We, Members of the European Parliament, are writing to voice our strong support for the recent letter signed and sent by 13 Member States calling on the European Commission to reintroduce immediately operating grants for health civil society organisations (CSOs) under the EU4Health Programme.
Last year, some of us strongly opposed the decision to remove operating grants from the 2025 EU4Health Work Programme, warning that such a decision would undermine trust and weaken the fabric of European cooperation in health policy. Those warnings were ignored. Today, the consequences are clear: for many health CSOs in Brussels, including patient organisations, 2025 has proven to be a particularly challenging year. The withdrawal of structural support has weakened operational capacity, forced staff cuts, reduced activities, placed organisations under intense pressure and, in some cases, even led to office closures.
At a time when balanced debate on ongoing EU legislative initiatives is more necessary than ever, weakening NGOs risks undermining the foundations of informed democratic debate. In this context, we wish to underline several key points:
• Operating grants only represent €9 million per year within the EU4Health Programme’s original €5.3 billion budget, later reduced to €4.4 billion. Over the programme’s seven-year duration, this represents only around 1% of the total budget. Their removal was therefore a political choice rather than a budgetary necessity.
• EU project-based funding cannot replace structural support. Project funding is largely designed for narrow, technical, research-focused and time-bound actions. Of note, many priorities outlined in the 2025 EU4Health Work Programme are directed primarily at Member States and therefore do not provide an adequate basis for many of the core activities carried out by health NGOs.
• Operating grants do not merely cover administrative overheads; they provide the time, continuity and organisational capacity needed for health NGOs to engage in EU policymaking, contribute expertise, consult their communities, and represent patients and the public interest in a meaningful and consistent way. EU legislation provides for the participation of patient and other civil society representatives in EU stakeholder fora, such as the Health Technology Assessment Stakeholder Network and the Medical Devices Coordination Group. In these fora, patient representatives contribute directly to the successful implementation of key EU legislation. At the moment, this work is not supported by any EU contribution.
• As you know, the Commission closely monitors the use of public funding by health NGOs, in accordance with good stewardship principles. Activity reports, levels of EU financial support and deliverables have consistently been transparent and are publicly accessible through the EU Funding & Tenders Portal. The review of the EU4Health Programme has clearly outlined the value of CSOs’ contribution.
The European Union cannot simultaneously issue a Civil Society Strategy while at the same time depriving health civil society organisations and patient organisations of the basic means to exist and contribute. To do so would be inconsistent with the values the Union seeks to uphold, particularly in a wider geopolitical context in which democratic principles are increasingly being challenged. A Europe that speaks about democratic resilience must also be prepared to sustain the civic actors that make democratic resilience real in practice.
Put simply, cutting the organisations that represent patients and the public health interest while health legislative and policy processes continue to advance risks signalling that independent civil society is expendable.
For all these reasons, we urge the Commission to:
• Reinstate structural funding for health NGOs in the EU4Health Work Programme 2026 through operating grants.
• Ensure a more transparent and accountable process for the development of the EU4Health Work Programme, taking due account of the input received by the Commission from Member States, the European Parliament, and stakeholder consultations.
We count on the Commission’s leadership to swiftly rectify this situation and safeguard the vital contribution of civil society to European health policy.
Yours sincerely,
Christophe Clergeau, Member of the European Parliament, Socialists & Democrats
CLERGEAU Christophe (S&D), S&D Vice-President for SANT
JARUBAS Adam (EPP), Chair of the SANT Committee
JERKOVIĆ Romana (S&D), Vice-Chair SANT Committee
METZ Tilly (Greens/EFA), Vice-Chair SANT Committee
BOSSE Stine (Renew), Vice-Chair SANT Committee
SOKOL Tomislav (EPP), SANT Coordinator
LIESE Peter (EPP), ENVI Coordinator
ANDRIUKAITIS Vytenis (S&D), SANT Coordinator
WOLKEN Tiemo (S&D), ENVI Coordinator
VOICULESCU Vlad (Renew), SANT Coordinator
MARINO Ignazio Roberto (Greens/EFA), SANT Coordinator
ZDECHOVSKÝ Tomáš (EPP)
PIETIKÄINEN Sirpa (EPP)
ZDROJEWSKI Bogdan Andrzej (EPP)
TONIN Matej (EPP)
SOMMEN Liesbet (EPP)
HUMBERT Sergio (EPP)
RIPA Manuela (EPP)
FARSKY Jan (EPP)
AGIUS Peter (EPP)
MENDES Ana Catarina (S&D)
PELLERIN-CARLIN Thomas (S&D)
PAPANDREU Nikos (S&D)
SIDL Günther (S&D)
JOUVET Pierre (S&D)
VIGENIN Kristian (S&D)
ANGEL Marc (S&D)
CEULEMANS Estelle (S&D)
TEMIDO Marta (S&D)
GONZÁLEZ CASARES Nicolás (S&D)
RAFOWICZ Emma (S&D)
FRITZON Heléne (S&D)
NEGRESCU Victor (S&D)
PICULA Tonino (S&D)
LAURENT Murielle (S&D)
Ó RÍORDÁIN Aodhán (S&D)
GUZENINA Maria (S&D)
MORETTI Alessandra (S&D)
LUENA César (S&D)
LALUCQ Aurore (S&D)
ARNAOUTOGLOU Sakis (S&D)
MEBAREK Nora (S&D)
DI RUPO Elio (S&D)
BENIFEI Brando (S&D)
TRAMACERE Georgia (S&D)
JOVEVA Irena (Renew)
CIFROVÁ OSTRIHOŇOVÁ Veronika (Renew)
DECERLE Jérémy (Renew)
GOZI Sandro (Renew)
HOJSIK Martin (Renew)
AGIRREGOITIA MARTÍNEZ Oihane (Renew)
HERMIDA VAN DER WALLE GARCÍA Raquel (Renew)
CORMAND David (Greens/EFA)
BOSANAC Gordan (Greens/EFA)
TOUSSAINT Marie (Greens/EFA)
SBAI Majdouline (Greens/EFA)
PREBILIČ Vladimir (Greens/EFA)
FOURREAU Emma (The Left)
SMITH Anthony (The Left)
GEORGIOU Giorgos (The Left)
MONTERO Irene (The Left)
EVERDING Sebastian (The Left)
SERRA SÁNCHEZ Isabel (The Left)
AUBRY Manon (The Left)
HÄUSLING Martin (The Left)
FLANAGAN Luke Ming (The Left)
TAMBURRANO Dario (The Left)
KYLLÖNEN Merja (The Left)
BOTENGA Marc (The Left)
KONEČNÁ Kateřina (Non-attached Member)