Opinion on the guidelines for the 2027 Budget - Section III

24.02.2026

Mr Johan Van Overtveldt

Chair

Committee on Budgets

BRUSSELS

Subject: Opinion on the guidelines for the 2027 Budget - Section III (2025/2246(BUI))

Dear Mr Van Overtveldt,

The Coordinators of the Committee on the Public Health (SANT) decided on 18 December 2025 that SANT would provide an opinion on the Guidelines for the 2027 budget – Section III (2025/2246(BUI)) in the form of a letter. Therefore, as SANT Chair, allow me to provide you with SANT’s contribution in the form of resolution paragraphs, which was adopted by SANT at its meeting of 24 February 2026 and which I kindly request will be taken into account by your committee:

1.Stresses that the Union’s health objectives can only be delivered if the 2027 budget provides sufficient, visible and predictable funding to implement agreed EU legislation and flagship initiatives, including health security preparedness and the operational capacity for medical countermeasures, the roll‑out of the European Health Data Space, and the implementation of Europe’s Beating Cancer Plan and Safe Hearts Plan; underlines that new initiatives, such as the proposed Critical Medicines Act, will require adequate resources to translate objectives into concrete results for patients, Member States and industry, including to reduce shortages and improve access to medicines; emphasises that stable resourcing for Rare Diseases, European Reference Networks (ERNs), and scaling up EU action on cardiovascular health, are necessary to turn European cooperation into measurable health outcomes and reduce inequalities across the Union; calls on the Commission to establish a European Organisation for Rare Diseases, bringing together European Reference Networks, the European Health Data Space (EHDS) and Horizon instruments to research, diagnose and treat rare diseases collectively and effectively;

2.Stresses the importance to gear the EU budget towards a healthy lifestyle and environment, with a particular focus on mental health as well as brain health in Europe; calls on the Commission to uphold also in the budget proposal its environmental and climate commitments for the benefit of citizens’ health;

3.Stresses that the Union’s budget for 2027 should be aligned with the realisation of the European Union’s objectives to ensure a high level of human health protection in all EU policies, prevent disease and reduce health risks, including by tackling major cross‑border health threats, and to support cooperation between Member States to make health systems more effective, interconnected and interoperable, accessible and resilient, including through sufficient support to regions for the upgrade of their public health infrastructure, hospitals and health systems; highlights that EU policies must respect, that organisation and delivery of healthcare remain primarily national responsibilities; emphasises, however, that reinforcing cross-border healthcare is essential to ensure that patients, particularly those with Rare Diseases and complex conditions, can effectively access specialised expertise, diagnosis and treatment across Member States, where such care is not available nationally;

4.Calls on the Commission to design the budget with sufficient allocation to programmes strengthening preparedness and response to serious cross‑border threats, improving access to quality healthcare and affordable medicines, medical devices and crisis‑relevant products, addressing health inequalities, and supporting the digital transformation of health systems;

5.Calls for strengthened EU‑level surveillance and comparable reporting on antimicrobial resistance (AMR) of hospitalised patients, through an EU wide database using information from hospitals, to support detection, coordination, prevention and effective targeted action;

6.Emphasises the need to allocate sufficient funding for each individual budget line that contributes to the achievement of public health objectives, with a focus on prevention and health promotion, to reduce the burden of non‑communicable diseases through strengthening health systems’ resilience and effectiveness, including better and disaggregated health data, digital tools, services and interoperability, to ensure equitable access to healthcare and reducing health inequalities across the EU, while promoting a gender-based approach to health policies; calls on the Commission to provide sufficient funding to programs tackling a holistic approach to mental health and autism from childhood to adulthood;

7.Stresses that the 2027 budget should help address health workforce shortages by supporting cooperation on training, skills and better workforce planning tools, in full respect of Member State competences, to ensure that health systems can meet current and future demands effectively across all Members States; highlights the need to improve skills and professional qualifications of the healthcare workforce across Member States;

8.Considers that sustained investment in prevention is key to the long-term sustainability of health expenditure and to address the growing health needs affecting all Member States; emphasises the need to strengthen prevention as a cost-effective investment; calls on the Commission, in cooperation with Member States and within their competences, to encourage the reinforcement of evidence-based screening campaigns and population-based early detection programmes, as well as sustained investment in primary prevention measures addressing lifestyle risk factors and individual behaviours;

further underlines the importance of stepping up EU-supported awareness, prevention, testing and timely treatment actions on sexually transmitted infections (STIs), in light of the documented rise in STI notifications across several EU/EEA countries; invites the Commission to ensure that relevant EU programmes and agencies support Member States in improving outreach, access to services, surveillance and comparable reporting;

9.Calls for targeted support to ease the day‑to‑day burden on transplant patients, particularly for facilitating cross‑border pathways; highlights the need to address the rising burden of liver and kidney disease through prevention and early intervention; calls for funding to support prevention and health‑promotion measures at local level, such as placing automated external defibrillators (AEDs) in schools and installing hygienic drinking‑water fountains in schools and public spaces, financed through a dedicated health line or cohesion investments where appropriate;

10.Notes the relevance of the European Court of Auditors’ (ECA) work for ensuring sound financial management of Union health spending; calls on the Commission and Member States to follow up on ECA’s recommendations, including those on critical shortages of medicines and on the effectiveness of EU support for the digitalisation of healthcare;

11.Stresses that reliable and sustainable support to public‑health stakeholders, including patient organisations and professional and scientific networks, is important to strengthen public health, improve implementation on the ground and enhance public trust; underlines that such funding must be transparent, proportionate and conditional on sound financial management, representativeness and measurable results; reminds that a stronger European Health Union requires adequate funding with health-related expenditure that follows the ‘One Health’ and ‘Health in all policies’ approaches;

12.Regrets the Commission’s decision to discontinue operating grants for health civil society organisations under the EU4Health 2025 Work Programme, noting that such grants represented only a small share of the programme’s budget; notes the concerns expressed by many organisations as regards the impact on staffing, project continuity and support for patients and communities; emphasises the importance of stable and predictable support mechanisms for health civil society organisations, where appropriate and in full respect of the principle of subsidiarity; takes note of findings from the external evaluation of the EU4Health Programme confirming that organisations receiving operating grants meet their objectives, use public funds responsibly and provide valuable expertise and community input to EU health policy; underlines the need for future funding to continue to be based on clear criteria of European added value, transparency, neutrality and measurable impact, in order to sustain meaningful civil society contributions to Union health objectives;

requests operational grants to be reconsidered in the EU4Health 2027 Work Programme;

13.Strongly reiterates its regrets over the redeployment from the EU4Health programme of 1billion EUR over the 2025-2027 period; considers that this funding shortfall threatens the programme's ability to achieve its critical objectives; renews its call to the Commission, Member States, and other stakeholders to identify practical solutions to offset this cut, ensuring that the programme’s objective of building stronger, more resilient, and more accessible health systems is achieved; calls as well for increased amounts allocated to the Health Cluster in Horizon Europe; calls for reliable and stable EU funding for cutting‑edge research and clinical trials, including cancer, autism, rare diseases and non‑communicable diseases, and pharmaceutical development and manufacturing; calls on the Commission to ensure that clinical trials are pursued throughout the EU, including in small Member States despite their size, and to ensure that the EU aims at bridging the gap between research and market deployment;

14.Recognises that stronger health systems directly contribute to economic stability, competitiveness and productivity, as well as reducing inequality by reducing health-related workforce disruptions and increasing the resilience of the labour market; calls for adequate resources to support the Union’s work on critical medicines and medicines shortages, including coordinated measures to strengthen security of supply;

15.Notes that the Union’s 2026 programming includes key health initiatives and calls, notably under the EU Mission on Cancer and under Horizon Europe health calls addressing cardiovascular health; stresses, therefore, that the Commission should ensure that the 2027 draft budget does not propose lower levels of appropriations than those foreseen for 2026 for the relevant budget lines supporting these priorities, so as to guarantee continuity, delivery and EU added value for patients and health systems; highlights the need to allocate sufficient human and financial resources to Union bodies and agencies supporting public health objectives, including EFSA, ECDC and EMA, so that they can deliver timely scientific and regulatory outputs and support Member States effectively;

16.Emphasises that health security preparedness and resilience are integral to the Union’s overall security and strategic autonomy; calls on the Commission to ensure adequate, visible and swiftly deployable resources in the 2027 budget for prevention, surveillance, stockpiling and medical countermeasures; recalls that this should include sufficient and predictable funding for both the Union Civil Protection Mechanism (UCPM) and HERA to support an end-to-end pipeline approach to medical countermeasures and health emergency preparedness activities, covering threat intelligence, research and development, manufacturing (including scale-up), stockpiling and capacity building to enhance preparedness for future health threats;

17.Emphasises that the 2027 budget should translate EU added value into tangible, visible projects that citizens and local communities can experience directly, alongside larger strategic investments; stresses that the external dimension of the EU budget should, where operationally appropriate, support health‑related operations benefiting victims of protracted conflicts in third countries, including in the Middle East;

18.Highlights the need for a strengthened EU own resources system that can address current challenges while supporting the Union's health objectives.

I have sent a similar letter to Mr Nils Ušakovs, general rapporteur for the 2027 budget.

Thank you very much for taking the SANT opinion into account.

Yours sincerely,

Adam Jarubas

ANNEX: DECLARATION OF INPUT

The Chair declares under his exclusive responsibility that he did not include in his opinion input from interest representatives falling within the scope of the Interinstitutional Agreement on a mandatory transparency register, or from representatives of public authorities of third countries, including their diplomatic missions and embassies, to be listed in this Annex pursuant to Article 8 of Annex I to the Rules of Procedure.