In the worldwide competition for innovation, the ultimate winners are those capable of financing, testing, producing, and scaling novel technologies faster than others, states Italy’s former Prime Minister, Enrico Letta, in his opinion article for Euronews, advocating for a «fifth freedom» within the EU.
Europe finds itself in a paradoxical situation. It develops some of the world’s most outstanding scientific research, yet seldom succeeds in establishing companies that commercialize these scientific achievements globally. Although the continent educates exceptional researchers and entrepreneurs, many end up migrating abroad to develop their ideas further.
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Europe struggles to convert outstanding science into thriving businesses
Nowhere is this more apparent than in the fields of health and life sciences. Europe’s scientific foundation remains strong; however, the continent faces challenges in transforming this prowess into commercial ventures and retaining the businesses it does establish. The European Commission’s own analysis, outlined in its 2025 Biotech Act, is straightforward: funding and expansion increasingly happen elsewhere. From 2015 through June 2025, biopharma start-ups in the US secured about €219 billion in venture capital dedicated to health biotechnology, whereas European start-ups attracted only €25 billion, approximately nine times less in late-stage investments.
The disparity also extends to medical trials: the European Economic Area’s portion of global clinical studies declined from 18% in 2013 to 9% in 2023, while China’s share increased from under 10% to nearly 30%. A similar pattern emerges regarding the rollout of new treatments: they reach American patients sooner than those in Europe. Moreover, post-approval, Europe’s fragmented market causes uneven and sluggish access across member states; health care equality remains elusive. The lesson here is clear: excellent science alone is insufficient. Without adequate funding and scale, Europe risks becoming merely a consumer for international industries.
Europe must retain its innovators or face uncertain prospects
This narrative repeatedly surfaced during the preparation of my report on the future of the Single Market. Numerous young entrepreneurs shared the sentiment, «We value Europe, but to expand, we must leave.» This statement deserves profound reflection. A continent unable to keep its visionaries is gradually surrendering its own future.
The defining race of this century won’t be decided by the first to invent, but by those who can fund, test, manufacture, and scale innovations fastest. The United States combines vast capital reserves with a large domestic market that promptly rewards ambitious ideas. China channels significant public investment not only into science but also its commercialization.
Reasons behind the EU’s need for a ‘Fifth Freedom’
As leaders across the Atlantic propose ‘reshoring’ industries, Europe faces a critical question: reshoring to what exactly? Without a sizable, open, and investment-worthy health market, no strategy papers alone will entice companies back or keep them rooted here.
This insight prompted me to propose the concept of a Fifth Freedom, adding to the existing free movement of goods, services, capital, and people: the unrestricted flow of knowledge, research, and innovation throughout Europe. This would allow a start-up based in Lisbon to access investors in Paris, collaborate with scientists in Warsaw, and set up manufacturing in Milan, all without crossing an ocean.
European biotech founders should not be forced to leave the continent
The health sector exemplifies both the issue and the opportunity. Europe’s public health systems house some of the most valuable medical knowledge globally, which, if responsibly harnessed and shared across borders, could position the continent as a leader in future medicine. The science is in place. What remains lacking is the determination to link these assets, finance their development, and foster growth at a continental level.
Europe cannot continue to be stuck between exceptional scientific research and a fragmented market. The Fifth Freedom offers a pathway forward — and the benchmark is straightforward: future generations of European biotech pioneers should be able to establish their ventures, secure investment, and serve patients without ever needing to leave Europe.