7 days in healthcare (February 19th-25th, 2024)

 

Summary

From the point of view of Biomedicine, the mega-study of 250,000 genomes made public by the National Health Institutes of the USA stands out. This is in line with carrying out genome studies combining it with electronic medical record data from very large groups initiated in the United Kingdom by Genomics England and also developed in Iceland and Japan. A very promising way to improve knowledge of many diseases. New treatments for type 1 diabetes, based on the transplant of insulin-producing beta cells, obtained from stem cells, neutralizing the immune reaction. Gene therapy is the great promise for many rare diseases, currently without treatment. The problem to be solved is the high price of the treatments. At the present time, saying breast or prostate cancer is almost saying nothing. The treatment of tumors is no longer based on their anatomical origin, but rather on their molecular characterization. Bispecific antibodies that act on two targets at the same time, useful in hematological and solid tumors. The FDA approves a drug to prevent the amputation of fingers and limbs.

As far as Global Health is concerned, long covid was understood as a sequel to covid, but an article in The Economist states that covid is not the only infectious disease that leaves pathological conditions that are difficult to label. An article in Health Affairs places the solution to the obesity epidemic as a joint effort of prevention and treatment.

In terms of International Health Policy, more than half of USA’s rural hospitals do not offer childbirth services, which means that pregnant women have to be treated in centers located 30-40 minutes from their home, sometimes more. This is related to the high maternal and infant mortality in the USA, higher than that of most developed countries. The 4th anniversary of Brexit encourages the debate about whether it was good or bad for the National Health Service. The truth is that the NHS is worse now than before Brexit (waiting lists, professional strikes, etc.) and the difficulty of recruiting health professionals from the EU has increased. The investigation was also damaged. Increasing funding for the NHS was one of the arguments used by Brexiteers. France addresses the carbon footprint in the health system, within the general “France Nation Verte” program. Germany legalizes recreational cannabis, with one of the most liberal laws in Europe, after Malta and Luxembourg. More than controversial attempt in Germany to take control of non-communicable diseases from the Robert Koch Institute, one of the most prestigious organizations in German health, to give it to another organization, created as a result of covid. The European Medicines Agency recommends approving a drug against ALS.

If we talk about National Health Policy (Spain), as a result of a specific scandal, the entire problem of purchasing masks and other materials during covid is introduced into the national debate. Precisely everything related to the purchase of these materials was somewhat overlooked by the report “Evaluation of the Performance of the Spanish National Health System in the face of the covid-19 pandemic”, dated April 30, 2023, although published by the Ministry of Health in December of that year. It is already serious that an issue such as the problems of purchasing materials are not analyzed in the report, as if this had not been one of the most serious problems in the management of covid. The PNV requests the return of the text of the Public Health Agency law. That this law was going to have problems with the nationalist parties, always opposed to the creation of cohesion bodies in the National Health System, was something known. Surely this will mean delays in the appearance of the law and, what may be more serious, affect its content and functions. There is a risk that the announced Agency will be little more than an empty shell. The government creates the Extreme Temperature Observatory to analyze the health impact of climate change. The Basque Country approves a new Mental Health Plan 2023-2028. The EU denounces the high level of interim contracts in the Spanish public health system. At the current time, 43% of contracts are interim.

As for Companies, internationally, AstraZeneca reveals successes in the treatment of lung cancer. Indian drugmakers make versions of Novo Nordisk’s anti-obesity drug. At the national level, Sanitas intends to open a new hospital in Barcelona. Fever of construction of private hospitals in Valencia: Vithas, Quirón, IMED and Ascires in that race.

Biomedicine

• Mega study of 250,000 genomes from the National Health Institutes in the USA. The study called “All of Us” publishes an analysis of 250,000 genomes linking health information. Launched in 2018, the project is similar to others in the United Kingdom, Iceland and Japan. The intention is to reach one million participants, analyzing DNA, blood tests and data from the electronic medical record (https://pubmed.ncbi.nlm.nih.gov/38386750/)
• New treatments for type 1 diabetes. Advances try to transplant cells similar to the beta cells of pancreatic islets, from stem cells, together with a system to avoid the immunosuppressive reaction of rejection (https://www.economist.com/science-and-technology/2024/02/20/new-treatments-are-emerging-for-type-1-diabetes)
• Gene therapy can transform rare diseases. This NYT article describes an effective treatment for Duchenne disease. Gene therapy is presented as the future of medicine, particularly for rare diseases. The big obstacle is the price of these treatments, which can reach 1-2 million dollars/year. (https://www.nytimes.com/2024/02/19/opinion/gene-therapy-dmd-elevidys.html)
• An antiviral protein seems to be a good indicator of long covid. High levels of interferon-gamma may be useful to detect long covid (https://www.ft.com/content/c649ebb5-3d69-4d15-a983-b91abae335f0) Original article published in Science Advances:https://www.science.org/doi/10.1126/sciadv.adi9379
• The time has come to rename breast or prostate cancer. For decades, the location of tumors guided the way they were treated. Not anymore. Advances in molecular biology and personalized treatments are changing the approach to many tumors. (https://www.alimente.elconfidencial.com/bienestar/2024-02-22/cancer-tumores-biologia-molecular_3831412/) Original article in Nature: https://www.nature.com/articles/d41586-024-00216-3
• Bispecific antibodies: an open window for the treatment of orphan solid tumors or those with poor prognosis. Biotechnological development has managed to create a new type of antibodies to recognize and bind to two targets at the same time. They began in hematological tumors, but trials in solid tumors are growing (https://www.diariomedico.com/medicina/oncologia/anticuerpos-biespecificos-ventana-abierta-tratamiento-tumores-solidos-huerfanos-o-mal-pronostico.html)
• The FDA launches a treatment to prevent finger and limb amputations. The medication is called iloprost, it is given intravenously and works by dilating blood vessels to improve circulation (https://www.nytimes.com/2024/02/24/health/frostbite-treatment-amputation.html#:~:text=The%20drug%2C%20iloprost%2C%20is%20given,stop%20circulation%20and%20kill%20tissue.)

Global Health

• Long covid is not the only disease driven by infections (https://www.economist.com/science-and-technology/2024/02/21/long-covid-is-not-the-only-chronic-condition-triggered-by-infection)
• Solving the obesity epidemic will require prevention and treatment working together (https://www.healthaffairs.org/content/forefront/addressing-obesity-epidemic-require-prevention-and-treatment-working-together)
• An intense dengue epidemic is devastating Guyana (https://www.lemonde.fr/planete/article/2024/02/22/l-epidemie-de-dengue-la-plus-intense-depuis-vingt-ans-met-a-plat-toute-la-guyane_6217971_3244.html#:~:text=«%20Cette%20épidémie%20de%20dengue%20est,»)
• An invasion of mosquitoes hits Buenos Aires (https://elpais.com/argentina/2024-02-21/una-invasion-de-mosquitos-azota-buenos-aires.html#)
• A low socioeconomic level increases the possibility of suffering from dementia before the age of 65 (https://elpais.com/salud-y-bienestar/2024-02-19/un-nivel-socioeconomico-bajo-multiplica-por-tres-the-risk-of-dementia-before-age-65.html#)
• The climate emergency threatens the reduction in mortality of pregnant women in India (https://elpais.com/planeta-futuro/2024-02-24/la-emergencia-climatica-amenaza-los-logros-en-la-reduction-of-maternal-mortality-in-india.html#)
• Brazil expands dengue vaccination as cases rise (https://www.ft.com/content/bb78b972-83d9-4809-9fd2-84c6af42904a)

International health policy

• USA
  • More than half of rural hospitals in the US do not offer childbirth services. More than 200 rural hospitals have closed their delivery services in the last 10 years. Patients must travel long distances, usually between 30-40 minutes, to be treated. Among advanced nations, the US has among the worst maternal and infant mortality rates (https://jamanetwork.com/journals/jama/fullarticle/2815499) Original report on rural maternal care in the US: https://ruralhospitals.chqpr.org/downloads/Rural_Maternity_Care_Crisis.pdf
  • It is shown that banning menthol cigarettes can reduce the rate of smoking. A quarter of former smokers of these cigarettes quit tobacco (https://www.nytimes.com/2024/02/22/health/menthol-cigarette-bans-smoking.html)

• United Kingdom and the National Health Service
  • Brexit and health. January 31, 2024 was celebrated as the 4th anniversary of the United Kingdom’s effective departure from the European Union. The Lancet asks whether or not that was good for the NHS, with two possible answers: the easy one, which says there is no evidence; and the difficult one, which confirms that the NHS is in fact worse now than before, as demonstrated by the long waiting lists and the continuous strikes by health professionals. What is certain is that it has become difficult to recruit doctors from the EU. At present, the majority of foreign doctors hired in the NHS are from outside the EU. Research plans were also negatively altered. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00157-0/abstract)
  • The government changes its policy and plans to double the number of medical students in 2031 (https://ground.news/article/government-u-turn-on-plans-to-double-number-of-medical-students-in-england)

• France
  • An exceptional aid of 500 million euros unlocked for hospitals in difficulty (https://www.lemonde.fr/societe/article/2024/02/19/une-aide-exceptionnelle-de-500-millions-d-euros-deblocke-pour-les-hopitaux-en-difficulte_6217328_3224.html)
  • France addresses the carbon footprint of the health system, within the general policy “France Nation Verte” an “Ecological Planning of the health system” is designed (https://sante.gouv.fr/IMG/pdf/planification-ecologique-du-systeme-de-sante-feuille-de-route-mai-2023.pdf)

• Poland
  • The Polish Parliament liberalizes access to the morning-after pill (https://www.lemonde.fr/international/article/2024/02/22/le-parlement-polonais-liberalise-l-acces-a-la-pilule-du-lendemain_6217948_3210.html#:~:text=que%20sur%20ordonnance.-,La%20loi%2C%20qui%20doit%20encore%20passer%20au%20Sénat%20et%20être,de%2015%20ans%)

• Germany
  • Germany legalizes recreational cannabis with one of the most liberal laws in Europe (https://www.lemonde.fr/international/article/2024/02/23/l-allemagne-legalise-le-cannabis-recreatif-avec-une-des-lois-les-plus-liberales-d-europe_6218206_3210.html)
  • Reform of the public health system. The government, opposed by a large part of medical opinion, proposes removing the control of non-communicable diseases from the Robert Koch Institute, the most serious German organization in health, which it assigns to an organization created in the wake of covid (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00347-7/abstract?rss=yes)

• South Korea
  • Strike for the first time by doctors in the public system (https://www.theguardian.com/world/2024/feb/23/south-korea-doctors-strike-public-health-alert-hospitals-surgeries-details-protest-seoul)

• Argentina
  • Argentine unions stand up to Milei with transport, health and education strikes (https://elpais.com/argentina/2024-02-22/los-sindicatos-argentinos-plantan-cara-al-trabajo-de-milei-with-transport-strikes-health-and-education.html)

• European Union
  • The European Medicines Agency recommends approving a new treatment against ALS in the EU (https://www.diariomedico.com/medicina/farmacologia/ema-recomienda-aprobar-nuevo-tratamiento-ela-ue.html)

National health policy

• Problems with the purchase of material during covid
  • Commission agents on the lookout for the multimillion-dollar loot from the purchase of masks (https://elpais.com/espana/madrid/2024-02-23/comisionistas-al-acecho-del-botin-multimillonario-de-la-compraventa-de-masks.html#)
  • A judge charges two former senior Health officials accused of distributing defective masks to doctors (https://www.eldiario.es/politica/juez-imputa-exaltos-cargos-sanidad-acusados-repartir-mascarillas-defectuosas-medicos_1_10952621.html#:~:text=The%20Court%20of%20Instruction%20Number,of%20the%20pandemic%20of%20coronavirus.)

• The PNV and the State Public Health Agency
  • The PNV requests the return of the decree on the AESP and predicts a “competence conflict.” He assures that the text represents a “duplicity of functions” and that it may conflict with the Public Health Law approved by the Basque government (https://diariofarma.com/2024/02/19/el-pnv-pide-la-return-of-the-decree-on-the-aesp-and-predicts-a-competence-conflict)

• ALS Law
  • The ALS Law remains stagnant for two years (https://elpais.com/sociedad/2024-02-21/la-ley-de-ela-sigue-estancada-dos-anos-y-mas-de-2200-deceased-after.html)

• Observatory on extreme temperatures
  • The government presents the Observatory on extreme temperatures and health. Cross-cutting initiative (Ecological Transition, Health and Innovation), to address health crises derived from extreme climate (https://elpais.com/clima-y-medio-ambiente/2024-02-22/el-gobierno-presenta-the-observatory-to-address-extreme-temperatures-the-climate-crisis-is-a-public-health-crisis.html)

• Mental Health and the Basque Country
  • Mental Health Strategy 2023-2028 of the Basque Country (https://gacetamedica.com/politica/estrategia-de-salud-mental-2023-2028-euskadi-se-dota-de-dos-unidades-de-tca-and-a-day-hospital-infanto-juvenil/#:~:text=Gaceta%20Médica-,Estrategia%20de%20Salud%20Mental%202023%2D2028%3A%20Euskadi%20se%20dota%20de,hospi). Access to the original document: https://bideoak2.euskadi.eus/2023/11/21/news_89832/Estrategia_de_Salud_Mental_es.pdf

• Reconfiguration of health departments in the Valencian Community
  • The community goes from 24 departments to 8 interdepartmental health groups (https://www.diariomedico.com/medicina/politica/valencia-define-ocho-agrupaciones-sanitarias-interdepertamentales.html)

• Valencian Community Incentives
  • Incentive of 10,000 euros in the rural doctor salary in the Valencian Community (https://www.redaccionmedica.com/autonomias/valencia/los-medicos-valencianos-del-medio-rural-cobraran-un-incentivo-10-000-euros-2456#:~:text=La%20Generalitat%20Valenciana%20define%20los,of%206,500%20euros%20for%20Nursing.)

• Health and Education, leaders in interim contracts
  • The EU points to Health and Education in Spain for the high percentage of interim contracts. Health has 43% of its staff as interims (https://www.eleconomista.es/economia/noticias/12690168/02/24/sanidad-y-educacion-los-grandes-senalados-por-europa-due-al-abuse-of-interim-contracts-.html)

Companies

• International News
  • AstraZeneca reveals successes in the treatment of lung cancer (https://www.ft.com/content/b845e8ab-9cbc-482c-aa22-0b5c020be099)
  • Moderna registers a 65% drop in revenue in 2023 (https://www.consalud.es/salud35/economia/moderna-registra-caida-ingresos-2023_140644_102.html#)
  • Boehringer and Lilly launch a therapy for patients with chronic kidney disease (https://www.pmfarma.com/noticias/54901-la-fda-aprob-jardiance-para-el-tratamiento-de-adultos-con-enfermedad-renal-cryinica.html#:~:text=The%20drug%20of%20the%20Alianza,of%20fase%20III%20EMPA%2DKIDNEY.)
  • Abbie completes the purchase of InmunoGen for 9,235 million euros (https://www.plantadoce.com/empresa/abbvie-culmina-la-compra-de-immunogen-por-9235-millones-de-euros#:~:text=of%20euros%20%7C%20PlantaTwelve-,Abbvie%20culminates%20the%20purchase%20of%20ImmunoGen%20for%209,235%20million%20of,of%20ovary%2C%20as%20el%20Elahere.)
  • The venture capital giants fight for Sanofi’s consumer division for 18.5 billion (https://cincodias.elpais.com/companias/2024-02-20/los-gigantes-del-capital-riesgo-pugnan-por-the-sanofi-consumer-health-division-per-18,500-million.html)
  • Indian pharmaceutical companies make versions of NovoNordisk’s anti-obesity drug (https://www.expansion.com/empresas/industria/2024/02/23/65d7e7dae5fdeaf31d8b45cb.html)

• National
  • Colonial and Sanitas are negotiating to open a hospital in Barcelona (https://www.expansion.com/catalunya/2024/02/19/65d24f90e5fdeaa9278b4592.html)
  • Fever due to private hospitals in Valencia: Vithas, IMED, Ascires, Quirón (https://www.eleconomista.es/salud/noticias/12686393/02/24/la-fiebre-por-los-hospitales-privados-contagia-a-valencia-vithas-imed-ascires-y-quiron-suman-proyectos.html)
  • Vafidemstat, the promising molecule that can launch Oryzon to the Nasdaq (https://cincodias.elpais.com/extras/ciencia-salud/2024-02-15/vafidemstat-la-prometedora-molecula-que-may-lanzar-a-oryzon-al-nasdaq-y-mas-alla.html)
  • Sha Wellness, from the Bataller family, plans to expand to Mexico (https://www.expansion.com/fueradeserie/cuerpo/2024/02/23/65d8895ee5fdeab4668b45b6.html)
  • Almirall loses 38.5 million in 2023, but rises on the stock market after signing an agreement with NovoNordisk (https://cincodias.elpais.com/companias/2024-02-19/almirall-pierde-385-millones-de-euros-in-2023-but-it-improves-by-36-its-net-sales.html)