Risks and rewards of digital therapeutics in treating mental disorders

More Americans than ever before are suffering from mental and emotional distress. In the U.S., the mental health problem is exacerbated by issues across infrastructure, government, and culture. However, because the resources for those living with mental health issues are constrained, startups could have a big impact.

In particular, we believe that digital therapeutic-approaches offer great promise in overcoming the problems inherent in traditional approaches to mental and behavioral therapy. Such problems relate to stigma, cost, and general inaccessibility of cost-effective treatments for the general population.

We are starting to see new energy behind innovators in the mental health space. Examples include Enlyte (discussed in greater detail below); Talkspace, an online therapy app that connects users with licensed therapists; Calm, a sleep and meditation app; and Feel, a wearable designed to monitor the user’s emotional state. Other examples are listed in the Appendix at the back.

Each of these companies—whether they aim to provide easy access to mental health professionals, to promote overall mental wellness, or to better monitor the user’s mental state—has the potential to be highly impactful as well as profitable.

In our view, the time is right to invest in mental health and digital therapeutics. In this paper, we provide an overview of the field of digital therapeutics for mental health, as well as the legal, regulatory and ethical issues that should be considered by entrepreneurs and investors.


Table of Contents


The big four mental health afflictions: Stress, anxiety, addiction, depression

Image via Getty Images / Feodora Chiosea

The mental health crisis costs companies around the world over $1 Trillion in lost productivity and increased health care insurance premiums annually. The productivity losses are primarily caused by absenteeism, and turnover and replacement costs.

In addition, the costs attributable to the family members and loved ones of employees (employee ecosystem) cost employers approximately 250% more in lost productivity than their direct employees. According to a report from the World Health Organization (WHO), 450 million people are currently suffering from mental health disorders leading to illness and disability.

The Lancet Commission on mental health predicts that by 2030, mental illness will cost the world USD 16 trillion. If we look at the US alone, 40.3 million people are affected by the disease of addiction. Twenty percent of US deaths are attributed to addiction to tobacco, alcohol, drugs and other substances.

Stress

The National Institute for Health (NIH) defines stress as a “physiological response to challenge or demand”. There are two forms of stress: acute and chronic. Acute stress is frequently referred to as your body’s fight-or-flight response.

San Francisco is getting closer to an e-cigarette ban to protect kids, but it may hurt adult smokers who use vaping to quit

San Francisco is getting closer to banning the sale of e-cigarettes in the city in a bid to prevent minors from accessing them—but the new legislation may also hurt adult smokers who are trying to quit. The city’s Board of Supervisors today voted unanimously to approve two proposals: legislation that would ban the sale or delivery of e-cigarettes in San Francisco and a separate proposal that would prohibit the sale, manufacturing and distribution of tobacco products, including e-cigarettes, on property owned or managed by the city.

The bill to ban the sale of e-cigarettes at stores in the city, as well as the delivery of e-cigarettes purchased online for delivery to San Francisco addresses, still requires final approval. If it passes (a likely outcome since the board voted 11-0 to pass the ordinance), it will go into effect seven months after it is signed by the mayor. Juul, which is headquartered in San Francisco, has already started lobbying to stop the ban.

The second proposed ordinance to ban the sale of e-cigarettes on city property will require two readings and needs to pass a second vote next week before it can be put into effect. It seems designed to take aim at Juul, since the company’s headquarters are in city-owned buildings at Pier 70. (Juul recently bought an office tower on Mission Street, but says it plans to keep its headquarters at Pier 70.)

Many of the most serious concerns over vaping center on underage use. The Center for Disease Control and Prevention’s research shows the number of middle and high school students who use tobacco products grew from 3.6 million in 2017 to 4.9 million in 2018. The increase was driven in part by e-cigarette use, which rose from 2.1 million in 2017 to 3.6 million in 2018 among middle and high school students.

The use of e-cigarettes by minors is indisputably harmful, especially because nicotine, which is derived from tobacco plants, can harm brain development. Juul, which controls three-fourths of the U.S. e-cigarette market according to Nielsen, has also been accused of contributing to the increase in tobacco product use among teens by lowering the barrier to entry for nicotine addiction. It is currently trying to win favor with regulators by taking steps to prevent underage users from accessing their products.

But a ban on the sale of e-cigarettes may also hurt adult smokers who use vaping to transition off cigarettes. While many vape juices contain nicotine, some are also available without the highly addictive chemical. Juul has drawn fire for only offering pods that contain nicotine, but vapers also use refillable devices to gradually transition to juices with lower levels of nicotine, with some ultimately weaning themselves off dependency.

While the negative impact of both nicotine and cigarettes have been well documented, vaping is a relatively new technology, so there is still little information available about how it affects health. A study by researchers at the Roswell Park Comprehensive Cancer Center found that urine from people who use e-cigarettes contained higher traces of lead, cadmium, pyrene and acrylonitrile than people who don’t smoke or vape.

On the other hand, some researchers support the use of vaping as a technique to help adult smokers quit or reduce their dependency on cigarettes. For example, the U.K. government recently launched a campaign to convince smokers to switch to vaping instead. From a health perspective, the ideal solution would be to not smoke or vape, but Public Health England, a government agency, claims vaping is 95% less harmful than smoking and said data from its smoking cessation program showed that 65% to 68% of smokers who used e-cigarettes with nicotine replacement therapies, like patches and gum, successfully quit.

Other places in the United States that are working on or have already passed legislation targeting vaping include Aspen City, which recently passed a ban on flavored e-cigarette products (vape juice comes in many flavors, including ones meant to mimic candy, and that has been blamed for making vaping more appealing to kids). In Maine, a bill is being sponsored that would essentially ban vaping by prohibiting the same of nicotine liquid containers. Many states also have laws in place that prohibit vaping wherever cigarettes are also banned.

House lawmakers demand end to warrantless collection of Americans’ data

Two House lawmakers are pushing an amendment that would effectively defund a massive data collection program run by the National Security Agency unless the government promises to not intentionally collect data of Americans.

The bipartisan amendment — just 15 lines in length — would compel the government to not knowingly collect communications — like emails, messages and browsing data — on Americans without a warrant.

Reps. Justin Amash (R-MI, 3rd) and Zoe Lofgren (D-CA, 19th) have already garnered the support from some of the largest civil liberties and rights groups, including the ACLU, the EFF, FreedomWorks, New America, and the Sunlight Foundation.

The Amash-Lofgren amendment. (Image: supplied)

Under the current statute, the NSA can use its Section 702 powers to collect and store the communications of foreign targets located outside the U.S. by tapping into the fiber cables owned by run by U.S. telecom giants. But this massive data collection effort also inadvertently vacuums up Americans’ data, who are typically protected from unwarranted searches under the Fourth Amendment.

The government has consistently denied to release the number of how many Americans are caught up in the NSA’s data collection. For the 2018 calendar year, the government said it made over 9,600 warrantless searches of Americans’ communications, up 28 percent year-over-year.

In a letter to lawmakers, the groups said the amendment — if passed into law — would “significantly advance the privacy rights of people within the United States.”

Last year, Section 702 was reauthorized with almost no changes, despite a rash of complaints and concerns raised by lawmakers following the Edward Snowden disclosures into mass surveillance.

The EFF said in a blog post Tuesday that lawmakers “must vote yes in order to make this important corrective.”

Leaving for a competitor? Onboarding new employees? Avoid accusations of trade secret theft

When a company hires talent away from a competitor, onboarding the new employee can pose significant legal risks for both the company and the new employee. A fundamental aspect of Silicon Valley is that employees are generally free to move between competitors.

This unrestricted movement of talent facilitates the robust competition that helps drive the Silicon Valley economy. While this is no doubt positive, unfettered employment mobility also creates unique challenges when it comes to protecting a company’s trade secrets, which are the lifeblood of many Silicon Valley companies.

Because of California’s policies regarding free employment mobility, unlike in most other states, California companies cannot protect their trade secrets with non-compete contracts. So, they instead rely heavily on trade secret laws for protection.

And, of course, when trade secret theft occurs, it is often when an employee transitions from one company to another. Thus, when a key employee gives notice that he or she is leaving for a competitor, it sets off alarm bells for the soon-to-be former company.

Unfortunately, because of the hypersensitivity to protecting trade secrets, many departing employees who have no interest in actually taking their former company’s trade secrets get accused of theft. This allegation can trigger a long, stressful, expensive legal process for both the employee and the new company, and sometimes cost the employee his or her reputation and new job.

This article explains how this situation arises and provides some practical considerations for how the employee transitioning jobs, and the onboarding company, can avoid an unnecessary legal fight.

1. California companies’ aggressive protection of trade secrets.

GoTenna is ramping up public sector mesh networking with a $24M C round

GoTenna is best known for its outdoors-oriented consumer products that let you text and share locations between smartphones off the grid. But the company has found that government work — military, fire, rescue — is the real market, and is pursuing it with a vengeance on the strength of a $24 million funding round.

“We’ve been busy!” said Daniela Perdomo, founder and CEO of the company, in an interview. “We have a good problem, which is a technology that can be so foundationally enabling for so many use cases.”

GoTenna’s core tech is mesh networking over radio frequencies normally used for walkie-talkies: long range but low bandwidth. Yet if all you need to send are GPS coordinates or a short message, it’s perfectly sufficient and works great where mobile and satellites connections are impractical. Just on the device, smaller than a deck of cards, and you can chat over miles in the middle of nowhere with your climbing partners or back country ski pals.

In the last couple years the company has shifted its priorities from consumer tech — the GoTenna and Mesh series of gadgets — to filling the needs of public sector clients that have been asking for something like this for years.

Firefighters, military operations, local law enforcement, search and rescue — many were using bulky, over-engineered, expensive solutions that haven’t changed much in decades. GoTenna works with nearly any smartphone and instantly creates a mesh network that can span miles, making it perfect for off-grid communications.

Perdomo said this was actually more or less the plan from the beginning.

“It was in my first ever pitch deck when we raised our seed in 2013, there was this blue-sky vision of how the technology would be used,” she told me. “But it was simpler to launch an MVP to consumers. We always felt that product was going to bring in the public sector. And that’s exactly what happened — when we launched our first generation product, I think within 24 hours we had a variety of different public sector customers reach out to us.”

“We now have some federal agencies that have been customers through every generation of the product. We sill have our consumer product, and people love it, but it’s a small part of our business compared to the public sector,” she said.

An example of how the interface might look in use. It can relay the locations of other GoTenna devices at intervals, helping teams keep in touch automatically.

While disaster response crews could of course just buy a couple dozen of the regular GoTenna products, they were quick to ask for “pro” versions with features prized by advanced users and military customers.

Longer range, more programmable wireless parameters, compatibility with various legacy systems — the Pro and new ProX versions of the GoTenna system hit a lot of sweet spots. As Perdomo told me when the Pro first came out, legacy systems are powerful in some ways but can also be horribly expensive, incompatible with foreign wireless systems, or even have legal restrictions on where they can be used.

For a cash-strapped NGO that goes around doing global aid, a $100-$500 gadget that turns an ordinary phone into a versatile mesh node is potentially game-changing. (You can also use them to temporarily replace destroyed communications infrastructure.)

But deep-pocketed federal agencies and military branches are also shelling out for the devices, and increasingly for the software support contracts that go with them. GoTenna’s Aspen Grove is a proprietary mesh network protocol that they’ve engineered to be faster and more robust than anything else out there. I’d exert a little skepticism here normally, but from what I’ve seen the systems GoTenna is replacing or augmenting aren’t exactly competitive.

In fact GoTenna’s next major hardware project is to create a mesh networking board that can be integrated right into existing hardware, simplifying the systems and baking its protocols in even deeper.

“We have a long list of companies that want to integrate our tech into vehicles, aircraft, anything you can think of,” Perdomo said. “So you can put one of these babies on a UAV and let ‘er rip! Our record range, point to point from a UAV, is 69 miles.”

Meanwhile the company is also releasing a broader open source mesh platform called Lot 49 that’s meant to be capable of supporting a global messaging infrastructure without relying on any wireless providers. That could be a big deal for internet of things type devices as well.

Interestingly, Perdomo doesn’t feel threatened by the new and rather scary kid on the block: communications satellite constellations like Starlink and OneWeb. If the idea is that GoTenna lets you communicate where the grid doesn’t reach, what happens when the grid is global?

“No matter how many satellites you put up, repeaters you put up, cables you lay down, you always have that last mile. You need resiliency, access, and I believe neutrality as well,” she said. And indeed you’re not going to take a Starlink ground station with you on a covert operation or into an active wildfire. And having an existing, ongoing business agreement with a satellite communications provider may not even be desirable in the first place.

“There’s a reason why certain incumbents in the tactical radio space as well as carriers are partnering with us,” Perdomo pointed out — and indeed Comcast Ventures is a new face among the investors. “We’re creating a new layer in the communications stack, mesh networks with a focus on bursty data. I think of us as perfectly complementary to every other communications company.”

As for that funding, it will go towards easing the rapid growth the company is experiencing, finishing the pro and embedded options, hiring up, and expanding operations to support their growing services business. The $24M round was led by Founders Fund, with participation from Comcast Ventures and existing investors Union Square Ventures, Collaborative Fund, Walden VC, MentorTech, and Bloomberg Beta.

“We’ve been in R&D for a really long time,” Perdomo said. “It’s exciting now to also be becoming a business. All of the most impressive mainstream telecommunications technologies we use today, things like the internet or GPS, they hit it out of the park with the public sector first. If you can win there, in life or death situations, you know you can win everywhere else as well.”

Climate justice and environmental ethics in tech, with Amazon engineer Rajit Iftikhar

Nearly 8,000 Amazon employees, many in prestigious engineering and design roles, have recently signed a petition calling on Jeff Bezos and the Amazon Board of Directors to dramatically shift the giant company’s approach to climate change.

By deploying a kind of corporate social disobedience such as speaking out dramatically at shareholders meetings, and by engaging in a variety of community organizing tactics, the “Amazon Employees for Climate Justice” group has quickly become a leading example of a growing trend in the tech world: tech employees banding together to take strong ethical stances in defiance of their powerful employers.

The public actions taken by these employees and groups have been covered widely by the news media. For my TechCrunch series on the ethics of technology, however, I wanted to better understand what participating actively in this campaign has been like some of the individuals involved.

How are employees in high-pressure jobs balancing their professional roles and responsibilities with being actively, publicly in defiance of their employers on a high-profile issue? How do leaders in these efforts explain the philosophy underlying their ethical stance? And how likely are their ideas to spread throughout Amazon and beyond – perhaps particularly among younger tech workers?

I recently spoke with a handful of the Amazon employees most actively involved in the Employees for Climate Justice campaign, all of whom inspired me– in similar and different ways. Below is the first of two interviews I’ll publish here. This one is with Rajit Iftikhar, a young software engineer from New York who moved to Seattle to work for Amazon after earning his Bachelor’s of Engineering in Computer Science from Cornell in 2016.

Rajit Iftikhar

Rajit struck me as a humble and precociously wise young man who could be a role model — though he seems to have little interest in singling himself out that way — for thousands of other software engineers and technologists at Amazon and beyond.

Greg Epstein: Your personal story has been key to your organizing with Amazon Employees for Climate Justice. Can you start by saying a bit about why?

Rajit Iftikhar: A lot of why I care about climate justice is informed by me having parents from another country that is going to be very adversely affected by [climate change]. Countries like Bangladesh are going to suffer some of the worst consequences from climate change, because of where the country’s located, and the fact that it doesn’t have the resources to adapt.

Bangladesh is already feeling the effects of climate crisis; it is much harder for people to live in the rural areas, [people are] being forced into the cities. Then you have the cyclones that the climate crisis is going to bring, and rising sea levels and flooding.

So, my background [emphasizes, for me] how unjust our emissions are in causing all these problems for people in other countries. And even for communities of color within our country who are going to be disproportionately impacted by the emissions that largely richer people [cause].

After Equifax breach, US watchdog says agencies aren’t properly verifying identities

A federal watchdog says the government should stop relying on the credit agencies to verify the identifies of those using government services.

In a report out this week, the the Government Accountability Office said several government departments still rely on the credit agencies — Equifax, Experian and TransUnion — to check if a person is who they say they are before they can access their services online.

Agencies like the U.S. Postal Service, the Social Security Administration, Veterans Affairs, and the Centers for Medicare and Medicaid Services ask several questions of a new user and match their answers to information held in an individual’s credit file. The logic is that these credit files have information only the person signing up for services can know.

But following the Equifax breach in 2017 those answers are no longer safe, the watchdog said.

The Equifax breach resulted in the theft of 148 million consumers. Much of the consumer financial data had been collected without the explicit permission of those whose data it held. An investigation later found the breach was “entirely preventable” had the credit agency employed basic security measures.

“The risk that an attacker could obtain and use an individual’s personal information to answer knowledge-based verification questions and impersonate that individual led the National Institute of Standards and Technology (NIST) to issue guidance in 2017 that effectively prohibits agencies from using knowledge-based verification for sensitive applications,” wrote the watchdog.

In response, the named agencies said the cost of new verification systems are too high and may exclude certain demographics from the population.

Only Veterans Affairs implemented a new system but still relies on knowledge-based verification in some cases.

The other downside is that if you have no credit, you simply don’t show up in these systems. You need a credit card or some kind of loan in order to “appear” in the eyes of credit agencies. That’s a major problem for the millions who have no credit file, like foreign nationals working in the U.S. on a visa. In 2015, some 26 million people were estimated to be “credit invisible.”

“Nevertheless, until these agencies take steps to eliminate their use of knowledge-based verification, the individuals they serve will remain at increased risk of identity fraud,” wrote the watchdog.

Where is the EU going on tech and competition policy?

Huge technology policy questions are looming for whoever takes the top jobs at the European Union in the coming months. Decisions that could radically reshape tech business models, reconfigure the competitive landscape and change the relationship between Internet users and the content and services they consume.

In short, the entire future of the tech industry — and potentially not just in Europe but worldwide — is at stake.

The incoming European Commission will be faced with a lengthy list of pressing questions. How will they reboot competition law for the digital era? Should they rush in swinging a break-up hammer at monopolistic tech giants or take a scalpel to the competition-crushing problem of networked dominance by slicing up their data flows?

They will have to defend fundamental rights that call for privacy by design and data minimization against AI’s rapacious demand for data and the predictive powers of pattern-spotting algorithms.

They will have to evaluate how to make sure platforms play fair — and ensure that the initial embrace of sellers or service providers doesn’t evolve into crushing abuse. They will have to fashion rules that can wrap around digital giants, rather than getting bent out of shape by ‘winner takes all’ business models.

The power of tech giants to influence entire nations is now writ large in EU domestic politics. Europe knows it needs to hammer out an agreement on reforming digital taxation, with rising citizen anger over tax inequalities. The question is how to do it when certain states with low corporate tax rates have been colonised by tech giants which definitely don’t want tax reform to happen.

There’s also the tricky business of arbitrating between Europe’s traditional creative industries and the predominantly US sharing platforms that have gotten fat off of the back of others’ content — a battle so fraught it’s already yielded an EU copyright reform as polarising as Brexit.

How, too, to level the playing field between Internet giants and traditional telcos?

That requires winning agreement on an update to ePrivacy rules that’s been stalled for months. Because, again, new rules are urgently needed — to wrap around digital comms and address digital marketing’s weed-like sprawl, an outgrowth that’s spawned an entire shadowy industry of trackers, data brokers and people profilers which can be linked to many a data scandal and has driven EU consumers into the arms of ad blockers. How to find a way through all the competing interests to bring order to the unregulated mess that is modern adtech?

Then there’s hate speech and online disinformation. What’s to be done to shrink the democratic risks of political manipulation without trampling freedom of expression? And how can Europe best equip its citizens for the next waves of deepfaked information warfare while also getting platforms to accountably clean up their act?

Europe needs to shape a strategy to support AI too. It wants to do this in a way that reflects and bakes in European values. But how to ensure ethical guardrails to make AI development sensitive and “human-centric” don’t just end up kneecapping homegrown technologists versus whatever’s coming out of China?

Speaking of China, then of course there’s 5G. The Commission has to chart a delicate course between member states’ national security priorities and the fragmentation threat to its flagship digital single market policy if EU nations respond differently to Huawei. The whole project risks collapsing into mutual mistrust — which would reverse the intended gains to Europe’s digital economy.

On the legal front, an ongoing clash of priorities between US surveillance practices and EU fundamental rights also looks like trouble brewing.

A flagship EU-US data transfer mechanism launched by the Commission in 2016 is now facing serious legal questions. Does the next Commission have with a plan B to keep critical business data flowing for the thousands of companies signed up to its Privacy Shield framework if it gets struck down by a judge’s pen?

This is not a theoretical threat; the predecessor arrangement that had stood for fifteen years was invalidated in 2015, after a legal challenge which drew on NSA whistleblower Edward Snowden’s revelations of US mass surveillance programs. Trump’s ‘America First’ policy agenda clearly risks exacerbating this clash.

The US president is also of course continuing to rain down trade uncertainties that are rocking the stability of East-West technology supply chains. How should Europe respond to the wreaking ball potential of Trump’s trade war? What support can it offer its own tech industry to manage a level of uncertainty that makes brexit look like a picnic?

And, as the Internet splinters into increasingly localized flavors, how will Europe prepare and position itself?

The techie to-do list crossing the next Commission’s desk is packed with highly charged, pressing and politically fraught problems.

Over the past year the EU has dined out on making a name for itself on the world stage with a shiny new set of digital privacy rules — aka, the General Data Protection Regulation (GDPR) — at a time when US policymakers are just waking up to the rude incursions of homegrown data-mining tech giants. But attention now needs to be paid to ensuring it actually delivers what was promised or else the global spotlight will be pointing at policy failure.

So yet another task for the next Commission will be applying the right level of strategic pressure to make sure the regulation’s wheels are turning.

National data protection agencies are where GDPR enforcement will fly or fail. Te highest profile cases that will really test their mettle are of course attached to tech giants — including Facebook and Google. The latter’s handling of personal data for behavioral advertising is now under scrutiny in Ireland.

The Irish DPC also has more than ten open investigations into Facebook-owned businesses, covering a range of issues — from probes of specific security breaches to whether it is lawfully gaining consent to process the data of users of its platform being as it offers no opt-out from behavioural ads.

If Ireland fails to defend European values and rights against the commercial incursions of some of the world’s most powerful companies it would represent EU policy failure at the highest level.

It could also invite revolt from less conflicted parts of Europe. A dispute resolution mechanism is baked into GDPR, which allows the European Data Protection Board to step in if disagreement between DPAs om cross-border cases threatens to derail decisions. While this does look intended as a tool of last resort, the market denting power of tech giants is piling the pressure on — with record numbers of such complaints awaiting judgement.

Either way, battles are brewing. And the biggest fight looks to be for the future shape of the commercial Internet.

Ad-funded business models that have been allowed to grow like weeds are under regulatory scrutiny like never before — thanks, in large part, to European interventions. So too are the tech giants that have profited so handsomely by being able to use data how they like.

At the same time a new generation of privacy-conscious startups is thinking differently and doing what it can to gain footholds in markets where platform giants suck most of the oxygen out of the room.

Strong decisions by the next Commission to defend European rights and reboot digital markets with fairness and competition at the center have the potential to transform the digital economy so that there are far more winners, not just a few taking all.

The question is whether Europe’s leaders will rise to the challenge.

Who’s in the running to be the next EC president?

The center right’s preferred candidate — and therefore the technical favorite for the EU’s top job — is German conservative, Manfred Weber.

Manfred Weber. Photo by David Speier/NurPhoto via Getty Images

In Commission president candidate debates he has billed himself as offering “stability” for the European project, via a “pro-compromise approach” — and talked about strengthening “the innovation field” as the key to building a stronger EU economy, saying he also wants to upgrade the EU-US trade relationship to bolster Europe’s prospects.

But Weber has a lack of executive experience and suffers from something of a charisma vacuum at a time when a big personality might well be required to sit in the chair and ‘sell’ the next Commission to a more fragmented European Parliament.

The kaleidoscope twist of European parliamentary politics may also have undermined Weber’s frontrunner chances by allowing critics to argue against him on the grounds that his party, the EPP, failed to grow its share of the votes. So it may be that another European People’s Party candidate comes through in the end. One who offers a finer-grained political compromise.

The EU’s chief Brexit negotiator, Michel Barnier, looks to have potential — and is being tipped by some of the current political chatter — having played a high profile role in recent European politics, calmly handling the chaotic mess produced by the UK’s 2016 referendum vote to leave the EU.

More importantly, perhaps, Barnier is French. One of the EU’s powerful national leaders — France’s president, Emmanuel Macron — has been seeking to assert authority over the parliament by indicating he won’t be bound by a system of preferred candidates put forward by its political blocs.

That’s bad news for Weber, but it could lift Barnier out of the wider field if Macron prevails in stamping France’s mark on the Commission presidency.

Michel Barnier. Photo by Thierry Monasse/Getty Images

Although plenty of other establishment names are still being bandied around for the top job — including chair and MD of the International Monetary Fund, Christine Lagarde (also French); and Dutch PM, Mark Rutte, to name just two.

It’s certainly hard to imagine a more symbolically safe pair of hands for the EU to choose for its top job right now than Barnier: The man tasked with holding the EU together in the face of the threat posed by Brexit.

Brexit risks not just the UK’s stability but could very well scatter wider seeds of destruction if it erodes and destroys the cohesion required to keep the European project together. So Barnier’s proven ability to glue the 27 remaining Member States on a common negotiating path could be seen by EU leaders as having strategic appeal.

What his presidency might mean for wider EU policy is less clear, though, given his focus on Brexit has kept him out of the fray — and away from participating in public debates with some of the proposed candidates.

The center left’s pick for president, Dutch politician Frans Timmermans, would need to prevail against the dominant EPP bloc to succeed in getting the nomination. Which likely means persuading a strengthened liberal contingent to throw its backing behind a ‘progressive alliance’ of socialists and liberals.

While possible, it looks to be a challenge.

Frans Timmermans. Photo by Pier Marco Tacca/Getty Images

Timmermans has made a public pitch as a change candidate, saying Europe needs more social justice and sustainable social policies — including putting taxing tech giants front and center of his talking points, and dubbing it “unacceptable” that some companies have gotten so big they can “arm twist” entire Member States to vanquish taxes.

Climate policy is another stated focus. He has called for stepped up efforts to enable a European-wide viable carbon tax plus quicker transformation of the energy sector as well as suggesting new ideas in agriculture — such as switching to more sustainable food production.

He has also said he wants to see a corporate tax rate floor across the EU, and called for every state to implement a minimum wage. An articulate and at times impassioned speaker, Timmermans posses at least some of the charisma Weber lacks — even while he faces plenty of political hurdles.

An outside bet — who has betted against big tech… 

For those who like an outside bet, the more fragmented European Parliament vote may have buoyed the chances of liberal candidate for Commission president, Margrethe Vestager — who could emerge as a compromise alternative since the liberals grew their presence in parliament (and her own party in Denmark did well in national elections).

Margrethe Vestager. Photo by Thierry Monasse/Getty Images

Although she is just one of a full slate of candidates fielded by the liberals, which also includes another prominent EU politician, MEP Guy Verhofstadt — who has also made his ire over big tech’s rights incursions felt when he heckled the Facebook founder last year, when Zuckerberg addressed some MEPs and failed to answer most of their questions.

Few can compete with Vestager’s profile on that front though.

The EC’s current competition commissioner has gained fame on both sides of the Atlantic for going after big tech, including issuing three high profile antitrust decisions against Google, such as a $5 billion fine for Android as well as action on EU illegal state aid that saw the Commission order Apple to pay $15 billion in back taxes to the Irish state, covering a decade of unpaid taxes. On her order, Amazon also got hit with a large illegal tax benefits bill, and may yet face antitrust action.

As a result of holding a key office and how forcefully she has spent her time as antitrust chief, she remains one of the most high-profile European commissioners.

Asked about what she would offer as Commission president she has said “you have to be forceful to serve people well.” Naturally, she is pro-regulation — a sentiment that chimes well with rising public concern over unfettered and even feckless Internet giants. But while demonstrably forceful, she is also thoughtful and methodical, and can’t be accused of jumping on the bandwagon of populist positions.

She’s also shown her steel in office, issuing competition decisions that have angered powerful heads of EU states — which might therefore have been politically disadvantageous to her prospects of further advancement in the Commission.

Towards the end of her time as commissioner, she instigated a review of competition policy to respond to the challenges posed by digital markets, signaling a reform agenda. She has also talked publicly about regulating data flows as a more intelligent route to regulate big tech versus swinging the hammer to break companies up.

A Commission headed by Vestager would surely have a strong appetite for stamping its mark on digital regulation. At very least it would drive discussion, even if winning consensus on pan-EU digital reforms may be more difficult to achieve (especially on a highly divisive issue like tax reform).

In public debates of Commission presidency candidates, Vestager has said that increasing diversity and managing climate change would be priorities if she took the top job, emphasizing too the need for an inclusive transition to a sustainable economy.

Given her high personal profile, it seems at least reasonable that should she miss out on the top job she will end up with another major post, such as vice president. It would also, of course, signal progressive change if European institutions were to appoint a woman to one of the top jobs for the very first time.

It’s also not inconceivable that she could be reappointed as competition commissioner, given how she has owned the office.

Either way, Vestager’s influence on competition policy looks very unlikely to fade — not least because similar ideas are catching fire across the Atlantic.

At this stage, though, all is still in play where the Commission presidency is concerned.

More clarity may emerge after the next meeting of EU leaders, on June 20 and 21, when the Council will convene to discuss nominations — and adopt a first draft of their strategic agenda for the next five years.

What’s on the EU Council’s strategic agenda?

An outline of discussion topics for this agenda last month included, among myriad talking points, Europe’s migration challenge; tackling online disinformation, bolstering cybersecurity and addressing hybrid security threats; deepening and strengthening the single market and developing an industrial strategy, as well as investing in skills and education, promoting innovation and research.

Ensuring fair competition was also on the list.

A section on “building a greener, fairer and more inclusive future” suggested accelerating the energy transition and investing in “mobility of the future” among its listed points.

While a section entitled “embracing the digital transition” cited developing AI, promoting “access, sharing and use of data,” and ensuring connectivity as key talking points.

Elsewhere the document talked about defending European people’s rights and freedoms, and indeed projecting European values on the rest of the world. But with so many power games still to play out, the shape of Europe’s future tech and competition policy remains just that: A draft, with priorities hard to predict.

“It’s most unlikely that there’s going to be any reversal of major policies,” suggests Dr. Alistair Jones, an expert on EU political policy at De Montfort University. “What we are likely to see — and this is pure conjecture — is assuming Brexit goes ahead (and that’s still an if) then what we’ll probably see is a Commission being a little bit more tentative on the integration process and wanting to go forward more gradually on integration to keep everyone on board.

“So things like the digital market will proceed, slowly and carefully. I don’t see a huge lunge forward in greater integration on any aspects. I think it’s going to be very tentative, very much small steps.”

Online disinformation is an issue where the EU does have serious concerns. The Commission has been paying close attention to how platforms are responding to increased pressure, via a (for now) voluntary code of practice — setting up a monthly monitoring requirement for them to deliver progress reports, and issuing sharp rebukes that progress hasn’t been good enough.

But a pan-Europe regulatory response to online muck spreading is complicated by whether it’s an EU or national competence.

“The problem is it probably lies with the national governments and they are loath to want to give greater responsibility to the EU in this area because they have their own ways of doing things,” says Jones.

The Germans, for example, haven’t been shy about passing a law to punitively punish platforms if they fail to swiftly remove hate speech, while the UK remains focused on devising a framework to control a broader range of online harms.

Where online content rules are concerned, Europe’s cultural differences suggest that this sort of policy patchwork will remain the norm.

Image via Getty Images / AdrianHancu

Similarly, Jones believes core decisions on regulating 5G will remain at a Member State level — with the Commission likely only moving to set a future floor for trans-national EU minimum standards, rather than seeking to impose hefty security restrictions on procurement decisions.

“As it moves forward, I can see the Commission — as it’s done in the past — taking over a broad brush big picture regulatory role,” he says. “So who can be involved in the delivery of 5G, which businesses are involved, things like that. I can see as it is rolled out the Commission and the EU collectively wanting a degree of consistency, and that links to single market rules, it links to competition rules, it links to commercial policy rules. Some of that’s already in place but at the same time there may be a need for greater policing that further down the line.”

One issue that does generally cut across the political spectrum is digital taxation, though achieving agreement on that front may be hampered by a political requirement for the EU to be more sensitive to concerns about increased integration — and not be seen blindly pushing on the accelerator.

Again, says Jones, Brexit complicates matters. He suggests a more broad-brush approach may win out in the near term, such as the Commission looking at the operation of the entire single market — “and how that can be done more effectively and efficiently” — rather than trying to tackle head-on national resistance if the EU pushes to get input on Member States’ tax systems.

“It’s something that may bubble along just below the surface,” he posits of digital tax reform. “Maybe in five years times, after the next elections, [there could be a] big package to possibly change the whole taxation system of the EU. And it may be that it gives the EU some input into national taxation policies but that is going to be resisted by some countries.”

Some Member States have voiced loud concern about digital tax inequality. Including France and the UK, which are pursuing their own flavors of reform. Though without a pan-EU approach there’s no real chance of addressing the problem.

Getting political agreement on that will be difficult, with smaller states having lucratively leveraged a low tax economy to pull in the tech giants. So the Commission may remain caught in the middle. 

“We often assume that the Commission sets the policies. The Commission don’t. The Commission tries to mold the agenda but it’s up to the Council’s ministers and also the European Parliament to take that forward,” says Jones. “So if we have a Commission that’s willing to say — ‘hey, digital economy, the EU needs to have greater involvement in all of this’. The national governments have got to buy in. And if they don’t buy in it doesn’t matter how good the commissioner is, it doesn’t matter how farseeing they are, they’re not going to get anywhere. So there’s got to be this ability to get buy-in from the Member States.”

That said, individual commissioners can be key to driving a particular reform agenda. So the personalities and expertise involved can make a big difference — if it helps them win the support of member states.

“There probably is going to be more appetite for big tech regulation but the problem they’ve got at the Commission is that at times, collectively, their head is stuck in the sand and they are loath to go forward on a number of issues,” says Jones. “It may be up to individual commissioners who have got that individual get up and go, that individual vigor, that knowledge of the area they are in charge of — it may be the individual commissioners who may actually drive things forward.”

“It may be there’s a commissioner in the digital economy who’s going to grow into the role, if they’re not already there,” he adds. “But what they will need is the support of the individual member states.”

Image via Getty Images / KatarzynaBialasiewicz

After the Commission president, the competition commissioner role stands out as a critical appointment, given its high degree of autonomy and power. Whoever lands the brief will certainly be one to watch, not least for how they respond to growing political appetite over the Atlantic to crack the back of tech giants’ platform power.

A future date to look out for on that front is when the nominee for the EU antitrust brief gets questioned by the European Parliament — both to see how they respond but also what kind of questions they face. That will offer a flavor of the new parliament’s priorities for regulating competition.

A parliament signalling it wants more action to rein in big tech could act as fuel for the next commissioner, says Jones.

The EU’s next antitrust chief will also have on their desk the review Vestager instigated of digital markets — so it will be up to them to make a call on how to take that work forward. A decisive commissioner could have a major impact on digital markets and business models. So it’s a critical appointment.

But again we’re still a long way off knowing who the person will be. Not least because individual commissioner appointments can depend upon how big a personality the Commission president is.

“If you’ve got a big personality who can drive things through with the support of the European Parliament they can get the national nominees into the places that they want,” says Jones.

“This is the problem that the president has — they do not know who the individual nominees are going to be from which Member States. So until they know who the nominees are from which Member State and then what portfolios they may be appropriate for — what portfolios they want to give them — it’s all up in the air.”

How is the next Commission president decided? 

Multiple candidates remain in the running to take over from Jean-Claude Juncker as Commission president come November 1. Though even that timeline is not 100% certain. If, for example, MEPs take a dislike to a Council pick for president they can reject the whole Commission, delaying the entire process.

The process for deciding the next Commission president involves a nomination, by a qualified majority, from the European Council that’s required to factor in the result of the most recent European elections.

Members of the European Parliament (MEPs) then vote on the choice — with an absolute majority required for the Council’s nomination to prevail.

While the Commission’s top job is influential, as regards shaping pan-EU policy — with the president responsible for setting political direction and chairing their cabinet of commissioners atop the various policy areas — the office shouldn’t be thought of as the equivalent of the president of the United States. But is a key strategic role. Collectively, the Commission executes on a pan-EU legislative program. It’s responsible for drafting the budget and is the only EU institution that can propose legislation.

The European Council is the power behind this throne, feeding in whatever policy priorities can be agreed by a roomful of heads of government/state of the EU’s (currently) 28 members — in addition to playing kingmaker by nominating their choice for Commission president.

Image via Getty Images / Dado Daniela

There is also a president of the European Council, who works to seek consensus between Member States. This position is set to change shortly too, via election by Council members, albeit for an initial term that’s half as long as the Commission president.

Nominations for the various European commissioners typically involve large amounts of horse-trading and power playing for portfolios between the Member States.

The aim is for the Commission to contain representation across the bloc, factoring in regional differences in politics, nationality, north vs south, east vs west, diversity and so on. But it’s a political compromise, never a flawless mirror.

In practice, the selections of Commission nominees can be a surprising process in which little known figures can suddenly find themselves with the right combination of strategy, nationality and diplomacy to unlock the right support.

With so many balancing and compromise factors in play, the make-up of the next Commission is always complex and hard to predict, and arguably more so this time around, given wider shifts in the European political landscape — including ongoing ructions caused by the UK’s vote for Brexit — adding extra layers to the usual palimpsest.

A more fragmented European politics

Elections for the parliament were held last month and the vote returned a more fragmented hemicycle — weakening the traditional center-right and center-left blocs that have dominated for 40 years. Although they still remain the major political forces it’s the liberals, greens and nationalists that gained ground.

A more fragmented parliament suggests reaching consensus on both the shape of the next Commission and what legislation it will go on to propose could prove more difficult unless new political alliances can be forged. At this stage, it’s not clear what the new European parliament voting blocs will be.

There remains a risk that EU legislative processes could be stalled if compromise can’t be reached across a differently stripped spectrum of divergent political positions.

“We don’t really know what the groups are going to be in the European Parliament,” says Jones. “Those groupings are fluid. So if you look for example at the Brexit Party going in with the Europe of Freedom and Direct Democracy — when Britain leaves, that whole grouping disintegrates. Because they’d only have six countries represented. They’d need seven.

“If that’s the case it may be that some of those party groups may look elsewhere… We simply don’t know. So how the actual structures of the smaller parties are going to be — that is up in the air. Until that is resolved, the whole establishment of the Commission beyond the presidency is up in the air as well.”

“Everything’s up in the air at the minute,” he adds, noting just one certainty: That the two major parties still dominate, despite their vote shrinking.

“If they have organized things so that there’s an agreement that whichever party has the most seats their nominee for the presidency for the Commission would go forward,” Jones suggests. “If they stick with that, then the starting point of establishing the Commission presidency means that the EPP will keep their person in place.”

The full phalanx of Commission president and commissioner appointments has also got to be approved by the European Parliament, en masse — with MEPs getting a vote to either accept or reject.

“So what you’ve got therefore is a huge haggling process. And this is why when people say there’s a fragmented European parliament we don’t know what’s going to happen — they’re absolutely right. Until the groups are actually sorted in the European Parliament then we’ll get a better idea of the power structures, and then we’ll get a better idea in relation to with the presidency having been sorted how the rest of it will flow through.

“It could be — could be — really problematic in trying to get a Commission membership through if the smaller groups in the European Parliament work together to try to block appointees they could cause problems.”

So, again, much hangs on who will be the next Commission president, and how persuasive they prove across a more fragmented political landscape. As noted earlier, Barnier’s negotiating glue may look like a handy special power. Although, as a personality, he’s hardly overflowing in the force of character department — famed only for having an unnerving stare.

Image via Getty Images / robertiez

Jones takes the view that the policy agency of the next Commission isn’t likely to emerge until Brexit itself has happened — assuming, of course, that Brexit does actually go ahead. (And where Brexit is concerned there are still absolutely no guarantees at all.)

“When/if Britain leaves the entire power structure in the European Parliament could change. Because the Freedom and Direct Democracy Group could collapse with Brexit leaving that group [assuming the party follows the UKIP template and involves itself with the same group]. So everything is up in the air at the minute. That will get resolved, probably by if we’re lucky the middle of next month.

“Then you start on the commission appointments and it’s the summer — and some of the countries effectively shut down. So it may be that it’s September or possibly even early October that we’re going to see this entire process completed. That’s the nightmare scenario. So the EU basically flounders for the next three to four months.”

Meanwhile, if muscle-flexing Macron misses out on a French Commission presidency it’s conceivable he could push for the powerful antitrust portfolio as a consolation prize. Which perhaps lends some color to Facebook’s recent attempts to cozy up to the French government to work on ideas for Internet ‘co-regulation.’

Zuckerberg may be placing his own bets on the future shape of the Commission by seeking to make powerful French friends in the hopes of influencing pan-EU policy before the next commission has had chance to take shape.

But where EU politics is concerned, the phrase that’s been repeated ad nauseam of the Brexit negotiations applies here too in spades: ‘nothing is agreed until everything is agreed’.

This time around Europe’s political dial the risk of disagreement appears to be zooming alarmingly into view. So the real test of the European project will be whether it can weather disruption to its usual philosophy of onwards and upwards — its political push for ‘more Europe’ — when some of its people are voting for less.

If the EU can’t carry all its people along there will be little hope of driving any major policy agenda — which means key questions of technology and competition going unaddressed, generating legal uncertainty and compliance risk for business with knock-on economic effects.

Tech giants have the resources to manage political uncertainty — indeed, they’ve shown themselves adept at exploiting political vacuums and blindspots — so it will be startups and the next generation of entrepreneurs that get failed.

Consensus works until it doesn’t, as the UK’s Brexit schism illustrates. So there’s a clear cautionary tale for the EU powers that be — if they can but put their heads together and listen.

“The issue is going to be how the rest of the European countries work together. Because although [the UK is] a reluctant European, and we’re never very keen, one of the roles that we played was as a break on some of the more excessive integrationist ideas that might have arisen from the Commission that some of the other big countries such as France and Germany bought into,” says Jones when asked whether he thinks the European project can survive Brexit. “With that role going, assuming we leave, it does give the EU the opportunity for the EU to drive forward for greater integration — and it may be that we see the development of a two-speed Europe. If that happens the whole project will disintegrate. Of that I am convinced.”

“They need to be taking on the more reluctant members,” he adds. “So the Hungarys, the Polands, the Czech Republics… as well as the more integrationist countries, such as Belgium, such as Luxembourg, such as Germany and France. They’ve got to be taking everybody along together… Everybody’s been dragged along a bit reluctantly. They’re going to have to be a little bit more considerate if Brexit goes ahead because otherwise the project could disintegrate.”