As oncology research and innovation become increasingly complex and promising, Europe must ensure its scientific leadership translates into value and impact. While the European value concept is shaping EU policy, there is a growing focus on strengthening Europe’s capacity to develop, scale and manufacture health innovation while reducing dependencies. For oncology, this emphasis raises broader questions: how can Europe strengthen its strategic capacity while preserving the openness and collaboration needed to bring innovative therapies to patients? What does this mean in practice for Europe’s ability to attract investment and retain the talent needed to develop clinical trials and build manufacturing capacity? How can European preference support strategic capabilities without limiting competition or access to global expertise, technologies and supply chains? And how can Europe ensure that the value created by its ecosystem ultimately translates into better and more timely access for European patients?

While Europe’s life sciences ecosystem continues to drive breakthroughs in areas like oncology and advanced therapies, millions of patients living with severe, high-burden chronic conditions remain underserved. The challenge spans across the full lifecycle of innovation: from weak incentives for research and development, to health systems not recognizing the true societal and psychological burden of these diseases – making them, in turn, difficult to be considered as priorities for investment. Immune-mediated skin diseases – such as psoriasis, vitiligo, and atopic dermatitis – are a clear illustration of this systemic gap. Frequently dismissed by health systems as merely "cosmetic," these conditions carry a profound, chronic, life-altering burden that is rarely captured in traditional health frameworks. These conditions often begin in adolescence and early adulthood, and persist across a patient's entire life, with a huge cost to society: lost education, reduced workforce participation, and diminished productivity over decades.

Life-course immunisation should be understood not only as a public health measure, but as an investment in Europe’s economic resilience. In a context of rising healthcare costs, workforce shortages and growing pressure on health systems, where an ageing society plays a huge role, prevention offers a clear cost-benefit logic: avoiding disease is often less costly than treating its consequences. At the same time, declining vaccine trust and falling uptake rates are creating and bringing back risks. In a more mobile and interconnected world, infectious diseases are not contained by borders, and the re-emergence of vaccine-preventable diseases shows that prevention cannot be taken for granted. Strengthening life-course immunisation should therefore be a priority: not only to protect individual health, but to safeguard health system sustainability, economic productivity and public resilience, and to adapt health systems to the demographic change.

The ambition is clear: to reshape Europe’s medical technologies ecosystem and foster innovation. Through the proposed MDR/IVDR amendments and the Digital Omnibus on AI, the direction is increasingly explicit: a more competitive, innovation-friendly and predictable framework for health technologies. But the CE mark is not everything. A device may be safe, compliant and legally available, yet still fail to reach patients if hospitals cannot buy it, integrate it or sustain its use. In medical technologies, value often depends not only on the product, but on training, infrastructure, interoperability, service models, workflow adaptation and long-term outcomes. This creates a sharper challenge across Europe: innovation may be adopted quickly in well-resourced Member States, regions and hospitals, while others remain unable to absorb it. If procurement rewards the lowest upfront price, if implementation capacity varies widely, and if value is defined differently across territories, certified innovation can end up reinforcing existing inequalities. The vision now moves forward regulating innovation, to whether Member States and regions can recognise and adopt it.

Health security is increasingly becoming part of Europe’s broader resilience and security agenda. From biosecurity threats and critical supply chains to civil-military coordination, cybersecurity and strategic stockpiling, the boundary between health policy and security policy is becoming increasingly blurred. Russia’s invasion of Ukraine, growing geopolitical fragmentation and rising concerns around biological threats have reinforced the understanding that health systems are not only social infrastructure, but also strategic assets essential to Europe’s stability and preparedness. At stake is whether Europe can build the coordination, industrial capacity and strategic foresight needed to respond not only to future pandemics, but also to a more volatile geopolitical environment where resilience, rapid response and the protection of critical health infrastructure are becoming central to European security itself.

With accession negotiations open with Ukraine, Moldova, Montenegro and Albania, among others, and broader political questions continuing around the EU’s relationship with countries such as Türkiye and Iceland, the European Health Union is at a crucial moment. As an enlarged Union will also mean an enlarged health space, questions raise for Europe’s capacity to prevent, detect and respond to cross-border health threats, from infectious diseases and antimicrobial resistance to food safety risks and future crises. It also brings a single market dimension, as future members will need to align with EU standards on medicines, medical devices, digital health, data governance, consumer protection or public procurement. At the same time, differences in investment, infrastructure, access to care and system capacity are a key piece for European equity standards, while health workforce mobility may deepen them: a wider area for freedom of movement could exacerbate the workforce shortages already present in some regions and countries.