As Europe plans its response to the neurological disease burden, a fundamental measurement gap is being overlooked — and the cost of ignoring it is being felt.

A briefing requested earlier this year by the European Parliament’s Committee on Public Health (SANT) put it plainly: neurological diseases are one of Europe’s most urgent and rapidly expanding health, social and economic challenges. Published in February 2026, it calls for a coordinated European plan linking prevention, early diagnosis, research and innovation.¹ But before Europe considers what that plan should look like, a foundational question demands attention: are we measuring the right things?

Multiple sclerosis (MS), a chronic, progressive disease of the central nervous system that disrupts communication between the brain and the body, offers a revealing case study. Consider a woman in her mid-30s, working, raising a family, managing what her neurologist calls “stable” MS. She has not slept properly in years, her memory has been slipping and she is cutting her hours at work. Her last clinical note reads: “No change.” On paper, she is stable, but in reality she is anything but.

Her story is not unusual. According to research commissioned by Sanofi^*, the gap between what health systems measure and what people with MS experience may be costing individuals, families and economies more than we realize.³

The stakes for Europe

Over 3 million people globally live with MS and Europe has the highest prevalence, at 133 per 100,000 people.^2,3 The condition strikes primarily during prime working years, meaning hundreds of thousands of people are navigating a progressive, unpredictable disease at precisely the point when inadequate support is felt most acutely.³

That support begins with measurement. And right now, the tools used to assess MS in clinical practice do not fully capture what people with the disease experience.³

The consequences extend far beyond the clinic: 82 percent of people with severe MS rely on unpaid family caregiving, yet this burden rarely appears in standard health data or policy design.³ When the full impact of disease is not measured, health systems can underestimate need, delay support, and overlook the wider effects on work, welfare and family life.³

The measurement gap

The Expanded Disability Status Scale (EDSS), the primary tool used to measure MS disability, was developed in 1983 to assess walking ability. We now know that MS affects far more than mobility. Fatigue affects 94 percent of people with MS, while 75 percent report cognitive difficulties, but both are absent in the EDSS assessment.³ In a field where clinical consensus is rare, seven in ten neurologists agree: a more comprehensive approach is needed.³

Growing recognition of smouldering neuroinflammation has made the need for new methods of quantifying MS progression increasingly urgent. This slow, chronic disease activity can persist even when a patient appears clinically stable, with effects that are subtle, cumulative and easy to miss until significant damage has already occurred.⁴

This is why Sanofi initiated the development of the Smouldering Associated Worsening (SAW) Index⁺. The SAW Index Study — led by an international steering committee of leading MS clinicians, researchers and patient advocates — is due to complete in 2027. Based on hundreds of hours of in-depth qualitative research with people with MS, the goal of the SAW Index is to provide neurologists with a comprehensive measurement framework that bridges the gap between lived experience and what clinical tools are currently able to detect.

According to the European Multiple Sclerosis Platform, people with MS experience an average of 14 symptoms within the first five years of diagnosis, with fatigue, sensory problems, sleep disturbances, cognitive impairment and balance problems among the most common.⁵ These are precisely the experiences the SAW Index is designed to surface, replacing static labels like “moderately affected” with measurement metrics grounded in the experience and words of people with MS.

The cost of this gap

These aspects of MS can be challenging to quantify and are associated with substantial societal and economic burdens. Lifetime productivity loss per person with MS ranges from €394,000 in France to €668,000 in Germany.³ The cost profile shifts significantly as the disease progresses: in mild MS, direct healthcare costs dominate; in severe MS, indirect costs become the primary driver.³ Indeed, lost wages, absenteeism, early retirement, disability payments and the growing burden on unpaid carers outweigh medical costs in many countries, placing growing long-term pressure on social insurance and disability systems.³

Early identification of progression could change that trajectory, extending years of employment, preserving household income, and reducing long-term dependence on disability and social benefits.^3,6 That is a cost-avoidance opportunity current measurement frameworks are missing.

Progress in motion

There is no single fix, but there is momentum.

MS care has advanced significantly in recent decades: diagnosis is happening earlier, treatment options have expanded and the focus is shifting from relapse control alone to slowing long-term disability progression.⁷ Furthermore, there is growing recognition of the importance of cognition, mental health, rehabilitation and the day-to-day realities that shape whether people living with MS can remain independent and active.⁸

The challenge now is to ensure policy keeps pace with that progress, and better measurement is part of the answer. If Europe wants health spending to deliver lasting value, it should see these improvements not as costs to be managed, but as investments in independence, participation, productivity and more sustainable health systems.

Time to act

The European Parliament’s SANT Committee has called for a fully funded European neurological health plan — one with the scale and ambition of Europe’s Beating Cancer Plan, aligning health, research and societal action in a unified framework.¹ MS offers a clear and immediate test case for what that ambition looks like in practice.

But ambitious plans require accurate data. If Europe is serious about a coordinated response to neurological disease, getting measurement right is not a secondary concern; it is the foundation on which everything else depends.

The people living with MS across the continent cannot wait for the tools that measure their disease to catch up with the science that understands it. Neither should policymakers.

^*Research commissioned by Sanofi. All editorial control retained by Economist Impact.
⁺Sanofi initiated and funds the SAW Index Study.

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References

1. European Parliament. Strengthening Brain Health: Policy Recommendations to Tackle the Rising Burden of Neurological Diseases. Available at: https://www.europarl.europa.eu/telastatic/cmsdata/302850/Briefing_Strengthening%20Brain%20Health_EN.pdf. Accessed: September 2026
2. MS International Federation. MS Atlas. Available at: https://atlasofms.org/map/global/epidemiology/number-of-people-with-ms. Accessed: September 2026
3. Economist Impact. Measuring what matters: Bridging the gap between disability impact and economic burden in multiple sclerosis. Available at: https://impact.economist.com/health-society/measuring-what-matters. Accessed: September 2026
4. Scalfari, A, et al. (2024) Smouldering-Associated Worsening in Multiple Sclerosis: An International Consensus Statement on Definition, Biology, Clinical Implications, and Future Directions. Ann Neurol 2024;00:1. DOI: 10.1002/ana.27034.
5. European Multiple Sclerosis Platform. (n.d.). Impact of multiple sclerosis symptoms (IMSS) [Fact sheet]. Accessed: October 2026
6. Cicely Dudley, Victoria Donnaloja and Karen Steadman. A guide for Health Care Professionals to have Conversations on Work with People with Multiple Sclerosis. Available at: https://emsp.org/wp-content/uploads/2017/02/Ready-for-Work-Employment-Guide.pdf. Accessed: September 2026
7. Montague T, Drummond J, Ng K, Parratt J. Advancements in multiple sclerosis. Intern Med J. 2025 Jun;55(6):895-904. DOI: 10.1111/imj.70023.
8. Giovannoni G, et al. MS care: integrating advanced therapies and holistic management. Front Neurol. 2024 Jan 30;14:1286122. doi: 10.3389/fneur.2023    

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Disclaimer

POLITICAL ADVERTISEMENT

• The sponsor is Sanofi.
• The political advertisement is linked to driving action in how neurological disease is measured in the EU (using MS as a case study) and driving action around the briefing requested by the SANT committee aimed at strengthening brain health (Policy Recommendations to Tackle the Rising Burden of Neurological Diseases).

More information here.

DUBLIN — The Irish capital, which doubles as Europe’s de facto tech capital, hosted two very different AI summits in the past week.

Most eyes were on the International AI Summit, the signature tech event of Ireland’s six-month presidency of the Council of the EU, where top brass from the world’s biggest tech firms discussed ways to harness artificial intelligence and minimize safety risks.

But the weekend before, a very different conversation was taking place at the Workers’ AI Counter Summit, as Ireland’s tech workers demanded a say in how the burgeoning technology reshapes the workplace and society.

Ireland’s lucrative tech sector has been rattled by waves of AI-driven layoffs — and the country’s fledgling tech union has seen an exponential spike in sign-ups from workers who are worried about their future.  

There’s an “awakening” happening right now among workers in Ireland’s tech sector, and a growing “awareness that they’re not bulletproof,” said Sinéad Gibney, a social democrat lawmaker who previously worked for Google.  

“I do think what we will see is that parts of roles will be automated, which means that people will be competing more heavily for the same roles,” she said. “They won’t have the same labor power and therefore we’re going to see a drop in quality of work, we’re going to see more zero-hour contracts, in more places than we already see it.”

The labor movement brewing in Ireland, where many of the world’s tech giants have their EU bases, is part of a wider trend among tech workers globally, who have seen their work disrupted by rapidly evolving AI.

Rise in layoffs

Ireland’s dedicated union for tech workers, the Digital and Techworker Alliance (DATA), has seen a five-fold increase in membership since it was first founded in 2023.  

In its first year and a half of existence, membership hovered around 270 people. In the past year-and-a-half, it’s jumped to more than 1,350 members, DATA organizer John Bohan told POLITICO.  He added that this number tends to spike around layoffs and other actions.

“The tech industry was founded on the idea that it would never have a union, because they’re making people rich, and treat them really well,” Bohan said.  “But post-Covid, workforce adjustments happened again and again, with layoffs and declining conditions in the sector. We started to see more people wanting to get organized around redundancies.”  

The spike in sign-ups coincides with a wave of layoffs in Ireland’s tech bubble (and the tech sector globally), as companies corrected pandemic-era overhiring, and diverted investment to AI.  

Ireland hosts the EU headquarters of most of the world’s largest tech companies, and more than 170,000 people are employed in the tech sector, according to the country’s statistics institute.

Social media giant Meta has roughly halved its workforce in Ireland since the pandemic, axing well over 1,000 roles to offset AI investment and boost efficiency. Separately, Meta subcontractor Covalen also announced massive layoffs earlier this year, cutting more than 700 people.  

Video-sharing platform TikTok announced this year it would shed around 300 Irish jobs, mostly from its trust and safety team, shifting the work to other countries, outsourced vendors or automated AI solutions.  

A report by the IMF earlier this year warned that Ireland’s labor market is “relatively more exposed” to AI than many advanced economies, partly due to its concentration of tech workers.  

The AI race is also creating new jobs on the Irish market – as AI firms like Anthropic and OpenAI are setting up Irish bases and trying to lure Big Tech workers with even bigger salaries.  

Amid the uncertainty and volatility of the AI boom, tech workers are turning to unions for the first time as a safety net. One tech worker who used to work in trust and safety at a big tech firm told POLITICO that there used to be a feeling that as a “pampered” tech worker you “can’t ask for your rights, because you already have it so much better.” 

But as layoffs continue and teams get leaner, workers in fields like trust and safety “now have to deal with these issues with fewer and fewer resources”, and face a “constant threat of being chopped,” the worker said.  

That’s causing an “undoing of a certain perspective that we have of ourselves as tech sector workers,” they said, “because of undeniable experiences that now put us in situations where we clearly see our rights being violated, even if we may have it so much or somewhat better than most people.” 

A different tech worker who currently works for Covalen told POLITICO that there is a sense that “if they believe they can replace you with AI, they will do that.”  

“All these Big Tech firms only care about profit, and what I have realized is the Irish government protects that Big Tech capital [rather than workers],” the Covalen worker said. “But the question is, what’s the government going to do when the tech bros change their mind and move elsewhere?”  

Workers at the center

The speaker list at this week’s AI summit was a flex of the country’s strength as a tech hub, as top names from the world’s biggest companies like Google and Microsoft took to the stage.

Fionnuala Ní Bhrógáin, head of organizing and campaigning at Ireland’s Communications Workers’ Union (DATA’s parent union), was the only union voice on the line-up.

“The fact that 36 executives and industry bosses featured on the program, compared with just one trade union speaker — invited at the last minute after attention was drawn to the absence of workers’ voices — says a lot about the value the Irish government places on AI’s impact on workers,” she told POLITICO.

“The reality is that a meaningful conversation about AI’s future can only happen through genuine engagement with workers and collective bargaining,” Ní Bhrógáin added. “Without that voice, we risk deepening mistrust and resistance rather than creating the conditions for workers to shape these changes collectively.”

DATA organized its counter-AI summit the previous weekend, to put “workers at the center of the debate about power, AI, technology and the future of work.” 

The event cut through the “hype and futurism of politicians and industry figures to focus on the real present harms faced by ordinary workers and communities,” DATA’s Bohan said.  

The union is pushing for stronger legal protections for tech workers caught up in AI-driven layoffs in Ireland, including making it mandatory for employers to recognize unions during collective bargaining. It is also calling for a ban on cooling-off clauses that prevent laid-off workers from moving between Big Tech subcontractors.  

A spokesperson for Ireland’s department for enterprise told POLITICO in a written statement that the government is “committed to strengthening collective bargaining and industrial relations” and has published an action plan to do so between now and 2030.  

They said that employers already have to comply with obligations under Irish employment law, including consultation and notification procedures for collective redundancies, and workers who feel those rules have been broken can complain to the Workplace Relations Commission. 

Firefighting to future-proofing 

Naoise Ó Cearúil, a center-right Fianna Fáil lawmaker who chairs the AI committee, pointed out that while there have been high-profile job cuts in Ireland’s tech sector, “the actual net is that there has been an increase [in jobs], particularly over the past year and even five years.” 

According to Ireland’s central statistics office, total employment in tech and related sectors surpassed 177,000 in the second quarter of this year, up from around 144,000 at the same time in 2021.  

Ó Cearúil pointed out that many job losses were in trust and safety jobs like content moderation that are “very difficult mentally,” and now tech firms are able to “utilize AI and software to be able to do a lot of detection, rather than using humans.”  

He has called for a national program to be established, to support workers whose jobs are at risk due to AI and automation.  

A spokesperson for Ireland’s department of enterprise acknowledged that the country’s tech sector has “experienced significant adjustment in recent years,” but said the changes were generally part of wider global restructuring “rather than reflecting any Ireland-specific weakness.” 

They said the Irish government is currently focused on “ensuring workers and businesses are equipped to adapt to technological change through investment in education, training, lifelong learning and digital skills.”  

LONDON — The U.K. government is planning to commit to a full or partial ban on non-compete clauses in workers’ employment contracts, six people with knowledge of the discussions told POLITICO.

All six of the people, who were granted anonymity to discuss government policy, said they believed an announcement is due imminently and could be made as soon as Friday. Three of those people said they believed the announcement was likely to be fronted personally by Prime Minister Andy Burnham, who is expected to give a speech Friday.

The government of Burnham’s predecessor, Keir Starmer, set out options in November 2025 to limit the use of non-compete clauses, which aim to restrict a person’s ability to work for or set up a competing business after they leave their job.

The founders of more than 20 U.K. tech start-ups wrote to the government last month saying the restrictions, along with long notice periods and enforced gardening leave, were and “undermin[ing] the innovation that drives economic growth”.

The options set out 11 months ago ranged from a total ban on non-compete clauses to a partial ban, such as allowing non-compete clauses only for workers earning more than a set salary threshold, or limiting their length.

However, two of the six people quoted above said that the government would stop short of backing a specific option at this stage.

Ministers are expected to set out a broad intention of ensuring that non-compete clauses are no longer a hiring problem for start-ups and innovative firms, but finer details will be worked out further down the line in consultation with industry.

No. 10 declined to comment.

The announcement comes after Chancellor John Healey said he wanted to tackle the costs for businesses in his budget on Oct. 28. One of the six people quoted above said: “They want to sell it as pro growth and freeing up the labour market.”

AI Minister Kanishka Narayan said last week that the government was “working extremely rapidly” on potential changes to the system.

Non-compete clauses are common in the financial services industry. The lobby group TheCityUK opposed a ban earlier this year, arguing that non-compete clauses “promote competition and innovation in high-value industries” as they are often the “only way to pre-emptively protect confidential information and intellectual property.”

The government argued last year that even though non-compete clauses are “unenforceable” as a starting point under current law, ministers were “concerned about the behavioural effect of including a non-compete clause in an employment contract. Even if broadly drafted and unlikely to be enforceable, workers may perceive the clause as binding and comply with it for fear of legal repercussions.”