Germany's "National Decade Against Post-Infectious Diseases"

I see it the other way: it leaves the door open. But I only see it this way because it literally always happens like this. It should be banned entirely from this program, for the same reasons why faith healing and any other form of pseudoscience would be, on grounds of validity and quality of proposals alone.

I have zero doubt that plenty of resources will be wasted on psychosomatic nonsense, because it's always disguised, and this language easily allows it. Plus there is all the pressure that will happen in secret, behind closed doors, which is where 99% of decisions are made.

The emphasis on clinical trials is also problematic. Clinical trials are not viable without a plausible mechanism to address a known pathophysiology, and we don't have that yet. Given everything that's happened with the debacle of LC research, it's very clear that money spent on clinical trials is entirely wasted at this stage. This is especially problematic because trials take years to slowly cruise from one end of the pool and back. They are one of the least effective and efficient processes known to humanity, and almost never work out, even when we know what to target. Which we don't.

If someone has a plausible mechanism for a drug that might work, it would be far more efficient to do basic research to validate this mechanism, rather than trying anything that might affect it. It's faster and cheaper, while actually serving the purpose.

This is not encouraging at all.
There are the acyclovir responders like me and there's herpes abortive lytic reactivation theory and acyclovir has a very good activity against EBV early phase "mise-en-place" work of virus replication.

I feel not taken seriously with these ideas on this forum since months because half of the forum is obsessed with fighting PBW nonsense like you and the other half with the hypes around the drug study of Fluge and the genetics and machine learning project at Edinburgh.

I agree with you at least on the emotional plane. Yes, it's very frustrating.
:)
 
There is no reason to ban a field explicitly if the quality assessment by the grant panels is good enough because bad research won’t get through it then. And they’d still find ways to get the research framed as biological, e.g. by doing some basic bloodwork alongside the CBT or whatever.
This is the reason to ban it, because it always slips through with overt misrepresentation, which everyone involves is aware of, and it only works because those making the decisions want it to pass through with overt misrepresentation, they think it's fine to do it this way.

We saw how it went in Norway, with language that banned it, and most of the money was grabbed by psychosomatic ideologues anyway. It's not just that it has to be banned, it should be an over-the-top ban that explicitly guards against dishonest attempts at misrepresenting the research objectives, because this happens a lot. It's like that one thieving client at a bar that keeps disguising themselves so the bar has to post photos of the person with their multiple disguises, explicitly reminding how devious they are and to look out for anyone resembling them.

When people have a history of malfeasance, the rules guarding against them have to be very explicit about how they operate, and especially the ways by which they game the system. I know it won't happen, but this is what's needed to produce good outcomes. We never see good outcomes, because overt misrepresentation is the norm on issues like this.
 
This is the reason to ban it, because it always slips through with overt misrepresentation, which everyone involves is aware of, and it only works because those making the decisions want it to pass through with overt misrepresentation, they think it's fine to do it this way.
I don’t think it’s even possible to design rules that would exclude all psychosomatic research on the basis of being psychosomatic.
 
I don’t think it’s even possible to design rules that would exclude all psychosomatic research on the basis of being psychosomatic.
I agree, doesn't matter how well you try to cover all bases they have just changed the name, the reason and what is done to constantly keep it evolving as the science catches up and proves its harmful. Everyone is on rehab now for autonomic dysfunction, its still just CBT and GET with a new name and reason for doing it. They will always find a way. You have to actually remove the people selecting this stuff for funding in the committees or its always going to keep getting funded. Its a belief system impervious to evidence and does not care about the measured real consequences to patients at all.
 
Statement from mecfs.de:

Machine Translation:

New Funding Initiative for Clinical Trials​

An Opportunity for Meaningful Patient Involvement​

Through the National Decade Against Post-Infectious Diseases, the German Federal Government aims to sustainably strengthen both research and healthcare for conditions such as ME/CFS and Long COVID. A key component of this initiative is the recently published funding guideline for clinical trials with high relevance to healthcare. It is intended to stimulate the development of evidence-based diagnostics and treatments while also creating new opportunities for the systematic involvement of patients in research.

The funding guideline is structured into three main modules:

Module 1 supports exploratory and confirmatory clinical trials. Funding is available for multicentre, prospective, randomized, and controlled studies designed to demonstrate the efficacy of diagnostic or therapeutic interventions. Exploratory clinical trials with smaller patient populations (Phase IIb studies), which serve to prepare larger multicentre confirmatory trials, are also eligible for funding.

Module 2 supports novel, high-quality systematic reviews that synthesize and evaluate the existing evidence from clinical studies. These reviews should have clear relevance for clinical practice and for people living with post-infectious diseases.

Module 3 funds concept development phases during which clinical studies are designed with the active involvement of patients and other relevant stakeholder groups.

Together, these three modules enable a continuous development pathway—from evidence synthesis and participatory study design to the implementation of clinical trials.

A mandatory requirement of the funding programme is the integration of patient involvement, which is treated as a core element rather than an optional addition. All applications must explicitly describe how patients will be involved, and the quality of patient engagement will form part of the evaluation process. Module 3 is particularly significant in this regard, as it specifically funds participatory concept development. Patients are expected to play an active role in shaping study designs through intensive consultation—for example, by helping to identify target populations, contributing to initial feasibility assessments, or participating in the development of study protocols. Different levels of participation are possible, ranging from intensive consultation to genuine research partnerships.

The funding programme has been deliberately designed with a broad thematic scope, creating opportunities to extend research beyond Long COVID. This includes advancing research into conditions such as ME/CFS following infectious triggers other than SARS-CoV-2, as well as Postural Orthostatic Tachycardia Syndrome (POTS). At the same time, the wide range of potential research topics requires careful prioritisation and strong scientific justification. To ensure that funded projects make a meaningful scientific contribution, proposals should build on the existing body of knowledge regarding the symptoms and pathophysiology of ME/CFS and use this evidence as the foundation for study planning and the rationale for the proposed research. Since the funding call explicitly focuses on post-infectious causes, there remains a risk that patients without a clearly identifiable infectious trigger may not be adequately represented.

The funding guideline represents an important step forward. Key demands from patient organisations—particularly the call for structured patient involvement—have been incorporated into the programme. Its ultimate success will depend on the quality of the submitted projects and on the active collaboration of all stakeholders involved.

The German Society for ME/CFS is available to support researchers throughout this process, both by providing advice during the development of study concepts and by serving as a collaboration partner to ensure meaningful and effective patient involvement.

Link to information on the website of the German Federal Ministry of Research, Technology and Space (BMFTR):
 
Machine translated Tweet by NichtGenesen:
@NichtGenesen
National Decade: We received feedback from a university hospital that would like to conduct ME/CFS research.
The PAIS call for proposals appears to be open to ME/CFS research, but it blocks important pilot studies: single-centre projects are only permitted "in exceptional cases," while multicentre studies are mandatory.
At the same time, additional centres are only allowed to recruit participants—without receiving their own budget.

The lump-sum reimbursement of €1,200 per patient is entirely unrealistic for complex ME/CFS studies.
It is expected to cover staff, diagnostics, treatment, and follow-up.
Many hospitals simply cannot afford to conduct such studies under these financial conditions.

This creates a contradiction: multicentre studies are required, but the funding model makes them financially unfeasible.
The model is designed for conventional large-scale clinical trials and is poorly suited to the exploratory ME/CFS projects that are urgently needed.
As a result, the call for proposals provides only limited support for current ME/CFS research.

HNL3_tvXsAAhvC3.webp
Machine translation of the graphic:

1. What is this about?

This concerns a new funding call for ME/CFS research (PAIS).

On paper, it sounds promising—but in practice there is a major problem.


Purpose of the funding:

Clinical studies are intended to test new treatments and approaches for ME/CFS—especially exploratory pilot studies.

This is important and welcome.

We need more ME/CFS research—but the funding rules make it very difficult.



2. Multiple study sites are mandatory—but there is hardly any funding for them

The funding call states:

Studies should be conducted at multiple hospitals (multicentre).

This means:

At least one additional hospital must participate and recruit patients.

The problem:

These partner hospitals do not receive their own budget. Instead, they receive only a fixed reimbursement of €1,200 per patient—regardless of how complex the study is.

The catch—and this is crucial:

If this reimbursement is insufficient for the partner hospital, it will not participate.

Without a partner hospital, there is no multicentre study.

And without a multicentre study, funding is often unavailable under the rules of this call.

As a result, a study may fail before it even begins.


3. Why is this a major problem for ME/CFS?

ME/CFS studies are often particularly complex and resource-intensive.

  • Extensive diagnostic assessments
  • Trained staff and study nurses
  • Treatment
  • Documentation
  • Follow-up over several months
All of this costs far more than €1,200 per patient.

Many hospitals cannot afford these studies and are therefore unlikely to participate.



4. Why doesn't this model fit ME/CFS research?

For large drug trials, it works better:

✓ Many hospitals participate

✓ Each hospital recruits large numbers of patients

✓ Procedures are highly standardised

✓ Fixed per-patient reimbursement is often sufficient

ME/CFS studies are different:

✗ Small exploratory pilot studies

✗ Complex diagnostics and treatments

✗ More time and patient support required

✗ Significantly higher workload per patient

This standard model is not a good fit.


5. Our conclusion

The rules of this funding call have largely been adopted unchanged from traditional clinical trials.

The requirements do not match the needs of ME/CFS research.

The funding is insufficient to enable meaningful studies.

This makes urgently needed research and progress for patients more difficult.

We need funding rules and financing that are tailored to ME/CFS—so that research can actually be carried out.

ME/CFS research needs support—but it also needs to be genuinely feasible.



Official guide in German:
Guidance for Preparing Project Outlines under the Funding Guideline "Clinical Studies of High Relevance for the Care of Patients with Post-Infectious Diseases – National Decade Against Post-Infectious Diseases"
 

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Response of the Federal Government
to the Minor Interpellation submitted by Members of Parliament Sonja Lemke, Nicole Gohlke, Dr. Michael Arndt, other Members of Parliament, and the parliamentary group Die Linke
– Bundestag Printed Paper 21/6613 –
National Decade Against Post-Infectious Diseases

The full document in German:

A summary in German found on Twitter by @Community4MEcfs
Corresponding Machine Translation:
Minor Interpellation by the Parliamentary Group The Left (Bundestag Printed Paper 21/6613)
Summary of the Responses by State Secretary Hauer

Our comments are indented.

  1. The key issues paper is not a working basis for the National Decade for Post-Infectious Diseases (NDPE). However, it was taken into account.
This does not actually say anything.
  1. There will be no major national health challenge, contrary to what is envisaged in the key issues paper.
  2. The Federal Government does not intend to ensure the "binding and equal integration of patient representatives into all decision-making and governance bodies of the Decade," as provided for in Pillar 6 of the Lauterbach–Albani paper. This is evident from the fact that patient representatives are not included among the partners listed in the response.
  3. No answer is provided to the question of the criteria used to select the partners for the National Decade.
  4. Unlike the National Decade Against Cancer, and contrary to what is envisaged in the Lauterbach–Albani paper, the NDPE does not require representation from the healthcare delivery sector, such as the German Medical Association, among its partners.
  5. No answer is provided to the question of why, unlike the National Decade Against Cancer and contrary to the Lauterbach–Albani paper, there is no patient or affected persons' organization among the partners of the National Decade.
  6. In addition to participating in the Steering Committee, partners may contribute their expertise and are co-signatories of the joint declaration.
It remains unclear why affected persons were not allowed to participate. However, this was not part of the question.
  1. The partners are not planning any activities beyond participating in the Steering Committee and making use of funding.
This undermines the argument that the NKSG was excluded because it receives funding. Presumably, all partners receive funding, since according to the BMFTR this is the only activity they undertake in addition to participating in the Steering Committee.
  1. Members of the Steering Committee are selected on the basis of their professional expertise, their institutional role within the healthcare and research systems, and their thematic relevance to the field of post-infectious diseases.
Is the BMFTR claiming that there is only a single patient organization with relevant expertise? To what extent does the NUM have expertise in PAIS? Or the G-BA Executive Office?

  1. The Steering Committee has no decision-making authority.
  2. Participation in the Steering Committee is entirely voluntary and unpaid.
  3. The Steering Committee has no decision-making authority.
  4. The Steering Committee has no decision-making authority.
Regarding Questions 10–13: The key issues paper referred to the "binding and equal integration of patient representatives into all decision-making and governance bodies of the Decade." However, there is now no involvement of patient representatives in any decision-making bodies.

  1. To date, the Steering Committee has met only once every six months.
Intensive oversight.
  1. No answer is provided to the question of how the working groups are composed. No additional working groups are planned.
  2. No answer is provided as to the specific remit of each working group. The only information given is what can be inferred from the respective working group's name.
  3. The second "patient organization" is the Office for Patient Participation in the Innovation Committee of the Federal Joint Committee (G-BA).
  4. The question of how this office contributes the expertise and perspectives of affected persons was reinterpreted (the response: "orally and in writing"), and the actual question was therefore not answered.
  5. The inclusion of specific scientific expertise or specific patient perspectives (e.g. those of affected children and adolescents) in the work of the Steering Committee is not planned, although such input could theoretically be requested in individual cases.
  6. The additional participation format for patient organizations consisted of a one-off meeting and a questionnaire sent to the organizations. There are no plans for further participation, only an "intention."
  7. Psychosomatic medicine is not excluded, but it is not a priority.
  8. At present, there are no plans to fund anything other than biomedical research.
  9. Psychosomatic medicine is not excluded.
  10. Mental health is incorporated into the National Decade in the sense of a holistic approach. There are no plans regarding the scope of future measures in the areas of mental health, psychosomatic medicine, or BPS.
  11. There are no plans regarding the allocation of funding between basic research, health services research, clinical research, or research infrastructure.
No information is provided on the allocation of funding for this year.
  1. There is no funding for drug development. Funding is limited to basic research and clinical trials.
The highly relevant stage in between, where Mitodicure operates, is not being funded. The BMFTR explicitly acknowledged that this stage is part of drug development, yet it does not appear among the activities eligible for funding. They are therefore aware that they are leaving this critical stage unsupported.
  1. Disease subgroups are acknowledged as relevant, but no answer is given as to how appropriately defined cohorts will be ensured.
  2. Bär's statement before the Research Committee on 25 March 2026 that parts of the reporting on the establishment of the National Decade were "wrong from beginning to end" refers to the claim that the BMFTR had seen no need for additional funding for ME and Long COVID.
This is correct insofar as the Ministry did identify an additional funding need of approximately €10 million. That said, the National Decade itself was established by the Bundestag, whereas the Ministry had not sought such an initiative.
  1. The Steering Committee has no authority over the allocation or use of funding.
  2. Apart from funding provided through the federal budget, the BMFTR is not aware of any additional public or private funding.
31–33. Table on awarded and committed funding for the period 2026–2030. Key points include:

  • Almost all funded projects have already been running for several years. These therefore appear to be reallocations of existing funding rather than new investments.
  • Only two projects, with combined funding of €6.7 million for 2026, are genuinely new. These projects run until 2027 and 2028, respectively.
  • No additional new funding commitments beyond 2026 have been made so far.
  • The NKSG is scheduled to receive a total of €4.6 million in 2026 (including previously committed funding).
  • The expansion of the NUM data infrastructure will receive €4.3 million in 2026—almost as much as the NKSG.
  • In total, only €22.2 million has been approved for 2026.
  • Approximately €26 million is planned under the current funding guideline.
  • It remains unclear how much of this funding actually represents new money.
  • To date, only a relatively small proportion of the planned funding has been approved.
  • It also remains unclear whether NDPE funding had already been spent in 2025, as suggested by the Federal Government's response to a minor interpellation by the Green parliamentary group.
  • Funding is appropriated annually through the federal budget. Consequently, any funds that are not committed during the respective budget year simply lapse.
  1. Within the framework of the "Alliance for Post-Infectious Diseases," no activities or projects are planned other than exchanging information.


Question 24 and answer from the official document about grants for psychosomatic research:

23. Does the Federal Government rule out funding research projects that pursue psychosomatic explanatory approaches from the funds allocated to the National Decade?

24. What is to be funded, and to what extent, under the project funding subtopic "Mental Health" announced in the Joint Declaration on the National Decade, and what role will psychosomatic or biopsychosocial approaches play in this context?

Questions 23 and 24 are answered together.

There are currently no funding measures planned that explicitly target psychosomatic projects. A general exclusion of individual disciplines or topics is not envisaged. With regard to the prioritization of topics, reference is made to the answer to Question 21.

The topic of mental health also forms part of the discussions on shaping the National Decade Against Post-Infectious Diseases, in the sense of a holistic approach to post-infectious disease. There are no plans regarding the scope of any future project funding measures in the area of mental health or in the context of psychosomatic or biopsychosocial approaches.
 

Machine Translation:
"The Federal Government Is Failing to Deliver"
€500 Million for ME/CFS — But the Funding Still Hasn't Reached Patients
The Federal Ministry of Research has earmarked €50 million for the “National Decade” initiative in 2026 alone.
But responses from Dorothee Bär’s ministry to a parliamentary question from the Left Party reveal that not even half of that amount has so far been approved—just over €22 million, according to the ministry.
By mid-July, only €5.1 million had actually been spent.

Moreover, it remains unclear how most of the total €500 million will actually be used.
According to the ministry’s response, only about one-tenth of the total—just over €56 million—has so far been approved for funding measures through 2029.
The response also states that there are no “plans for the allocation of funds” across the various research areas.
Instead, further funding decisions will be made “based on needs and adapted in light of current research findings,” while taking the respective research fields into account.

“The federal government made major promises with the National Decade and raised great hopes, but it is failing to deliver.
There is a real risk that allocated funds will go unused,” Left Party MP Sonja Lemke told our newsroom.
Lemke criticized the fact that there was “no sign” of the concerted national effort that had been promised.
“If things continue this way, the Decade will become a major disappointment.”

To change course, she said, the federal government must “quickly adopt a different way of working.”
The Left Party lawmaker also called on the government to treat the National Decade “as a major political priority.”
In addition, Lemke argued that people affected by ME/CFS should be given greater decision-making authority.
At present, there is only an advisory body that includes people with lived experience, but it has no decision-making powers.
 
From Sonja Lemke (Die Linke) on Instagram / Imginn (no account required):


Posted On: September 18th, 2026, 11:27 am​
€50 million was supposed to be allocated to research into ME/CFS in 2026. However, our inquiries have shown that only a fraction of this amount has actually been spent, and it is likely that almost half of the funding will go unused!
This must not be allowed to happen! Research into treatments and a cure must finally be carried out, because ME/CFS is a serious illness. €50 million is already far too little, and at the very least, this funding must finally be used for research as intended!​




Explanation from X:



Anja @Annifragtnach​
I headed a research department for many years. When funding is not drawn down, it is usually because there were not enough eligible projects capable of utilizing the full amount of funding available. The funds then usually lapse.​
In most cases, a panel of experts decides on funding applications to ensure that the intended purpose of the funding is met and that the required quality standards are satisfied. Either there were too few applications, the amounts requested were below the total funding available, or the applications did not meet the panel’s requirements.​



 
However, our inquiries have shown that only a fraction of this amount has actually been spent, and it is likely that almost half of the funding will go unused!
That's really a shame and what I have been afraid of. Money's there but now we're lacking the (interested) researchers. Still somewhat hopeful that there will be a 'bootstrapping' process in the first years.

TU Munich and multiple groups at Charité seem to be at it. Then there's seems to be activity at Hanover, Frankfurt, Jena and Leipzig.

But there's many 'prestigious' (whatever that's worth) universities, where are they? A bit hopeful that Tuebingen will get involved with INCAP and CONFIDENCE (although these are 'just' care projects so far). Freiburg has a post-infectious ward. Heidelberg seem not to care so far. Would really love to see some neurology involvement.
 
That's really a shame and what I have been afraid of. Money's there but now we're lacking the (interested) researchers. Still somewhat hopeful that there will be a 'bootstrapping' process in the first years.

TU Munich and multiple groups at Charité seem to be at it. Then there's seems to be activity at Hanover, Frankfurt, Jena and Leipzig.

But there's many 'prestigious' (whatever that's worth) universities, where are they? A bit hopeful that Tuebingen will get involved with INCAP and CONFIDENCE (although these are 'just' care projects so far). Freiburg has a post-infectious ward. Heidelberg seem not to care so far. Would really love to see some neurology involvement.
Is this money available outside Germany? Could we start a grassroots campaign to put the unatttributed funds at year end toward SequenceME?
 
Is this money available outside Germany? Could we start a grassroots campaign to put the unatttributed funds at year end toward SequenceME?
Not really:

Cooperation with thematically related projects in other European and non-European countries is possible, provided that the international partner generally has its own national funding for its share of the project. Additional costs incurred, for example, for scientific communication, the organization of workshops and working meetings, visits by early-career researchers (doctoral students and postdoctoral researchers) to external research institutions and clinics, and invitations extended to visiting researchers are generally eligible for funding where synergistic effects can be expected as a result.

If cooperation with a foreign research group is necessary for carrying out a substantial subproject, personnel and material costs may be eligible for funding in the form of a “subcontract.” The need for such cooperation and its scientific added value must be justified.

Contributions toward membership in the Technology and Methods Platform for Networked Medical Research (TMF e. V.; see http://www.tmf-ev.de/Mitglieder/Mitglied\_werden.aspx) are eligible for funding under these funding guidelines if membership in the TMF contributes to the progress of the project and, consequently, to the achievement of the project’s objectives.

If the participation of clinical institutions from abroad in clinical trials is necessary, funding for case-based flat-rate payments abroad may be eligible.
Source:

Google Translate:
 
Had a quick glance, and seems like only academic institutions in Germany are eligible, there's the possibility of subcontracting but there's some limitations on that as well.
Ah fair enough.

Maybe we could find a German clinician who would be interested in Buspirone/prolactin?

Or even a competent one who could do a small Campath trial?

One to collaborate with @jnmaciuch to collect the muscle samples she was after a while back?

Etc.

Maybe these are pipe dreams and/or not possible so late in the year but its so frustrating when there are things we could be doing and moneys going to waste
 
Maybe these are pipe dreams and/or not possible so late in the year but its so frustrating when there are things we could be doing and moneys going to waste
I really think this might be worth a shot, but I don't know how to best do it. Cold-emailing is so ineffective (but not entirely hopeless), especially when it comes from patients.

The best way (at least in my field) would be to bump into someone at a conference and strike up a conversation. But even then, it needs a lot of luck because people are often reluctant to do something that is even slightly outside their area and most researchers are overworked anyway, so every project you pitch needs to compete against what they have on their plate anyway. A good argument is readymade funding of course, but how to go about that?

The first step would probably to have a set of researchers and research groups and a good idea where their interests lie, so one can pitch the appropriate projects. If it doesn't tie in with their existing work, chances are probably slim.

Happy to be corrected by someone from the field or with more experience in academia.
 
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