Debate contributions by Michele PICARO

Mr President, Commissioner, ladies and gentlemen, the growing geopolitical instability is revealing the European Union's serious fragility in access to essential medicines, especially cancer medicines. The shortages are the result of supply chains that are too dependent on third countries, especially China and Asia. The global context, also in light of the US policy of the "most favoured nation", risks exacerbating price and availability imbalances in European markets. The problem is structural: In 2023, the EU developed only 17 new active substances compared to 28 of its main competitors, with R&D investments of 4% compared to 5.5% in the US and 10% in Asia. Weakening intellectual property reduces innovation and investment and increases strategic dependency: Europe must choose whether to strengthen its industrial and scientific autonomy or depend on others. And Italy wants to lead this strategic and important choice for all European citizens.

Madam President, ladies and gentlemen, travellers have the right to rely on simple rules, real protections and certain times in the event of inconvenience. The revision of the Air Passenger Rights Regulation is a very important issue because it touches the lives of millions of European citizens. It is important to correct and strengthen some points, also in light of what the latest international emergencies have taught us. I am thinking of the need for clearer procedures for reimbursements through intermediaries, fairer time limits for compensation and greater transparency in the relationship between airlines and passengers. It is also important to strengthen accessibility for persons with disabilities or in fragile conditions. Finally, a shared and objective definition of exceptional circumstances is needed to avoid different interpretations from country to country. This is why Parliament has the task of improving this proposal, defending passenger rights and supporting the competitiveness of the sector.

Madam President, ladies and gentlemen, on 13 June in Francavilla Fontana, Brigadier Carlo Legrottaglie was killed while pursuing those responsible for a robbery. A gunshot snatched him from life. He was 59 years old. A few days left to retire, after more than thirty years of honorable service in the carabinieri's weapon. And yet, until the last moment, Carlo did what he had always loved to do: serve the state, protect citizens, honor the uniform with discipline, humanity and an unwavering sense of duty. But today our thoughts go to his family. May our most sincere and heartfelt embrace come to them from this House. It is time for the European Union to acknowledge these sacrifices. That is why I call for the establishment of a Day of Remembrance for those members of the police who have fallen into service, so that every Charles, in every country of Europe, finds a place in the collective conscience of our democracies. Honor to Carlo Legrottaglie forever.

Mr President, ladies and gentlemen, mental health at work is not a luxury but a necessity. Work must represent an opportunity for growth and fulfillment, not become a cause of chronic stress or psychological malaise. In an age of hyperconnection, isolation and growing pressure, protecting the mental well-being of workers means investing in productivity, social cohesion and the future of our businesses. The Italian government, led by Giorgia Meloni, has already set a clear course: centrality of the person, support of the family, promotion of healthy, working and inclusive environments. In Europe, we need to act consistently, promoting concrete measures, such as management training on stress management, psychological support in the workplace, granting and reconciling work-life balance, and shared guidelines that are not binding but supportive to the Member States. We do not need proclamations but useful tools, flexible and adaptable to national realities.

Mr President, ladies and gentlemen, I would like to thank Commissioner Varhelyi and the Commission for their response and their sensitivity to the phenomenon of health tourism, which involves more and more sectors of medicine, such as cosmetic and plastic surgery, medically assisted reproduction, orthopaedic and ophthalmological surgery, innovative therapies and finally the most affected sector, dentistry. Our citizens, often attracted by lower costs and shorter waiting times, travel to countries outside the European Union to receive health care; however, alongside these apparent benefits, there are significant health risks: non-compliant sanitation standards, lack of continuity of care and little possibility of protection in the event of malpractice. However, the lack of statistical data on malpractice health tourism does not prevent us from bringing into this authoritative assembly concrete cases and testimonies of citizens returned from these treatments with serious infections, poorly positioned prostheses and the need for corrective interventions, which consequently fall on the national health system and often on the patient, who must privately incur additional expenses. We cannot prevent the free choice of our citizens, but we have a duty to protect them by means of information, prevention and, if necessary, regulatory measures. With this in mind, I consider it appropriate to make a concrete proposal to the Commission: introduce at European level a certification mechanism for third countries providing health services to EU citizens. This system should provide a classification of levels of compliance with minimum European standards on quality of care, patient safety, qualification of staff, evaluation of clinical protocols and traceability of medical devices. The aim is to ensure that the freedom of choice of European citizens in the health sector is based on objective and verifiable criteria, reducing the risks linked to the phenomenon of health tourism and combating the situations of malpractice, through transparent and comparable information. That is why, dear Commissioner Varhelyi, I remain available to work together on all the activities – legislative and non-legislative initiatives – that we can undertake to protect our citizens.

Mr President, Commissioner, ladies and gentlemen, rare diseases are one of the most complex public health challenges, affecting almost 30 million people in the European Union, including 2 million in Italy. It is in this context that the European Union needs a strong regulatory framework to promote policies that support the development of orphan medicines; The upcoming revision of the pharmaceutical package will be an opportunity to ensure that the European Union remains a globally competitive place for investment for a long time. A key aspect to be considered in the legislative process is the market exclusivity for orphan drugs which, with its ten years of protection, ensures the stability needed for innovation. Alignment between the Directive and the Regulation on market exclusivity for orphan medicinal products is also crucial to ensure fair protection of orphan medicinal products, in particular for those with authorisation prior to the entry into force of the new Regulation. With this approach, the European Union will leave no one behind and make a difference for millions of people waiting for answers.

Mr President, ladies and gentlemen, the COP16 of the Convention on Biological Diversity ended in Rome in February, a complex conference, of course, but above all a successful one. As many as 168 countries, differing in political orientations, economic conditions and cultural contexts, managed to find an agreement. At the heart of the negotiations is the mobilisation of resources for biodiversity, an issue that has remained open since 1992. We have finally launched a permanent financial mechanism, as provided for in Article 21 of the Convention; It is not just a diplomatic success, it is a sign of justice for developing countries. It is true, many details still remain to be defined: the operational structure of the instrument will be decided by 2028 and will only be operational in 2030, but what matters today is that the international community has chosen to act together, opening a structured dialogue between environment and finance ministers, adopting a methodology to monitor progress, starting the preparation of the first global inventory on biodiversity. Exactly as the European Union delegation said, we have shown collectively that the world can still agree on issues of common interest. Here, my hope is that Rome will not only remain the place where COP16 took place, but will become the symbol of a new season of global commitment to the protection of biodiversity.

Madam President, ladies and gentlemen, how long can we tolerate shortages of essential medicines in Europe? Colleagues, this crisis is a structural problem that puts the health of our citizens at risk. Our goal is an independent Europe in the production of medicines, because health cannot depend on external actors. It is a matter of security and sovereignty for all Member States: Without a strong and autonomous industry, we remain exposed to unacceptable vulnerabilities. For this reason, we will ensure that the Critical Medicines Act pursues two key strategic objectives: the first is to avoid new bureaucratic superstructures and exploit existing monitoring and response tools; the second is to strengthen Europe's strategic autonomy, ensuring health security and global leadership in the sector, both in the production of essential medicines and in the development of future innovations. And to do that, we need concrete tools, incentives for intellectual property, public procurement rules that reward innovation, and faster approval procedures for innovative medicines.

Mr President, ladies and gentlemen, the mental health of our young people is not only a problem of well-being, but an essential right, often overlooked in our health budgets. More than half of mental illnesses occur before the age of 14, with devastating effects such as declining school performance and social isolation. This represents a moral failure that we have a duty to prevent. Access to care should not depend on the geography or economic situation of the family. Practical tools for protection and prevention in the educational, digital and work context must be put in place, promoting an integrated approach to mental health care, such as the Mental Health Programme. Technical Support Instrument 2024. Policies alone are not enough. We need a collective commitment from institutions, communities, schools, employers, health professionals and, above all, from each of us. We must build a culture that desires mental health as the same importance as physical health, overcoming prejudice and indifference. Let us engage in prevention and ensure fair access to treatment, also using European Union funds to strengthen our national initiatives.

(IT) Mr President, ladies and gentlemen, let us imagine a Europe in 2030 with a shortage of medical and health personnel of around 4 million. This is what the WHO tells us. In order to reverse this negative trend, Europe must immediately intervene with the revision of the next multiannual budget, increasing the resources of the EU4Health, Erasmus+ and 4th Health Programme, in addition to development and cohesion programmes. The joint action It has already put us on the right track, but we must extend our commitment to the training of health professions with a constant updating of staff. It is essential that each Member State improves its foresight tools to identify and respond promptly to the future needs of our health system. In this perspective, it is essential to speed up and simplify recruitment procedures, removing red tape that hinders rapid access to the medical professions, as well as to increase resources and programmes dedicated to the health sector and to finance training projects for staff in countries outside the European Union, including from a linguistic point of view. It is our duty to ensure a strong and responsive European health system, on which every citizen must be able to rely.

(IT) Mr President, ladies and gentlemen, the year 2024 will go down in history with record high temperatures, with the agricultural sector suffering economic losses estimated by the European Commission at over EUR 14 billion, a figure that brings our food security and the economic stability of many rural communities to their knees. We know that, in the face of this emergency, the European Union has responded through the Green Deal, allocating significant funds from the NextGenerationEU recovery plan, beyond the relative and concrete results that, especially on the automotive issue, we strongly criticise. Specifically, of the planned €1.8 trillion, a third was directed to support sustainable initiatives. However, to reach our environmental and climate targets by 2030, the European Commission has calculated that an additional investment of €620 billion per year will be needed, an essential financial commitment not only to mitigate the effects of climate change, but also to accelerate the transition to a green economy. However, the overall need for green infrastructure in Europe exceeds €1 trillion per year, a figure that highlights the need for stronger action and increased investment in research and development for sustainable agriculture, strengthening infrastructure that can withstand climate extremes and also increasing support to hard-hit rural communities. We need to review and strengthen our financial approach, ensuring that every investment is targeted and effective, focused on projects that can really help make Europe more resilient and sustainable. Our response must be swift, concrete and proportionate to the urgency of the situation. Today more than ever our commitment must be translated into concrete actions that ensure a sustainable future for Europe, but to do this we must ensure that the Europe system, the Italy system can also be conditioning for all other international partners. Only in this way will we be able, together, to bring about a result that improves the quality of life of our citizens and to launch a real Green Deal, a real ecological transition.

Madam President, ladies and gentlemen, today it is essential to address the need to update the European Strategy for the Rights of Persons with Disabilities. Despite the progress made in recent years, many barriers still remain. People with disabilities continue to face difficulties in accessing essential services, such as care, education and work. The European Union must do more to ensure that all people can live fully and independently. Special attention should be paid to autism: the number of people diagnosed with autism spectrum disorders is constantly increasing, yet many families are facing enormous difficulties in bearing the costs of the necessary therapies. Here too, the European Union must act decisively, providing adequate resources to support the Member States. Autism can no longer be considered a secondary problem, but must become a priority in European policies.

Mr President, Commissioner Ribera, ladies and gentlemen, the Green Deal is a clear example of how the European Union is legislating without assessing the impact that these policies will have on the lives of our citizens. It is undeniable how the desire to quickly achieve ecological goals has led to laws that damage vital sectors such as agriculture and industry. This contrasts with the positive work of the European Commission since 2015, with the Better Regulation package, which sought to raise the quality of legislation. With the Green Deal, we risk making laws without a thorough assessment, which not only puts at risk the effectiveness of policy choices but also undermines citizens’ trust in the European Union. This is why we need more than ever laws that truly address the challenges of our communities and respond to the needs of citizens, ensuring that every measure is sustainable, fair and affordable for everyone.

(IT) Madam President, ladies and gentlemen, the COP16, which took place in Cali from 28 to 31 October last, while representing an important opportunity for confrontation between nations to face the challenges related to climate change, was characterized by internal divisions among the participants, with very divergent positions on issues crucial for financing, for the energy transition, and the responsibility of developed countries, such as to end with a suspension of negotiations. My speech, as a member of the ECR Group, underlined the importance of concrete and practical solutions for the fight against climate change. Specifically, we advocated the need for global engagement but also a balance between environmental policies and economic development, especially for emerging economies that need more support to adopt green and sustainable technologies. For this reason, although the interruption of the conference represents a setback, it is essential to continue working together to find practical and shared solutions, without renouncing the hope of a concrete commitment on the part of all nations.

Mr President, ladies and gentlemen, 'violence against women is one of the most shameful violations of human rights': With these words by Kofi Annan, I call the attention of the European Parliament, because today we are called to reflect on a scourge that crosses our society, which has no borders and makes no distinction between class, ethnicity or age. It is a deep wound that marks not only the victims but also us as a community. Every year thousands of women in Europe and around the world suffer physical, psychological and economic abuse. Yet, too often silence and fear fuel this cycle of violence. That is why we must ensure that national laws are stronger, that rights are protected and that every woman, in every corner of Europe, is safe. The fight against violence against women must be a top priority and not just a one-day theme but a daily battle. Enough with the list of the number of victims: It is our duty now, and not tomorrow, to build a society in which violence no longer finds space.

Madam President, ladies and gentlemen, as we know, the European steel industry is at a crucial junction due to global economic crises, regulatory changes and environmental pressures. With reference to Italy, steel is a fundamental pillar of our economy, with a production of 22 million tons, 25,000 direct jobs and 300,000 indirect jobs. One of the keys to tackling the steel crisis is efficient scrap management, of which Italy recycles only 60%. Investing in innovative recycling technologies and promoting collection policies can create a virtuous cycle for industry, as well as investing in research and development of low-carbon technologies and supporting small and medium-sized enterprises with tax incentives and funding, starting with an increase in the Research Fund for Coal and Steel and the promotion of public-private partnerships. We must understand that, in order to deal with the crisis, we must implement an integrated strategy to promote competitiveness and sustainability, because the European steel industry has the potential to become and return to leadership.

Mr President, ladies and gentlemen, dental tourism in non-EU countries is a growing phenomenon that raises major public health concerns. In recent years many European patients, in particular Italians, have turned to destinations such as Albania and Turkey for dental treatments at competitive prices. However, an investigation of the British Dental Association 70% of patients who sought treatment abroad experienced serious adverse events, such as infections and abscesses or chewing difficulties, which compromised not only their health, but also the duration of prostheses and implants, thus nullifying the initial economic advantage. Health standards in these countries often lack strict regulation. This is why it is necessary to promote information campaigns that provide citizens with clear and reliable data on the risks and benefits of dental care abroad. Informing patients about the health regulations of the destination countries, the training of medical personnel, the quality standards of the facilities is crucial to allow informed choices. For this reason, it is imperative that the European Parliament considers these issues and promotes initiatives to ensure the safety and quality of dental care. On the contrary, it is a matter of ensuring that each patient makes informed, safe choices that are supported by appropriate regulations. Only in this way will we be able to guarantee and protect the health of citizens and maintain trust in the health system.

Mr President, ladies and gentlemen, World Mental Health Day makes us reflect on the importance of psychological well-being, especially for young people. About one in six Europeans faces a mental health problem every year, with disorders such as anxiety and depression affecting more than 25% of the population. The pandemic exacerbated the situation by increasing depressive and anxious symptoms by 20%. Recalling Rita Levi-Montalcini's "Praise for Imperfection", we have and must develop a comprehensive strategy for mental health in the European Union, with integrated policies that guarantee access to adequate services, educational support and awareness-raising campaigns. Investing in mental health is crucial for a prosperous and resilient future. We must act together to ensure that every European citizen receives the necessary support. It's time to make a difference.

Mr President, ladies and gentlemen, Europe must remain a leader in health and technology, protecting the well-being of our citizens. But current industry regulations are complex and limit innovation. In her mission letter of 20 September to the Commissioner-designate for Health, President von der Leyen clearly identified as one of the priorities of her mandate the need to ensure both the availability of medical devices and the strengthening of the competitiveness of the medical technology sector. The College of Commissioners should make it a primary objective to cut red tape for businesses to ensure that EU rules are fit for purpose. The European Commission is asked to speed up the regulatory review process of the medical devices sector, otherwise our global competitiveness is at risk. This review will not only benefit innovation, but above all it will facilitate access to prevention and treatment for the European citizens whom, I am sure, we all want to guarantee.

Mr President, Commissioner, ladies and gentlemen, today we are dealing with a crucial issue: drought and extreme weather events, which pose a growing threat to our communities and European agriculture. In the context of climate change, these challenges cannot be ignored. Agricultural regions – I am thinking in particular of those in southern Italy, which is at the heart of our economy – are suffering devastating impacts. Water scarcity compromises crops and reduces productivity, putting food security at risk. Farmers – who are the guardians of our land, not the enemies – face ever higher costs and unprecedented uncertainties. It is our duty to act. We need investment in state-of-the-art infrastructure and adaptation strategies that ensure the protection of our land and farmers. It is essential that the European Union coordinates activities between Member States, creating an early warning system and an emergency fund to support affected communities. Together we can turn this crisis into an opportunity to build a stronger and more sustainable Europe. Our actions today determine the future actions of our generations.