7 days in healthcare (September 11th-17th, 2023)

 

Summary

From the point of view of Biomedicine, it is worth highlighting that the famous doctor and communicator Eric Topol publishes an article in the magazine Science about the multiplication of medical applications of artificial intelligence. The number of variables of each individual person (anatomical, genomic, metabolomics, epigenomics, etc.) can only be captured and used in diagnosis and treatment through the use of artificial intelligence. Clinicians must become familiar with these new tools and possibilities.

Regarding Global Health, The Lancet comments on what happened with the mpox pandemic (previously called monkeypox), which triggered a global alarm from the WHO and which today has decreased significantly. UN high-level meeting on tuberculosis, whose mortality has increased recently, after years of decline. The Gates Foundation proposes simple and cheap measures to improve the health of women who give birth, since 800 women globally die in childbirth every day.

In terms of International Health Policy, there is an emphasis on measures not learned during Covid, as global politicians seem to move away from fundamental concerns such as equitable access to vaccines and greater transparency. Alcoholism is a serious and very common disease in the USA, causing around 140,000 alcohol-related deaths each year in that country. It seems that the new medications (Ozempic, Wegovby) now used for obesity may also be useful in alcoholism, by curbing consumption. In the NHS the waiting list continues to grow, reaching historic record levels, which contrasts with Prime Minister Sunak’s promises. Serious problem for the Nigerian government to retain its doctors, since six out of ten intend to emigrate in search of better opportunities. Eurostat publishes the most frequent surgical interventions in Europe. Caesarean sections and cataracts, the most frequent interventions.

If we talk about National Health Policy (Spain), covid infections skyrocket due to the drop in immunity. Spain has 100 million vaccines not adapted to the new strains. However, the public health commission recommends the use of adapted vaccines. Problem for Spain, since these vaccines not prepared for the new strains cannot be sold or donated. Spain takes 780 days to supply the new medications. Apart from the 629 days recognized in the WAIT report, from the time the drug is approved by the EMA until the price and public financing are approved in Spain, another five months must be added for approval by the autonomous communities and it would even be necessary to add delays due to approval by hospital commissions. Cosmetic surgery operations have increased rapidly in Spain in recent years.

In the field of Companies, at the international level, the Strasbourg plenary session supports the plasma law that favors Grifols. At the national level, private hospitals (ASPE) take the Sanitas and Generali alliance to court. Ferrer and Almirall, with very good prospects.

Biomedicine

• Article in Science magazine by the famous doctor and communicator, Eric Topol: as artificial intelligence becomes multimodal, medical applications multiply. The high dimension of data underlying the particularity of each human being, and its relationship with diseases, can now be captured. This includes anatomy, biomarkers, genome, microbiome, metabolome, immunome, proteome and the epigenome. There are already virtual AI chatbots for specific conditions, such as diabetes, hypertension, obesity, and depression (https://www.science.org/doi/10.1126/science.adk6139)
• Research opens the way to early detection of breast cancer through breast milk (https://elpais.com/salud-y-bienestar/2023-09-14/una-investigacion-abre-la-puerta-to-early-detection-of-breast-cancer-through-breast-milk.html)
• A mouse with 100,000 human neurons in its brain illuminates the enigma of Alzheimer’s (https://elpais.com/ciencia/2023-09-14/un-raton-con-100000-neuronas-humanas-en-su-brain-illuminates-the-enigma-of-alzheimer.html)

Global Health

• What happened to the mpox pandemic? (initially called monkeypox) This pandemic appeared in Spain in May 2022 and by July 16,000 cases had been reached in 75 countries. Currently it has decreased a lot. It is believed that the combination of vaccination, changes in sexual habits and early detection has contributed to this favorable evolution (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01956-6/fulltext #:~:text=Mpox%20has%20not%20disappeared%2C%20neither,usually%20been%20in%20single%20digits.)
• The Lancet Editorial: Tuberculosis, a different way of looking at things. The UN will hold a high-level meeting on this issue in September. Mortality from tuberculosis has increased after years of decline and in 2021 it killed 1.6 million people. Apart from vaccines, treatments and diagnostics, it is vital to attack the causes: nutrition, poverty and inequalities are at the origin of the spread of tuberculosis (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01955-4/fulltext)
• Low-cost measures can significantly reduce infant mortality. The lives of 2 million women and babies can be saved with small innovations in care, says the Gates Foundation. 800 women die during the childbirth process every day. They propose seven innovations (https://www.ft.com/content/2d26c1ba-8f51-43d8-a3a5-b96b5b387df8)

International health policy

• COVID-19
  • Lessons not learned from covid. Politicians globally are believed to have moved away from some concerns, such as equitable access to vaccines and greater transparency (https://www.ft.com/content/22ddcaab-e5ec-4362-b21c-e88008674a01)
  • The Director of the WHO asks China for “full access” to clarify the origin of covid. He is willing to send a new mission to China, since the origins of covid are unclear after the four years that have passed since the first cases in Wuhan (https://www.ft.com/content/b25ff661-92fc-4e9b-bedf-a0dd24f12aa4)

• USA
  • Therapy with psychedelics, close to approval in the USA for post-traumatic stress disorders (https://www.nytimes.com/2023/09/14/health/mdma-ptsd-psychedelics.html#:~:text=Results%20of%20a%20new%20study,use%20as%20a%20PTSD%20treatment.&text=MDMA%2Dassisted%20therapy%20seems%20to,a%20study%20published%20on%20Thursday.)
  • The FDA approves new “boosters” for covid from Pfizer and Moderna (https://www.ft.com/content/7d395b36-74c7-471f-a244-1ba896871b3c)
  • NEJM article: The need for balance for accelerated approval of cancer drugs. With new regulations, the FDA seeks to reinforce the balance between quickly making these medications available and, at the same time, not exposing patients to medications with unconfirmed results and risks (https://www.nejm.org/doi/full/10.1056/NEJMp2306872)
  • Medications to treat alcoholism are underused. There are almost 30 million Americans who suffer from alcoholism. 140,000 die from alcohol-related diseases each year. Although there were some medications for alcoholism, they were rarely used. Ozempic and Wegoby, popular for treating obesity, may also be useful in curbing alcohol consumption (https://www.economist.com/united-states/2023/09/14/drugs-to-treat-alcohol-addiction-are-underused)

• China
  • The Chinese government launches a campaign against medical corruption. The campaign started in July and will last a year. It is said that there are already 176 hospital directors under investigation. But it is feared that the campaign addresses the symptoms and not the causes, among which is the low regard for primary doctors and the recourse to hospitals for everything (https://www.economist.com/china/2023/09/14/chinas-government-launches-a-campaign-against-medical-corruption)

• United Kingdom and the National Health Service
  • The waiting list for routine procedures reaches a record 7.7 million in England, which is a blow to Prime Minister Sunak, who had declared this issue a priority, and who faces an election next year (https ://www.ft.com/content/fd585336-15a0-46d6-9631-07319ee604fe)
  • A third of medical students plan to leave the NHS within two years of practice (https://www.bmj.com/content/382/bmj.p2103)

• Germany
  • The German Medical Association objects to the cannabis legalization plan. This plan, which contemplates the legalization of the use of cannabis in private clubs, has been criticized for its potential effects on young people, by the Association of Doctors, as well as judicial groups and security (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01958-X/fulltext#:~:text=A%20German%20Government%20plan%20for,say%20it %20is%20too%20bureaucratic.)

• Mexico
  • Abortion, not criminalized in Mexico. The decision of the Supreme Court to reject the law that criminalized abortion opens the door to its legalization, increasing the liberalization of abortion in Latin America (https://www.bmj.com/content/382/bmj.p2060)

• Nigeria
  • The Nigerian government wants to retain its doctors by law. Serious problem of retention of doctors in that country of more than 200 million inhabitants. Six out of ten doctors are considering emigrating in search of opportunities, while the country suffers from a deficit of health workers (https://headtopics.com/br/el-gobierno-nigeriano-quiere-retener-a-sus-medicos-en-the-country-by-law-they-are-not-willing-44306816)

• European Union
  • Eurostat publishes a report with the most frequent surgical interventions and procedures in Europe. Caesarean sections and cataracts are the most common surgical interventions in Europe. Spain among the countries with the lowest percentage of cesarean sections per birth. Türkiye, where else (https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Surgical_operations_and_procedures_statistics#Number_of_surgical_operations_and_procedures)

National health policy

• COVID
  • Covid infections in Spain are skyrocketing due to the drop in immunity (https://www.lavanguardia.com/vida/20230913/9222958/contagios-covid-espana-repuntan-bajada-inmunidad.html)
  • More than 100 million vaccines have become obsolete and unused in Spain. The agreement of the public health commission requires that the covid vaccination campaign be with vaccines prepared for the new strains, which means that some 100 million vaccines already purchased in Spain cannot be used. The government recently purchased 3.2 million doses of the Hipra vaccine, not adapted to the new strains. International agreements prevent the sale or donation of these vaccines (https://elpais.com/sociedad/2023-09-16/mas-de-100-millones-de-dosis-de-vacunas-contra-la-covid-han-become-obsolete-and-unused-in-espana.html#)
  • Experts recommend getting vaccinated only with the new injections against covid (https://theobjective.com/sanidad/2023-09-13/expertos-recomiendan-vacunarse-solo-nuevas-inyecciones-covid/#:~:text=With%20the%2085%2C9%25%20of,updated%20those%20people%20who%20form)

• Delays in the approval of new medications
  • Spain takes 780 days to supply the new medicines authorized by the EU, since to the 629 days it takes Spain to finance a drug since the EMA gives approval, five more months must be added due to delays in the autonomous communities ( https://theobjective.com/sanidad/2023-09-15/espana-suministro-medicamentos-ue/#:~:text=España%20tarda%20780%20días%20en%20suministrar%20los%20nuevos%20medicamentos%20que% 20authorizes%20the%20EU,-When%20Sanidad%20da&text=Spain%20es%20una%20power%20globa)

• Growth of cosmetic surgery activity
  • Cosmetic surgery operations have grown by 215% in recent years. Presented the study The reality of Aesthetic Surgery in Spain 2022, the most carried out are those related to the breast. (https://www.elmundo.es/ciencia-y-salud/salud/2023/09/11/64ff3fd0fdddff33a48b458f.html). To access the original report: https://secpre.org/noticias-detalle/279/1/Nota%20de%20Prensa:%20SECPRE%20presenta%20’La%20reality%20de%20la%20Cirugía%20Estética%20en%20España ‘,%20the%20study%20with%20updated%20data%20on%20the%20interventions%20more%20demanded%20by%20ages%

Companies

• International News
  • The Strasbourg plenary session supports the plasma law that benefits Grifols (https://www.eleconomista.es/salud/noticias/12441202/09/23/la-eurocamara-da-su-visto-bueno-a-la-plasma-regulations-that-benefit-grifols.html)

• National
  • The insurer Asisa demands 60 million from Muface for health care for civil servants (https://www.eldiario.es/economia/aseguradora-asisa-exige-60-millones-muface-asistencia-sanitaria-trabajorios-durante-pandemia_1_10511076 .html)
  • Sanitas says it has an investment appetite (https://www.elespanol.com/invertia/observatorios/sanidad/20230911/inaki-peralta-ceo-sanitas-apetito-inversor-nuevas-adquisiciones/793170812_0.html)
  • Private hospitals take the Sanitas and Generali alliance to court (https://www.expansion.com/empresas/2023/09/11/64fb7a10468aebe97f8b4664.html)
  • Ferrer earns 82% more and prepares his jump to the United Kingdom, France and Italy (https://www.expansion.com/catalunya/2023/09/10/64fdb061468aebb8168b4573.html#)
  • Almirall obtains EU approval to sell its dermatological promise (https://www.eleconomista.es/salud/noticias/12446447/09/23/almirall-obtiene-la-aprobacion-de-la-ue-para-sell-your-dermatological-promise-.html)