Europe Should Create Vouchers for Global Health Innovation, Say Experts — But Not the Ones You Think

Europe’s Competitiveness Challenge in Health Innovation

In 2021, European Commission President Ursula von der Leyen remarked, “Europe is a powerhouse in science. But while we’re good at making science with money, we need to get better at making money out of science.” This sentiment touches on a fundamental challenge within the EU’s global health innovation ecosystem too: Europe struggles to translate scientific developments into tangible impacts.

Two recent reports by prominent Italian figures, Enrico Letta, former Prime Minister, and Mario Draghi, former President of the European Central Bank, have attempted to diagnose and address this malaise. Letta advocates for a more integrated single market for research, where funding, data, and initiatives can move freely. Draghi emphasises the need to increase and align public and private health R&D investments, while accelerating EU regulatory processes to counter the pharmaceutical industry’s declining competitiveness in Europe.

One of the more contentious issues in EU health policy today is how to stimulate health innovation and the competitiveness of the industry while ensuring the solvency of public health systems and the accessibility of health innovations to patients. This debate took centre stage at the European Health Forum Gastein held last week, which transforms the picturesque Austrian village into a hub for EU health policy discussions each year.

“The issue of pull incentives has been central to the reform of the EU’s general pharmaceutical legislation, particularly with a proposal for a transferable exclusivity voucher (TEVs) for new antimicrobials, but global health innovation has been conspicuously absent from the discussion,” said Rosa Castro from the global health NGO DSW, who chaired the session “Empowering global health innovation in the EU” at the forum. Ilona Kickbusch , Founder of the Global Health Centre at the Geneva Graduate Institute, echoed this view: “Global health crises, including outbreaks and pandemics like COVID-19 and mpox, call for global collaboration and solidarity. The EU must play a more crucial role in supporting the development and ensuring timely and equitable access of global health innovations.”

A Neglected Solution to Drive Additional Investments

A different type of voucher programme was prominently discussed in the session: the US Priority Review Voucher (PRV), created in 2007 to incentivise the development of treatments for unmet medical needs, such as rare paediatric and neglected diseases. According to the US National Organization for Rare Disorders (NORD), the programme has been a success, with 53 PRVs awarded across 39 rare paediatric diseases, compared to just 3 products approved before the programme’s launch.

The importance of the US FDA Priority Review Voucher (PRV) programme in the development of the first-ever vaccine against Chikungunya (which also received grant funding from CEPI/EU), and the potential of an EU counterpart was also highlighted by Olivier Jankowitsch , Vice President of Governmental Affairs at Valneva, a global specialty vaccine company. “A PRV programme in the EU could help companies reach the last mile of development, ensuring access to medical innovations in and beyond Europe, where the need is greatest”, said Jankowitsch. Joelle TANGUY , External Affairs Director at the Drugs for Neglected Diseases initiative (DNDi), echoed this sentiment, highlighting how the US FDA PRV programme incentivised industry collaborations and complemented Horizon Europe push funding to enable the development of Fexinidazole, the first oral treatment for sleeping sickness which opened the path to the disease elimination after decades of neglect. “A PRV programme, with strong access conditionality, would be a valuable addition to Europe’s funding ecosystem for global health innovation, helping to accelerate the development of treatments for tropical diseases, including climate sensitive and pandemic prone diseases that are becoming increasingly common in Europe due to climate change”, Tanguy said.

Maria Daniel Loureiro , Intelligence Analyst at the European Health Emergency Preparedness and Response Authority (HERA) discussed the EU’s efforts to strengthen its capacity to respond to global health threats. HERA has been exploring innovative financing approaches, including joint procurement of vaccines for COVID-19 and mpox, explained Loureiro, who also stressed that HERA is undergoing a revision, which could open new opportunities for exploring additional mechanisms to support global health research and innovation in the EU.

A Critical Crossroads for EU Global Health Leadership

Europe’s role in global health innovation is at a critical juncture. As climate change accelerates the spread of vector-borne diseases and antimicrobial resistance weakens the effectiveness of current treatments, expectations for decisive EU action are high. However, the controversial choice for Commissioner-designate for Health has raised concerns that health may once again slip to the bottom of the EU’s long list of priorities. “Given how far Europe lags behind the US in R&D investments, and the foreseeable difficulties in securing additional resources for health in the next multiannual budget, the EU should seriously explore all available options to promote innovation—especially those with no cost to taxpayers and a proven track record, like the Priority Review Voucher (PRV) programme”, Castro concluded in her final remarks.