7 days in healthcare (March 27th-April 2nd, 2023)

 

Summary

From the point of view of Biomedicine, the latest issue of The Lancet dedicates a special article and an editorial to chronic pain, which affects millions of people daily; For its part, the New England Journal of Medicine publishes a review and an editorial on Artificial Intelligence in medicine. It seems that humanity will soon break historical records in terms of longevity. It is also worth highlighting the advances that are being announced in regenerative medicine (xenotransplant, 3D organ printing and stem cells).

With regard to Global Health, the most important thing is the WHO’s warning to governments in dedicating efforts to health professionals, since many of them are close to retirement and the needs are increasing for many reasons.

Regarding International Health Policy, in the United States, the FDA authorizes the free sale of Narcan, a nasal spray against opioid overdose, which represents life or death for many people. In the United Kingdom, the popularity of the NHS is the lowest it has been for 40 years, when this type of study began.

If we talk about National Health Policy (Spain), a new replacement in the Ministry of Health. Some consider that this Ministry has become the electoral launching pad for its incumbents (Illa, for Catalonia; Darias, for Las Palmas, and, apparently, Miñones, for Galicia). This approach, together with the short duration of the ministers, is one of the causes that contribute to the loss of prestige, leadership and role of the Ministry of Health, which has a policy of contingency management, but without a true project of transformation of the system, to propose to the different agents. The Minister of Health of Catalonia seems to have a plan to reinforce and retain professionals, something very necessary. I hope this plan works. The EMA has given the green light to the Spanish vaccine against the HIPRA covid, although only as a booster dose to the mRNA vaccines. Important social debate around surrogacy, as a result of the use of this procedure by a “celebrity”. Very different positions on the subject. Perhaps the most correct approach, as a quoted writer does, is to see who this procedure harms, if the parents, the unborn child, or the woman who lends her uterus. If the conclusion is that no one has been harmed, the most reasonable thing to do would be to approve this practice in our country, as it is in so many others.

In the field of Companies, internationally, BioNTech’s sales forecasts plummet, as a result of the lower demand for covid vaccines. At the national level, perhaps the most far-reaching news is the purchase by Viamed (Macquarie) of the Fátima hospital in Seville, after stiff competition with many other interested parties, including Vithas and Sanitas. Hospitales Parque (CASER) is set to grow at the rate of one hospital per year in the next three years.

Biomedicine

• Chronic pain can be treated (https://www.nature.com/immersive/d41586-023-00869-6/index.html). Chronic pain, defined as pain that lasts for more than three months, affects millions of people every day. Nature editorial (https://www.nature.com/articles/d41586-023-00885-6)
• Artificial Intelligence in clinical medicine. There is practically no area of medicine that is not affected by AI, for example from capturing the dictation of medical notes, along with laboratory results, to producing clinical notes without the intervention of a clinician. Or in the interpretation of medical images (https://www.nejm.org/doi/full/10.1056/NEJMra2302038). NEJM editorial: https://www.nejm.org/doi/full/10.1056/NEJMe2206291
• Obesity and autoimmunity, strong association between overweight and obesity and the risk of developing an autoimmune disease (https://www.science.org/doi/10.1126/science.ade0113)
• Humanity will break historical records for life expectancy in a decade (https://www.elmundo.es/ciencia-y-salud/salud/2023/03/29/6424750ffc6c832c7c8b45a3.html), original article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281752
• Advances in regenerative medicine, from xenotransplant (transplants with animal organs), artificial organs printed in 3D or the use of stem cells (https://www.consalud.es/tecnologia/tecnologia-sanitaria/medicina-regenerativa-revolucion-avances_128358_102 .html)

Global Health

• WHO warning to governments: Invest in health professionals or risk collapse. 40% of doctors are close to retirement in a third of the countries, with a high presence of chronic diseases and the effects of the pandemic (https://www.bmj.com/content/380/bmj.p713)
• The invasion of Ukraine and the impact on health in Russia. There are indirect effects of sanctions on Russia, such as drug shortages and other problems (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00674-8/fulltext)
• Health in Nigeria (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00676-1/fulltext)

International Health Policy

• COVID
  • Data from Gisaid, the global repository of covid genomic data, increases the chances of discovering the origin of covid. Three years into the pandemic, it is still not certain whether the virus arose accidentally from a laboratory or was transmitted through an animal host (https://www.ft.com/content/f0733683-cb6d-4578-915a-aa60d7ba4c1d)

• USA
  • The FDA approves Narcan, a nasal spray against opioid overdose, as an over-the-counter medicine. It is expected that Narcan will soon be sold in drugstore chains, vending machines, supermarkets, convenience stores, gas stations, and online vendors. This can mean the difference between life and death for those who experience an overdose (https://www.nytimes.com/2023/03/29/health/narcan-over-the-counter.html)
  • North Carolina expands Medicaid. The provision expands coverage to families of four, with less than $41,000 in income (https://www.nytimes.com/2023/03/27/us/politics/north-carolina-medicaid-expansion.html)
  • The Supreme Court is making decisions that harm public health (https://jamanetwork.com/journals/jama/fullarticle/2803498)

• UK and the NHS
  • Satisfaction with the NHS plummets to its lowest levels in 40 years. The most common interpretation is that it is the result of more than a decade of underfunding and lack of planning by healthcare professionals (https://www.ft.com/content/35ac0276-1c6a-4d4c-9c97-3e9a26d8f7b8)
  • Junior doctors will go on strike for 96 hours starting April 11 (https://www.bmj.com/content/380/bmj.p701)

National Health Policy

• COVID
  • The cumulative incidence at 14 days drops to 68.99 points, and mortality stands at 53 in the last week. There are currently 2,048 admitted for covid, of which 102 are in ICU beds (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-suma-120426-muertes-mientras-ia-baja-6899-points_128359_102.html)

• Change in the Ministry of Health
  • The Ministry Health, from a secondary ministry, to a candidate incubator (https://www.eldiario.es/politica/sanidad-ministerio-maria-incubadora-candidatos_1_10071809.html)
  • Numerous laws that the new minister will have to finalize before the elections, if he has time, including the law on Guarantees and Rational Use of medicines, as well as the law on the State Public Health Agency, at the same time as the initiatives in of the Spanish Presidency of the Council of Europe (https://www.diariomedico.com/politica/estas-son-las-leyes-que-minones-deberia-dejar-listas-antes-de-las-elecciones-le-give-time.html)

• Conflicts in public healthcare
  • The health unions call a strike in Madrid two days before the elections (https://www.vozpopuli.com/espana/sindicatos-sanitarios-convocan-huelga-madrid-dos-dias-antes-elecciones.html)

• Public healthcare
  • The Minister of Health of Catalonia has a plan to reverse the lack of toilets, among them a plan endowed with 40 million euros, improvement of working conditions, increase in training places, plan for places that are difficult to cover, development of nursing specialties, shared professionals between primary and specialized care, etc. (https://www.redaccionmedica.com/autonomias/cataluna/cataluna-impulsa-50-acciones-e-invierte-40-millones-para-atraer-sanitarios-8871)

• The Spanish HIPRA vaccine
  • Europe gives the green light to the Spanish vaccine against covid, but only as a booster dose of the RNA vaccine (https://www.elmundo.es/ciencia-y-salud/salud/2023/03/30/642598ae21efa0b9738b4597.html)

• Controversy about surrogacy
  • Surrogacy in the world, in which countries is it legal and where is it prohibited. It is authorized in many states of the United States, Canada, Russia, Ukraine, Georgia, Greece, United Kingdom (altruistic variety), Australia, India, South Africa and Thailand. (https://www.elmundo.es/ciencia-y-salud/salud/2023/03/29/6423eab221efa052758b459b.html)
  • Spain has registered more than 2,300 children in ten years through surrogacy (https://www.abc.es/sociedad/abci-espana-inscrito-mas-2300-ninos-nacidos-gestacion-subrogada-ultimos-diez-years-202102210033_news.html)
  • Opinion article: who does surrogacy harm? In the opinion of this author, it does not harm the parents, the unborn, or the woman who leaves her womb (https://blogs.elconfidencial.com/economia/laissez-faire/2023-03-31/gestacion-subrogated-harmed-parties-involved_3603110/)

• Transplants in Spain
  • Transplant activity in Spain grew by 23% in the first quarter of 2023 (https://www.diariomedico.com/medicina/trasplantes/la-actividad-de-trasplantes-en-espana-crece-un-23-in-the-first-quarter-of-2023.html)
  • The government will try to defend the Spanish transplant model during the Spanish presidency of the EU (https://www.consalud.es/politica/gobierno-modelo-espanol-donacion-trasplantes-durante-presidencia-consejo_128293_102.html)

• Regulatory framework
  • The advertising of health products, to public consultation (https://www.diariomedico.com/farmacia/politica/la-publicidad-de-productos-sanitarios-consulta-publica-previa.html)

• Pharmaceutical policy
  • Kanahuati, CEO of Bayer for Spain: “Our ambition is for a Spaniard to access medicines like a German. This is not the case today” (https://www.elespanol.com/invertia/observatorios/sanidad/20230323/kanahuati-bayer-ambicion-espanol-medicamentos-hoy-no/750675058_0.html)
  • Recommendations of the Advisory Commission, for medicines approved by the EMA but without a price in Spain (https://www.sanidad.gob.es/profesionales/farmacia/pdf/CAPF_Recomendaciones_Financiacion_Provisional.pdf)

Companies

• International News
  • BioNTech sales forecasts plummet as demand for covid vaccines wanes (https://www.ft.com/content/bdb3a125-7077-402d-9e0b-86acadcf1a26)
  • Moderna will pay more than 70 million euros to Generation Bio for genetic medicines (https://www.plantadoce.com/empresa/moderna-pagara-mas-de-70-millones-a-generation-bio-para-medicamentos-genetics.html)

• National News
  • Macquarie (Viamed) buys the Fátima hospital in Seville for 80 million (https://www.expansion.com/empresas/2023/03/31/6425d41e468aeb841c8b456d.html)
  • Sanitas increases its profit by 29% in 2022, up to 273 million euros (https://www.plantadoce.com/empresa/sanitas-incrementa-un-29-su-beneficio-en-2022-hasta-273-millones-de-euros.html)
  • Hospitales Parque fixes for 2025 sales of 100 million and three new complexes (https://www.plantadoce.com/empresa/hospitales-parque-fija-para-2025-ventas-de-100-millones-de-euros-y-three-new-complexes.html)
  • CASER bets on the senior business and prepares its landing in Andalusia (https://www.plantadoce.com/empresa/caser-apuesta-por-el-negocio-senior-y-prepara-su-desembarco-en-andalucia.html)
  • Ribera opens a private clinic in the Torrevieja area (https://www.consalud.es/ecsalud/nacional/ribera-clinica-privada-tecnologia-ciudad-quesada-torrevieja_128268_102.html)
  • Vithas expands with a new hospital and medical centers in Estepona, Madrid, Barcelona and Vigo (https://www.elespanol.com/invertia/observatorios/sanidad/20230316/vithas-expande-hospital-estepona-madrid-barcelona- vigo/748925276_0.html)