Seven EU states reject 2026 EU4Health work programme over NGO funding cuts

EU countries are sharply divided over the allocation of this year's EU health budget, particularly regarding funding for health advocacy groups, as a vote by member states demonstrated.

On Wednesday, as reported by Euractiv, the European Commission presented its health-related work programme for the current year to national representatives. The programme, called EU4Health, sets out how the funds are to be used.

Voting Outcome

One EU diplomat told Euractiv that seven member states voted against, ten abstained, and ten supported the programme.

The "dealbreaker," another EU diplomat told Euractiv, was the removal of core funding through the Commission's proposed cuts to operating grants for civil-society health organisations.

Among those opposing were:

• Malta
• Belgium
• Luxembourg
• the Netherlands
• France
• Spain

The seventh country is likely Slovenia, which earlier backed a French-led non-paper calling for the reinstatement of operating grants for health NGOs – a position also supported by Belgium, Spain and Luxembourg in February.

The diplomat added that even those who supported the programme shared concerns about the NGO grants.

With the voting outcome in the programme committee meeting, the Commission did not secure the majority required to approve the programme.

Mounting Tensions

The vote comes amid broader restructuring. In July, the Commission announced that the €4.4 billion stand-alone EU4Health programme would be folded into the new European Competitiveness Fund (ECF), alongside agriculture, biotechnology and bioeconomy funding.

Funding tensions have been mounting since the Commission cut EU4Health's envelope from €5.3 billion to €4.1 billion – nearly 20% – citing shifting priorities toward defence and security. The annual work programme sets out how this budget should be allocated.

In July 2025, the Commission published its delayed 2025 work programme and confirmed it would withdraw operating grants for many patient and health advocacy groups.

The decision has triggered months of concern among NGOs, MEPs and several governments, who warn that without predictable core funding, health civil society risks becoming fragmented, weakened and increasingly sidelined in EU policymaking. Some organisations have already had to lay off staff or close their Brussels offices.

Two Ways Forward

Despite the backlash, the Commission described the 2026 programme as "ambitious." A spokesperson told Euractiv they "regret that Member States were not able to support the work programme," adding only that the institution will "now reflect on the most appropriate route forward."

A Commission official told Euractiv that one step could be to refer the matter to an appeal committee of senior member state representatives – a move that can be taken within one month of the Programme Committee's decision.

Another possibility is to amend the work programme to reflect member state concerns and reconvene the committee for a new vote within two months – a scenario mostly welcomed by the NGOs.

The European Patient Forum (EPF) called the outcome a "positive signal." Also, EURORDIS-Rare Diseases Europe welcomed the member states' intervention and called it a sign of renewed commitment to "strong, independent and adequately funded" health NGOs.