Insiders, outsiders and the funding of NGOs: Reshaping the heavenly chorus in European Union health policy

For many years the European Commission has directly funded non-governmental organisations (NGOs), seeking to increase the input legitimacy of its policy. Whilst their approaches vary, existing frameworks of insider and outsider interest groups generally concur that this funding is a strong predictor of insiderness, in that it suggests a recognition of legitimacy by the Commission and supports participation in consultation activities. This article examines what happens when such funding is taken away and participation is curtailed. In early 2025, the Commission wrote to NGOs in the heath field instructing them that their EU funds must not be used for lobbying and advocacy activities and, a few months later, cancelled its annual programme of operating grants, the traditional mechanism by which the Commissions has supported health NGOs. These developments raise the possibility of the significant downsizing, and even closure, of the traditional insiders of the EU health policy system, and consequent reduction in the scope and reach of their activities. Understanding the effect of such a decision is hampered by a lack of research – and more fundamentally a lack of data – about the interests represented by NGOs and the extent of their participation in policy processes. This article constructs a new dataset, drawing on the EU Transparency Register, to address (1) an empirical question about the future landscape of interest groups in EU health policy, and (2) a theoretical question about the implications for our understanding of insiders and outsiders.