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

A 1000 word article by Martin Rücker on the decision of the german government to invest 500 million euros in the next decade to research post-infectious diseases:


Research Decade Against Post-Infectious Diseases: The 500-Million Boost

A Historic Government Initiative

Germany’s federal coalition is launching a “National Decade Against Post-Infectious Diseases,” the world’s largest state-funded program for researching Long Covid, ME/CFS, and related conditions. While the United States retreats from earlier initiatives, Germany plans to invest 500 million euros over ten years. The funding is framed as an investment in the future of hundreds of thousands of affected adults and children, as well as in the country’s scientific landscape.

The Scale of the Research Gap
Although the sum appears large, 50 million euros per year is modest for clinical studies that might lead to approved treatments, especially given gaps left by the pharmaceutical industry. ME/CFS has been known for more than 50 years with minimal research, and many pathogens besides SARS-CoV-2 can trigger long-term illness. Some patients recover, but others become chronically ill or even bedridden, making increased research urgent.

Political Delays and Activism
The initiative also highlights failures in research policy. Although former health minister Karl Lauterbach recognized the scientific need, he publicly called it “state failure” only after leaving office. The eventual breakthrough resulted from determined activism: protests, letters, and persistent dialogue by severely ill people and their families. Their efforts underline how difficult it is for patients to receive support, especially with ongoing poor healthcare provision.

Internal Conflicts and Media Missteps
Some activists overshot their goals, at times attacking supportive politicians or researchers. Their frustration grew as certain scientists continued to frame Long Covid and ME/CFS as psychological despite contrary evidence. Media coverage often amplified conflict and sometimes misrepresented budget negotiations, risking public support and potentially endangering the research decade.

Ensuring Effective Use of Funds
The challenge now is to allocate the money wisely. Past examples, such as state-funded Kneipp-therapy studies in Bavaria, show how funds can be misdirected. The decade’s success depends on supporting researchers with real clinical experience in post-infectious conditions. If done well, Germany could face the future far less uncertain than today.
 
Is there a risk of BPS ideology shaping this new project? I’m not aware of how the situation with BPS is in Germany.
Yes, germany’s neurology association is spouting unfounded BPS stuff:
 
Is there a risk of BPS ideology shaping this new project? I’m not aware of how the situation with BPS is in Germany.
They are for sure going to grab and waste a big part of this budget. The only viable goal is to keep this as low as possible, and given the history, even 50% actually spent on useful research would be a big win. Zero chance it can be fully utilized, unfortunately. Germany has a very strong psychosomatic tradition.

As long as we avoid a disaster like in the Netherlands, where all the funding was captured by quacks even though it was explicitly meant to go to anything but them. This is just how medicine does its thing, I guess. It's not slow and expensive just because it's a difficult and expensive industry.
 
How I wish I could welcome this news with unmitigated joy. Alas, we’ve seen in the US how quickly an enormous amount of money can be wasted if you don’t get the settings right from the start. We really don’t want to see that history repeating itself

Any chance the German patient organisations can push for something similar to the DecodeME PPI steering group (with adherents of the psychosomatic faith excluded from membership, ditto ideally those who believe any one of the many hypotheses is fact and the one and only truth)?
 
Any chance the German patient organisations can push for something similar to the DecodeME PPI steering group (with adherents of the psychosomatic faith excluded from membership, ditto ideally those who believe any one of the many hypotheses is fact and the one and only truth)?
DecodeME was unique in that everyone on board knew this was important, so this is unlikely to be replicated at such a large scale. But there might be a way to at least have one such group, even if it means essentially two groups being split apart between the real science and the pseudoscience folks. It would probably even be good if it were explicitly so.

That would be worth pushing for, it's much better to have half the program know what they're doing than the whole thing become a total waste by trying to find a bridge between the ideologues and the realists and pleasing no one in the process.
 
They are for sure going to grab and waste a big part of this budget. The only viable goal is to keep this as low as possible, and given the history, even 50% actually spent on useful research would be a big win. Zero chance it can be fully utilized, unfortunately. Germany has a very strong psychosomatic tradition.
Given Germany's current medical system and the researchers involved 50% is the best we can hope for. I would say its more realistic that we get maybe 5 million a year into real research and the rest gets wasted and used against us. That seems to be about the ratio in Europe generally and we shouldn't set hopes higher than that. Just handing out money it will go to the people who did all the harm to begin with, they are after all the experts with research experience. Unless the German government wake up to the reality of the situation and set things up properly we really can't hope for more than about 1 good study out of this a year, if that. There is still every chance this literally ends up funding the best funded PACE 2.0 trials you have ever seen.
 

Health minister Warken about the initiative:
“We want to help affected people in their everyday lives”: Minister Warken pushes for improved care for Long Covid patients

The German federal government aims to support people suffering long-term effects of the Covid-19 pandemic through expanded research and improved medical care. Health Minister Nina Warken and Research Minister Dorothee Bär have launched a ten-year initiative on “post-infectious diseases,” funded with 50 million euros annually.

Long Covid is described as prolonged severe exhaustion and reduced performance, and there is currently no specific medication available. Warken stated that the goal is to help affected individuals in daily life, raise physicians’ awareness, and enable the use of existing medications where possible.

The initiative seeks to strengthen networking between doctors and researchers and to establish more clinics providing rapid, local assistance. According to Warken, the government plans a parallel approach: pursuing research, bringing new medicines to market, improving understanding of the illness, and enhancing patient care. She emphasized the need for basic research to develop effective treatments.

The minister also announced intensified exchange with the medical community and researchers to identify where concrete improvements in diagnosis and care are needed. Regarding the absence of approved medications so far, Warken explained that the disease first needs to be understood, but the moment has now come to bring medicines quickly to patients.
 
Long Covid is described as prolonged severe exhaustion and reduced performance, and there is currently no specific medication available.
Well then we are in real trouble because that isn't correct at all. Is this yet another initiative where they just make it all about fatigue, the 1980s on replay again and again.
The initiative seeks to strengthen networking between doctors and researchers and to establish more clinics providing rapid, local assistance.
That scares me a bit, what is it they will be offering exactly since they admit rightly they have no drugs and need research to work out what to do?
According to Warken, the government plans a parallel approach: pursuing research, bringing new medicines to market, improving understanding of the illness, and enhancing patient care. She emphasized the need for basic research to develop effective treatments.
Well indeed, but these are serial things, you understand the disease, then you develop medicines to target it and then that enhances patients care.
The minister also announced intensified exchange with the medical community and researchers to identify where concrete improvements in diagnosis and care are needed. Regarding the absence of approved medications so far, Warken explained that the disease first needs to be understood, but the moment has now come to bring medicines quickly to patients.
[/SPOILER]
There is little point asking medicine what to do, they don't believe the disease even exists. Ask the people who understand the disease what the heck needs to be done! How do you bring medicines quickly to patients if you don't yet understand the disease?!

This just shows no clarity of thought on what they are actually doing and why and how it should be organised. They don't understand the disease, the problem with the research so far, the problem with healthcare provision nor how to address any of it. This is a recipe for another its all fatigue disaster.
 
Well then we are in real trouble
Good points.

Luckily, she sounds much more coherent in this interview:

It is about helping people who are ill, said Minister Warken on the ARD Morgenmagazin: “Helping them in their daily lives, supporting them, raising greater awareness among doctors, and already approving medications where possible that already exist for other diseases.” She said she keeps hearing that those affected are not taken seriously and that symptoms go unrecognized. That should change.​
When asked why there is still no approved medication for Long Covid, Warken replied: “Because, of course, the first step is to research where this illness comes from and what defines it.” In the long term, more basic research on Long Covid is needed — something the government now intends to pursue, said Warken. New medications should therefore be brought to patients quickly.​
The goal is to bring doctors and researchers together to determine where exactly improvements are needed — both in diagnosis and in patient care. In terms of care, more outpatient clinics are to be established so that “help can be provided quickly and close to home,” Warken said.​
 
One of germany‘s most provocative ME/CFS deniers, Professor Kleinschnitz, xcreeted this:
@prosieben @sat. 1 hatte mich heute kurzfristig um ein Interview zur nationalen Dekade gegen postinfektiöse Erkrankungen gebeten (Long-Covid, MECFS). Heute ab
Nachmittag/Abend in deren News-Formaten.
Zur Erforschung dieser Erkrankungen sollen 500 Mio Euro (!) zur Verfügung gestellt werden. Ich halte das in Anbetracht der aktuell massiven Budgetkürzungen bei Universitäten und in anderen Bereichen der Forschung und Gesundheitsversorgung für eine eklatante Fehlverteilung von Mitteln. Keine Krankheitsgruppe hat bisher solche politische Aufmerksamkeit bekommen. Wir bräuchten stattdessen dringend mehr Gelder zu weiteren Erforschung, z.B. von Krebs, Herzkrankheiten oder Demenzen. Die Long-COVID Betroffenen leiden ohne Zweifel und benötigen kompetente Hilfe. Wie haben @neurologie.essen selber 1000ende dieser Patienten behandelt. Fakt ist, dass sich so gut wie nie organische Auffälligkeiten finden lassen, dafür so gut wie immer eine
psychosomatische Ursache zugrunde liegt. Bleibt zu hoffen, dass dieses gigantische Förderprogramm zumindest nicht nur weiter nach den unwahrscheinlichen körperlichen Ursachen schaut und Tabletten entwickeln will, die es nie geben wird,, sondern v.a. auch psychosomatische Forschung zulässt und dafür sorgt, dass Menschen endlich schneller und einfacher Zugang zu Psychotherapeuten
bekommen.

@prosieben @sat.1 asked me at short notice today for an interview about the national decade against post-infectious diseases (Long Covid, ME/CFS). It will air this afternoon/evening in their news formats.

A total of 500 million euros (!) is to be made available for research into these diseases. In view of the current massive budget cuts at universities and in other areas of research and healthcare, I consider this an egregious misallocation of funds. No disease group has ever received this level of political attention. Instead, we urgently need more funding for further research into, for example, cancer, heart disease or dementia.

There is no doubt that people with Long Covid are suffering and need competent help. At @neurologie.essen we ourselves have treated thousands of these patients. The fact is that organic abnormalities are found only in extremely rare cases, while there is almost always an underlying psychosomatic cause. One can only hope that this gigantic funding program not only continues to search for unlikely physical causes and tries to develop medications that will never exist, but above all also allows for psychosomatic research and ensures that people finally gain quicker and easier access to psychotherapists.

1763563868142.jpeg
 
Reddit thread that includes a post by Kleinshnitz, a German Michael Sharpe analogue, saying something about trying to derail this, though not sure of the specifics as it isn't translated. Includes steps to take and a suggestion to write to the government, with a sample text.

Help saved the german funding to not be seen as a waste by society
Here’s the translation of the well written email template from this reddit post:
One of the biggest German TV channels is hosting a show where they only want to invite a ME-critical neurologist who claims that research funding is completely wasted on ME. This will turn so much hatred against us and could potentially affect how funding is used.

Everyone can write an email to kontakt@prosiebensat1digital.de

Text you can use:

Dear ProSieben Sat.1 Team,

I am writing to ask why you have invited Christoph Kleinschnitz for your segment on the National Decade against Post-Infectious Diseases—a man known for his unscientific and fact-detached criticism of ME/CFS and Long Covid. With his statements, he directly opposes both the WHO and the consensus of experts conducting research on ME/CFS.

Have you invited any other experts who are familiar with the current state of research?

Contrary to Mr. Kleinschnitz’s repeated claims, there are now plenty of studies demonstrating that many bodily processes in ME/CFS do not function as they should. There are numerous publications and interviews with researchers such as Professor Scheibenbogen. I would like to refer you to the Charité’s clinical practice guideline, which links to extensive studies, as well as the German ME/CFS Society (https://www.mecfs.de/).

I would also like to point out that ME/CFS has long been among the most severely underfunded diseases. Despite a higher number of affected individuals, it has received less funding than, for example, MS. The National Decade is urgently needed to address decades of neglect and to make up for the research that has been missed. Each year, more people fall ill with ME/CFS and Long Covid following infections. Unlike diseases such as cancer or MS, there are still no effective treatment options covered by health insurance.

Patients who have been left alone by medicine and the state for decades suffer from an illness whose severity is, on average, higher than that of MS, some types of cancer, or COPD. Such a serious disease must be researched.

With overall societal costs of 63 billion euros per year and more than 1.5 million affected people (with numbers rising), it is of universal importance for German society and the economy to better understand these diseases and find a treatment.

I hope you will live up to your journalistic responsibility and contextualize Mr. Kleinschnitz’s statements in accordance with the current state of research so as not to spread misinformation. Otherwise, my family, friends, and I will feel compelled to refrain from watching your channels in the future.

Kind regards
 
ProSieben and SAT1 are big and popular TV channels. I guess they are comparable to ITV.
It's awful to have someone this arrogant and unpleasant to present the wrong side of this story, but in a way this is preferable to someone with good political instincts. Whenever someone like this is a goto spokesperson, you are 100% on the wrong side of history, and he's more likely to turn people away from the old tropes by simply being so damn unpleasant.
 
It's awful to have someone this arrogant and unpleasant to present the wrong side of this story, but in a way this is preferable to someone with good political instincts.
Indeed, there’s even a full length satire show episode on ME/CFS that showcases this guy’s worst Xcretions (he tried to delete some of his posts but pwME have been collecting snapshots systematically over time):
 
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Long COVID and ME/CFS: Ministries Launch “Alliance for Post-Infectious Diseases”

Berlin
– To improve care for people affected by post-infectious diseases, the Federal Ministry of Health (BMG) and the Federal Ministry of Research (BMFTR) have announced closer, better-coordinated cooperation. Health Minister Nina Warken (CDU) and Research Minister Dorothee Bär (CSU) launched the “Alliance for Post-Infectious Diseases: Long COVID and ME/CFS” in Berlin.

An initial kickoff event was held today at the Health Ministry. This is an important joint signal from the ministries, involving affected individuals and experts alike, Warken said. The goal is to more closely link basic and clinical research with health services research in order to achieve progress in diagnosis and treatment as quickly as possible. According to Bär, the new alliance is also about closer networking with researchers, healthcare experts, and people living with the conditions.

Late last week, it became known that Germany will establish a National Decade Against Post-Infectious Diseases starting in 2026, intended to boost research in this field with 500 million euros over ten years. Deutsches Ärzteblatt reported on this. According to Bär, the funds will come from her ministry’s budget.

Affected individuals asked for patience

The ministers appealed for understanding that research takes time. “But we want to clearly convey to those affected that they are not alone,” said the Health Minister. Bär emphasized that, given the complex and not yet fully understood disease mechanisms, no cure-all is in sight: “There is no miracle pill that makes everything disappear.” For this reason, research must be strengthened.

Bär also stressed that this is not a fresh start from zero. Several projects had already been launched during the previous legislative period under former Health Minister Karl Lauterbach (SPD). Additionally, there had been repeated exchanges between affected individuals, experts, and policymakers during the Long COVID Roundtable.

Regarding ongoing projects within her ministry, Warken explained that around 118 million euros would be made available for a total of 34 health services research projects through 2028. She emphasized that there had been no cuts to these funds in the federal budget. Initial results are expected to be presented as early as 2026. Furthermore, 16 projects with a total of 30 million euros are being funded through the Innovation Fund of the Federal Joint Committee (G-BA).

Off-label medications: Decision possible in 2026

In addition to the already available therapy guide, the responsible expert group submitted four active substances to the G-BA in mid-October for review as potential off-label-use medications for the treatment of Long COVID, Warken said.

The G-BA is now reviewing the recommendations for plausibility and involving professional circles in the process. The question at hand is whether the statutory health insurance will cover the costs. The minister said they are optimistic that a decision could be reached by mid-2026. Further steps would, of course, have to follow.

As much as those affected long for rapid access to medication and for improvement or even recovery, Bär added that in addition to assessing the effectiveness of potential drugs, it is also essential to ensure their safety. After all, this concerns human lives. Patients who are already weakened must not be exposed to additional harm. The Health Ministry estimates that there are roughly 1.5 million affected individuals in Germany.



Nina Warken and Dorothee Bär Forge Alliance
Ministers Integrate Their Departments in the Fight Against Long Covid and ME/CFS


The goal of the programs is to promote the development of care structures and care pathways. Establishing outpatient clinics for affected children and adolescents is also to be a priority. Additional funding will be provided for this purpose.

Berlin. Federal Health Minister Nina Warken (CDU) and Federal Research Minister Dorothee Bär (CSU) launched the “Alliance for Post-Infectious Diseases: Long Covid and ME/CFS” on Wednesday.

The aim, Warken said at an afternoon press conference in Berlin, is to send a clear message to the at least 1.5 million affected people that they are not facing their illnesses alone. Better coordinated cooperation between the two ministries is intended to more closely link basic and clinical research on Long Covid and ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) with health services research.

Research Minister Bär emphasized the necessity of this foundational work: Worldwide, there are still no therapeutic approaches to cure these diseases. One task of the alliance will be to network with researchers.

According to Warken, the Federal Ministry of Health will provide a total of 118 million euros for 34 projects through 2028. Priority funding will go to care structures and care pathways. Another funding focus concerns, for example, outpatient clinics for affected children and adolescents.

An additional 30 million euros from the Innovation Fund of the Federal Joint Committee will flow into 16 more projects.

The amounts mentioned apparently do not count toward the financial resources of the Decade Against Post-Infectious Diseases. Under this label, the federal government plans to invest a total of 500 million euros by 2036.

Next year, the newly established alliance will focus, according to the Federal Ministry of Health, on the “research and strengthening” of needs-based care for the long-term consequences of Covid-19. This program will focus on “patient-centered and epidemiological research, integrative and innovative care for those affected, as well as information preparation, processing, and education.” Around 22 million euros will be available for this in 2026.

The second funding focus for the coming year aims at “model measures for the care of children and adolescents with Long Covid and diseases with similar causes or disease patterns.” Fifteen million euros have been allocated for this in the budget. (af)


 
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