7 days in healthcare (March 7th-12th, 2023)

Summary

From the point of view of Biomedicine, the geneticist Francisco J Ayala, one of the great Spaniards of science, with important contributions in the field of the human genome and other diseases, dies. Some obscure episodes, not fully clarified, pointed to him as a target of the “me too” initiatives. It is increasingly clear that gene therapies will soon explode and will be useful in multiple hematological, cardiac, ocular, muscular and even neurodegenerative processes. An ethical reflection is essential, which ensures, on the one hand, that these treatments are accessible, and, on the other, the limits of these treatments. It seems that we are closer to having specific treatments against fatty liver, a serious disease responsible for tens of thousands of deaths.

As regards Global Health, young people, including adolescents, with gender dysphoria are growing all over the world. There is no accepted professional consensus on how to approach these situations. It seems increasingly clear that inequality in the face of covid vaccines responsible for thousands of deaths from this disease. Although there is no absolute consensus, it seems increasingly clear that smartphones and social networks are responsible for serious mental health problems among young people. 24/7 access to these technologies minimizes face-to-face contact between young people.

Regarding International Health Policy, the WHO maintains the covid as a “health emergency of international concern”. In the United States, the budget presented by Biden – which will not be approved – proposes a significant increase in funds for Medicare. Problems continue for the Walgreens pharmacy chain for not selling abortion pills in 21 states. The USA plans to eliminate hepatitis C, almost a decade after highly effective therapies for this disease appeared. Concern in the United Kingdom about the interruption of the improvement in life expectancy for a decade, before the covid, contrary to what is happening in France or Denmark, for example. Australia is preparing to tackle a health reform, after the preparation of an independent report, a model that could well be inspiring for Spain. Newsweek magazine publishes its well-known ranking of the best hospitals in the world. The Mayo Clinic, in Rochester, and the Cleveland Clinic, in Cleveland, considered the best hospitals in the world. Among the first hundred there are 6 Spaniards, all of them public, except one private: the Clínica Universidad de Navarra (CUN).

If we talk about National Health Policy (Spain), in terms of covid, the accumulated incidence continues to rise slightly, with a fairly high mortality (139 patients in one week). In Castilla y León, the health areas will have access to a team on rare diseases. Serious concerns among psychiatrists about the large increase in cases of gender dysphoria. The actors in the cyber attack on the Hospital Clínic de Barcelona request a ransom of 4.5 million dollars, which the Administration refuses to deliver. Some Catalan doctors are organized to attend only in Catalan, something against repeated court rulings and the Generalitat’s own protocols.

At the Corporate level, at the international level, investors are rubbing their hands at the prospects of big business in anti-obesity drugs. Morgan Stanley has quantified what this can mean in billions of dollars worldwide. Pfizer places its vaccine against covid as the drug with the highest income in the world. At the national level, Quirón reaches an agreement with the City Council for the construction of its hospital in Gijón and Hospitén announces the construction of a new hospital in Madrid with a large investment of 160 million euros. Thus, the boom in new private hospitals continues, for which there is a real race in which several actors participate (Quirón, Viamed, Vithas, Hospitén, Imed, and others). Hipra will return aid to the covid vaccine in ten years.

Biomedicine

• The geneticist Francisco J Ayala dies at 88 years of age, one of the most prestigious Spanish scientists, who participated in the sequencing of the human genome and in the understanding of diseases such as Chagas disease or malaria. He was charged with dubious evidence for the “me too” movement. (https://elpais.com/ciencia/2023-03-05/muere-el-genetista-francisco-j-ayala-a-los-88-anos-de-edad.html)
• The study of broken chromosomes can illuminate neuroscience, as has been done with studies of chromosomes 7 and 22 (https://www.economist.com/science-and-technology/2023/03/08/studying-broken-chromosomes-can-illuminate-neuroscience)
• A mapping of human histology is prepared, which would mean for histology what the human genome does for genetics (https://www.economist.com/science-and-technology/2023/03/08/a-cartography-of-human-histology-is-in-the-making)
• We need rules before we let gene editing out of the bottle. Gene editing treatment means adding, deleting or altering genetic material and can be done in germ cells or somatic cells (https://www.ft.com/content/8b65ddfb-b4a3-444c-93ca-73dfb881399e)
• Experts warn that going ahead with gene therapy raises serious ethical issues. Sure, there may be gene-editing treatments that can address blood, heart, eye, and muscle diseases, and potentially even neurodegenerative diseases, but the cost will put these therapies out of reach for many patients (https://www.theguardian.com/science/2023/mar/06/forthcoming-genetic-therapies-serious-ethical-questions-experts)
• How AI can be used to detect tumors that doctors miss. AI tools may eventually replace radiologists (https://www.nytimes.com/2023/03/05/technology/artificial-intelligence-breast-cancer-detection.html)
• A European project seeks to diagnose pancreatic cancer with a blood test (https://elpais.com/salud-y-bienestar/2023-03-07/un-proyecto-europeo-busca-diagnosticar-el-cancer-of-pancreas-with-a-blood-analysis.html)
• Closer to drugs to treat fatty liver. The FDA is expected to approve between this year and next year two drugs to treat this disease, for which there is currently no specific treatment (https://www.diariomedico.com/medicina/endocrinologia/mas-cerca-of-drugs-to-treat-fatty-liver.html)

Global Health

• Young people with gender dysphoria are growing, as well as professional malaise. While cases of gender dysphoria are growing, especially in the USA, there is no international professional consensus on how to address it (https://www.bmj.com/content/380/bmj.p382)
• The catastrophic response to the earthquake in Syria. Politicization, indifference and neglect were the characteristics of the response (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00440-3/fulltext)
• The Lancet Report: Desperate Deaths and Genocide Among Native American Communities. Deaths due to despair are those related to overdose, suicide and alcoholism (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02404-7/fulltext)
• Vaccine inequality, guilty of the high covid mortality rate (https://www.ft.com/content/fcddc944-5112-4e32-be22-6ead2bc06cc7)
• Smartphones and social networks are destroying the mental health of young people. This idea is neither new nor totally accepted, but it has more and more support (https://www.ft.com/content/0e2f6f8e-bb03-4fa7-8864-f48f576167d2)
• The WHO confirms the first case of Marburg virus in West Africa. There are no vaccines or approved treatments and the mortality rate is very high (https://www.larazon.es/sociedad/oms-confirma-primer-caso-virus-marburgo-africa-occidental_20230310640b5b5d96c07c000178f035.html)

International Health Policy

• COVID
  • WHO maintains covid as a health emergency of international concern (https://www.bmj.com/content/380/bmj.p504)
  • Persistent covid after three years (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00493-2/fulltext)

• USA
  • Biden’s budget proposes tax increase to strengthen Medicare (https://www.nytimes.com/2023/03/07/business/biden-budget-medicare-tax-increase.html)
  • Pressure on Big Pharma is growing in the USA (https://www.lemonde.fr/economie/article/2023/03/07/aux-etats-unis-la-pressure-croit-sur-les-big-pharma_6164481_3234.html)
  • Pharmacy chain Walgreens faces problems over non-dispensing of abortion pills in 21 states (https://www.nytimes.com/2023/03/07/business/walgreens-abortion-pill.html)
  • Oregon has become the laboratory for medical aid in dying in the USA (https://www.lemonde.fr/international/article/2023/03/09/l-oregon-laboratoire-americain-de-l-aide-medicale-a-mourir_6164853_3210.html)
  • The USA plans to eliminate hepatitis C. 9 years after the effective antiviral against this disease, the therapy has not spread sufficiently in the USA, with 15,000 Americans dying a year from hepatitis C. The Biden Administration launches a program to eradicate the disease in five years (https://jamanetwork.com/journals/jama/fullarticle/2802533)

• China
  • Two books appear that tell the story of the lockdown in Wuhan (https://www.economist.com/culture/2023/03/09/two-brave-books-tell-the-story-of-lockdown-in-wuhan?utm_medium=cpc.adword.pd&utm_source=google&ppccampaignID=18151738051&ppcadID=&utm_campaign=a.22brand_pmax&utm_content=conversion.direct-response.anonymous&gcl)

• UK and the NHS
  • Editorial of The Economist: the United Kingdom, in a decade of premature mortality, with more than 250,000 mysterious deaths. The causes are not clear, but the increase in life expectancy stopped in the United Kingdom before the arrival of the pandemic. The situation affects the poor the most. This has not been seen in other countries such as France or Denmark. (https://www.economist.com/leaders/2023/03/09/britain-has-endured-a-decade-of-early-deaths-why)
  • The consultans (Heads of Medical Departments) in England about to go on strike, after a vote with 86% in favor (https://www.bmj.com/content/380/bmj.p539)
  • Inflation alters the British Government’s promises to build 40 new hospitals (https://www.ft.com/content/bcb4b4e9-b325-4fe9-a2e1-fc7869678062)

• Australia
  • Health reform in Australia. Although the Australian health system is considered one of the best in the world, the Government is preparing to introduce reforms, following the recommendations of an independent report. The problem is that the system had not been reformed in 40 years (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00495-6/fulltext). To access the report entitled Strengthening Medicare Taskforce: https://www.health.gov.au/committees-and-groups/strengthening-medicare-taskforce

• Best hospitals in the world
  • Newsweek magazine publishes its traditional ranking of the best hospitals in the world. The first three are: the Mayo Clinic in Rochester, the Cleveland Clinic in Cleveland, and the Massachusetts General Hospital in Boston. Among the first 100 are 6 Spanish hospitals: La Paz, (53); Barcelona Clinic (62); October 12 (72); Vall d’Hebrón (83), Gregorio Marañón (90) and the CUN (97) (https://www.newsweek.com/rankings/worlds-best-hospitals-2023)

National health policy

• COVID
  • The cumulative incidence at 14 days rises to 63.64 points, and what is worse, mortality rises, 139 deaths in one week. There are currently 2,006 admitted for covid, of which 94 are in ICU beds (https://www.consalud.es/pacientes/especial-coronavirus/espana-notifica-casos-covid_127468_102.html)
  • Three years after the start of the covid, health is at a minimum. The situation of Primary Care and Public Health, main problems (https://www.lavanguardia.com/vida/20230312/8818453/tres-anos-sanidad-minimos-pandemica-covid-estado-alarma.html)

• Flu
  • An unexpected wave of flu hits all of Spain (https://elpais.com/sociedad/2023-03-07/una-inesperada-segunda-ola-de-gripe-hit-a-espana-a-las-puertas-of-spring.html)

• Public healthcare
  • All health areas in Castilla y León will have a reference medical team to address rare diseases (https://diariodecastillayleon.elmundo.es/articulo/castilla-y-leon/areas_salud_equipo_referencia_enfermedades_raras/20230310121118066334.html)

• Private healthcare
  • The Association of Private Clinics of Madrid reaches an agreement with the unions for four years on the collective agreement (https://www.plantadoce.com/entorno/asociacion-de-clinicas-y-hospitales-privados-de-madrid-reaches-an-agreement-with-the-collective-of-private-healthcare.html)

• “Trans” law
  • Celso Arango, head of Psychiatry at the Gregorio Marañón Hospital, warns of an increase of 1,000 per 100 minors who say they are trans. Defends a psychiatric assessment of minors before any intervention (https://www.abc.es/sociedad/celso-arango-avisa-aumento-mil-cien-menores-20230310194653-nt.html)

• Pharmaceutical policy
  • Diariofarma publishes its report “Pharmaceutical Policy in 2022” (https://drive.google.com/file/d/1V_9DQjl0yji6Y3_VI9LRKWWt6HEP43zb/view)
  • The Ministry of Health makes drugs from Pfizer, Novartis, Roche and Sanofi cheaper by 15% (https://www.eleconomista.es/salud/noticias/12173714/03/23/Sanidad-abarata-un-15-farmacos-de-Pfizer-Novartis-Roche-and-Sanofi.html)
  • Biosim asks communities to become more involved in promoting biosimilars (https://diariofarma.com/2023/03/10/bisoim-pide-que-las-cc-aa-se-impliquen-cada-vez-more-on-the-incentivization-of-biosimilars)

• Other news
  • The perpetrators of the cyber attack on Hospital Clínic request a ransom of 4.5 million dollars (https://www.elconfidencial.com/espana/cataluna/2023-03-10/autores-ciberataque-hospital-clinic-piden-rescate-millions-dollars_3590349/)
  • The Generalitat tolerates the illegal rebellion of doctors against Spanish. Some doctors are organized to attend only in Catalan, against court rulings and the Generalitat’s own protocols (https://www.elmundo.es/cataluna/2023/03/12/640cb4f7e4d4d8046d8b4580.html)

Companies

• International News
  • Mental health support, salary supplement for some banks and legal firms (https://www.ft.com/content/adf2d395-b100-403a-8653-ae48fb278be1)
  • Obesity drugs, good for investors, with some restrictions. Morgan Stanley says that the market for these drugs can reach US$54 billion in 7 years (https://www-ft-com.ezp.lib.cam.ac.uk/content/8a63fbe6-b8fe-4fb7-9ed4-ca81cf80312f)
  • Merck increases its profit by 8.5%, up to 3,326 million euros (https://www.plantadoce.com/empresa/merck-eleva-un-85-su-beneficio-en-2022-hasta-3326-millones-de-euros.html)
  • Lilly fails in its trial on Alzheimer’s (https://www.consalud.es/ecsalud/internacional/lilly-fracasa-en-su-ensayo-impulsar-tratamiento-enfermedad-alzheimer_127370_102.html)
  • Eli Lilly will reduce the price of insulin by 70% in the USA (https://www.plantadoce.com/empresa/eli-lilly-reducira-los-precios-de-la-insulina-en-un-70-in-states-uhtml)
  • Pfizer places its covid 19 vaccine as the drug with the highest revenue in the world (https://cincodias.elpais.com/companias/2023-03-07/pfizer-coloca-a-su-vacuna-del-covid-19-as-the-drug-with-the-highest-income-in-the-world.html)

• National News
  • Quirónsalud and the Gijón City Council are making progress in the start-up of the new hospital (https://www.plantadoce.com/empresa/quironsalud-y-el-ayuntamiento-de-gijon-avanzan-en-la-puesta-en-march-of-the-new-hospital.html)
  • Lusíadas, Sanitas, Vithas and Viamed bid for the Hospital de Fátima in Seville (https://www.plantadoce.com/empresa/lusiadas-sanitas-vithas-y-viamed-pujan-por-el-hospital-de-fatima-de-seville.html)
  • Hospitén will start up a new university hospital in Madrid for 150 million euros (https://www.plantadoce.com/empresa/hospiten-pondra-en-marcha-un-nuevo-hospital-universitario-en-madrid-por-150-million.html)
  • Hipra will return the vaccine aid in 10 years (https://www.redaccionmedica.com/secciones/industria/hipra-tardara-10-anos-en-devolver-las-ayudas-millonarias-de-su-vacuna-covid-7778)

This post is also available in: Spanish