7 days in healthcare (January 30th- February 5th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting the review by The Lancet on lung cancer screening, which shows that the low-dose Scanner is effective in reducing mortality, although there are aspects of cost-effectiveness that they remain as a problem; neural implants in rats open the prospect of brain transplants; the gene therapy revolution, previously abandoned for safety reasons, is now in full swing; and mRNA vaccines, which may be useful for cancer, with fewer side effects than conventional chemotherapy. The debate on check-ups is current, proving, once again, that annual check-ups do not reduce mortality, and despite everything, they are increasingly in demand.

As regards Global Health, The Lancet publishes an editorial in which it tries to change the narrative of little hope until now on cancer, due to the great disparities between countries in this fight.

Regarding International Health Policy, the New England Journal Medicine magazine publishes an article that affects the approach to the new reality of the covid, despite the new perception as a minor nuisance, it continues to represent between 300 and 500 deaths a day in USES. According to The Economist, we will most likely never know the number of deaths from covid in China, since the official mortality figures are not credible. The crisis in the British NHS continues, which seems to have been exacerbated by Brexit. Prime Minister Sunak’s proposals are for more ambulances, more hospital beds and home care. El Mercurio, the leading newspaper in Chile, editorializes on the critical situation of the ISAPRES (health insurers) in that country, which could fall into insolvency, which occurs due to the government’s indifference to this situation.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop, although mortality remains high. World Cancer Day (February 4) coincides with the appearance of interesting publications on the cancer situation in our country, both by SEOM and the OECD. This latest report warns Spain about accessibility problems. The implementation of cancer screening has been uneven, which leads to inequities between autonomous communities. Cancer already represents 10% of public health spending. The celebration of Cancer Day also coincides with two new inaugurations of centers dedicated to this disease: the Cancer Center of the Clínica Universidad de Navarra and the experimental oncology center of the Hospital 12 de Octubre in Madrid. The Ministry of Health of the Valencian Community announces the non-extension of the Denia concession contract. The Government publishes the Regulatory Plan for 2023, the law of the National Public Health Agency among the three health laws planned for 2023.

In the field of Companies, internationally, it should be noted that Pfizer is the first pharmaceutical company to reach revenues of more than $100,000 a year, thanks largely to the boost of the covid vaccine. As far as Spain is concerned, both Vitaldent and IMED are launching new centers. It seems that we are witnessing a fever of new private hospitals (Vithas in Barcelona; Sanitas in Madrid; Viamed in Tarragona; IMED in Alicante; Quirón in Asturias; and a long etcetera).

Biomedicine

Global Health

International Health Policy

  • COVID
    • Addressing the new reality of covid. The covid passed, in the popular perception from a terrible threat to a minor inconvenience with a few days of symptoms. The reality, however, is not that and the covid still means between 300 and 500 deaths a day in the USA, equivalent to a mortality higher than that of a serious flu epidemic. To this must be added the effects of persistent covid (https://www.nejm.org/doi/full/10.1056/NEJMp2213920)
  • Changes in the United States
    • The implications of the results of the US elections in 2022 in health. Results of a survey conducted by Robert Blendon. It is striking that despite the fact that the United States is the country that spends the most on healthcare, the majority of the population thinks that little is spent. This opinion is very predominant among Democrats, but also in the majority among Republicans (https://www.nejm.org/doi/full/10.1056/NEJMsr2214949)
    • The response of the National Health Institutes (NHI) to covid (https://www.science.org/doi/10.1126/science.adf5167)

National health policy

Companies

7 days in healthcare (January 23rd-29th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting, as the Nature article does, that among the 7 most promising technologies for 2023, at least three are directly related to biomedicine. It seems that not only neurons have a role in brain function, but also a relevant role of glial cells in certain disorders is beginning to be recognized.

As regards Global Health, the WHO requests 2.5 billion dollars to deal with health emergencies, particularly in Yemen, Afghanistan, Syria and Ethiopia.

As for International Health Policy, a consensus began to be created three years after the start of the pandemic that, although not totally overcome, it is no longer the emergency that it was. The problems in China with the covid continue. The crisis in the NHS is the biggest for many years. Basically, there are two positions: the one that seems to be held by the current conservative government that the system is unsustainable without co-payments and very profound changes; or the one represented by The Lancet, which says that the system is perfectly viable, if it is provided with more resources. What is clear is that the UK lags behind other European countries in many resources (hospital beds etc.). Two good news in terms of health policy are led by countries that are not usually at the forefront on these issues: the smoking ban in Mexico and the mental health law in Nigeria. Tensions between governments and pharmaceutical companies over the price of medicines are increasing and this time they are not only in Europe, but also in the United States (the largest pharmaceutical market).

If we talk about National Health Policy (Spain), the incidence of covid continues to drop, although mortality remains high (above 250 deaths per week). The medical conflict in public health continues, mainly in Primary Care. While there are communities that have reached agreements (Andalusia, Navarra, Aragon, Extremadura), in others (Madrid, Catalonia) there does not seem to be any sign of agreement, which makes us think and we will have to draw conclusions about different behaviors of the Administrations and of medical leaders. Conflict also between private health doctors and health insurers. It seems that the Equity Law is going ahead, after Darias’ agreement with Podemos. Interesting agreement in Madrid so that hospital specialists can also take leave. Aragon proposes that the issue of health be dealt with in the President’s Conference, which seems reasonable, given the seriousness of the problems, although the document of said community does not contain great innovative elements. After the more than debatable success of the operations in Alzira and Torrevieja, it seems that the Valencian government also wants to rescue Denia. At this point, a deeper and more articulate justification of political decisions should be demanded.

In the field of Companies, at the international level, it is necessary to highlight the great activity of private equity companies worldwide in the field of health, as revealed by the Bain report. In Spain, Ribera Salud leaves Extremadura. Important investments in our country from Bayer and Novartis are confirmed

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (January 16th-22nd, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting, as the Science article does, the celebration of a decade of CRISPR gene editing technology, whose impact on medicine is only just beginning. Janssen withdraws from the HIV vaccine, a new failure in the attempt to discover a vaccine against this disease. Moderna, on the other hand, presents positive results with a vaccine against bronchiolitis. A new report points to wastewater analysis as fundamental to monitoring threats from a wide variety of diseases, not just covid.

As regards Global Health, The Lancet in an editorial underlines the importance of the One Health concept, this idea of the interdependence between human, animal and ecosystem health. The Economist publishes an editorial and an article on the problems of health systems that are in crisis everywhere in the post-covid era (even in Switzerland!), which is making mortality in Europe have been in the last year 10% higher than in a normal year.

Regarding International Health Policy, in the USA the opponents of abortion are manifested. Problems continue in the NHS, with Sajid Javid, former health secretary, proposing something as unusual in the UK as a co-pay in Primary Care and Emergency. He says an overly religious view of the NHS prevents reforms. Important debate and tensions about the price of medicines in the European continent (UK and EU) in relation to prices in the USA. Pharmaceutical companies, very reluctant to price controls, when they are also in the USA with the application of the Inflation Act, which gradually imposes a negotiation of the price of medicines between the Medicare Administration and pharmaceutical companies.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop. Medical conflicts extend to various autonomous communities (Madrid, Catalonia, Navarra, etc.). The agreement in Aragon should be highlighted, which indicates that it is possible to reach agreements, possibly when they are well negotiated. The Ministry, completely absent from this problem. As for the public system, the statements by Lasquetty, Madrid’s Treasury Councilor, who points to “my own place” as one of the great rigidities of the public system, are very interesting. Conflict also in private health between doctors and insurers, raised in Seville. Abortion enters the national debate, following the picturesque proposals of Vox in Castilla y León, never applied. The Constitutional Court opens its new session with the debate on the recourse to the Law of deadlines presented in its day by the PP. The CIS survey presents health as the second problem that worries the Spanish.

In the field of Companies, internationally, Pfizer’s initiative to sell medicines at cost prices in 45 poor countries must be highlighted. At the national level, the launch by DKV of an insurance product that allows choosing a family doctor is notable. In a context in which insurers actually forget about Primary Care, this is something that deserves to be highlighted.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

7 days in healthcare (January 9th-15th, 2023)

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Summary

From the point of view of Biomedicine, everything seems to indicate that important advances in the diagnosis and treatment of certain diseases are coming in the not too distant future, with cancer vaccines, the new FLASH radiotherapy, the diagnostic revolution of virtual biopsies and the incorporation of certain devices (such as smart watches) in the prevention and monitoring of certain pathologies.

With regard to Global Health, it should be noted that climate change seriously threatens our health, according to The Lancet. Another important article in this magazine refers to the fact that the covid has revealed the inequalities between social groups and countries in dealing with the pandemic, as well as the absence of a global health architecture.

As for International Health Policy, with regard to covid, an editorial in The Lancet says that far from being overcome, 2023 brings new concerns, such as the impact of the situation in China or the new form XBB.1.5 in the United States. In China, the post-covid zero situation continues, officially acknowledging almost 60,000 deaths in the last month, despite the fact that the WHO insists on the request for more transparency in that country. In the United States, the abortion pill, according to the FDA, can already be purchased in pharmacies and by mail order, even in states where abortion is totally prohibited, which indicates the difficulty of shortcuts and of wanting to close doors to the field. In the United Kingdom the serious crisis of the NHS continues. The health minister of the shadow Labor cabinet publishes in the Financial Times an article with a long-term approach to reforms, something that, regardless of its content, we miss in Spain by all parties. An important editorial in The Economist where it says that part of the solution to the NHS’s problems involves solving the problems of Primary Care, proposing several changes, but without losing perspective that a large part of the problems are in hospitals, with the situation of waiting lists and emergencies. He also opposes the Labor Party’s proposal, made last week, to end the independent mini-company character of Primary Care in the UK, in order to make primary care physicians salaried. The Economist carries out a study that says that in the United Kingdom there are 260 deaths a week (more than 12,000 a year) as a result of delays in the emergency room. The British are turning more and more to private healthcare, as increase problems in the public sector. The EU devises plans to avoid medicine shortages and dependence on China.

If we talk about National Health Policy (Spain), the drop in the incidence of covid continues, despite the situation in China and the American variant called Kraken. The Primary Care strike in the Community of Madrid is reactivated and a strike is on the brink in 8 autonomous communities, while the emergencies are collapsed. Despite the plans, recent studies show that almost half of public health workers are temporary. In relation to the Strategic Plan of the pharmaceutical industry, both BIOSIM and AESEG, as well as the representatives of orphan drugs, position themselves with requests, in a clear attempt not to leave this plan only in the hands of large innovative companies, as suggested by the photo of La Moncloa, with Sánchez meeting with the main leaders of pharmaceutical multinationals.

In the field of Companies, internationally, relevant news for Pfizer, BioNTech and AstraZeneca. In our country, it is worth noting the steps taken by Viamed (new hospital in Tarragona), Ribera (great growth in turnover in 2022), Miranza (which continues its growth), Korian (which is preparing to integrate Group 5) and the CUN (which has just renovated part of its hospitalization area). For its part, KKR has completed the acquisition of IVI, an important in vitro fertilization company of Spanish origin.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (January 2nd-8th, 2023)

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Summary

From the point of view of Biomedicine, it is important to highlight significant advances in the treatment of some diseases, such as Alzheimer’s, breast cancer (a project inspired in its day by José Baselga), brain tumors, including the dreaded glioblastoma multiforme, and resistant tuberculosis.

With regard to Global Health, the WHO warns of global health threats in 2023: the Ebola outbreak in Uganda, which fortunately already seems to be in recession; the drought in the Horn of Africa; cholera, endemic in 69 countries; non-communicable diseases (particularly cardiovascular, diabetes, respiratory diseases and cancer), as well as the global stagnation due to the pandemic in the fight against various diseases: HIV, malaria and tuberculosis. Science reminds us that wastewater analysis has proven to be extremely useful for monitoring infectious diseases.

As for International Health Policy, with regard to covid, global concern is not so much for the cases that may come from China (which seem to correspond to the omicron that we already know) but for the new variant (Kraken) of United States, much more contagious than omicron and already affects a high percentage of cases in that country. The serious problems of the end of covid zero in China continue, with the opening of the country on January 8, which has been closed for three years. An editorial in The Economist looks at how the grand reopening may affect the global economy. Once again, the WHO says that mortality from covid in China is underestimated, if official figures are taken into account. Big change in the United States, where the abortion pill can be purchased in ordinary pharmacies. The large pharmacy chains, willing to participate in this sale. It must be remembered that a high percentage of abortions in the United States are already pharmacological. Serious crisis in the British National Health Service, with staff strikes, long waiting lists, saturation of emergencies and statements by unions and the Prime Minister. Labor wants to pass NHS employees to GPs (primary physicians), something that is in contradiction with the founding political pact of 1948 for the creation of the National Health Service, in which Aneurin Bevan participated. In France, health is also at the center of the political debate, with some statements on January 6 by President Macron, who considered among the solutions nothing less than ending fees per act, which in France are big words.

If we talk about National Health Policy (Spain), the year opens with the prospect of regional elections in 12 autonomous communities (May 28) and general elections at the end of the year, as well as a change in the head of the Ministry of Health. Several laws have been announced, including some advanced (new framework personnel statute, abortion, equity law), others more delayed (Public Health Agency, law of guarantees, possible reform of the dependency law). The Platform of Patient Organizations (POP) makes 10 proposals for chronic patients. As for professionals, some health insurance companies (DKV) have reacted quickly and announced increases in rates for doctors, which is undoubtedly a response to the criticism they had received from some medical associations, which even have raised certain protest actions. A piece of news says that the Zendal hospital has only 56 patients, which speaks of the fact that it has not yet found its place in Madrid’s health system, not surprising, since it seems that this hospital was established without the corresponding and obligatory Functional Plan (which defines the service portfolio, the population to be served, the incardination in the rest of the system, technology, personnel needs and other basic issues). Biosimilars, under the leadership of BIOSIM and starting in Extremadura, delve into the experience of shared benefit.

In the business sphere, in the international arena, Moderna acquires a genomics company. On the other hand, the completion of the Da Vinci robot patent will change the prospects for robotic surgery. At the national level, Ribera assumes the management of the Cascais hospital in Portugal, which is good news for public/private collaboration in our country.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (December 26th, 2022-January 1st, 2023)

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Summary

From the point of view of Biomedicine, it is worth noting the ambitious project of the United Kingdom “Our Future Health”, which aims to place this country at the forefront of genomic research, and which seeks to carry out genetic analyzes of 5 million adult British volunteers, then looking at the correlation with lifestyles and medical records. Undoubtedly, this project will allow us to advance a lot in the knowledge of a wide variety of diseases.

With regard to Global Health, great concern in the world, since the large number of cases in China increase the probability that new variants will appear. There is no doubt that the covid – which had appeared, artificially or naturally, in China – has entered a new phase in which the epicenter is once again China.

Regarding International Health Policy, countries are preparing to put control measures at airports and borders against travelers from China, although the ECDC sees this type of control as unfounded and the EU has not adopted a common policy. Joschka Fischer (former – German Foreign Minister) publishes an in-depth article, whose conclusion is that, in contrast to what had previously been said that authoritarian regimes that do not depend on public opinion can impose drastic and effective measures in crisis situations such as covid, experience has shown that liberal democracies are more effective than autocracies in dealing with these situations. Great controversy in the European Union over the claim of the pharmaceutical industry to agree to produce new antibiotics, under the condition of increasing the patent term of certain drugs.

If we talk about National Health Policy (Spain), Spain has approved airport control measures to control travelers from China, which will be in force between December 31, 2022 and February 15, 2023. Primary Care doctors have opposed the hiring of doctors without MIR training, since this seems more like an opportunistic measure than addressing the underlying problems of Primary Care. The central government, so little fond of publishing and preparing expert analyzes on the covid management, instead presents a self-assessment on its management. According to this report “Cumpliendo” (“Fulfilling”) 64% of the health promises have already been fulfilled and 35% are in process. Bearing in mind that none of the structural healthcare problems have been addressed (personnel regime, management model, governance, accessibility and waiting lists, etc.) this self-assessment seems to us grated on complacency and even propaganda. Unless the promises -which are said to have been fulfilled- have nothing to do with the real problems of the sector. An interesting initiative from the private sector through the IDIS Foundation, which announces the start-up of a pilot on interoperability, should be highlighted. The fact that companies that compete with each other -both from the insurance and provisioning fields- agree on the interoperability of medical records is something that deserves to be highlighted.

In the field of Companies, the American Congress has taken an unusual decision: criticize the FDA for its inadequate collaboration with Biogen for the approval of the drug against Alzheimer’s. At the national level, Atrys continues its growth, both in Spain and abroad (United Kingdom, Middle East and Latin America).

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (December 19th-25th, 2022)

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Summary

From the point of view of Biomedicine, it should be noted that 2022 has been an extraordinarily productive year from the point of view of the appearance of effective drugs, among others against obesity or different forms of cancer. mRNA vaccines open the way to new therapeutic approaches

With regard to Global Health, the British Medical Journal summarizes the human and health damage caused by the floods in Pakistan.

Regarding International Health Policy, discussions continue about the origin of the covid. President Biden is accused of complacency in saying as early as September that “the pandemic is over”, while the mortality continues. Everything seems to indicate that the end of the covid-zero policy in China is producing a large number of cases (millions in just one day), which is putting maximum pressure on the health system and, probably, since there are no reliable figures, with a high mortality. UK nurses and ambulance strike.

If we talk about National Health Policy (Spain), the incidence of covid has risen slightly in the last week, with a high death toll (241). The strike of Primary Care doctors in Madrid is paralyzed until January 11, to analyze the administration proposals. The Government undertakes to launch the working group for the elaboration of the Strategic Plan on the pharmaceutical industry, after the promises of investments in the next three years made by the heads of the most important pharmaceutical companies in a meeting in La Moncloa . Government and Community of Madrid launch the Neurotechnology Center.

In the field of Companies, internationally, it seems that private equity companies are oriented in the USA towards hospital emergencies. In Spain, Warren Buffet acquired the largest medical error insurance.

Biomedicine

Global Health

International Health Policy

National health policy

  • Pharmaceutical policy

Companies

 

 

7 days in healthcare (December 12th-18th, 2023)

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Summary

From the point of view of Biomedicine, The Lancet commemorates the 200th anniversary of the birth of Pasteur, the creator of the germ theory. Even today a high percentage of deaths are from infections. Promising results of an mRNA vaccine against melanoma, presented by Moderna and Merck.

As far as Global Health is concerned, it is worth highlighting the article published in Nature that says that without a strategy and global financing of vaccines, the world will be unable to successfully face new epidemics.

As for international health policy, the discouraging news of China’s abandonment of the covid-zero policy continues, when the country is not prepared and is most likely to suffer high mortality. The CDC quantifies the deaths from persistent covid in the USA. The conflict of nurses in the NHS continues, which coincides with the appearance of a report from the Institute for Fiscal Studies in the United Kingdom that attributes the problems of the NHS to underfunding of the system. New Zealand, the second country in the world to announce a ban on tobacco sales.

If we talk about national health policy (Spain), in terms of covid, the incidence continues to decrease, what has not completely decreased, or has decreased very slowly, is mortality (236 deaths in the last week). After confinement in a unit of the Regional Ministry of Health, the strike committee of primary care doctors in Madrid decided to continue the strike, extending the conflict to a demonstration, along the lines of the “white tides”.

In the field of companies, internationally, it seems that Jeff Bezos and Bill Gates are making an important bet in the field of neurotechnology with the company Synchron. As far as national news is concerned, perhaps highlighting that it seems that the hopes placed on the Spanish HIPRA vaccine are fading.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (December 5th-11th, 2022)

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Summary

From the point of view of Biomedicine, an emotional farewell in the New York Times of the “young” (81 years old), Anthony Fauci, who had such a presence in our homes throughout the years of the pandemic. Without a doubt, his scientific contributions are notable, but it is not a minor merit that he has contradicted President Trump on several occasions in the honest exercise of his office, something unusual in our environment. A new type of biomarkers seems to open the doors to the possible diagnosis of different types of cancer at an early stage with a simple blood test.

With regard to Global Health, to highlight the serious problems of diabetes, which continues to grow; and suicide, which is increasing markedly among young Americans, although, as the WHO says, it is in Africa where there are the highest suicide rates in the world.

Regarding International Health Policy, China continues to distance itself from the covid-zero policy, although we will see the increasing consequences of covid mortality. Labor problems continue in the NHS, with several strikes announced. Macron promises free condoms for minors and young people up to 25 years of age. Several initiatives in the field of health of the European Union, which makes health more and more a European Union policy, without prejudice to the fact that the management of national health services is the responsibility of the Member States.

If we talk about National Health Policy (Spain), in terms of covid, the incidence continues to decrease, what has not completely decreased is mortality (314 deaths in the last week). The strikes continue in the Primary Care of Madrid, without it seeming that the negotiations are progressing. The results of the Third Wave (2022) of the Health Barometer appear, which well deserves a careful analysis. Spain is the European Union country that performs the most instrumental deliveries, according to the “European Perinatal Health Report” (2015-2019).

In the field of Companies, at the international level, an important initiative by Pfizer to increase production in Europe, something necessary as seen during the pandemic and the difficulties for Europe to fully depend on production in Asia. Spin off of GE Healthcare from General Electric. Regarding national news, it should be noted that Blackrock increases its stake in Grifols.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (November 28th-December 4th, 2022

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Summary

From the point of view of biomedicine, the most noteworthy are the debatable but hopeful advances in the treatment of Alzheimer’s, a disease whose treatment has been investigated for many years, without results. A coalition (CEPI) that brings together governments, philanthropic entities and companies, intends to develop future vaccines in 100 days, a third of the record time in which the covid vaccine was developed. The “express” radiotherapy, of milliseconds, a great promise.

As regards Global Health, numerous cases of malaria are detected in Haiti, which had been eradicated three years ago. A mosquito (Anopheles) until now located in Asia, is spreading through Africa, with the risk of increasing malaria, due to its character as a vector of the malaria parasite.

As for international health policy, the most notable is what is happening in China, where, as The Economist says, a health problem is turning into a serious political crisis. In the UK, a negative consequence of Brexit is that the shortage of doctors has worsened.

If we talk about national health policy (Spain), in terms of covid, the incidence is decreasing. What has not just been published is the announced report on the analysis of the management of the crisis. Now it is said that in April, but with the regional and municipal elections in May, we could doubt the date. Harsh criticism of Miguel Sebastián on data management during the pandemic. Serious medical conflict both in Madrid and in the rest of Spain. In addition to job insecurity and poor medical work conditions, there are serious service problems for the population with waiting lists and difficulties in accessing Primary Care. That is the underlying problem, which is very serious, unavoidable and in some cases legitimate political uses on the side. Neither do private doctors seem to be treated very well: low tariffs, which require intensive work, with very little time for patients, are also a problem.

In the field of companies, at the international level we are getting to know Amazon’s most recent commitment to telemedicine a little better, it seems that it focuses on processes that are not very complex and very frequent. It does not seem that he wants to enter the “core” of the difficult health provision. An Alphabet company (Google) advances the use of artificial intelligence for drug discovery. At the national level, it is worth noting the initiatives of ITA, a new unit for neurodevelopmental disorders in Madrid; CASER, with a new residence for the elderly in Majadahonda; and HM Hospitales, which intends to create its own University for doctors.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies