Health
Germany’s Growing Dependence on Chinese Pharmaceuticals Sparks Supply Concerns
Germany’s reliance on Chinese-made medicines has deepened significantly, with new data showing that China supplied more than twice the volume of pharmaceuticals to Germany in 2024 than it imported from Europe’s largest economy. According to figures from the German government, Germany sold more than 15 million tonnes of pharmaceutical products to China last year, while imports from China reached over 33 million tonnes — underscoring the extent of the dependency between the two markets.
China has become indispensable to Germany’s healthcare system, particularly for essential drug components. A report by the pharmaceutical association Pro Generika e.V. found that 76 percent of all active ingredients used in antibiotics imported to Germany now originate from China. Even medicines produced in India or the United States often rely on Chinese raw materials.
The diabetes drug Metformin illustrates this global interdependence. Of the 22 key manufacturers worldwide, 15 are based in India and two in China, while 80 percent of the compound dicyandiamide — essential for producing Metformin — comes from China. German pharmaceutical firms, pressured by discount agreements with health insurers, have been forced to source cheaper materials abroad to remain competitive.
Experts warn that this cost-driven strategy has left Europe vulnerable. “Cheap production abroad was the result of a ‘cheap is cool’ mentality,” said Michael Müller, professor of pharmaceutical and medicinal chemistry at the University of Freiburg. He cautioned that bringing production back to Germany would be prohibitively expensive and constrained by a shortage of skilled workers. “We can’t produce the required raw materials ourselves. We are clearly dependent on China,” he said.
The consequences are already visible. The Federal Union of German Associations of Pharmacists reported that roughly 500 prescription drugs were difficult to obtain in 2024, with shortages hitting antibiotics for children and medications for asthma and ADHD particularly hard. “Germany used to be the pharmacy of the world. Now the pharmacy of the world is in China or India,” said Thomas Preis, the union’s president. “If factories there have production problems, this is immediately reflected in supply here.”
Economists have also voiced concern that China could leverage its pharmaceutical dominance for political gain, similar to how it restricted exports of rare earth minerals during trade tensions with the United States. While some experts believe Germany would pay higher prices to secure medicines in a crisis, others argue that long-term resilience requires innovation and investment in new drug development.
“The global network is not an enemy but an opportunity — if we use it wisely,” Müller said, calling for Germany to focus on developing advanced manufacturing technologies and pioneering new treatments rather than competing on low-cost production.
Health
More Europeans Take Up Sport, but Major Gaps Remain Across Countries
More Europeans are exercising regularly than they were four years ago, but participation continues to vary sharply depending on where people live, their age, education and financial circumstances, according to a new European Commission survey.
The latest Eurobarometer survey on sport and physical activity found that 39% of respondents said they never exercise or play sport, down from 45% in 2022. Nearly half of the 26,508 people surveyed said they exercise or play sport every day or several times a week.
The results also showed wide differences between countries. Finland recorded the highest share of people exercising daily, at 21%, followed by Denmark at 20%. In both countries, another 59% of respondents said they exercise several times a week.
At the other end of the scale, 68% of respondents in Portugal said they never exercise or play sport. Greece and Romania followed, with 66% in each country reporting that they never take part in sport or exercise.
Time was the most commonly cited barrier among people who wanted to exercise more, with 37% identifying it as an obstacle. A lack of motivation or interest was mentioned by 26%, while 15% pointed to health problems or injury. Cost was cited by 12%.
Education and household finances were also closely linked to participation. Some 59% of people who continued their education until at least the age of 20 said they exercise or play sport several times a week. That compared with 23% among those who left education at 15 or younger.
Financial circumstances showed a similar divide. People who said they had the greatest difficulty paying their bills were twice as likely to report never exercising as those who rarely or never faced financial difficulties, at 54% compared with 26%.
“More Europeans are getting active, but the opportunity to take part still depends too much on income, age and education,” said Roxana Mînzatu, Executive Vice-President for Social Rights and Skills, Quality Jobs and Preparedness.
The survey also highlighted a significant age gap. Nearly three-quarters of people aged 15 to 24 exercise or play sport at least several times a week, compared with 25% of those aged 75 and over. Health problems or injury were the main barrier for older respondents, while younger and middle-aged people were more likely to cite a lack of time.
Physical activity linked to everyday life also increased. Active commuting rose from 24% in 2022 to 37%, while 72% of respondents said they now walk for at least 10 minutes at a time.
The survey found, however, that some Europeans do not consider their neighbourhoods suitable for walking or cycling, potentially restricting opportunities for active travel.
Mînzatu said affordable sport and safe places to exercise should be available close to where people live, including for children from families unable to afford club fees, older people and those with disabilities.
Health
Congenital Infections Linked to Higher Risks of Autism and Intellectual Disability
Children born with certain infections acquired during pregnancy face substantially higher risks of autism and intellectual disability later in life, according to a study of more than 3.7 million people in Sweden.
Researchers found that children with congenital infections were about three times more likely to be diagnosed with autism and more than seven times more likely to receive a diagnosis of intellectual disability than those without such infections.
The findings suggest that infections transmitted from a pregnant woman to her foetus may have lasting effects on brain development, although the study identifies an association rather than proving that the infections directly cause autism or intellectual disability.
The research focused on TORCH infections, a group that includes syphilis, rubella, toxoplasmosis, cytomegalovirus and herpesvirus. These infections can cross the placenta and affect the developing foetus, potentially increasing the risk of miscarriage, stillbirth and other pregnancy complications.
“Although these congenital infections are rare, some of them can be prevented, which makes them important from a public health perspective,” said Reneé Gardner of the Department of Global Public Health at Karolinska Institutet, who contributed to the study.
The researchers examined people born in Sweden between 1987 and 2021 and followed them for up to 30 years. Among the 3.7 million participants, 975 had been diagnosed with a congenital TORCH infection.
Although congenital infections accounted for only a small proportion of autism cases across the population, the risk among affected children was considerably higher. The researchers estimated that about one in five children born with a TORCH infection could later develop autism.
The study also found elevated risks of intellectual disability across different levels of severity. The risk of severe to profound intellectual disability was as much as 30 times higher among children with a congenital infection than among those without one.
The researchers found evidence of an impact on educational outcomes even among people who were not diagnosed with autism or intellectual disability. A total of 420 participants with a TORCH infection showed poor school performance without receiving either diagnosis.
Congenital cytomegalovirus, or CMV, is the most common of these infections globally and affects roughly one in 150 newborns. Its burden is substantially greater in low- and middle-income countries.
The researchers said the findings highlight the importance of prevention, particularly in regions where these infections are more common. They pointed to vaccination programmes and other preventive measures as important tools for reducing congenital infections.
They also called for improved identification of affected newborns. Current screening systems, including those used in Sweden, may miss asymptomatic infections because universal screening for TORCH infections is not routinely carried out.
The authors said stronger screening and prevention strategies could help identify children at risk earlier and improve long-term support and care.
Health
AI Chatbots Make Faster, Less Nuanced Kidney Transplant Decisions Than Doctors
Artificial intelligence chatbots may make faster and more confident decisions than human doctors when determining which patient should receive a life-saving kidney transplant, but a new study found that the systems often rely on fewer factors and show less sensitivity to the ethical complexity of such choices.
Researchers from Penn State University in the United States compared decisions made by large language models (LLMs) with choices made by people in earlier studies on kidney allocation. The researchers presented AI models with hypothetical cases based on existing datasets in which human participants had previously chosen between two patients competing for a single available kidney.
The patients were described using characteristics including age, health and drinking habits. Both were considered eligible for the transplant, requiring the decision maker to determine which patient should receive the available organ.
The researchers tested the AI systems in several ways. Some scenarios focused on individual characteristics, while others combined several traits to examine how the models handled competing considerations. In some tests, participants and AI systems were also given the option of flipping a coin, allowing researchers to assess indecision as part of moral decision-making.
Human participants generally placed greater importance on age, often favouring younger patients over older patients. Many of the AI models, however, placed greater weight on lower alcohol consumption.
Hadi Hosseini, the study’s lead researcher at Penn State University, said the findings showed that AI chatbots can diverge from human values when weighing characteristics of patients.
The researchers found that human decisions tended to consider several factors together and were more sensitive to context. LLMs, by contrast, frequently focused on a single characteristic when making their choices.
Another difference involved uncertainty. Human participants were more likely to recognise that organ allocation can involve competing ethical considerations and that there may not be one objectively correct answer. AI models generally showed little hesitation and committed to one choice.
John Dickerson, chief executive officer of Mozilla.ai and a collaborator on the study, said humans recognise ambiguity when allocating scarce resources and use debate to shape how such decisions are made.
The findings come as AI systems are increasingly being used in healthcare for clinical workflows, diagnosis, treatment planning and decisions involving limited medical resources.
The researchers said kidney allocation presents a particularly important test because decisions over deceased-donor and living-donor organs involve medical, ethical and moral considerations.
Hosseini said the ethical stakes are high because decisions involving organ allocation can directly affect patients’ lives. He stressed that the study was not intended to encourage replacing professional medical judgment with AI.
Instead, the researchers said understanding how AI systems behave in high-stakes situations is becoming increasingly important as individuals, organisations and businesses use AI to make decisions or provide recommendations.
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