It is one of the EU's most remarkable achievements that a citizen in Helsinki and one in San Lawrenz, Gozo should enjoy the same rights and standards of care. Yet, when it comes to access to medicines, unfortunately, smaller member states still face challenges related to economies of scale, to the detriment of their patients.  In fact, citizens in Malta and Cyprus routinely face delays, shortages, and limited choice when it comes to medicines.

The problem is not new. For years, pharmaceutical companies have prioritised larger, more lucrative markets over smaller ones. This was one of the areas I sought to address when elected to the European Parliament, as I was fully aware of the hardships faced by Maltese patients. That is why I chose to join the Health Committee, being the first Maltese MEP to sit on this important body.

For a country with barely half a million people, the economics of supply often make Malta an unattractive proposition. As a result, the European Federation of Pharmaceutical Industries and Associations (EFPIA) Patients W.A.I.T. Indicator paints a rather alarming picture. While the EU average for medicine availability scores 80, Malta's standing hovers around a measly 17, the lowest in the bloc. Put simply, medicines available in Germany or France this year, will likely reach Maltese pharmacy shelves in the year 2029!

In a bid to address part of this situation, I have presented three sets of amendments to improve medicine access in the ongoing EU negotiations in The Critical Medicines Act, The Regulation on the Pharmaceutical Package, and The Directive on the Pharmaceutical Package.

In the Critical Medicines Act my amendments aim to improve cooperation, ensuring fair access, and guaranteeing that EU-funded pharmaceutical projects benefit all Europeans, including those in islands.

In practice, the amendments aim to widen the scope of the act, to be better used by Malta and other small Member States by extending responsibilities for beneficiaries of EU project to supply islands and extend the possibilities of joint procurement to three member states intead of nine as originally proposed by the EC. Moreover, the amendements seek to oblige pharmaceutical companies benefiting from EU funds, to commit to suppling smaller Member States.

In the case of the Regulation on the Pharmaceutical Package, our proposed changes aim to guarantee a predictable supply chains through practical solutions that improve access to medicines. This can be improved in particular through an electronic patient leaflet in a QR code affixed to medicines replacing or in parallel with the print leaflet and information on packaging. This measure would mean that Malta's importation market would extend beyond the language speaking Member States to include much bigger markets like Spain, Germany and Italy.

Furthermore, in the wake of Brexit, Malta, Cyprus, and Ireland were allowed to keep sourcing some medicines from the UK in view that we all share the same packaging language. The derogation however is envisaged to end in 2026, well before the new electronic labelling system is in place. To avoid medicine shortages, I have also proposed to extend this transition until the new system is ready.

Through these three sets of amendments, we are finetuning the European legal structure to better reflect a reality which affects thousands. The European Union is often criticized, sometimes rightly, that it is too Brussels-centric as the peripheries are lost to distance. The only way we can address this reality is through expert, laser focus action that makes a difference.

Peter Agius is a Member of the European Parliament, representing the Nationalist Party