Eleven European Union health ministries have called for the Critical Medicines Act (CMA) to be included in the ReArm Europe initiative proposed by European Commission President Ursula von der Leyen. Their move points to the political weight of medicines – and presents an opportunity to shape a radically different drug policy, rather than reducing it to a matter of trade or military readiness.
When the CMA was first launched in May 2023, its stated goal was to strengthen weakened supply chains and reduce Europe ’s dependence on pharmaceutical production in Asian countries. Now, the health ministers write: “With geopolitical tensions rising, globalisation can have threatening side effects. Especially when it comes to essential goods.”
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In light of this, they are pushing for this initiative to be a part of the new so-called defense budget in time for the CMA’s introduction, which still has to pass in the European Parliament and the European Council. The budget of the CMA is currently set at €83.02 million for 2026 and 2027. This should be understood as underfunding: said amount would be sufficient to cover e.g. one antibiotic agent, while the initiative officially aims to provide coverage of 280 pharmaceuticals. The approach to funding the CMA stands in stark contrast to the well-funded arms race the EU is engaging in with the ReArm Europe initiative.
Health ministers’ approach misses the point
Part of the ministers’ proposal is related to public procurement – a process during which the state directly purchases products – in this case also re-/near-shoring production by covering part of the costs to relocate and start production.
To achieve this, Dr. Thomas Steffen, State Secretary of the German Federal Ministry of Health, has called for deregulating state funding of the pharmaceutical industry. “We need rules that allow us to give financial incentives to an industry that we urgently need,” he stated. In saying that, Steffen demonstrates a familiar contradiction: being willing to use public money for pharmaceutical production, but without questioning the power of international corporations over the EU market.
His ideas fall short of tackling the root of the problem – the profit logic of Big Pharma – thus leading to a lack of transparency on real development and production costs. As a result, in Steffen’s scenario, the public would continue to foot the bill for the profit of the shareholders, paying inflated prices just to ensure access to highly critical medicines like antibiotics.
This approach is like taking half a step on the stairs: the foot, lifted with high cost, punches through the air and lands exactly where it was before. It’s a neoliberal shareholder’s dream – while we, the patients and the public, fall on our faces in the effort to deliver basic care.
Market logic puts pharmaceutical production in fragile state
The fact is that market and profit logic brought pharmaceutical production in Europe to a fragile state. For example, 46% critical generic medicines have only one supplier, and 83% have only one majority supplier. This means that a single disruption – a hurricane, for instance – can interrupt the supply of basic supplies such as saline solution. Today, extreme weather events are no longer rare, so events like hurricanes should be taken for granted rather than considered an exception in the context of climate catastrophe.
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It is this supply fragility, combined with fears over future (trade) wars, that the EU health ministers are addressing in their statement. But their approach raises a crucial concern. Nothing in the CMA obligates the companies to set up production in Europe long term: they are likely to ask for more and more benefits in exchange for staying, making states pay as much as they can. So, should we really spend money to support corporate profits, when we could use it to build a public pharma system instead?
Opting for the choice of Public Pharma would bring long-term benefits far beyond Europe. Here is how:
- Bringing production under public control would mean environmental regulation and stable supply chains can be ensured.
- Patients and tax payers would benefit financially.
- Public Pharma would also help reduce antibiotic resistance and allow medicines to be developed and distributed based on need, not market price.
Open knowledge and cheaper drugs
Taking this one step further, financing public research and development, including clinical studies, would lead to open knowledge and cheaper drugs. The Drugs for Neglected Diseases Initiative (DNDi) shows that private production is vastly overpriced, indicating that non-profit partnerships “can develop and register new treatments based on existing drugs at a cost of €4-32 million, and new chemical entities for €60-190 million, attrition included” – compared to the private industry’s often-cited figure of USD 1 billion.
Public Pharma would be based on an open source approach, not patents, in its research. That would mean lower development costs, no monopoly pricing, and shared benefits. European healthcare systems would save billions, and global production capacity could be built around shared, unpatented formulas.
Neoliberal logic has weakened local supply and global health. Public pharma represents a true defense strategy, fostering equitable access as well as good international relations. A drug that can be produced anywhere – and a patent that does not exist – cannot be used as leverage in a trade war. Additionally, a critical part of life, people’s health, would be protected from ‘fear to lose,’ a notable driver of war. In other words: allocating money to public pharma means allocating funds to a world vision where health is not seen as a potential weapon.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
