides a strong physical and logical security boundary to enforce access restrictions so that nobody, including AWS employees, can access customer data running in Amazon EC2. The security design of the Nitro System has also been independently validated by the NCC Group in a public report.

With AWS, customers have always had control over the location of their data. In Europe, customers who need to comply with European data residency requirements have the choice to deploy their data to any of our eight existing AWS Regions (Ireland, Frankfurt, London, Paris, Stockholm, Milan, Zurich and Spain) to keep their data securely in Europe. To run their sensitive workloads, European customers can leverage the broadest and deepest portfolio of services, including AI, analytics, compute, database, internet of things, machine learning, mobile services and storage. To further support customers, we’ve innovated to offer more control and choice over their data. For example, we announced further transparency and assurances, and new dedicated infrastructure options with AWS ‘Dedicated Local Zones’.

To deliver enhanced operational resilience within the EU, only EU residents who are located in the EU will have control of the operations and support.

Announcing the AWS European Sovereign Cloud

When we speak to public-sector and regulated-industry customers in Europe, they share how they are facing incredible complexity with an evolving sovereignty landscape. Customers tell us they want to adopt the cloud, but are facing increasing regulatory scrutiny over data location, European operational autonomy and resilience. We’ve learned that these customers are concerned that they will have to choose between the full power of AWS or feature-limited sovereign cloud solutions. We’ve had deep engagements with European regulators, national cybersecurity authorities, and customers to understand how the sovereignty needs of customers can vary based on multiple factors, like location, sensitivity of workloads, and industry. We recently announced our plans to launch the AWS European Sovereign Cloud, a new, independent cloud for Europe, designed to help public sector organizations and customers in highly-regulated industries meet their evolving sovereignty needs. We’re designing the AWS European Sovereign Cloud to be separate and independent from our existing ‘regions’, with infrastructure located wholly within the European Union, with the same security, availability and performance our customers get from existing regions today. To deliver enhanced operational resilience within the EU, only EU residents who are located in the EU will have control of the operations and support for the AWS European Sovereign Cloud. The AWS European Sovereign Cloud will launch its first AWS Region in Germany available to all European customers.

Built on more than a decade of experience operating multiple independent clouds for the most critical and restricted workloads.

The AWS European Sovereign Cloud will be sovereign-by-design, and will be built on more than a decade of experience operating multiple independent clouds for the most critical and restricted workloads. Like existing regions, the AWS European Sovereign Cloud will be built for high availability and resiliency, and powered by the AWS Nitro System, to help ensure the confidentiality and integrity of customer data. Customers will have the control and assurance that AWS will not access or use customer data for any purpose without their agreement. AWS gives customers the strongest sovereignty controls among leading cloud providers. For customers with enhanced data residency needs, the AWS European Sovereign cloud is designed to go further and will allow customers to keep all metadata they create (such as the roles, permissions, resource labels and configurations they use to run AWS) in the EU. The AWS European Sovereign Cloud will also be built with separate, in-region billing and usage metering systems.

Delivering operational autonomy

The AWS European Sovereign Cloud will provide customers with the capability to meet stringent operational autonomy and data residency requirements. To deliver enhanced data residency and operational resilience within the EU, the AWS European Sovereign Cloud infrastructure will be operated independently from existing AWS Regions. To assure independent operation of the AWS European Sovereign Cloud, only personnel who are EU residents, located in the EU, will have control of day-to-day operations, including access to data centers, technical support and customer service.

Control without compromise

Though separate, the AWS European Sovereign Cloud will offer the same industry-leading architecture built for security and availability as other AWS Regions. This will include multiple ‘Availability Zones’, infrastructure that is placed in separate and distinct geographic locations, with enough distance to significantly reduce the risk of a single event impacting customers’ business continuity.

Continued AWS investment in Europe

The AWS European Sovereign Cloud represents continued AWS investment in Europe. AWS is committed to innovating to support European values and Europe’s digital future. We drive economic development through investing in infrastructure, jobs and skills in communities and countries across Europe. We are creating thousands of high-quality jobs and investing billions of euros in European economies. Amazon has created more than 100,000 permanent jobs across the EU. Some of our largest AWS development teams are located in Europe, with key centers in Dublin, Dresden and Berlin. As part of our continued commitment to contribute to the development of digital skills, we will hire and develop additional local personnel to operate and support the AWS European Sovereign Cloud.

Our commitments to our customers

We remain committed to giving our customers control and choices to help meet their evolving digital sovereignty needs. We continue to innovate sovereignty features, controls and assurances globally with AWS, without compromising on the full power of AWS.



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Harnessing innovation in robotic-assisted surgery


For nearly three decades, Intuitive has been developing innovative approaches in the field of minimally-invasive care. We are guided by the belief that minimally-invasive care can be life changing, that patient outcomes can be profoundly improved and that enhanced clinical outcomes can sustainably lower the total cost of comprehensive care.

Our focus is on helping customers in Europe and around the world achieve better outcomes, better surgeon and care team experiences, better patient experiences and lower cost of care. Positive impact in these areas requires a holistic effort that includes not only leading-edge, integrated systems and software, but also an ecosystem of education and support that extends across the patient care pathway and the broader health care system.

What is robotic-assisted surgery?

27 years ago, Intuitive launched the da Vinci robotic-assisted surgical system, transforming the field of minimally-invasive surgery.

Robotic-assisted surgery is a form of minimally-invasive surgery performed by a surgeon using a computer-assisted system to operate through small incisions using tiny, wristed instruments. Robotic-assisted surgical systems do not perform surgery on their own and they do not replace surgeons. Surgeons completely control da Vinci robotic-assisted surgical systems, while seated at an ergonomic console that uses high-definition, 3D vision to magnify the patient’s anatomy. The surgical system translates the surgeon’s hand movements in real time to bend and rotate the instruments with greater flexibility, precision and range of motion than the human hand. This approach can augment a surgeon’s skills and capabilities while allowing them to continue to apply their judgment and experience.

To date, more than 12 million da Vinci robotic-assisted surgical procedures have been performed worldwide — including more than 1.2 million in Europe — across a range of procedures including urology, gynecology, colorectal, thoracic, general surgery and more.

Robotic-assisted surgery is a form of minimally-invasive surgery performed by a surgeon using a computer-assisted system to operate through small incisions using tiny, wristed instruments.

A growing body of research, including more than 34,000 peer-reviewed studies, suggests that minimally-invasive, robotic-assisted surgery can offer patients benefits in many cases, depending on the procedure, including one or more of these benefits: less blood loss, fewer complications, shorter hospital stays, and less chance of hospital readmission.[i]

The added value of robotic-assisted surgery for European health care systems

Since the first robotic-assisted da Vinci prostatectomy was performed in Germany nearly 20 years ago, more than 1,500 da Vinci systems have been installed in Europe, highlighting Europe’s strong demand for this innovative technology. But, while Europe has helped drive this technology forward, more can be done to help hospitals in Europe become world leaders in the 21st century.

Similar to health care systems around the world, Europe faces challenges including rising health care costs, a pressured workforce, aging populations and increasing burdens of disease. At the same time, patients across Europe are seeking equitable access to innovative, high-quality care.

Using our more than two decades of experience working with hospitals and health care systems across Europe, we strive to offer solutions to these multifaceted challenges that are aligned with our customers’ clinical and economic capabilities and goals. A key insight from our experience is that we must provide more than a “robotic-assisted surgical system”; we must be a “technology-enabled solutions partner and provider”. Robotic-assisted surgery as a modality can help drive better patient outcomes; robotic-assisted surgical programs as a key part of a hospital’s care pathway can help optimize the cost and efficiency and advance the delivery and quality of care.

As one example, we collaborate with hospitals to examine opportunities to sustainably increase throughput and introduce efficiencies that can allow them to treat more patients and reduce patient backlogs. Solutions that our customers have enacted as a result of these engagements include improving operating room set up time, scheduling optimization, standardizing pre-operative planning for care teams, and starting surgical days earlier. 

In all cases, we work to assure that any effort is seamlessly integrated into the workflows of our hospital customers and their broader patient care pathways, and that our success is defined and measured in alignment with their goals.

Training

Central to our holistic approach is our technology training, which is essential to maximize patient safety and a vital part of any successful robotic-assisted surgery program. Our four-phase training pathway combines skills and technology training with opportunities for health care professionals around the world to learn from their peers. Our robust training offerings include a combination of simulation, virtual learning, in-person observation and hands-on training, with high-quality tissue models and peer-to-peer mentoring, proctoring and advanced learning opportunities. The training tools and technologies we offer are informed by our unique understanding of best practices and can help users build their skills by targeting individualized areas for improvement.

We believe that our robust training programs are contributing to the development of the next-generation health care workforce.

Last year, we became the largest provider of robotic-assisted surgical technology training to have our full global training portfolio accredited by The Royal College of Surgeons. And, our industry-leading offerings are more available than ever across both virtual and in-person opportunities; we now have more than 25 training centers and partnerships across Europe.

Looking forward, we believe that our robust training programs are contributing to the development of the next-generation health care workforce and motivating existing surgical staff to stay within our health care systems. We will continue to evolve and innovate our training offerings by listening to and learning from surgeons and teams to identify the practices that lead to better results and hone our efforts to offer meaningful interoperative guidance.

Total cost to treat

While there is an upfront investment in robotic-assisted technology, the experience of hospitals across Europe shows that da Vinci systems can help realize a return on this investment. The benefits of minimally-invasive care — fewer complications and readmissions, less blood loss, less pain — help to avoid higher ‘downstream’ costs and resource use associated with traditional, or “open” surgery, which typically requires longer hospital stays and presents a greater risk of post-operative complications.[ii] Robotic-assisted approaches, like the da Vinci system, can therefore help to reduce the costs and resources associated with a complete patient journey, or ‘episode of care’.

An important indicator of the economic value of this cost avoidance can be found in hospitals’ investment decisions in recent years. Based on their own medical records, financial data, and unique reimbursement and cost structures, hospitals are increasingly choosing to commit to robotic-assisted technology. Our own data shows that the number of hospital Integrated Delivery Networks, or IDN’s, with more than seven da Vinci systems has increased by more than 150 percent in the past five years.[iii] We believe this demonstrates a trend from cautious adoption to standardization based on recognized value. This trend brings the benefits of minimally-invasive care to an increasingly larger number of users, helping to accelerate and compound the potential savings to the health care system over time.

A vision for 2030: a future of European health care excellence

The next European Commission term will almost reach the end of this decade, serving as a useful marker for us to imagine where Europe could be in health care delivery by 2030.

Looking ahead, it will be essential that policymakers create an environment where advancements in robotic-assisted tools and technology, digital health and patient-focused innovation can be seamlessly integrated in a way that prioritizes patient safety and facilitates equitable access to and adoption of innovative technology.

The infrastructure and tools needed for future success are already present. Europe can lead the way in creating this environment, in part by avoiding policies which inhibit this kind of integration and innovation through duplicative or conflicting regulatory structures. We look forward to contributing to an ambitious agenda to bring cutting-edge health care, training, and innovations to European patients and health care professionals.

This material may contain estimates and forecasts from which actual results may differ.


[i] Bhama, A. R., et al. (2016). “Comparison of Risk Factors for Unplanned Conversion from Laparoscopic and Robotic to Open Colorectal Surgery Using the Michigan Surgical Quality Collaborative (MSQC) Database.” Journal of Gastrointestinal Surgery: 1-8

Oh, D. S., et al. (2017). “Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premier Data.” Annals of Thoracic Surgery 104(5): 1733-1740.

Ran, L., et al. (2014). “Comparison of robotic surgery with laparoscopy and laparotomy for treatment of endometrial cancer: a meta-analysis.” PLoS ONE 9(9): e108361.

Speicher, P. J., et al. (2014). “Robotic Low Anterior Resection for Rectal Cancer: A National Perspective on Short-term Oncologic Outcomes.” Annals of Surgery.

Tam, M. S., et al. (2015). “A population-based study comparing laparoscopic and robotic outcomes in colorectal surgery.” Surgical Endoscopy and Other Interventional Techniques.

Pilecki, M., et al. (2014). „National Multi-Institutional Comparison of 30-Day Postoperative Complication and Readmission Rates Between Open Retropubic Radical Prostatectomy and Robot-Assisted Laparoscopic Prostatectomy Using NSQIP (National Surgical Quality Improvement Program)“ Journal of Endourology, 430 – 436.

Tewari A, et al. “Positive Surgical Margin and Perioperative Complication Rates of Primary Surgical Treatments for Prostate Cancer: A Systematic Review and Meta-Analysis Comparing Retropubic, Laparoscopic, and Robotic Prostatectomy,” Eur Urol. 2012 Feb 24.7.

Carbonell, A. M., et al. (2017). “Reducing Length of Stay Using a Robotic-Assisted Approach for Retromuscular Ventral Hernia Repair: A Comparative Analysis from the Americas Hernia Society Quality Collaborative,” Annals of Thoracic Surgery.

Lim, P. C., et al. (2016). “Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications,” International Journal of Gynecology and Obstetrics.

O’Neill, Michelle, et al. “Robot-assisted hysterectomy compared to open and laparoscopic approaches: systematic review and meta-analysis,” Archives of gynecology and obstetrics 287.5 (2013): 907-918.

Geppert B, Lönnerfors C, Persson J. “Robot-assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery.”  Acta Obstet Gynecol Scand. 90.11 (2011): 1210-1217. doi: 10.1111/j.1600-0412.2011.01253.x. Epub.

[ii] Id.

[iii] Intuitive internal data measuring from year end 2017 to year end 2022.



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Poland turns toward bets on offshore wind

The development of offshore wind farms in Poland has never before taken place on such a large scale. The PGE Group is the biggest investor in offshore wind farms in the Polish part of the Baltic Sea in terms of wind turbine capacity. As part of its offshore program, the PGE Group is currently implementing three offshore wind farm projects.

Two of them are the offshore wind power plants Baltica 2 and Baltica 3, which comprise the Baltica Offshore Wind Farm with a total capacity of 2.5GW. PGE is implementing this project together with the Danish partner Ørsted. Both phases of the Baltica offshore wind farm have location decisions, environmental decisions, and grid connection agreements with the operator, and have been granted the right to a Contract for Difference (CfD).

As part of its offshore program, the PGE Group is currently implementing three offshore wind farm projects.

Last April, PGE and Ørsted took a major step in the Baltica 2 project. They signed the first of the contracts for the supply of wind turbines. Subsequently, they also signed a contract for the supply of offshore substations in June. Baltica 2 is expected to start producing green energy in 2027, while the entire Baltica Offshore Wind Farm will be completed within this decade.

Independently of the Baltica Offshore Wind Farm, the PGE Group is developing a third project, Baltica 1. Commissioning is scheduled after 2030 and its capacity will be approximately 0.9GW. The project already has a location permit and a connection agreement. In May 2022, wind measurement studies for this project started, followed by environmental studies in autumn 2022. The energy produced by all three farms will supply nearly 5.5 million households in Poland.  This means that more than a third of all Polish households will be provided with energy from wind power.

Baltica 2 is expected to start producing green energy in 2027, while the entire Baltica Offshore Wind Farm will be completed within this decade.

At the same time, the PGE Group has received final decisions on new permits for the construction of artificial islands for five new areas to be developed in the Baltic Sea, which will enable the construction of further offshore wind power plants in the future. The total capacity potential from the new areas provides PGE with more than 3.9GW. Considering the projects currently under development (Baltica 2, Baltica 3 and Baltica 1) with a total capacity of approximately 3.4GW, PGE Capital Group’s offshore wind portfolio may increase to over 7.3GW by 2040.

Offshore wind — a new chapter for the Polish economy

A long-term vision for the development of the Polish offshore wind sector, based on the carefully assessed potential of this technology, will support the development of the energy sector in Poland. The benefits of offshore wind development in Poland should be considered in several aspects — first and foremost, due to their total capacity, offshore wind farms will become a very important new source of clean, green energy for Poland in just a few years.

“Offshore wind energy will make a significant contribution to Poland’s energy mix. The three projects currently under construction by the PGE Group, with a total capacity of almost 3.5GW, will generate electricity for almost 5.5 million households. All the investments planned for the Baltic Sea are crucial for strengthening Poland’s energy security. Regarding the Polish economy, in particular the economy of the entire Pomerania region, the construction of offshore wind farms will provide a strong development stimulus. This is not only about businesses closely related to wind energy, such as companies supplying components for offshore wind power plants. Jobs will also be created by businesses willing to join the development of this new sector and take advantage of the opportunities it brings,” said Wojciech Dąbrowski, president of the management board of PGE Polska Grupa Energetyczna S.A.

All the investments planned for the Baltic Sea are crucial for strengthening Poland’s energy security.

The construction of offshore wind farms will ensure Poland’s energy security

The development of offshore wind is also crucial to Poland’s energy security and independence. Thanks to the production of energy from renewable sources, there is no need to import fossil fuels from abroad or rely on dwindling domestic coal resources.

This means that Poland will not be dependent on external fuel suppliers or various international developments. The ability to generate electricity independently contributes to strengthening the country’s energy sovereignty.

Energy, environmental and social benefits

Poland has ambitions and capabilities to become one of the leaders in offshore wind energy development in the Baltic Sea and even in Europe. We have plenty of resources for the development of offshore wind farms because of our favorable geographical location and natural conditions — strong, stable winds and the relatively shallow considerable area of the Baltic Sea, located in the exclusive economic zone. The Baltic Sea has some of the best wind conditions not only in Europe but also in the world, which are comparable to those in the North Sea.

Offshore wind energy is a key element of sustainable development. For Poland, green wind energy means savings, security and energy independence at the same time. Electricity from renewable sources is less expensive than that generated from fossil fuels. By choosing green energy, consumers can save on their electricity bills while at the same time supporting the development of a green energy sector. As a zero-emission energy source, it contributes to achieving climate policy goals and minimizing negative environmental impact. It is a huge step towards reducing greenhouse gas emissions. The creation of an infrastructure for the construction of alternative energy sources with wind farms will ensure the diversification of energy sources.



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Beyond forgetfulness: Why we must act on Alzheimer’s disease now

In the face of an increasingly aging population, today’s reality reveals a harsh truth: health systems in the EU and beyond are ill-equipped to provide early and timely diagnosis of Alzheimer’s disease and embrace innovative treatments that could help to preserve memory and, with it, independence.  

Recent advances suggest that timely intervention may hold the promise to slow the memory decline in Alzheimer’s disease, making early diagnosis more critical than ever before. Yet without the necessary health care infrastructure in place to diagnose and provide treatment, we risk missing the crucial early window and the opportunity to delay — and hopefully in the near future prevent — distressing symptoms for patients and heartbreaking experiences for families.  

The EU and its member countries have the opportunity to be remembered for leading in this space by increasing funding for research, improving health care infrastructure to support accurate diagnosis and timely intervention, and enhancing support services at a national and regional level. The forthcoming European Parliament elections in June 2024 are the ideal moments to make that pledge. For individuals, families and health care systems, Alzheimer’s disease is a ticking time bomb unless we invest in our future health today.  

The EU is not prepared for Alzheimer’s disease  

In Europe, approximately 7 million people are affected by Alzheimer’s disease, a number set to double to 14 million by 2050.1 On top of the physical and emotional distress this will cause, there are direct financial and social implications on families and communities, with Alzheimer’s costs expected to reach a staggering €250 billion by 20302 — bigger than the GDP of Portugal3 — placing an additional and substantial weight on global health care systems that are already struggling under cost and capacity burdens.4 

Timely diagnosis stands as a cornerstone in determining the appropriate treatment for patients.

That’s why MEP Deirdre Clune is leading the call for a European Parliament hearing to discuss a focused EU strategy on dementia and Alzheimer’s disease. “Timely diagnosis stands as a cornerstone in determining the appropriate treatment for patients,” argues Clune. “Therefore, the EU must create a strategic framework which lays out clear recommendations for national governments and recognises the toll of dementia and Alzheimer’s disease on societies across Europe, encourage innovation and take on board best practices to develop effective and efficient approaches. Together, with a unified approach and firm commitment, the EU can pave the way for better Alzheimer’s care.”

In the next EU political mandate, policymakers must answer the call by developing a comprehensive EU Beating Dementia Plan that specifically addresses the unique challenges posed by Alzheimer’s disease and building on established coordinated action plans for other significant health burdens, such as the EU Beating Cancer Plan. The European Brain Council and EFPIA’s, RETHINKING Alzheimer’s disease White Paper is a useful resource, calling for policymakers to rethink Alzheimer’s and offering policy recommendations to make tangible changes to improve the lives of people living with the disease.  

EU member countries must commit to investing in diagnostic infrastructure, technology and integrated care that can help to detect Alzheimer’s disease at an early stage and ensure timely intervention resulting in the preservation of memory and, thereof, independent living and normal social functioning.  

Laying the foundations at national level  

While action is certainly needed at the EU level, huge opportunity lies at the national and regional levels. Each member country has the chance to apply well-funded national dementia plans that tailor their strategies and responses to address the distinct needs of their populations, making a real and meaningful impact on the people and health systems in their country.  

Inspiration stems from Italy, which recently launched its Parliamentary Intergroup for Neuroscience and Alzheimer’s, dedicating its efforts to raising awareness, fostering discussions among national and regional institutions, promoting clinician and patient involvement, supporting novel research, implementing new diagnostic models, and strengthening patient access to care. 

Italian MP Annarita Patriarca, co-host of the Parliamentary Intergroup, affirms: “Primary responsibility of a member state is to ensure to all citizens the greatest standards of diagnosis and access to treatment and care. Thus, it is necessary to put in place a strong collaboration between the public and private sector to strengthen investments in neurological diseases. Improving patients’ diagnostic and care pathways, especially in a disease area like AD with such a high unmet medical need and societal impact will be the core focus of the intergroup.” 

Additionally, during the Alzheimer’s and Neuroscience Conference: a priority for the country in July, members of the Italian Parliament importantly put forward legislative and regulatory solutions to ensure an early and accurate diagnosis. 

Leading the conversation on the international stage   

Amid the growing burden of Alzheimer’s disease globally, this is a moment for policymakers to hold each other accountable. Member countries are uniquely placed to do this within the EU but also across the wider health care ecosystem, calling on countries and leaders to honor prior commitments that prioritized investment in relieving major health burdens, including Alzheimer’s.  

Encouragingly, the May G7 Hiroshima Leaders’ Communiqué specifically recognized and supported dementia as a freestanding issue, breaking away from the typical categorization with NCDs. Moreover, the G7 health ministers published a joint Communiqué spotlighting the priority to “enhance early detection, diagnosis and interventions, including developing care pathways and capability and capacity building of health and primary care providers by strengthening primary health care (PHC)”.  

These promising steps mean that Alzheimer’s disease is beginning to gain the recognition it deserves but also acts as a line in the sand to ensure complacency doesn’t creep in. Collectively, EU countries must assume a leading voice within the international fora, ensuring that Alzheimer’s disease remains a global health care priority and receives the investment it warrants. 

Time to commit to action in Alzheimer’s disease  

September marks World Alzheimer’s Month, and its theme Never Too Early, Never Too Late, reiterates the importance of early diagnosis. It presents a valuable foundation to initiate discussions on country- and regional-level strategies to drive and strengthen diagnostic infrastructure and services for the prevention, diagnosis, case management, monitoring and treatment of Alzheimer’s disease. 

Unless we act now, a generation of people will be forgotten as they begin to lose their memories.

“Unless we act now, a generation of people will be forgotten as they begin to lose their memories,” shares Frédéric Destrebecq, executive director of The European Brain Council. “By recognizing the urgency of the situation and making concerted investments, we can forge a path toward a more compassionate, empowered future for individuals, families and communities impacted by Alzheimer’s, and remember all those who’ve been lost to this devastating disease.”

It is never too early, never too late, to be remembered for taking action against this debilitating disease.  

References:  

1 – Jones RW, Mackell J, Berthet K, Knox S. Assessing attitudes and behaviours surrounding Alzheimer’s disease in Europe: key findings of the Important Perspectives on Alzheimer’s Care and Treatment (IMPACT) survey. The journal of nutrition, health & aging. 2010 Aug;14:525-30.  

2 – Cimler R, Maresova P, Kuhnova J, Kuca K. Predictions of Alzheimer’s disease treatment and care costs in European countries. PLoS One. 2019;14(1):e0210958. Published 2019 Jan 25. doi:10.1371/journal.pone.0210958 

3 – Published by Statista Research Department, 20 J. GDP of European countries 2022. Statista. June 20, 2023. Accessed August 1, 2023. https://www.statista.com/statistics/685925/gdp-of-european-countries/. 

4 – The Economist. Why health-care services are in chaos everywhere. Available at:  https://www.economist.com/finance-and-economics/2023/01/15/why-health-care-services-are-in-chaos-everywhere. Accessed: July 2023.  



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Labs: the (overlooked) building block of Universal Health Coverage

Hepatitis C (HCV) — a potentially life-threatening virus that infects 1.5 million new people around the world every year — is highly treatable if diagnosed early.[1]

Unfortunately,  access to quality screening is far from universal. Countries like Egypt — one of the countries with the highest prevalence of HCV in the world — demonstrate the impact screening can have. In 2015, HCV was prevalent in an estimated 7 percent of the country’s population and accounted for 7.6 percent of the country’s mortality, presenting a significant health care and societal burden.[2]

But since then, Egypt has turned a corner. In 2018, the Egyptian Ministry of Health and Population launched a massive nationwide HCV screening and treatment campaign as part of its 2014-2018 HCV action plan.[3] The campaign’s results were inspiring: by July 2020, Egypt had screened more than 60 million people[3] and treated 4 million residents.[2] Today, Egypt is set to be the world’s first country to eliminate HCV within its borders.[2]

The results of Egypt’s HCV screening program speak to diagnostics’ power in contributing to improved health outcomes around the world. Among the essential components of any health system is the capacity for prevention, which includes timely screening and detection. But a preventive approach based on timely diagnosis won’t work without the right infrastructure in place.

Strong laboratories as a cornerstone of building better health care

Matt Sause, CEO Roche Diagnostics | via Roche

The World Health Organization (WHO) highlights the critical role well-functioning laboratory services play in health systems with good reason.[4] Around the world, clinicians increasingly rely on  laboratory tests for diagnostic and treatment decisions. These tests help them make more informed decisions that result in better care and potentially improved outcomes for patients.

The challenges facing labs today — and tomorrow

Two key challenges facing laboratory systems today are underfunding and insufficient resources. Despite their central importance, laboratories struggle to garner the political and financial support they need to be as effective as possible. For example, it’s estimated that while lab results drive approximately 70 percent of clinical decision making, laboratories make up only 5 percent of hospital costs.[5]

After all, it’s the health care systems with strong, resilient labs that will be best placed to manage future pandemics and ever-growing health threats like heart disease and dementia.

What’s needed is a political commitment to provide everyone with access to accurate and timely diagnosis that paves the way to effective treatment and health. And putting this commitment into practice can only be achieved and sustained through coordinated multistakeholder efforts and public—private partnerships. This is not just a worthwhile investment for patients, but also the wider health care system in the long run. After all, it’s the health care systems with strong, resilient labs that will be best placed to manage future pandemics and ever-growing health threats like heart disease and dementia.

Another challenge is the health care workforce. Effective use of diagnostics requires qualified people to drive it, with expertise in pathology and laboratory medicine. Yet the world currently faces a laboratory staffing shortage. For diagnostics in particular, baccalaureate degree programs in laboratory science have previously been on the ‘endangered list’ of allied health professions.[6] In the end, inadequately trained staff, frequent turnover and scheduling problems all make quality lab results more difficult to guarantee.

This UHC ambition is only possible when backed by a network of strong laboratories that help ensure individuals can access high-quality diagnostics services without financial burden in all health care systems.

And that’s not all: inadequate infrastructure and staffing shortages are more present in low-income, rural communities, which exacerbate the broader diagnostics gap troubling global health care today. Many low-income countries lack an integrated laboratory network that can fully provide high-quality, accessible and efficient laboratory testing services for the entire population. In fact, a commission convened by The Lancet concluded that 81 percent of these populations have little or no access to diagnostics.[7]

The path to Universal Health Coverage

Put simply, innovative diagnostics are only meaningful if they reach people where and when they’re needed. Advancing this equity is at the heart of the WHO’s vision for Universal Health Coverage (UHC) by 2030. The goal? To guarantee all people have access to high-quality services for their health and the health of their families and communities, without facing financial hardship.

This UHC ambition is only possible when backed by a network of strong laboratories that help ensure individuals can access high-quality diagnostics services without financial burden in all health care systems. To do this, UHC should explicitly include diagnostics services. Financially, it’s savings from screening, early diagnosis and targeted treatment that make UHC feasible. Health care systems will have to undergo a systemic shift from focusing on treatment to focusing on prevention. And that’s just not possible when clinicians don’t have access to fast, accurate and cost-efficient lab results to inform their clinical decision-making. Policies and regulations that safeguard UHC goals of access and health equity are essential to make progress toward UHC.[8] The Saving Access to Laboratory Services Act (SALSA), in the United States, is an example of how national policies can help to ensure sustainable laboratory networks and contribute to equitable access to essential healthcare.

Stronger labs can not only help health care systems make savings in the routine management of population health; investing in them also helps to reduce costs and prepare in advance for any future public health crises.

This year has already seen encouraging progress toward achieving UHC through enhanced diagnostics capacity. The adoption of the resolution on strengthening diagnostics capacity at the World Health Assembly in May was an important signal of growing international political support for diagnostics. It was also a call to action. The next step for this month’s United Nations General Assembly and Sustainable Development Goals (SDG) Summit is channeling political support for diagnostics into the development of an action-oriented declaration.

To put us closer to UHC, this declaration should commit to ensuring that national health plans include access to timely detection and prevention. That starts with supporting laboratory systems and establishing National Essential Diagnostics Lists that identify the most critical diagnostic tests to help diagnose patients quickly and accurately so that they can receive needed treatment. At Roche, we’re advocating that governments, industry, civil society and other policy stakeholders will come together around concrete plans and shared resources that strengthen diagnostics and the lab infrastructure that makes them effective. In line with our commitment to increase patient access to important diagnostic solutions by 2030, we plan to do our part.


[1] Hepatitis C. World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/hepatitis-c (Accessed 22.08.2023)

[2] Egypt’s Ambitious Strategy to Eliminate Hepatitis C Virus: A Case Study. Hassanin, A. et al. Available at:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087425/ (Accessed 22.08.2023)

[3] Hepatitis C in Egypt – Past, Present, and Future. Roche Diagnostics. Available at: https://diagnostics.roche.com/global/en/article-listing/egypt-s-road-to-eliminating-hepatitis-c-virus-infection—a-stor.html (Accessed 22.08.2023)

[4] Monitoring the Building Blocks of Health Systems. World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/258734/9789241564052-eng.pdf (Accessed 14.07.2023)

[5] The Cost-effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing. Bogavac-Stanojevic N. & Jelic-Ivanovic Z. J Med Biochem. Volume 36, Issue 3, 238 – 242. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287218/

[6] Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century: Workshop Summary. National Academy of Sciences. Available at: https://www.ncbi.nlm.nih.gov/books/NBK215247/ (Accessed 14.07.2023)

[7] Essential diagnostics: mind the gap. The Lancet Global Health. Available at: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00467-8/fulltext (Accessed 14.07.2023)

[8] Private Sector Commitments To Universal Health Coverage. UHC Private Sector Constituency 2023 Statement. https://www.uhc2030.org/fileadmin/uploads/UHC2030_Private_Sector_Commitments_Statement_April2023.pdf (Accessed 29.08.2023)



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High-quality recycling loops are best for circular economy

On Europe’s journey to a circular economy, high quality recycling is essential. In fact, the recycling of fibre-based packaging constitutes one of the best examples. If you put your used paper products in the right recycling bin, you can count on them making their way to a facility that will recycle those materials so they can be used again many times to make packaging for breakfast cereal, boxes to carry your online deliveries, newspapers, and a whole host of other useful products.

Currently, about 75 percent of the raw materials used for the fibres in our packaging come from recycling. The rest comes from sustainably-managed forests. Our packaging helps keep fossil fuels in the ground, playing its part in making our planet greener. This is why fibre-based materials are widely recognized as one of the most sustainable choices available for packaging.

This is why fibre-based materials are widely recognized as one of the most sustainable choices available for packaging.

The EU’s packaging waste regulation: a key chance to enhance recycling systems

At Fibre Packaging Europe we believe the upcoming Packaging and Packaging Waste Regulation (PPWR) has a key role in making recycling even better. We now have a chance to set an ambitious 90 percent separate collection target for all EU member countries.  Here separate collection means transferring materials from your paper and board bin to the recycling plant. There is no better way to ensure that our packaging reaches recyclers after it has been used, and it will further increase an already-remarkable 81.5 percent recycling rate (Eurostat, 2020), higher by volume than plastic, metal and glass combined.

Where we see a risk in the PPWR is if the regulation gets the definition of ‘high-quality’ recycling twisted by restricting it only to what it calls ‘closed loops’. A closed loop means a cereal box would need to be recycled into another cereal box. When fibres are allowed to be recycled universally into any paper and board application and product, it is effective, it is resource efficient, and it reduces CO2 emissions through avoided transportation (to that cereal box factory). Most importantly, it is a good and simple way to continue increasing recycling rates.


Brought to you by Fibre Packaging Europe

Don’t get the loop twisted: why material loops make most sense for paper

But don’t just take it from us. We spoke to seasoned professionals in the recycling business that Fibre Packaging Europe represents to hear first-hand their thoughts on closed loops, the real challenges recyclers face and what can be done to overcome them.

Does closed-loop recycling have a role to play for fibre-based packaging? John Melia, strategy development and innovation director at DS Smith’s Recycling Division, is very clear on this point. “Closed-loop recycling of paper packaging would make no sense in a mature, well-functioning recycling system built on a thriving market for secondary raw materials. It would bring disruption to the market, reduce the quality and lifespan of fibre, and increase the use of fossil fuels in the supply chain. This would be a significant step back from the high-performing recycling system we have today.” 

Recycling systems based on ‘material loops’, on the other hand, mean that the raw materials we get from recycling processes are used in way that is far more versatile. They can be used to make a wide range of sustainable products that we use every day. The system works, and there is already in Europe a unique, thriving market for secondary raw materials in the fibre-based industry. In 2020, 56 million tons of ‘Paper for Recycling’ collected were transformed into equally high-quality new paper and board products.

If fibres get to the right recyclers, they have the tools to do the job

So how to make a high-quality recycling system even better? It all starts with collection.

“All fibre-based packaging is recyclable if, through collection and sorting, the material is guided to the right type of recycling mill”, explains Michel Willems, European Business Coordinator at Smurfit Kappa Recycling. ‘Separate’ collection systems, ones where non-paper materials such as plastic, metal and glass are collected separately from used paper products, can make it much easier to sort and send the material to the right recycling facilities. When it comes to fibre-based packaging products that are discarded by households, there’s an opportunity to further increase recycling rates.

So how to make a high-quality recycling system even better? It all starts with collection.

As a general principle, the more homogenous a fibre-based waste stream is, the easier it is to find the correct mill to do the recycling. Nonetheless, the great advantage of fibre packaging recycling is that a homogenous waste stream is not an absolute necessity for the majority of paper-based products. Most can easily be collected in the same bin, for example, at home. Such a stream, following standard quality checks, is ready for immediate recycling at many mills throughout Europe”, said Michel.

“Our business is built around reducing the environmental impact of packaging on the planet, improving supply chains for billions of people. We have an excellent, high-performance recycling system for cardboard with the highest recycling rate of any packaging material in Europe. Corrugated board packaging occupies a very special place because it has been the most recycled product forever. We recycle a box a minimum of 25 times in its life. At the end, it just returns to nature. Our environmentally friendly product is 100 percent renewable, recyclable and biodegradable”, added Michel.

For John Melia, this point is far more important to a successful circular economy than looking at changing recycling systems. “The EU should be focusing on what we know will bring rates of paper recycling even higher: better recycling infrastructure including increased segregation of recycling raw materials through separate collection of municipal waste,” he says. “We in the industry are doing our part, but achieving the full potential of the fibre recycling system will only be possible through government policies that focus on what we know will make a difference.”

So, when we look to complete the loop on the circular economy, let’s listen to the recyclers themselves. Let’s build on the high-quality recycling that already exists to build a greener Europe with the packaging products we know are sustainable.



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Blockaded on all fronts: Poland and Hungary threaten to cut Ukraine’s export route to the West

As Russia once again bombards and blockades Ukraine’s Black Sea ports — through which the country exports its vast agricultural produce — Poland and Hungary threaten to cut off the country’s western exit routes.

Poland will unilaterally block trade with Ukraine if the European Commission fails to extend temporary restrictions on grain imports at least until the end of the year, Prime Minister Mateusz Morawiecki told a meeting of agriculture ministers from five Eastern EU countries in Warsaw on Wednesday.

“I want to make it clear,” Morawiecki told reporters, “we will not open our border. Either the European Commission will agree to jointly work out regulations that will extend this ban, or we will do it ourselves.”

Hungarian Agriculture Minister István Nagy echoed Morawiecki, saying his country would “protect Hungarian farmers with all its means.”

Days after killing a deal to allow Ukraine to export grain across the Black Sea, Moscow unleashed a wave of attacks on the Ukrainian ports of Odesa and Chornomorsk — two vital export facilities — damaging the infrastructure of global and Ukrainian traders and destroying 60,000 tons of grain.

The EU’s top diplomat, Josep Borell, called Russia’s escalating offensive “barbarian” on Thursday. “What we already know is that this is going to create a huge food crisis in the world,” he told reporters in Brussels, adding that EU countries needed to step up alternative export routes for Ukraine.

Ukraine is one of the world’s biggest exporters of corn, wheat and other grains. Following Russia’s invasion and blockade of its Black Sea ports last year, the EU set up land export routes through its territory.

In the year since, export corridors set up by the EU called ‘solidarity lanes’ have carried about 60 percent of Ukraine’s exports — mostly along the Danube to the Romanian port of Constanța. The remaining 40 percent has trickled through the country’s own ports under the now-defunct Black Sea Grain Initiative brokered by the U.N. and Turkey.

But the opening of the overland routes also led to an unprecedented influx of cheap Ukrainian grain into neighboring EU countries — Romania, Poland, Hungary, Bulgaria and Slovakia — which was bought and resold by local traders instead of being exported further afield. The glut has put the solidarity of the bloc’s Eastern members with Ukraine in its war of defense sorely to the test.

With an election looming this fall, Poland sought to appease local farmers — a vital constituency for the right-wing government — by closing its border this spring to Ukrainian imports. Hungary, Slovakia and Bulgaria followed suit while Romania, which didn’t impose its own restrictions, joined the four in calling for restrictions at EU level.

In May, the five countries struck a deal with the Commission to drop their unilateral measures in exchange for €100 million in EU funding and assurances that Ukrainian shipments would only pass through the five countries on their way to other destinations. 

It’s these restrictions, which will expire on September 15, that the five countries want extended.

Other EU countries have criticized the Commission’s leniency towards the five Eastern troublemakers, saying the compromise undermined the integrity of the bloc’s internal market.

Open the borders

Borrell said that, instead of restricting trade, the EU should respond to Russia’s Black Sea escalation by opening its borders further.

“If the sea route is closed, we will have to increase the capacity of exporting Ukrainian grain through our ports, which means a bigger effort for the Ukrainian neighbors,” he said before a meeting of EU foreign ministers.

“They will have to contribute more, opening the borders and facilitating transport in order to take the grain of Ukraine from the Black Sea ports. This will require from Member States more engagement. We have done a lot, we have to do more.”

Separately on Thursday, Ukrainian Foreign Minister Dmytro Kuleba called on the EU to make “maximum efforts” to facilitate grain exports from the country.

“While Russia destroys the Grain Initiative, attacks Ukrainian ports and tries to make money on rising food prices, Ukraine and the European Union should make maximum efforts to simplify food exports from Ukraine, particularly by increasing the capacity of alternative transport corridors ‘Solidarity Lanes’ as much as possible,” he said.

During Wednesday’s meeting in Warsaw, agriculture ministers from the five EU countries signed a declaration calling on Brussels to extend and expand the trade restrictions, amid concerns that Russia’s renewed Black Sea blockade could further pressure their domestic markets.

Only Poland and Hungary threatened to take unilateral action if the restrictions were lifted.

Premature

Despite the threat, a senior Commission official said on Thursday it was “premature” to say whether there was a need to extend the restrictions beyond the September 15 deadline.

In recent months, officials have stepped up surveillance and customs checks, and Romania and other countries have significantly increased investment in infrastructure and investment to facilitate the transit of grain through their countries and to other markets, the Commission official said.

But in the year since the land-based export routes were opened, Poland has taken no major steps to improve its own infrastructure or the capacity of its Baltic ports. Analysts say it is unlikely the country will be able to repeat the feat come this summer’s harvest. The Polish government has repeatedly blamed Brussels for not providing enough help.

Despite the ongoing trade dispute, officials in Kyiv have been careful not to openly criticize their counterparts in Warsaw.

That’s because Poland has played a leading role in supporting Ukraine since the war broke out, acting as the main transit point for Western weapons and sending plenty of its own. It has also taken in millions of Ukrainian refugees.

“We highly appreciate all the work done so far within the solidarity lanes by the European Commission and neighboring member states,” Ukraine’s ambassador to the EU, Vsevolod Chentsov, told POLITICO.

Still, he added: “Statements by some member states of the need to extend the ban on the export of Ukrainian agrarian production [cause] serious concerns.” Without naming Poland he said that this “politicizes” the practical reality of what is a logistical challenge “jeopardizes the effectiveness of the solidarity lanes.”

Jacopo Barigazzi contributed reporting



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Putting health back in health care

Advances in medical science and technology are rapidly changing and as we saw with the pandemic, diagnostic tests play a pivotal role in health care decision making. They inform treatment decisions, save costs and, most importantly, deliver better outcomes for patients. Unfortunately, these life-changing innovations are all too often not available to many of the people who need them most. Currently, 47 percent of the global population and 81 percent of people in low and lower-middle income countries have little or no access to life-saving diagnostics.

If you’re following the policy trend at large — or even if you’re not — this is where we inevitably turn to discussions of the role of Universal Health Coverage (UHC) in the pursuit of better access to screening and diagnosis. Population health is not only in the best interest of individual countries, but as evidenced by a global pandemic, it is important to global health as well. UHC — ensuring people can access the health care they need, when they need it, without financial hardship — is foundational to improving world health care.  

Currently, 47 percent of the global population and 81 percent of people in low and lower-middle income countries have little or no access to life-saving diagnostics.

So, where do we start? With better access to diagnostics.

After the world faced a global pandemic and pulled together, we all learned vital lessons which must not be forgotten. First and foremost, we saw that by working together and sharing information early, we could develop diagnostics and vaccines faster. This learning must extend beyond times of crisis.

We also saw that health systems with well-developed diagnostics infrastructure were more effective at containing and controlling the pandemic. And they were better able to continue providing essential diagnostic tests and treatment monitoring for patients with other diseases such as cancer.        

Normally, it would take years to bring a new test to market. Here — through focus and collaboration — we managed to do so in months.

As the world responded to urgent calls for better access to COVID-19 tests, hopes were also expressed that this would spark innovation leading to widespread testing, vaccines and treatments, which ultimately would reduce the spread of the pandemic.

After the World Health Organization (WHO) declared COVID-19 as a public health concern, the urgency galvanized companies to work at full speed. The first Polymerase Chain Reaction (PCR) tests for SARS-CoV-2 were available for limited laboratory use within eight days. Only 64 days later PCR tests were authorized for use and available for scaled-up testing in major health centers.[1]

Normally, it would take years to bring a new test to market. Here — through focus and collaboration — we managed to do so in months.

As reported by the Lancet Commission, investing in diagnostic capabilities has been shown to lead to fewer misdiagnoses, better use of resources, and better patient care.

Driven by necessity, countries invested in diagnostics capabilities to fight the virus and, as reported by The Lancet, real change was seen at a pace that would previously have seemed impossible.

Why stop there? 

Ann Costello, Global Head of Roche Diagnostics Solutions | via Roche

The recommended WHO Resolution on strengthening diagnostics capacity represents an important step toward recognizing access to diagnostics as a policy priority as well as establishing concrete policy measures, to ensure equitable and timely access. It would pave the way for a considerable shift in strengthening our health care systems, driving progress toward global health equity and global health security.

As reported by the Lancet Commission[2], investing in diagnostic capabilities has been shown to lead to fewer misdiagnoses, better use of resources, and better patient care.

Early diagnosis is the cornerstone of sustainable, efficient and resilient health care systems. This in turn would reduce late-stage health care expenditures, including long-term costs of chronic disease management and disability, and better manage costs for patients, payors and governments. 

Increasing access to diagnostics is crucial to controlling and potentially even eradicating certain diseases like cervical cancer, HIV, tuberculosis, viral hepatitis and malaria.

Laboratories are an essential component of a sustainable, efficient and resilient health system. But only if there’s enough of them and trained staff to run them. 

The crux of the matter is that staff shortages in both high-income countries and low- and middle-income countries continue to create a barrier to diagnostic services. 

How short-staffed are we? Well, to put a number on it, an estimated shortage in diagnostic workforce capacity saw a need for an additional 480,000-576,000 staff to support diagnostic testing.[2] And who loses when we don’t have enough skilled laboratory professionals? Patients.

Investment in diagnostics such as improving laboratory infrastructure and workforce development must also be supported by smart local regulatory approaches. This will ensure that patients, regardless of where they live, have timely access to innovation and safe, effective diagnostics.

Health care could enter a new golden age, shifting our focus from primarily treating disease to preserving health through prevention and by helping people live longer, more healthy lives.

This can be through adherence to international best practices, such as those created by International Medical Device Regulators Forum and implementation of regulatory reliance models — where one regulatory body (or the WHO) relies on the decisions, such as marketing authorizations, inspections and product changes, already made by trusted authorities and recognized institutions.

Governments should prioritize expansion of professionals with expertise in pathology and laboratory medicine[3] and introduce laboratory personnel as a key component of workforce initiatives to address the needs of currently over-burdened health care systems. 

A new golden age for health care?

Roche is building partnerships to increase access to diagnostic solutions in low- and middle-income countries and to strengthen targeted laboratory systems through workforce training classes. In May 2022, Roche entered a partnership with the Global Fund to support low- and middle-income countries in strengthening critical diagnostics infrastructure. The aim is building local capacity to tackle infrastructure challenges to improve diagnostic results and manage health care waste. This is in line with Roche’s ambition to double patient access to innovative, high-medical-value diagnostics for people around the world.

Health care could enter a new golden age, shifting our focus from primarily treating disease to preserving health through prevention and by helping people live longer, more healthy lives.

To achieve the golden age we need to learn from the past. All public and private stakeholders have a duty to work together to ensure diagnostics continue to improve health outcomes around the world by bringing this important resolution to life. 

Where a person lives should no longer be the key determining factor in their health. We have a tremendous opportunity here, let’s take it. 


[1] Accelerating diagnostic tests to prevent a future pandemic. Bill Rodriguez. Cepi. Available at: https://100days.cepi.net/100-days-mission-diagnostic-test-future-pandemic/ (Accessed 04.04.2023)

[2] The Lancet Commission on diagnostics: transforming access to diagnostics. Fleming, Kenneth A et al.The Lancet, Volume 398, Issue 10315, 1997 – 2050. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(21)00673-5.pdf

[3] https://www.ihe.net/ihe_domains/ihe_pathology_and_laboratory_medicine/ (Accessed: 04.04.2023)



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No silver bullet: Ensuring the right packaging solutions for Europe

When most people think of McDonald’s they likely think of quality food, good value and consistently reliable convenient service. But I hope they also think about our values.

At McDonald’s, we care deeply about our impact on the world. Our purpose is to feed and foster local communities. We are always striving to use our influence and scale to make a positive impact on the planet and in the communities we serve across Europe and globally. We are on a journey to help implement and accelerate solutions to keep waste out of nature and valuable materials in use.

Our purpose is to feed and foster local communities.

During my trip to Europe, I’ve seen some of these solutions in action. While in Brussels I had the opportunity to visit one of our restaurants at the forefront of advancing our circularity goals. McDonald’s is the first major partner of a pioneering initiative ‘The Cup Collective’. It is a great project by Stora Enso and Huhtamaki to collect cardboard beverage and ice cream cups in and around our restaurants and recycle them on an industrial scale into paper fiber. At our busy  restaurant in Brussels-North station, I saw the initiative firsthand. This is a fantastic example of several stakeholders working together to solve a problem through their expertise and innovation.

I know policymakers across the EU are trying to solve many of the greatest challenges we face today, including Europe’s growing packaging waste problem, and we at McDonald’s fully support this, as the example above demonstrates. The problem is, history itself is littered with examples of the unintended consequences of well-meaning policies and laws. I believe the current Packaging and Packaging Waste proposal by the EU is one such regulation. By focusing solely on reusable packaging, we at McDonald’s and many of our partners and competitors in the informal dining out sector believe that Packaging and Packaging Waste Regulation (PPWR) will actually be counterproductive to the overall goals of the Green Deal. And we support the goals of the Green Deal, which is why this concerns us.

The informal eating-out sector is particularly complex and is not well understood. We feel the impact study the EU commissioned ahead of the PPWR proposal did not necessarily reflect that as much as it could have. We want such important decisions to be based on science, facts, and evidence, which is why we commissioned a report with the global management consultancy Kearney to assess environmental, economic, hygiene and affordability impacts of various packaging solutions. As a result of this, we firmly believe the proposal will be damaging not only for the environment, but also for the economy, food safety and for consumers.

Of course, the idea of reusing something over and over again as opposed to only once seems like the obvious solution — but it’s more complicated than that. For reuse models to have a positive impact on the environment, consumers need to return the reusables. A reusable cup needs to be returned and reused 50 to 100 times — whether for takeaway or dine-in — to make it environmentally preferable to a single-use paper cup.

Reusables by their very nature also need to be washed every time they’re used. For an industry like ours, serving millions of customers every day, that requires significant energy and water. Europe’s water infrastructure is already under stress, and the Kearney study shows reusable packaging requirements for dine-in restaurants would increase water use — and could require up to 4 billion liters of additional water each year. Washing also requires more energy resulting in increased greenhouse emissions. The study shows that a shift to 100 percent reusable packaging by 2030 would increase greenhouse emissions by up to 50 percent for dine-in and up to 260 percent for takeaway. They also require specialist washing to ensure they meet hygiene standards.

The study shows that a shift to 100 percent reusable packaging by 2030 would increase greenhouse emissions.

When it comes to plastics we are particularly concerned. McDonald’s has made huge progress when it comes to reducing plastic in our supply chain and restaurants. In the European Union, more than 90 percent of our packaging is locally sourced, primarily from European paper packaging suppliers. We are shifting packaging materials to more sustainable alternatives to ensure easier recovery and recycling. 92.8 percent (by weight) of McDonald’s food packaging in Europe is wood fiber and 99.4 percent of that fiber packaging comes from recycled or certified sources.

Worryingly though, the study we commissioned says that reuse models will lead to a sharp increase in plastic materials in Europe.Reuse targets proposed in the PPWR will create four times the amount of plastic packaging waste for dine-in, and 16 times for takeaway. That’s a lot more plastic instead of recyclable paper and cardboard and is the opposite of what the EU wants to achieve.

So, what should be done? Given that Kearney’s data shows recyclable, fiber-based packaging has the greater potential to benefit the environment, economy, food safety and consumers, we believe the EU should pause and conduct a full impact study before moving ahead. The European Commission’s current impact assessment lacks depth and does not consider economic and food safety aspects. Member countries should not unilaterally introduce legislation before this has been assessed to avoid fragmentation of the single market.

We believe the EU should pause and conduct a full impact study before moving ahead.

In dine in and takeaway, we are looking for equivalence of treatment between recycled and recyclable (paper based) single use packaging and reusable tableware. Any legislation should take into account the specific needs of complex business sectors, and the right packaging solutions.

A rush to a solution for a complicated situation will only make the problem worse. I hope that the report McDonald’s commissioned and launched with Kearney will stimulate the policy debate about the mix of solutions needed. Europe has a proud history of collaboration and pragmatism when it comes to solving important problems and challenges, and I am confident we can draw on that when it comes to this particular issue — because there really is no silver bullet when it comes to solving Europe’s packaging problem.

www.nosilverbullet.eu



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