It may be a cross between the Eurovision Song Contest, a papal conclave and a social club raffle but a ballot among European Union ministers today could hurt Europe's pharmaceutical industry and the health of millions.
It will fix the new home of the European Medicines Agency, which must leave London by 2019 when Britain leaves the European Union; most of its 900 staff may refuse to move to many of the 19 cities in the running, the EMA warns. Replacing them would delay drug approvals and patient safety checks.
Yet the result, diplomats agree, is utterly unpredictable; months of horse-trading on issues unrelated to healthcare will end up in hours of haggling between secret ballots in Brussels on Monday night. It could even come down to drawing lots.
"Nobody really knows what is going to happen," one diplomat said. "They will be locked there for hours ... You can try to secure some backing but it's a secret ballot and you have no way of checking whether what you agreed was honored."
The fate of the 160-strong, London-based European Banking Authority (EBA) will also be decided at the meeting of EU affairs ministers from the other 27 member states meet; but it is the promise of spin-off jobs and travel billions for the city that the EMA will transform into a hub for Europe's medical industry which is firing up intense national bidding rivalries.
The extent of the field is, in the memory of EU officials, probably unprecedented. Early talk of the EU executive winnowing down a short list on the basis of "objective" criteria went unheeded as governments have waded in for a share of the spoils.
Milan, Amsterdam and Barcelona campaigned hard. But there is a push from eastern states, whose tardy membership means they host fewer offices. Slovak capital Bratislava is a contender even though an EMA survey of its staff found most of them might quit if posted to the bloc's poor eastern regions.
A first ballot, to start from about 1500 GMT, will see ministers rank their top three choices. Unless a majority makes the same first choice there will be a second vote among the top picks then a third-round runoff. If it is still tied, the Estonian meeting chairman will simply draw lots.
The six countries not bidding for either agency have been courted assiduously and may seek favors elsewhere. Luxembourg and the Czech Republic are not bidding for the EMA but want others' votes in their bids for the EBA. Whoever wins the EMA must then drop out of the running for the Banking Authority.
Giving an example of how the EU's interlinked matrix of decision-making affects such votes, several diplomats said Slovakia might trade any disappointment at not getting the EMA into support for its finance minister taking the chair of the Eurogroup, which runs policy for the single currency area.
Senior officials liken the process to Europe's annual TV music schlock-fest, when the winner of the Eurovision Song Contest is often determined by viewers phoning in votes for acts from like-minded neighboring states and historic allies.
British bookmaker Ladbrokes has Milan the 2-1 favorite to secure the EMA, with Bratislava on 3-1 and Amsterdam 7-1. For the EBA, Frankfurt leads at 6-4 followed by Vienna and Dublin.
In Brussels, however, seasoned diplomats hesitate to quote odds: "The most likely result is one that will be perverse," said one, recalling previous upsets behind closed doors.Another referred to closeted cardinals electing popes at the Vatican: "In the end," he said, "We will get the white smoke."
