7 days in healthcare (September 18th-24th, 2023)

Summary

From the point of view of Biomedicine, Nature magazine in an article returns to artificial intelligence as an accelerator of the introduction of new medicines, also making the process less expensive. A second patient is implanted with a genetically modified pig heart. The prospects for transplants with animal organs are opening up more and more. Google (Deep Mind) identifies millions of mutations in proteins capable of generating disease, which will allow a much better understanding of numerous diseases.

Regarding Global Health, article in Science about the eradication of polio, which was a goal for the year 2000, but not yet achieved. Despite the success of vaccination campaigns, polio is still present in Afghanistan and Pakistan. Nature magazine warns of the danger that the pandemic treaty will not be concluded by 2024, as was the objective. The need to make vaccines accessible to everyone in all countries and the protection of intellectual property through patents, in contradiction, hinders progress.

Regarding International Health Policy, JAMA reviews the historic negotiation by Medicare of the price of prescription drugs, exposing the reservations of pharmaceutical companies and the different demands presented by each of them to the American government. Prime Minister Sunak is considering the possibility of banning the use of tobacco for new generations, in a way similar to that implemented in New Zealand. A report from the Institute for Public Policy Research (IPPR) states that in the United Kingdom there were 240,000 deaths in the period 2010-2020, which could have been avoided if standards of care on the European average had been applied. This is largely attributed to difficulties in access (in other words, waiting lists).

If we talk about National Health Policy (Spain), after an attempt at regional rebellion, the Ministry has had to withdraw the measure that provided for vaccination of health workers with the Hipra vaccine, not adapted for the new strains. Although the Ministry has not yet made public the announced report on the management of Covid, commissioned from four well-known experts, a group of prestigious academics has just published a valuable report on healthcare at the post-Covid crossroads. Changes in health are announced in both the Community of Madrid and Valencia. Time will tell if these changes address the real problems or remain cosmetic changes, to which some politicians are so accustomed. In Madrid, the final destination of the Zendal hospital does not seem to be clear, apart from its temporary use as a center for ALS. It is the consequence of building a large center without an adequate functional plan. The valuable EPINE report shows that more than 7,000 deaths occurred each year in Spain as a result of nosocomial infections. The conflict between doctors and health insurers, which began in Seville, threatens to spread to other communities, including Madrid.

In the field of Companies, on an international level, Abbot plans to acquire Bigfoot Biomedical at the end of 2023. On a national level, Novo Nordisk plans to open a technological and digital headquarters in Spain, which, if confirmed, would be excellent news.

Biomedicine

Nature article: Artificial intelligence as an accelerator of drug discovery. AI can make the emergence of new drugs faster and less expensive (https://www.nature.com/articles/d41586-023-02896-9#:~:text=19%20September%202023-,AI%20can%20help%20to%20speed%20up%20drug%20discovery%20—%20but%20only,techniques%2C%20for%20the%20common%20good.)
A genetically modified pig heart is implanted in a second patient (https://www.nytimes.com/2023/09/22/health/pig-heart-transplant-faucette.html)
Does Ozempic have temporary weight loss effects? (https://www.nytimes.com/2023/09/18/well/ozempic-weight-loss-plateau.html#:~:text=In%20clinical%20trials%20of%20semaglutide,weight%20at%20all%2C%20he%20added.)
Google identifies millions of mutations in proteins capable of generating disease (https://elpais.com/ciencia/2023-09-19/google-identifica-millones-de-mutaciones-en-las-proteinas-capaces-de-generate-diseases.html)

Global Health

A new approach to the Zika virus in Brazil. In 2015 alone there were 2,975 cases of microcephaly in Brazil. The studies were largely stopped by covid, now they are trying to recover (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02029-9/fulltext)
The pernicious consequences of the anti-homosexuality law in Uganda, passed in 2023 (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02028-7/fulltext)
The need to protect the integrity of WHO regional offices. The great challenges of global health (increasing inequities, growing weight of non-communicable diseases, danger of future pandemics, together with a climate crisis and multiple geopolitical conflicts) make it necessary to reinforce the regional offices of the WHO, with good governance (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02026-3/fulltext)
Article in Science about the eradication of polio. In 1988, the goals of eliminating polio by the year 2000 were defined. More than 20 years later, the goal has still not been achieved. Mass vaccination campaigns have reduced polio cases in Afghanistan and Pakistan. The greatest threat today is the vaccination itself, which is done with attenuated viruses, but which can regain virulence (https://www.science.org/content/article/global-polio-eradication-effort-struggles-end-game#:~:text=But%20the%20new%20report%20says,and%20political%20instability%20and%20indifference.)
Article in Nature: The treaty on pandemics for 2024, which states should not renounce, is in danger. The need to make vaccines accessible to everyone and the protection of intellectual property through patents, in contradiction (https://www.nature.com/articles/d41586-023-02904-y)
Tuberculosis after the pandemic, the WHO wants to revitalize the fight (https://www.lemonde.fr/planete/article/2023/09/23/tuberculose-apres-la-pandemie-de-covid-19-l-un-cherche-a-revitaliser-le-combat_6190634_3244.html#:~:text=Santé-,Tuberculose%20%3A%20après%20la%20pandémie%20de%20Covid%2D19%2C%20l%27,n%27ont% 20pas%20été%20)

International health policy

USA
- Medicare’s historic negotiation of the price of prescription drugs (https://jamanetwork.com/journals/jama/fullarticle/2809884)
- The Biden Administration wants to control the pharmaceutical industry. New rules have been designed to make drugs cheaper for Americans, but companies say innovation will suffer (https://www.ft.com/content/7e45d513-017f-4e68-9b23-68b974a21f1c)
- Almost 500,000 Americans will recover Medicaid, after errors by the states (https://www.nytimes.com/2023/09/21/health/medicaid-disenrollments-children.html)

United Kingdom and the National Health Service
- British Prime Minister Sunak is considering banning smoking for the younger generation (https://www.ft.com/content/b62856fe-fd6c-49bc-a7ce-4c3856a7ad8e)
- A report from the Institute for Public Policy Research (IPPR) says that 240,000 deaths could have been avoided in the United Kingdom between 2010 and 2020 if standards from other European countries had been applied. The report says this is largely due to access difficulties, which have worsened since the pandemic (https://www.bmj.com/content/382/bmj.p2092)
- NHS faces historic strikes as doctors walk out (https://www.ft.com/content/6e942e35-4907-4538-a353-f70033bdedd9)
- They consider that the United Kingdom should lead research in biomedicine but believe that the inertia of the NHS represents a brake (https://www.ft.com/content/e7c1546a-ecfa-4f43-8ac1-3d07c46dfe3a)