by Gerhard Polak and Nira Hrisenko
A controversial vote on the EU4Health Work Programme 2026 has highlighted growing concerns over the future role and funding of civil society in European health policy.
On 22 July 2026, EU Member States failed to approve the European Commission’s proposed programme, with several Member States opposing the proposal largely because it did not provide sufficient structural support for health civil society organisations.
EU4Health is the European Union’s main funding programme in the field of health. Its annual work programmes determine how EU funding is allocated to priorities ranging from disease prevention and health-system resilience to preparedness, digital health and cooperation between Member States.
When national representatives met in the EU4Health Programme Committee on 22 July 2026, however, the European Commission did not obtain the majority required for its proposed 2026 Work Programme.
According to reports, seven Member States voted against the proposal, ten abstained and ten voted in favour. The result was unusual and demonstrated considerable disagreement among Member States over the Commission’s plans for the programme.
The key point of contention
The central dispute concerned the continued absence of so-called Operating Grants for European civil society health organisations.
Unlike funding for a single, time-limited project, Operating Grants support the ongoing and independent work of organisations. This can include:
- staff and administrative structures,
- health policy analysis,
- representation of patients and citizens,
- participation in EU consultations,
- scientific and policy statements,
- networking activities,
- and long-term organisational development.
Already on 24 February 2026, Member States had been presented with a draft of the EU4Health Work Programme in which this form of institutional support was again not included. Earlier, 13 Member States had called for the restoration of Operating Grants for health civil society organisations.
The vote of 22 July can therefore be understood as follows:
The seven Member States voted against the adoption of the overall EU4Health Work Programme 2026, apparently above all because the Commission continued not to provide stable Operating Grants for health NGOs and patient organisations.
Important: the vote was not against NGOs
This distinction is essential.
The seven countries did not vote against civil society organisations or against supporting them. Quite the opposite: their rejection of the Commission’s proposal appears to have reflected concern that the planned support for health organisations was insufficient.
The ten abstentions may likewise be interpreted as a sign that a substantial number of Member States were not prepared to fully endorse the Commission’s proposal. However, politically and legally, an abstention is not equivalent to an explicit vote against the programme.
This makes the result particularly significant: only ten Member States actively supported the proposal, while seventeen either rejected it or abstained.
Which countries voted against?
According to information reported by Euractiv, Malta, Belgium, Luxembourg, the Netherlands, France and Spain were among the countries voting against the proposed programme. A seventh country was not officially identified in the available reporting immediately following the vote.
The result nevertheless reflects a broader debate. Opposition to ending structural funding for health civil society has been developing for several months, involving Member States, patient organisations, public health associations and Members of the European Parliament.
The European Parliament has also raised concerns
The European Parliament has also criticised the Commission’s decision to discontinue Operating Grants.
In its guidelines for the preparation of the EU budget for 2027, Parliament explicitly regretted the removal of Operating Grants for health civil society organisations under EU4Health. It stressed that stable and predictable support mechanisms are important for organisations contributing to European public health and noted the value of their expertise and community input.
The Parliament also called for Operating Grants to be reconsidered under a future EU4Health Work Programme.
This is important because the controversy therefore extends beyond a dispute between the European Commission and individual NGOs. It has become a broader political question about how independent civil society should participate in European health policymaking and how that participation should be financed.
Why civil society matters for European public health
European health policy depends on more than institutions, ministries and regulatory authorities.
Patient organisations, professional associations, scientific societies and public health NGOs frequently provide perspectives and expertise that would otherwise be difficult to integrate into EU policymaking. They connect European institutions with patients, health professionals, researchers and communities across different Member States.
Their role includes contributing to consultations, developing recommendations, disseminating evidence, supporting vulnerable patient groups and drawing attention to health issues that may otherwise receive insufficient political attention.
At the same time, public funding of civil society organisations needs clear rules regarding transparency, accountability, independence and measurable European added value.
As EUPHA and EPHA have argued in the European Journal of Public Health, civil society should be regarded as an essential part of Europe’s public health infrastructure.
The current debate is therefore not simply about whether NGOs should receive EU funding. It concerns the more fundamental question of how Europe can maintain an independent, knowledgeable and sustainable civil society infrastructure in the field of health.
What happens next?
The vote of 22 July does not mean that EU4Health 2026 has been rejected as a programme.
Rather, Member States failed to approve the Commission’s proposed annual Work Programme for 2026, which specifies how available EU4Health funding should be used.
Following the unsuccessful vote, the Commission has several procedural options. It may revise the proposal and return to the Programme Committee for another vote or pursue the next procedural steps foreseen under EU rules.
For health organisations across Europe, the next developments will therefore be closely watched.
The July vote has already sent a significant political signal: a substantial number of EU Member States are asking the European Commission to reconsider how civil society organisations are supported within EU health policy.
For public health professionals, patient organisations and other stakeholders, the debate also raises a question extending well beyond the EU4Health budget itself:
What role should independent civil society play in shaping the future of European health policy – and how can that role be sustainably secured?
Sources
European Public Health Association (EUPHA).
Beyond the summer break: Critical decisions for public health. Editorial by Dr. Tit Albreht, EUPHA President, and Julian Hein, EUPHA Deputy Director. EUPHA Newsletter, July 2026. The editorial reports on the 22 July 2026 vote in the EU4Health Programme Committee and highlights the continued absence of Operating Grants for civil society health organisations as a key concern.
Sokolović M, Lauriola P, Albreht T, Marchandise C.
Civil society is essential public health infrastructure that Europe cannot afford to lose. European Journal of Public Health. 2026;36(2). Published 24 February 2026.
Euractiv.
Seven countries vote against Commission’s health programme. Report by Magdalena Kensy on the vote in the EU4Health Programme Committee, including the voting result and information on Member States opposing the proposed 2026 Work Programme.
European Public Health Alliance (EPHA).
EPHA Welcomes Member States‘ Calls for the restoration of EU4Health Operating Grants for Civil Society. Statement by Milka Sokolovic, Director General, and Sara Bertucci, Policy Manager. Background on the initiative by 13 Member States calling for the restoration of structural funding for health civil society organisations.
European Parliament. Parliamentary documents and resolutions addressing EU4Health funding and the future support of health civil society organisations.
Websites of Interest
European Commission – EU4Health Programme
Official information on EU4Health priorities, work programmes, funding and calls.
https://health.ec.europa.eu/funding_en
European Public Health Association (EUPHA)
European network for public health professionals, researchers and institutions and publisher of the European Journal of Public Health.
https://eupha.org/
European Journal of Public Health (EJPH)
Scientific journal of EUPHA with research, editorials and policy analysis on European public health.
https://academic.oup.com/eurpub
European Public Health Alliance (EPHA)
European civil society alliance advocating for better health and stronger public health policies across Europe.
https://epha.org/
European Patient Forum (EPF)
European umbrella organisation representing patients and patient organisations in EU health policy.
https://www.eu-patient.eu/
National Focal Point EU4Health Austria – Gesundheit Österreich GmbH
Information on EU4Health funding opportunities, calls and Operating Grants.
https://nfp-eu4health.goeg.at/
EU4Health Austria – Operating Grants
Detailed overview of the purpose, eligibility criteria and funding mechanisms of Operating Grants for non-profit health organisations.
https://nfp-eu4health.goeg.at/knowledge-hub/foerderinstrumente/grants/operating-grants
European Parliament
Official source for parliamentary resolutions, reports and positions on EU health policy and the EU budget.
https://www.europarl.europa.eu/
For more information visit the website.
Citation
Polak, Gerhard and Hrisenko, Nira: „EU4Health 2026: Member States Push Back Against Cuts to Civil Society Funding“ (In: Polak, G. [ed.]: GI-Mail 08/2026, ISSN: 2312-0827 Going International, Vienna 2026)
Published in GI-Mail 08/2026 (English edition).
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