Budget dispute freezes EU health projects for 2026

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Many EU-funded health projects are on hold amid a dispute between the European Commission and capitals over support for NGOs.

At least seven countries, led by France, Spain and Belgium have twice blocked the Commission’s 2026 EU health budget proposal because they say it doesn’t contain sufficient funding for health NGOs. These organizations represent patients, doctors and public health workers in EU health policy debates, typically in opposition to sectors like tobacco, alcohol and, sometimes, the pharmaceutical industry.

The standoff means public tenders and grant applications for EU health projects — such as training more experts to assess medicines, beefing up health security and creating artificial intelligence platforms to monitor brain health — can’t yet go ahead.

“Various stakeholders have expressed frustration over the delay” as they are already putting together consortiums to bid for projects included in the draft budget, a spokesperson for Public Health Sweden told POLITICO.

The delay also has major implications for the EU’s health crisis response.

The Commission’s Health Emergency Preparedness and Response Authority published its work plan in June for the coming year, which includes the expansion of ‘ever-warm’ vaccine production facilities and the creation of a new European Diagnostics Hub to develop cutting-edge technologies — all of which is on hold until the money can flow, unless covered by funds under the 2025 budget.

European Commission spokesperson Eva Hrncirova declined to comment on the potential disruption to the EU’s health program, but told POLITICO the executive would “reflect” on the way forward.

Root cause

The standoff stems from the Commission’s decision to ax operating grants for NGOs, confirmed in July 2025. These had been in place in Europe since the early 1990s to enable civil society to participate in policymaking on a more equal footing with profit-driven entities.

The Commission told POLITICO the grants were cut to reflect diminished funds for EU4Health after the budget fell from €5.8 billion to €4.6 billion in 2025 to reallocate funds for Ukraine. Health Commissioner Olivér Várhelyi also previously claimed behind closed doors that NGO operating grants were “illegal.”

When countries voted on the Commission’s second proposal last week — which offered €1.3 million in NGO operating grants, having omitted them altogether from its original plan — at least 14 countries voted in favor of the plan, citing the urgent need for a budget.

“The Public Health Agency of Sweden voted yes and we seconded the criticism that came from the other countries on funding for civil society, but saw that further delays in the work programme were not preferable,” the spokesperson for the Swedish public health authority said in a written comment.

But countries standing firm with NGOs worry that ending support for their day-to-day functions will weaken democratic policymaking and leave lobbying as a preserve of private interests. Some NGOs have already shuttered operations in Brussels over the lack of funds.

Health Commissioner Olivér Várhelyi previously claimed behind closed doors that NGO operating grants were “illegal.” | Thierry Monasse/Getty Images

Spain and France have been the most vocal in their criticism, forming a blocking minority on the EU4Health Programme Committee that signs off on the budget, alongside Czechia, the Netherlands, Lithuania and Malta. Others, including Ireland and Luxembourg, abstained to signal their displeasure with the removal of NGO funds.

NGOs play “a vital role in representing patients’ interests and ensuring a balanced policy debate alongside well-resourced industry stakeholders,” a spokesperson for Malta’s ministry of health told POLITICO.

A joint statement read out on behalf of Belgium, Czechia, France, Luxembourg, Spain and the Netherlands at the July 31 meeting, and seen by POLITICO, called for “more adequate level of funding for operating grants while safeguarding other low-budget but high-impact actions from further reductions.”

They argue the Commission is at fault for the impasse and ignored multiple warnings from countries that they would not accept the defunding of civil society groups.

“Several Member States have raised the same concerns for two years, but these have not been adequately reflected. At the same time, the delay increases pressure from stakeholders to approve the programme regardless of those concerns, because important public-health actions and considerable expert work are involved,” a spokesperson for Luxembourg’s Ministry of Health and Social Security, which abstained in support of NGOs, said in a written comment.

‘Symbolic’ offering

The blocking countries didn’t put a figure on how much they wanted for NGOs, but pointed out the €1.3 million on offer was one-seventh what it was in 2023 and 2024, before the grants were scrapped.

Cyprus was among the countries ready to accept the latest proposal, with the country’s ministry of health telling POLITICO it “viewed positively the efforts made to address concerns regarding NGO funding and welcomed the allocation of dedicated funding.”

But Milka Sokolović, director general of the European Public Health Alliance, said the Commission should ensure the grants “provide meaningful support rather than a symbolic contribution.”

“Budget constraints are real, but so is the need to sustain the organizations that bring expertise, accountability and public engagement to Europe’s health ambitions,” Sokolović said.

The Commission has also angered countries with how late in the year it is seeking approval for the work program, combined with what they see as insufficient consultation in the run-up to the vote.

The Luxembourg ministry spokesperson said the Commission “traditionally” prepared the work program a year in advance. “This gave authorities and potential beneficiaries a reasonable indication of forthcoming priorities and call dates. For both the 2025 and 2026 programs, however, the first drafts reached Member States much later, reducing predictability for all concerned.”

Speaking for the Commission, Hrncirova said countries had been consulted. “In line with the EU4Health regulations and its procedures for the preparation, member states are consulted at several stages with several meetings. This has happened,” she said.

The Commission hasn’t yet scheduled another meeting to try to get a budget over the line. “We are now awaiting the invitation to the next EU4Health Programme Committee for the, hopefully, final meeting for the 2026 work programme,” the spokesperson for the Public Health Agency of Sweden said.

“At this stage, the matter is in the hands of the European Commission,” the Maltese spokesperson added.