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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• 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).

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European organizations have to reckon with how to keep up with the modern world without sacrificing sovereignty. Geopolitical instability, tightening regulatory expectations and the rapid adoption of artificial intelligence (AI) mean that, for many organizations, sovereignty now sits alongside resilience and business continuity in board-level risk discussions. The question they can no longer defer is how to harness the opportunities of the modern cloud without surrendering control over their own data. Answering it requires honesty about what sovereignty means, and about where it can actually be found.

A definition Europe can trust

The European Commission’s forthcoming Cloud and AI Development Act (CADA) is the right vehicle for that honesty: giving Europe a shared, enforceable definition of what “sovereign” actually means. Without such a definition, the market is filled with commercial offerings that claim the sovereignty label without delivering the substance, a practice described as “sovereignty washing.” This gap has led some organizations to treat open source as the answer. But open source software is a licensing model, not an operating model, and it doesn’t settle questions about infrastructure or jurisdiction or even reliability and access. It’s not a route out of dependency, it’s a different dependency on project sponsors and code maintainers. A definition gives policymakers a way to properly assess claims of sovereignty against a consistent standard rather than taking marketing at face value.

Europe should not wait for CADA to take effect before acting, though. European cloud service providers (CSPs) have been partnering with established technology providers to deliver real sovereign capability, without rebuilding the entire technology stack from scratch.

The best time to plant the sovereign tree was 10 years ago

If Europe wants to grow its industrial base, it has to support the ecosystem as it is now, not as it may in 10 years’ time. CADA’s own roadmap assumes roughly five to seven years to triple the EU’s data-center capacity. Providers who have already built capacity by blending EU capabilities with proven non-EU technologies would have to spend the intervening years relinquishing their growth. It is scale, not a shortage of skills or innovation, that is the biggest practical obstacle facing a stronger European cloud market. This is precisely why partnership with proven technology sources deserves a central place in the sovereignty debate rather than being treated as a second-best option.

Partnership shortens that timeline considerably, letting European CSPs deliver sovereign, scaled services now instead of waiting for domestic capacity to catch up organically. In Italy, IPZS, owned by the Italian Ministry of Economy and Finance, is using this model to build a modern Digital Application Platform for the Italian EUDI wallet, a foundational EU digital identity initiative. It provides a live example of that model working in Europe today, at the scale and speed the policy window demands.

It is through scale that the local industrial base can deliver sovereign capabilities, compete, capture market share, and invest in developing and integrating home-grown technologies. Hoping for the alternative to happen, that is for a European technological stack to fully emerge and be adopted, is the equivalent of putting the cart before the horse.

The rules need to allow for a model that’s already working

Providers, such as evoila, are now operating well beyond Europe’s borders, alongside Uniserver. This shows the model working at a broader scale, combining local operational and jurisdictional control with proven technology. Sovereignty spans jurisdictional, technological, operational and supply-chain dimensions, and a partnership model can address all four while drawing on technology already proven at scale, rather than asking every layer to be rebuilt from first principles by a single European provider.

Alongside its cloud platform, developed in-house and operated from data centers in Europe under EU jurisdiction, IONOS also offers customers a dedicated VMware-based private cloud. It is also operated within the EU and designed to provide European data sovereignty and operational control.

Broadcom’s role in that model is deliberately narrow. It supplies the VMware cloud software layer to the CSP, while the CSP itself runs the infrastructure and holds the customer relationship, so that no European customer data passes through Broadcom or is subject to its access. Trust, in this model, follows the architecture rather than the brand. If CADA’s tiers implicitly assume that sovereignty can only be delivered by a fully European-built stack, CADA would shut out precisely the route that is already allowing Europe to scale fastest: partnership between local operators and proven technology providers.

The path forward

Europe does not have to choose between moving quickly and building sovereignty. The two are compatible, provided the legislation is calibrated to recognize it. As the European Parliament and European Council work on CADA, the priority should be for it to recognize and reward the partnership models already delivering sovereign capability across Europe today.

The above column is sponsor-generated content.

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• The political advertisement is linked to Broadcom’s software business and advocacy around the Cloud and AI Development Act (CADA).

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BRUSSELS — The European Commission announced a new list of 46 projects Friday in a bid to diversify away from China’s grip on raw materials and establish its own mineral sovereignty.

The projects span extraction, processing, recycling, and substitution for raw materials to supply the EU’s defense, automotive, clean tech and technology industries.

Many of the projects are designed to support electrification and the battery value chain. Lithium, nickel, cobalt, manganese and graphite — the five key battery metals used in electric vehicles and grid-scale batteries — dominate the list. Copper and aluminum, conductors that are used in anything involving electricity, also figure prominently.

Through these projects, Brussels wants to meet its targets under the Critical Raw Materials Act, which, by 2030, the bloc aims to mine at least 10%, process 40% and recycle 25% of its own needs, while sourcing no more than 65% of any one material at any processing stage from a single non-EU country.

The list covers 15 of the 17 “strategic minerals” under the act, which the bloc needs to deliver these targets on each one.

Friday’s announcement is the second batch of strategic projects listed under the act, after the EU rolled out its first list in March 2025, featuring 47 projects and 13 non-EU country projects. The majority of those projects are behind schedule however, highlighting the complexity of getting critical mineral projects up and running.

“With the projects selected in 2025 and 2026, we could now fully meet our European extraction target for lithium, nickel, rare earths, magnesium and tungsten,” said the bloc’s industry chief, Stéphane Séjourné. “We could also meet our processing target for lithium and rare earths. And our recycling target for lithium, cobalt and rare earths.”

With over 170 applications received, the 46 projects span 16 EU member countries: Belgium, Bulgaria, Estonia, Finland, France, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, Slovakia, Spain, Romania and Sweden.

“Exactly one year ago, we experienced firsthand why this matters. On Oct. 9, 2025, China announced new export restrictions on rare earths,” said Séjourné. Those export controls are due to expire in January.

The “strategic project” label is meant to provide faster permitting and help secure public and private finance, with permitting deadlines of 27 months for mines and 15 months for processing and recycling projects.

The Commission will also announce strategic projects in non-EU countries later this year.

BRUSSELS — It was meant to be Europe’s escape from the web of Chinese critical mineral supremacy.

But two years after it took effect, the EU’s Critical Raw Materials Act is not on schedule. Just one in four critical mineral projects granted special status under the law is on track to be ready on time, according to new analysis shared with POLITICO.

On Friday, EU industry chief Stéphane Séjourné will unveil a new list of critical mineral projects that will receive privileged access to funding, accelerated permitting and help from Brussels to find buyers.

The idea is to make Europe a major producer of materials essential to clean energy, tech, and defense manufacturing. It’s currently a heavy importer.

But progress on the first round of 47 projects, announced early last year, offers little hope for the bloc’s ambitions.

“At least one in three mining and processing strategic projects is either late, stalled, at risk, or no longer exists, and only about a quarter are clearly on track,” said Diego Marin, policy officer for raw materials at the European Environmental Bureau, citing publicly available sources. The findings will be published in a report later this month.

Financial, regulatory, and political hurdles are blocking European mining projects, the industry says, despite the Critical Raw Materials Act’s aim to speed up the time it takes to get the shovels in the ground.

The EEB’s findings were echoed in an industry call in August, where 23 projects named in the first round claimed some were facing “immediate jeopardy,” in a letter sent to the Commission and obtained by POLITICO.

Those same companies also believe that announcing more strategic projects will create more problems. However, a Commission official dismissed that claim, saying that some of those projects had received direct funding from the Commission, and claiming the companies believe new projects would “dilute their status.”

The EU unveiled 47 projects in March 2025, covering 14 of the bloc’s 17 designated strategic raw materials—from lithium, nickel, cobalt and graphite for electric vehicle batteries and rare earths for magnets used in wind turbines, to tungsten for military equipment and gallium for semiconductors. It also includes 13 projects from outside the bloc.

These were designed to deliver the EU’s raw materials targets: by 2030, the bloc aims to mine at least 10 percent, process 40 percent and recycle 25 percent of its own needs, while sourcing no more than 65 percent of any one material at any processing stage from a single non-EU country.

Breaking Europe’s dependence on China for key metals is at the heart of the policy, a goal European Commission President Ursula von der Leyen highlighted in her State of the Union speech last month. “We are more than 80% dependent on China for many critical raw materials [and] 90% for some rare earths,” she lamented. 

A Commission official said that if all goes to plan, the EU will meet its 2030 goals for lithium, cobalt and rare earths, but results for other materials are mixed, with shortfalls in nickel processing and recycling and across the manganese supply chain. They did not give hard figures, though.

Industry skeptical

“Unless something happens that is absolutely not foreseen today, we will be far, far away from reaching the targets, even if they are quite low,” said Jan Moström, former CEO of Swedish mining giant LKAB and outgoing president of Euromines. He said better access to financing and faster permitting was key.

The EU is under additional time pressure as a pause on China’s export controls on rare earth minerals is due to expire in January.

Global think tank ODI found in June that “out of 60 projects, 14 are unlikely to contribute by 2030 because their estimated start of production falls between 2029 and 2031,” and that “three out of four are either behind their expected schedule or impossible to verify using up-to-date public evidence” — backing up the EEB’s numbers. 

A European Court of Auditors report this year also revealed that “many projects will struggle to secure supply for the EU by 2030” and that there was “no proper tracking of results.” 

The European Commission questioned the current validity of the ECA’s findings, saying it “audited a period of policy that does not cover everything we’ve done since this mandate. So the Court of Auditors had very relevant points that we took into account in our policy, but should absolutely not be seen as a fair assessment of the work we’ve done with the von der Leyen Commission number two,” said a Commission official. 

Desperate times

Since adopting the Critical Raw Materials Act in 2024, Brussels has rolled out a flurry of initiatives to get projects moving. They include a proposed critical raw materials center, for which Parliament is seeking €2 billion; the “RESourceEU” plan that’s mobilized more than €2 billion; a mechanism to identify suppliers; and plans to revise water rules and speed up environmental impact assessments. 

But industry leaders say the EU is moving too slowly. 

“I’m still to be convinced that it makes any difference,” Michael Staffas, CEO of Swedish miner Boliden, told POLITICO when asked about the benefits of being designated as a strategic project. Boliden’s subsidiary Somincor was granted strategic status for a copper and zinc mine in Portugal. 

The “strategic project” label promised faster permitting and help securing public and private finance, with permitting deadlines of 27 months for mines and 15 months for processing and recycling projects.

“In Sweden you have different authorities that can basically object to a permit process and that in itself creates way longer time than 27 months, just the legislation,” said LKAB CEO Johan Menckel, whose company currently has three strategic projects.

One is the Per Geijer deposit, home to Europe’s largest rare-earth deposits, which the local indigenous Sámi community opposes, arguing it would harm their reindeer-herding tradition. 

The local administration recently recommended that the State Mining Authority grant the concession on the condition that the Swedish company “minimize the impact on the reindeer industry,” but that will be subject to appeal from the Sámi.

Karin K Niia, a Sámi reindeer herder, said in comments that the EU will be complicit in cultural genocide if the project goes ahead. 

Europe’s lithium hope

Europe’s biggest bet to escape China’s foothold in battery metal supply chains is the Barroso lithium mine in Portugal, run by UK-based mining company Savannah Resources. The company says the mine could supply enough lithium for around half a million electric-vehicle batteries a year.

“I don’t think the strategic project stamp and the [Critical Raw Materials Act] have been absolutely essential, but it wasn’t also supposed to be. It was supposed to, in my understanding, be important to set a framework under which Europe can do the right thing faster, better, and for the better benefit of the next generation of Europe,” Savannah’s CEO Emanuel Proença said, calling it just another piece of a very big puzzle. 

Europe’s lithium-refining ambitions are also faltering: France’s Viridian Lithium went bankrupt after failing to secure funding, while Portugal’s José de Mello Group was unable to finance its planned €492 million refinery — despite both projects winning strategic status in the EU’s first round.

Viridian Lithium spokesperson Luc Pez said the strategic project label was a ‘curse.’ 

Rio Tinto’s Jadar project in Serbia, one of the non-EU projects to gain strategic-project status, was meant to provide double Barroso’s lithium capacity and cater to up to 25 percent of Europe’s demand. That, however, was suspended because of permitting issues and became a widely protested project amid allegations of corruption and environmental concerns. 

That reflected the simple fact that people don’t like mines in their backyard — an obstacle for mining projects worldwide, but especially in Europe, which is densely populated and has strong civil society.

“These projects had strategic status, EU money and fast-track permits, and it still wasn’t enough,” said EEB’s Marin. “If the supply push can’t deliver even under those conditions, the EU has to take demand reduction and sufficiency seriously. We can’t permit our way out of a market problem.”

Frida Preuß contributed to this report.