Germany’s coalition government has announced that employees will be required to provide a doctor’s certificate from the first day of illness, reversing a rule that allowed up to three days of uncertified absence and abolishing the telephone sick note introduced during the Covid-19 pandemic. Chancellor Friedrich Merz stated that the number of sick days in Germany is “too high” and that the country can no longer afford the competitive disadvantage caused by long periods of absence. The plan, agreed by the conservative CDU and the Social Democrats (SPD) as part of a broader economic reform package, makes the immediate certificate the legal default, though individual businesses may agree to waive the requirement.

Medical associations in Germany have condemned the move. The National Association of Statutory Health Insurance Physicians (KBV) described the plan as “bordering on madness,” warning that it would force thousands of people with minor infections into already overcrowded waiting rooms. The Association of General Practitioners cautioned that infection cases requiring only a day or two of rest would now fill surgeries. Within the coalition, SPD leaders have sought to soften the impact: Vice-Chancellor Lars Klingbeil called for “workable solutions,” and Labour Minister Bärbel Bas said she would examine whether the measure has any effect or merely causes difficulties. CDU parliamentary group leader Jens Spahn defended the reform, citing an average of 18 sick days per employee per year, among the highest in the EU.

Viewed from other European capitals, Germany’s sick-leave framework is seen as relatively generous but not unique. According to OECD data cited in Italian media, German employees average 3.5 weeks of sick leave annually, well above Italy’s 0.6 weeks but below Norway’s nearly six weeks. The German system combines full wage continuation for six weeks with comparatively long subsequent sick pay, a combination that employer groups say costs businesses between €82 billion and €85 billion per year. The reform marks a shift from a trust-based model to one of mandatory verification, a change that German commentators have described as a cultural shock for a society accustomed to self-declaration.

In Russia, the defence ministry has proposed a different trajectory: a draft amendment would cancel mandatory medical examinations for contract soldiers and mobilised personnel during periods of mobilisation or martial law, except in cases of injury or specified illnesses. The move, published on a government legal portal, would leave the military to set its own examination procedures. In Iran, a former deputy health minister told Khabar Online that the medical profession is losing income, job satisfaction and social status, and warned that without reforms—including a stronger family-doctor system and reduced direct payments—the country risks becoming dependent on foreign providers for simple treatments. The German government has indicated that the precise implementation of the new sick-note rule is still being drafted, with a spokesperson confirming that video consultations will remain possible and that the certificate need not be physically presented on the first day itself.