7 days in healthcare (May 15th-21st, 2023)

 

Summary

From the point of view of Biomedicine, to point out certain warnings about the use of blood tests for the detection of cancer, an area with great growth, since in some cases there may be errors in diagnosis, over diagnosis and over treatment . Researchers are trying to improve Nuclear Resonance imaging, through fMRI, which will be able to detect brain activity on the millisecond scale. The WHO warns about the use of sweeteners for weight control and ChatGPT in health, without careful prior examination.

With regard to Global Health, The Lancet denounces in an editorial the continuation of the practice of the death penalty in some countries, but most fundamentally in China. The International Treaty on Pandemics, which may be one of the positive consequences of the covid, seems to be ready in May 2024.

Regarding International Health Policy, very interesting statements by the Director General of the WHO to The Economist magazine, following the lifting of the global alarm due to the covid. Trying to explain why the covid affected developed countries (such as the USA) in many cases more than developing countries, he comments that possibly a certain self sufficiency about the strength of their health systems and a concentration towards investments in specialized hospitals and high technology, in instead of public health, is at the origin of this situation. The crisis in the NHS continues, Starmer (Labor Party leader) says the system cannot be fixed without fixing the “fundamentals”. He seems to understand by “fundamentals” the need for reforms and not just more funding. EMA 2022 annual report, which greets that year as very positive due to the rapid development of new vaccines and new drugs.

If we talk about National Health Policy (Spain), apart from the rise in the incidence of covid, possibly the most far-reaching news is the shortage of certain medicines in pharmacies. It seems that the causes can be multiple, but basically three: the dependence on certain raw materials that are manufactured in India and China; parallel exports due to the lower price of medicines in Spain compared to other European countries; and the very low price of some drugs that discourages their production. In Primary Care, the real problems far exceed the weekend promises to give more money, apparently already committed. In-depth reforms and increased funding is what Primary Care needs, after a deep negotiation and consensus. The PP of Asturias promises to end, if it wins, with the exclusivity of doctors in that region, apparently already the only one in Spain that rigorously applies this regulation. The project of the new Hospital Clinic (Barcelona) of more than 1,500 million surprises by its grandeur. It is to be assumed that such a large investment is fully justified and explained very well to the population.

In the field of Companies, at the international level, a large fine was imposed on the pharmaceutical chain Walgreens in San Francisco for promoting the use of opiates. In Spain, the construction of a new hospital in Alicante by IMED stands out (is there a real boom in new private hospitals?); the sale to a German fund of 26% of ESTEVE; and, as unusual, the denunciation by the hospital employer ASPE of the agreement between Sanitas and Generali. It seems that the discrepancy is that Sanitas extends the advantageous rates that it had negotiated with suppliers, which are more favorable than those of Generali, to Generali customers in this way.

Biomedicine

• Doubts about whether blood tests to detect cancer help or harm. Although these tests are being developed and have a great opportunity for growth, many experts denounce the risks associated with errors in diagnosis, over-diagnosis and over-treatment (https://www.ft.com/content/b5aaa6a9-a5a9-44a4-a57e-5ad69babcd7b)
• In pursuit of better imaging, researchers are trying to improve neuroscientists’ favorite tool: MRI. fMRI tries to detect brain activity on the millisecond scale (https://media.nature.com/original/magazine-assets/d41586-023-01616-7/d41586-023-01616-7.pdf)
• The WHO warns against the use of sweeteners for weight control (https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline#:~:text=The%20World%20Health%20Organization%20(WHO,of%20noncommunicable%20diseases%20(NCDs).) Access to original report: https://www.who.int/publications/i/item/9789240046429
• ChatGPT: the WHO calls for caution in its incorporation into the health field and requests that these tools undergo a “careful examination” (https://diariofarma.com/2023/05/16/chatgpt-la-oms-pide-cautela-in-its-incorporation-into-the-healthcare-field). Original statement: https://www.who.int/news/item/16-05-2023-who-calls-for-safe-and-ethical-ai-for-health

Global Health

• Editorial of The Lancet: the death penalty. This barbaric system of settling scores is still practiced in many countries. Officially documented executions increased 53% in 2022, compared to 2021. Most prolific countries in executions: China (thousands), Iran (576), Saudi Arabia (196), Egypt (56), and USA (18) (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01004-8/fulltext#:~:text=The%20death%20penalty%20is%20inhumane,maleficence%2C%20autonomy%2C% 20and%20justice.)
• The international treaty on pandemics will be ready in May 2024 (https://www.epe.es/es/sanidad/20230515/tratado-internacional-pandemias-oms-2024-87220641#:~:text=El%20calendario %20of%20negotiations%20anticipates,30%20of%20January%20of%202020.)
• Palestinians continue to face barriers to healthcare (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01001-2/fulltext#:~:text=Considerable%20barriers%20continue%20to%20hamper,implementation%20of%20a%20permit%20regime”.)
• Vaccine manufacturing in Africa. Africa produces only 0.1% of the vaccines in the world and only 30% of the population is vaccinated for covid. But the efforts for the production of vaccines in that continent with great (https://www.bmj.com/content/381/bmj.p908)
• In Polynesia, weak but existing impact of thyroid cancer from nuclear tests (https://www.lemonde.fr/sante/article/2023/05/15/en-polynesie-impact-faible-mais-existant-des-essais-nucleaires-sur-le-risque-de-cancer-de-la-thyroide_6173482_1651302.html)
• The exclusion of Taiwan from the WHO questions the independence of the WHO in relation to Beijing (https://www.lemonde.fr/idees/article/2023/05/18/l-exclusion-de-taiwan-de-l-oms-questionne-sur-l-independance-de-l-organisation-par-rapport-a-pekin_6173851_3232.html#:~:text=La%20raison%20principale%20de%20cette, partie%20tégrante%20de%20la% 20China.)

International Health Policy

• COVID 19
  • With the end of covid as a global emergency, what’s next? (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01003-6/fulltext)
  • Statements by the Director General of the WHO on the lessons of covid 19. During the last three and a half years, covid has officially claimed 7 million lives, although the reality must be closer to 20 million. Although there is no country that has gotten rid of the covid, it has hit developed countries the most. Why? Although there is no absolute answer, possibly these countries had a feeling of greater security due to the robustness of their health systems, more concentrated in specialized hospitals and sophisticated medical equipment, rather than public health aspects (https://www.economist.com/by-invitation/2023/05/15/tedros-adhanom-head-of-the-who-on-the-lessons-from-covid-19)

• China
  • What happened in China after the abandonment of the covid zero policy and the massive infection of omicron? The official figures for deaths are 87,475 between February 24 and March 16, 2023. Other estimates speak of between 1-1.5 million deaths. Surely the reality is somewhere in between (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804631)

• United Kingdom and National Health Service
  • Pharmacy Access to Primary Care Plan, praised by Pharmacy Leader (https://www.bmj.com/content/381/bmj.p1108#:~:text=Primary%20care% 20access%20plan%20could%20help%20narrow%20health%20inequalities%2C%20says%20pharmacy%20leader,-BMJ%202023%3B%20381&text=The%20government%27s%20plan%20to%20boost,a%20pharmacy%20leader% 20has %2)
  • Pediatricians condemn national scandal of 400,000 children awaiting treatment (https://www.bmj.com/content/381/bmj.p1097#:~:text=Paediatricians%20condemn%20“national%20scandal”%20of %20400%20000%20children%20waiting%20for%20treatment,-BMJ%202023%3B%20381&text=The%20Royal%20College%20of%20Paediatrics,the%20figures%20for%20March%202023)
  • Plan to reduce waiting lists fails (https://www.bmj.com/content/381/bmj.p1083#:~:text=Large%20push%20to%20meet%20NHS%20operations%20backlog%20falls% 20short%20on%20hitting%20targets,-BMJ%202023%3B%20381&text=Intense%20efforts%20to%20try%20to,figures%20for%20England%20have%20confirmed.)
  • Patients pay £550 an hour to see a private GP (https://www.theguardian.com/society/2023/may/19/patients-paying-550-an-hour-to-see-private-gps-amid-nhs-frustrations)
  • Starmer (leader of the Labor party, says that the NHS cannot be solved without fixing “the fundamentals”, meaning reforms and extra investment. He says that it is not serious to say that the system can be fixed only with more money (https:// www.theguardian.com/politics/2023/may/21/starmer-to-warn-nhs-not-sustainable-without-fixing-the-fundamentals#:~:text=Starmer%20is%20expected%20to%20say%3A %20“The%20NHS%20is%20not%20sustainable,That%27s%20not%20serious.”)

• France
  • Macron announces several hundred million euros for biomedical research (https://www.lemonde.fr/sante/article/2023/05/16/emmanuel-macron-annonce-plusieurs-centaines-de-millions-d-euros-d-investissements-dans-la-recherche-biomedicale_6173590_1651302.html)

• G7
  • Japan calls for more dedication in monitoring dementia (https://www.ft.com/content/25bd68d4-cf44-469a-9afc-d546d7856937)

• Europe
  • Annual balance of the EMA: new vaccines and drugs that bring an incalculable change (https://elglobal.es/politica/balance-anual-de-la-ema-2022-nuevas-vacunas-y-farmacos-que-traen-an-incalculable-change/). Access to the EMA annual report: https://www.ema.europa.eu/en/news/ema-annual-report-2022-published

National health policy

• COVID
  • The incidence continues to rise to 98.31; Mortality since the previous report of 15 days ago is 249 people. 2,354 patients admitted to hospitals, of which 104 in ICU beds (https://www.consalud.es/pacientes/especial-coronavirus/datos-covid-espana_130076_102.html)

• Problems of drug shortages in pharmacies
  • There is a lack of medicines in pharmacies, according to the AEMPS there are problems with 740 drugs. The fundamental causes of these deficiencies are: dependence on raw materials from India and China; lower price in Spain, which favors parallel exports; and the low price of some medicines, which discourages their production (https://www.epe.es/es/opinion/20230515/falta-medicamentos-creciente-farmacias-sanidad-87342336)
  • Editorial of El País (https://elpais.com/opinion/2023-05-15/autosuficiencia-farmaceutica.html)

• Electoral promises
  • Sánchez announces 580 million for primary care, although some say that they were already approved (https://www.elespanol.com/espana/20230520/sanchez-anuncia-inversion-millones-reforzar-atencion-primaria/765173541_0.html)
  • The so-called “oncological forgetfulness” affects banks and insurers above all, since at present they can cause problems for a mortgage or to contract health insurance (https://theobjective.com/legal/2023-05-21/oblivion-oncologico-banks-safe-cancer/)

• PP promises in Asturias
  • The PP promises to eliminate medical exclusivity in Asturias, since apparently it is already the only community in which it is applied (https://www.redaccionmedica.com/autonomias/asturias/-eliminaremos-la-exclusividad-medica-para-attract-more-professionals–6060)

• Public healthcare
  • The macroproject of the new Hospital Clinic (Barcelona), with an astronomical budget of more than 1,500 million euros (https://elpais.com/espana/catalunya/2023-05-18/el-macroproyecto-del-nuevo-clinic-nuevas-paradas-de-metro-works-in-the-access-to-barcelona-and-a-cost-of-at-least-1500-millions.html)

Companies

• International News
  • The Walgreens pharmacy chain will pay $230 million to San Francisco for promoting the opioid crisis (https://www.diariomedico.com/farmacia/politica/la-cadena-de-farmacias-walgreens-pagara-230-millones-of-dollars-san-francisco-for-promoting-the-opiate-crisis.html)

• National News
  • Vithas buys the Baren de Las Palmas obstetrics and gynecology clinic (https://www.plantadoce.com/empresa/vithas-compra-la-clinica-baren-de-las-palmas.html)
  • IMED will build a new hospital in Alicante for 48 million euros in 2024 (https://www.plantadoce.com/empresa/imed-levantara-un-nuevo-hospital-en-alicante-por-48-millones-de-euros-for-2024.html#:~:text=2023%20—%2010%3A45-,Imed%20will build%20a%20new%20hospital%20in%20Alicante%20for%2048%20millions,its%20center%20hospital%2 )
  • ESTEVE sells 26% of its capital to the German investment firm Lubea (https://www.plantadoce.com/empresa/esteve-vende-el-26-de-su-capital-a-la-firma-de-german-investment-lubea.html)
  • Atrys Health takes its drug against prostate cancer to Portugal (https://www.plantadoce.com/empresa/atrys-health-carries-su-farmaco-contra-el-cancer-de-prostata-a-portugal. html#:~:text=2023%20—%2018%3A15-,Atrys%20Health%20carries%20its%20drug%20against%20%20prostate%20cancer%20,theragnosis%20in%20the%20Portuguese%20market.)
  • The hospital employer ASPE will denounce the policy agreement between Sanitas and Generali (https://cincodias.elpais.com/companias/2023-05-18/la-patronal-hospitalaria-denunciara-el-pacto-de-polizas-de-health-of-sanitas-and-generali.html)

 

 

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