7 days in healthcare (May 22nd-28th, 2023)

 

Summary

From the point of view of Biomedicine, to point out the cerebral signs in the orbito-frontal cortex detected in chronic pain, which opens the possibility of implanting devices to alleviate pain. An AI-based digital bridge enables paraplegics to walk, raising hope that neurotechnology can help overcome numerous disabilities. The contribution of AI in the interpretation of radiological images is the subject of an extensive review in the New England Journal Medicine. Science magazine publishes advances in regenerative medicine, which helps to recover tissues damaged in many diseases.

With regard to Global Health, The Economist shows with its model that global deaths are 5% above the pre-pandemic era, speculating about whether the stress on health systems due to the covid could have left many people without treatment, which would have increased mortality. Child labor, so present even in developed countries, is the subject of an analysis by The Lancet. The WHO, for its part, warns that the next pandemic may be even deadlier than covid.

As for International Health Policy, the most striking thing is both the editorial and the article that The Economist dedicates to the National Health Service. He goes on to say that although the NHS may need more money, money alone would not solve its problems, calling for “a radical change of focus”, but not like those that some are calling for to move closer to social insurance-type models such as in Germany and France, which he considers unnecessary. He believes that the change consists of orienting the system more towards health, as its name indicates, and less towards disease. Less focus on hospitals and more on community health; from treatment to prevention; and valuing the results more than the activity inputs.

If we talk about National Health Policy (Spain), to highlight the change of political sign, with the departure of the PSOE and the arrival of the PP, in the governments of the Valencian Community, Cantabria, the Balearic Islands, Extremadura and Aragon. This is going to have health consequences. Although it is early to tell, it will surely give continuity to the concession model in the Valencian Community. The latest weekly report from the WHO on covid shows that Spain is currently the country in Europe with the highest mortality per 100,000 inhabitants from this disease. The Community of Madrid has a serious problem attracting professionals, leaving many positions for primary care doctors and paediatricians vacant. Debate on training in the SNS, for important professional associations, such as FACME, the SNS by itself will not be able to maintain teaching professionals without collaboration with the industry. The Government of Navarra is investigating several doctors for breach of exclusivity, apparently only in force in Navarra, Galicia and Asturias. It is surprising that the form of application of a national law depends on the political sign of the autonomous governments.

At the Business level, internationally, Pfizer reaches an agreement with the EU to reduce the supply of covid vaccines. At the national level, it should be noted that HIPRA, after two months of approval of its vaccine, only sells it in Spain.

Biomedicine

• Chronic pain linked to brain signs of the orbital-frontal cortex, an area related to emotion regulation, self-assessment and decision-making. The discovery opens the possibility of implanting devices to relieve pain (https://www.nytimes.com/2023/05/22/health/chronic-pain-brain-signals.html#:~:text=the%20main%20story-,Scientists%20Find%20Brain%20Signals%20of%20Chronic%20Pain,self%2Devaluation%20and%20decision%20making.). Original article: https://www.nature.com/articles/s41593-023-01338-z
• A digital bridge based on artificial intelligence allows paraplegics to walk. By decoding brain signals, this digital bridge allows walking only by thinking about the movement of the legs. Hopes Neuro Technology Can Help Millions Overcome Disabilities (https://www.ft.com/content/c58b3254-4fe4-4c89-b425-e933f73ef2c3)
• Review of the New England Journal of Medicine: the present and future situation of the interpretation of radiological images by artificial intelligence. AI is having success in the interpretation of medical images, be they dermatology, ECG, pathology, ophthalmology and, of course, radiology. The FDA has approved more than 200 AI-based products for radiology (https://www.nejm.org/doi/full/10.1056/NEJMra2301725)
• Science publishes a review on emerging frontiers in regenerative medicine. Almost all human diseases, be they injuries, infections, chronic or degenerative diseases, involve tissue damage, which accounts for a high percentage of deaths. How human tissues can recover is what regenerative medicine is all about (https://www.science.org/doi/10.1126/science.add6492)
• The National Health Institutes are driving the transformation of clinical research, to improve the efficiency, accountability and transparency of clinical trials (https://jamanetwork.com/journals/jama/fullarticle/2804493)
• Artificial brains are helping scientists (https://www.economist.com/science-and-technology/2023/05/24/artificial-brains-are-helping-scientists-study-the-real-thing?utm_medium=cpc.adword.pd&utm_source=google&ppccampaignID=18151738051&ppcadID=&utm_campaign=a.22brand_pmax&utm_content=conversion.dire)
• The therapies that are revolutionizing cancer treatment (https://www.lne.es/salud/opinion/2023/05/25/terapias-revolucionando-tratamiento-cancer-jefe-87713568.html)

Global Health

• The Economist model suggests that global deaths are 5% higher than in pre-pandemic times. The covid is not the only one responsible, it is suggested that the tensions in the health systems have led to a lack of care for many layers of the population (https://www.economist.com/graphic-detail/2023/05/23/our-model-suggests-that-global-deaths-remain-5-above-pre-covid-forecasts#)
• Child labor, still present, and has increased in the last decade from 151 million children globally in 2016 to 160 million in 2020. A problem that also affects developed countries (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01046-2/fulltext)
• A pandemic even deadlier than covid may be coming, warns the WHO (https://www.cbsnews.com/news/next-pandemic-threat-pathogen-deadlier-than-covid-world-health-organization/#:~:text=Prepare%20for%20next%20pandemic%2C%20future,than%20COVID%2C%20WHO%20chief%20warns&text=The%20head%20of%20the%20World,than%20the%20COVID%2D19%)
• More than 600 million people suffer from low back pain, the leading cause of disability in the world (https://elpais.com/salud-y-bienestar/2023-05-22/mas-de-600-millones-de-personas-suffer-lumbago-the-first-cause-of-disability-in-the-world.html)
• The new vaccines against malaria: a success with some shadows (https://elpais.com/planeta-futuro/red-de-expertos/2023-05-25/las-nuevas-vacunas-contra-la-malaria-a-success-with-some-shades.html#)

International Health Policy

• COVID19
  • WHO weekly update on covid, published on May 25, 2023. 2.3 million cases and 15,000 deaths in the last 28 days (April 28-May 21), representing 21% and 17% decrease, respectively, compared to the previous 28 days (https://reliefweb.int/report/world/covid-19-weekly-epidemiological-update-edition-144-published-25-may-2023)

• USA
  • The Surgeon General (kind of Medical Director of the American government) warns that social media can harm children and adolescents (https://www.nytimes.com/2023/05/23/health/surgeon-general-social-media-mental-health.html)
  • The fentanyl drug continues to act devastatingly in the United States (https://elpais.com/ciencia/2023-05-26/la-plaga-del-fentanilo-asi-actua-esta-droga-devastadora.html# )
  • Opinion in The New York Times: The FDA should move birth control “over the counter” (with free dispensing), breaking the medical monopoly on health (https://www.nytimes.com/2023/05/22/opinion/birth-control-over-the-counter-fda.html)
  • Curious finding: vasectomies rose 29% after the end of Roe (the sentence that declared abortion legal throughout the United States) (https://www.economist.com/united-states/2023/05/25/vasectomies-rose-by-29-in-the-three-months-after-the-end-of-roe)

• China
  • China foresees a new wave of covid with 65 million cases per week (https://www.elmundo.es/ciencia-y-salud/salud/2023/05/23/646c9855fdddfff2608b458e.html#)

• United Kingdom and National Health Service
  • The Economist weighs in on an editorial and a lengthy article on how to “fix” the National Health Service. Editorial: https://www.economist.com/leaders/2023/05/25/how-to-fix-the-nhs. The editorial says that what the NHS needs is not to transform into a system based on social insurance, as in France and Germany, which it considers unnecessary, but to live up to its name and focus on health: change the focus, from the hospitals to the community; from treatment to prevention; to encourage the activity to do it with the best results. Article: https://www.economist.com/britain/2023/05/25/to-survive-britains-nhs-must-stop-fixating-on-hospital-care?utm_medium=cpc.adword.pd&utm_source=google&ppccampaignID=18151738051&ppcadID=&utm_campaign=a.22brand_pmax&utm_content=conversion.direct-response.anony
  • An NHS app to make it easier for patients to book in the private sector (https://www.thetimes.co.uk/article/nhs-app-to-let-patients-book-private-healthcare-rrcf8dtzf)
  • GPs (primary physicians) can receive bonuses for increasing the number of patients in clinical trials (https://www.theguardian.com/science/2023/may/25/uk-life-sciences-plan-aims-to-quadruple-commercial-clinical-drug-trial-participation)
  • UK announces funding for life sciences research (https://www.ft.com/content/63c94dcf-e9cf-4fc8-aa56-9d32b249de63)

• France
  • Nosocomial diseases affect one hospitalized patient in 18 (https://www.lemonde.fr/planete/article/2023/05/26/les-maladies-nosocomiales-touchent-un-patient-hospitalise-sur-18_6174885_3244.html#:~:text=En%20mai%2Djuin%202022%2C%20un,survienne%20simplement%20durant%20l%27hospitalisation.)

• WHO
  • The WHO supports alcoholic beverage labels to include risk information such as cancer (https://www.elmundo.es/ciencia-y-salud/salud/2023/05/26/6470e589fdddffb5038b456d.html# )

National health policy

• COVID
  • High mortality from covid in Spain, According to the weekly WHO report, Spain is the European country with the highest mortality from covid per 100,000 inhabitants in the last 28 days: 745 deaths, 1.6 deaths per 100,000 inhabitants (https://reliefweb.int/report/world/covid-19-weekly-epidemiological-update-edition-144-published-25-may-2023)

• 28M election results
  • Change of political sign, with the departure of the PSOE and the arrival of the PP, in the governments of the Valencian Community, Cantabria, the Balearic Islands, Extremadura and Aragon (https://elpais.com/espana/2023-05-28/el-pp-seizes-the-psoe-almost-all-autonomous-power-and-the-big-cities.html)

• Electoral promises
  • Sánchez announces the distribution of 38.5 million to communities to promote mental health care (https://www.elindependiente.com/espana/2023/05/21/sanchez-anuncia-el-reparto-de-385-millions-to-ccaa-to-boost-mental-health/)

• Health professions
  • Madrid is unable to retain its doctors, it covers 41 of the 173 primary care positions and only one of the 62 in pediatrics (https://www.eldiario.es/madrid/madrid-no-logra-retener-medicos-cubre-41-plaza-173-primary-care-82-pediatrics_1_10232950.html)
  • Debate on whether the SNS can cover medical training needs. Both FACME (which brings together scientific societies), SEPAR (Spanish Society of Respiratory Pathology), and SEMERGEN (one of the Primary Care physicians’ associations), affirm that the SNS does not have the capacity to support all training needs, without rely on the industry (https://www.redaccionmedica.com/secciones/medicina/el-modelo-de-formacion-medica-relegada-al-sns-aleja-a-espana-de-europa-3903)

• Public healthcare
  • The wait for a primary care consultation doubles in four years (https://www.eldiario.es/sociedad/espera-consulta-atencion-primaria-duplica-cuatro-anos_1_10230593.html)
  • The government of Navarra is investigating 11 doctors for improperly charging the exclusivity supplement, as reported by the LAB union. Navarra is with Asturias and Galicia the only communities that maintain exclusivity. (https://elpais.com/sociedad/2023-05-25/el-gobierno-de-navarra-investiga-a-11-medicos-por-el-cobro-indebido-del-complemento-de-exclusividad.html#)

• AIDS
  • According to the report of the Carlos III Health Institute, 92.5% of people living with HIV in Spain would know their infection diagnosis; 96.6 are receiving antiretroviral treatment and 90.4 have suppressed viral load. The decrease in the undiagnosed fraction is the data that presents the greatest evolution in this report (https://www.isciii.es/Paginas/Inicio.aspx)

Companies

• International News
  • Africa faces the challenge of dialysis, which may represent an opportunity for private providers (https://www.ft.com/content/9937f0ca-6d49-4362-a237-daf396b90c1c)
  • Brussels and Pfizer agree to lower the supply of covid vaccines (https://www.ft.com/content/eb4fe823-66bd-4e1a-8b96-13b8f8c3dce9)

• National News
  • Esteve, an injection of 450 million euros of German money to grow in Europe (https://www.elconfidencial.com/empresas/2023-05-27/esteve-inyeccion-450-millones-dinero-aleman_3637368/)
  • Hipra only sells its vaccine in Spain two months after its approval (https://www.eleconomista.es/salud/noticias/12292992/05/23/hipra-solo-vende-su-vacuna-en-espana-tras-two-months-from-your-approval.html)
  • Almirall trusts in its next drugs to start a recovery from 2024 (https://cincodias.elpais.com/companias/2023-05-22/almirall-confia-en-sus-proximos-farmacos-para-iniciar-a-recovery-from-2024.html)

This post is also available in: Spanish