7 days in healthcare (November 21st-27th, 2022)

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Summary

Most notably from the Biomedicine standpoint, the FDA is approving a drug that could delay the onset of type 1 diabetes, the devastating disease that often occurs in adolescents. Also the preclinical study that seems to foreshadow a universal flu vaccine. Likewise, the minirobot designed by Apple capable of taking medicines to the brain, that organ until now practically inaccessible to drugs.

With regard to Global Health, the COP27 summit is considered in an article in The Lancet a “collective failure”, given the lack of agreement on the lower use of fossil fuels. We must also note the race for the production of vaccines in several African countries.

Regarding International Health Policy, mortality from covid remains high and is very worrying in some countries, mainly Japan, Brazil, India, China, the Russian Federation, South Korea and Spain. The covid-zero policy is generating problems and discontent in a country where public demonstrations are as controlled as in China. The nurses’ strike in the United Kingdom is a historic event in that country, which will undoubtedly will have consequences.

If we talk about National Health Policy (Spain), mortality from covid remains high in Spain (260 cases in the last week). At this time Spain has 0.6 deaths per 100,000 inhabitants, a fairly high mortality, although lower than other European countries, such as France, Greece, Denmark, Norway, Croatia, Estonia and Luxembourg, according to WHO data. The waiting lists for June 30 are published by the Ministry of Health. A real national problem and a serious delegitimization of the public system, which some minimize. The strike of Primary Care doctors continues in Madrid, while the conflict threatens to spread to other autonomous communities. The rise in the electricity bill threatens the profitability of private hospitals, according to ASPE.

In the field of Companies, at the international level, Amazon is making a new foray into healthcare, this time with the “Amazon Clinic” platform, a telemedicine service that will be extended to 32 American states and offers virtual care for 20 clinical conditions. At the national level, news at HM Hospitales, with the new hospital in Rivas; in Recoletas, which extends to Salamanca; and, in Sanitas, which intends to create its own clinical analysis laboratory.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

  • International News
    • Amazon makes a new attempt at healthcare. The offers of the big technological platforms are diversified: Apple tries to monitor through the iPhone; Microsoft, offers computer services to companies; Alphabet (Google), relies on wearables. Amazon launches the most ambitious offer, with “Amazon Clinic”, an online service that will operate in 32 American states and that offers virtual care for 20 clinical conditions, from acne to allergies (https://www.economist.com/ business/2022/11/20/amazon-makes-a-new-push-into-health-care)
    • The big pharma aims for 50,000 million dollars in medicines against obesity, a disease that affects 650 million people in the world, as demand grows. Lilly will submit a drug for authorization (https://www.ft.com/content/f28e8ca1-87a7-4c14-8b05-0ead0e831c0f)

 

 

7 days in healthcare (14th-20th November, 2022)

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Summary

From the point of view of Biomedicine, the promising advances in the clinical trial of monoclonal antibodies against malaria are noteworthy. Although malaria has declined remarkably in the last 20 years, progress stopped in 2014. 6 African countries suffer 55% of global malaria cases. There is no doubt that the world would be much better without this disease.

As regards Global Health, the COP27 summit approves what was a general demand: the creation of a fund to help countries vulnerable to warming, although it does not agree to end fossil fuels. Faced with the opinion of the Director General of the WHO to hail the Qatar soccer championship as good for health, The Lancet is more skeptical, pointing out, among other things, that it had already shown in 2021 that the Olympic Games do not contribute to the generalization of the practice of physical exercise among the population.

Regarding International Health Policy, it seems that China is beginning to soften the covid-zero policy with regulations that are not as draconian as up to now. The American CDC initiates the changes, after the report that was made that demonstrated notable failures during the pandemic. The pharmaceutical industry warns in the United States and the United Kingdom that a change in price conditions in the first country and an increase in taxes in the second, could harm investments and, consequently, innovations in medicines.

If we talk about National Health Policy (Spain), the incidence of covid has risen in the last week, after two weeks of decline. With the announced change of the Minister of Health, Spain will have the sad record of having five Ministers of Health (Montón, Carcedo, Illa, Darias and the new one) in five years. Not surprisingly, the Ministry of Health has become a contingency management ministry, rather than the driver of transformative system change. If any of those ministers, which is quite doubtful, had had any transformation approach, he would not have had time to even raise it. It is not surprising that, in these circumstances, the Ministry of Health has not had the opportunity to rule on the conflict between Primary Care doctors, as if it did not affect it, when local circumstances aside, the working and professional conditions of healthcare personnel at Primary Care are a national problem. It confirms what was already known: that Spain is among the countries with the most doctors per 1,000 inhabitants in the world. Important and necessary organizational revolution at the Vall d’Hebrón hospital in Barcelona, ​​creating 32 areas of knowledge. The approach will be presented at the next meeting of the European University Hospitals Alliance (EUHA).

In the field of Companies, at the international level, obesity is seen as the expected Eldorado of Big Pharma. In Spain, Sanitas acquires a hospital in Mexico; Ribera buys a hospital group in Murcia; and, Imed considers the construction of three new hospitals: Valencia, Alicante and Barcelona.

Biomedicine

Global Health

International Health Policy

National health policy

  • Other themes
    • Francesc Moréu, a well-known health manager, updates his document published in 2020 entitled: “A new health model for a new society” to November 2022. The fundamental thesis is that the health sector was created for another society and the fact that in-depth reforms have not been carried out for more than 40 years is creating problems for patients and professionals (https://drive.google.com/ uc?export=download&id=1W3l4Lz6gH3s-cG7rlKX_2kqKlsorkCy0)

Companies

 

7 days in healthcare (November 7th-13th, 2022)

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Summary

From the point of view of biomedicine, to highlight the blood transfusion with cells generated in the laboratory from donor stem cells, carried out in the United Kingdom, which opens up possibilities for what has been pursued for years: the so-called “artificial blood”. Likewise, two advances that originate in Spain: the discovery of a genetic variant that favors thinness (CNIO) and the fact that malignant cells break off from cancer and cause deaths by metastasis (Institute of Medical Research of Barcelona).

As regards Global Health, Nature insists in an editorial, following the COP27 meeting, that rich countries must advance compensation for polluting. Important challenges for the new Brazilian President in health matters, particularly in primary care.

Regarding International Health Policy, debate on the covid-zero policy in China, on the one hand, there seem to be signs that China is easing quarantines, on the other hand, according to José Luis Puerta in an article, this policy is a death trap , since its abandonment may mean assuming a high number of deaths, given the low percentage of vaccination in China. In the United Kingdom (NHS) a nurses’ strike for salary demands is raised for the first time, which. according to the Government, they are unaffordable.

If we talk about National Health Policy (Spain), it seems that the crisis of Primary Care, long incubated, has exploded. Although the problems of low wages, poor working conditions for doctors and flight or refusal to go to Primary Care is a national problem, the crisis has broken out above all, although not only, in Madrid, which has some peculiarities that aggravate the situation: 1. the closure of out-of-hospital emergencies for two years; 2. the low funding of the health system in Madrid and of Primary Care; and, 3. some confrontation practice. The truth is that the “white tide” has been activated, with a large demonstration in defense of public healthcare in the center of Madrid, which was a great success for the organizers. As always in these cases, the defense of public healthcare is mixed with the rejection of any form of public/private collaboration. Tensions in primary care also in the rest of Spain. Highly recommendable is the video on YouTube entitled “Doctors are lacking in Spain”?

In the field of companies, at the international level Bavarian Nordic increases its growth due to the monkeypox vaccine, while BioNTech’s revenues fall, due to the drop in sales of the covid vaccine. In Spain, changes in the CEO of Quirón, to whom Víctor Madera, the company’s founder, returns to executive positions. Success for Ribera, which is awarded an important contract for a hospital concession in Cascais (Portugal). New delays in the approval by the EMA of the HIPRA vaccine.

Biomedicine

Global Health

International health policy

  • COVID-19
    • China eases quarantine rules, with Guangzhou close to lockdown. There is speculation that Beijing is considering a relaxation of the covid-zero policy (https://www.ft.com/content/709e95e6-cc63-4fe0-9c4a-5683c87f7e7b)
    • Interesting article by José Luis Puerta: “China: the deadly trap of the covid-zero policy”. If the government lifts the restrictions, which are sinking the economy, the country risks suffering a tsunami of infections, due to the low level of vaccination. It is estimated that this could cause 1.6 million deaths and a demand for intensive care that exceeds its current capacity by 15.6 times (https://theobjective.com/internacional/2022-11-12/china-covid-zero/ )

National health policy

Companies

 

7 days in healthcare (October 31st-November 6th, 2022)

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Summary

From the point of view of Biomedicine, the start of human trials of drugs discovered by Artificial Intelligence should be highlighted, something that is attracting the attention of all Big Pharma companies.

With regard to Global Health, it should be noted that COP27, the major international conference on climate change, will be held in Cairo on November 7 and 8. His opening coincides with the editorial in The Economist in which he says that the goal of keeping the temperature from rising 1.5º is totally unrealistic, proposing various alternatives. Ukraine’s health system prepares for nuclear disaster. Cholera outbreaks in various parts of the world.

Regarding International Health Policy, the WHO publishes a document on the development of telemedicine in Europe, identifying the problems of the user, technology and infrastructure as the main obstacles to its development. Problems in the British and French health systems.

If we talk about National Health Policy (Spain), the CESM denounces the proliferation of contracts for doctors without a MIR system. Surprisingly, there is no exact figure for how many doctors practice in Spain without MIR. Serious tensions in the Madrid healthcare system, mainly in out-of-hospital emergencies, although not only. It seems that the politics of confrontation prevails, which is neither positive nor desirable. There are no good memories of the famous “white tides” in Madrid, which should not be reactivated. The debate on the delay in access to medicines continues. The Ministry of Health affirms that part of this delay is due to pharmaceutical companies, which prioritize some countries over others in their marketing requests. At the national level, mention must be made of the death of Dr. Fernando Alonso-Lej, the great introducer of the MIR system in Spain and, therefore, deserving of maximum recognition.

In the Corporate arena, internationally J&J acquires a cardiac device company. In our country, it should be noted that the private sector builds more than 80% of nursing homes.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (October 24th-30th, 2022)

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Summary

From the point of view of Biomedicine, it is worth highlighting the studies that show that certain types of breast cancer, which respond to chemotherapy, will not require surgery. The link between Alzheimer’s and certain viruses is surprising. As for proton therapy, it seems that an increase in its indications (prostate, lung, etc.) is in sight.

As far as Global Health is concerned, the WHO study on a prioritized list of fungal threats should be noted. Cases of resistant tuberculosis, on the rise, which is a big problem with high mortality. Shortage of cholera vaccines. “Nature” magazine considers the possible second term of Bolsonaro in Brazil as a threat to science, democracy, the environment and the world. Said alarm had already been launched by this magazine as a result of his first term.

As for International Health Policy, monkeypox is in clear recession and covid is apparently less serious, possibly due to increased immunity. The truth is that mortality and cases requiring hospitalization are falling. Plan in the United Kingdom so that pharmacies can collaborate in the treatment of minor disorders (hypertension, high cholesterol, etc.)

If we talk about National Health Policy (Spain), a surprising proposal from ASPE to the Ministry of Health for the homologation of foreign doctors through a kind of two-year express MIR. The problem is surely more complex and it should be considered that we are one of the countries with the most doctors per 1,000 inhabitants and the most Faculties of Medicine. To analyze the shortage by areas and specialties, as well as the expansion of nursing work. It is doubtful that exporting quality doctors after an excellent MIR and importing foreign doctors with an express MIR is the solution. Perhaps the salary and working conditions of Spanish doctors should also be considered. Also striking is the new approach of the PSOE in terms of the Trans law, which tries to involve judges in changing sex between 12 and 15 years, compared to the bill approved by the Council of Ministers, which did not contemplate this possibility. AESEG, very willing to increase the use of generics, through regulatory and price changes.

In the field of Companies, at the international level, the extensive job cuts at Philips are striking, after its withdrawal of devices for sleep apnea. As for Spain, Sanitas publishes a study on mental health, which shows that the private health sector is agile in its response to a serious problem, which has become more evident after covid. Orange’s agreement with Mapfre confirms the great interest of telecommunications platforms in the world of health and their need to ally with traditional operators.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (October 17th-23rd, 2022)

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Summary

From the point of view of biomedicine, the announced “vaccine against cancer” should be highlighted, which could be prepared before 2030. Although not strictly a vaccine, it represents a promising treatment against this disease based on mRNA technology, the same used for covid vaccine.

Regarding Global Health, an important announcement by the WHO about the dangers of a sedentary lifestyle, which could produce 500 million chronic patients in 2030. The WHO dedicates 2,600 million in its next strategy 2022-2026 for the eradication of polio .

Regarding international health policy, an important debate introduced by The Economist on the massive use of antidepressants, when only in 15% of cases do they have an effect other than placebo. Opioids in the United States and antidepressants worldwide are examples of the misuse of medications, which can lead to, and in many cases lead to, health problems. The post-pandemic horizon has generalized a hybrid work model (face-to-face and online) for office professionals.

If we talk about national health policy (Spain), the pressure on hospitals due to covid remains low, despite a slight rise in this disease. Intense debate on the flight of Spanish doctors to other countries, attracted by better salary and professional conditions. No matter how much the number of MIR vacancies and Faculties of Medicine increases, the problem will not be solved if working conditions are not acted upon. Teleconsultations seem to consolidate in Primary Care, already being more than 50% of the visits. The Trans law is the subject of great controversy. Most psychiatrists and psychologists, against. Obviously, we are in favor of the position of the WHO by removing from the list of diseases already in 2018 these cases of having a gender identity other than biological sex and wanting to change the morphology of their body. We welcome that there is a law on the subject as in most Western civilized countries. But one thing is that and another that 14-year-olds can choose sex without a psychological evaluation carried out by experts, who can rule out cases. Irreversible problems may occur. There is a certain consensus that the current wording of the law does not sufficiently protect minors.

In the field of companies, at the international level, we must welcome the first agreement with a pharmaceutical company (Novartis) to produce an anticancer drug as a generic that is still protected by patent, for its production in developing countries. As far as Spain is concerned, the continuous growth of health insurance should be highlighted, which in 2022 until September grows considerably more than the insurance as a whole.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (October, 10th-16th, 2022)

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Summary

From the point of view of biomedicine, to review the advances in knowledge of the human organ that, to a large extent, remains a mystery, the brain: the implantation of human cells in mice, which can send signals and the creation of a kind of synthetic intelligence, by verifying that nerve cells in a dish can learn. In the United States, it is found that mortality from breast cancer has decreased a lot, due to early detection and better treatments. Something that is not exclusive to the United States and that surely also occurs in Spain.

As far as Global Health is concerned, the serious health problems, for very different reasons, in Pakistan, Somalia, Syria and Lebanon must be highlighted.

Regarding international health policy, there is great concern in the WHO and other organizations about the effects of persistent covid. Threat of hospitals in Germany by covid. The Economist introduces the debate on the legalization of cocaine, which it strongly defends, considering that the problems of an illegal market far outweigh those that could arise in a controlled market. Put the simile of whiskey and cigarettes.

If we talk about national health policy (Spain), the rise in the incidence of covid continues, although in Spain without notably affecting hospitals. Promising launch of the Neurotechnology Center in Madrid.

In the field of companies, at the international level, the WTO (World Trade Organization) continues with its efforts to free the patents of medicines related to covid. As far as Spain is concerned, HIPRA suffers a new delay in the approval of its vaccine by the EMA, which practically excludes it from the fourth dose vaccination campaign.

Biomedicine

Global Health

International health policy

  • European Union
    • A step forward towards a Europe of health. The reinforcement of the ECDC (European Center for Disease Prevention and Control), the EMA (European Medicines Agency) and the creation of the Health Emergency Preparedness and Response Authority, constitute important steps towards a European policy of health, something not contemplated in the founding European treaties (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01980-8/fulltext)
  • The debate on the legalization of cocaine
  • New Code of Medical Ethics
    • Approved the new International Code of Medical Ethics of the World Medical Association. After the initial version of this Code in 1949, a new wording has been approved at the General Assembly of the World Medical Association, held in Berlin in October 2022 (https://jamanetwork.com/journals/jama/fullarticle/2797507)

National health policy

Companies

 

 

7 days in healthcare (October, 3rd-9th, 2022)

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Summary

From the point of view of biomedicine, to review the Nobel Prize in Physiology and Medicine, won by Svante Pääbo, a scientist who is recognized for his studies on the DNA of human ancestors, which allows us to better understand genetic evolution towards the “homo sapiens”. It seems that a study with Artificial Intelligence of the eye will help predict coronary risk in minutes, without the need for blood tests or other studies.

As far as Global Health is concerned, it is believed that malaria could be definitively eradicated from the world, with the help of new vaccines.

As for international health policy, alerts in Europe about avian flu and diphtheria, brought by immigrants from Africa and Asia. To highlight the changes in Portugal, which incorporate an independent team to the management of the SNS.

If we talk about national health policy (Spain), the rise in covid cases prevents the Interterritorial Council from approving the abolition of masks on public transport. The health items in the General State Budgets are analyzed with a magnifying glass in the professional press, despite the low weight of the expenses of the Central Administration in the total health expenses. However, it allows to detect some priorities for the Ministry, although the economic items are usually below the challenges: primary care, genomic portfolio, mental health, dental care, primary care infrastructure, etc. The CEOE charges against the Equity Law, which it describes as “unprecedented risk”. The debates and controversies continue in relation to the delays in the incorporation of pharmaceutical innovation in Spain. However, these debates do not usually consider that the approval by the EMA of a medicine does not mean automatic public financing in Spain, according to article 92 of the Law on Guarantees and rational use of medicines, which establishes the “financing selective and not indiscriminate” according to a series of criteria, which are established. AESEG and BIOSIM no longer agree with the plan approved a couple of years ago on generics and biosimilars, but want the new approaches to be included in the Guarantees Law.

In the field of companies, in the international arena, BioNTech signs an agreement with Australia, for the establishment of research centers in that country. As for national news, the growing weight of online pharmacy (prescription drugs excluded by law). HM reinforces itself in Andalusia, incorporating four hospitals in Malaga into its network.

Biomedicine

Global Health

International health policy

National health policy

  • General State Budgets (impact on health)

Companies

 

7 days in healthcare (September 26th-October 2nd, 2022)

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Summary

From the point of view of Biomedicine, to review the advances, still to be confirmed, in the treatment of two terrible diseases: ALS and Alzheimer’s.

Regarding Global Health, concerns continue about the evolution of polio, whose eradication was announced in 2019, but which is reappearing in several countries.

Regarding International health policy, it is worth noting the similarities between the covid-zero policy in China and the era of prohibition in the United States, something pointed out by The Economist. Very worrying is the “burnout” of doctors, a phenomenon highlighted by the New York Times in the United States, but which seems to be universal.

If we talk about National health policy (Spain), the debates on the Equity Law continue. The update of the RD on the minimum data set of the SNS leaves out the private sector, despite the opposition of the POP, IMAS Foundation, IDIS Foundation and ASPE. It is a modification of a 2010 RD, but in twelve years the private sector has developed a lot and it is no longer so easy to leave it out in certain decisions. The Senate rejects the PP’s motion to facilitate access to medicines and reduce the time it takes to join the SNS. Surely the motion of the PP was too vague and, at this point, it is necessary to explain very well the “what” and the “how” of any proposal.

At the corporate level, at the international level, big rise in Biogen shares, spurred by what appear to be hopeful results from its Alzheimer’s drug. At the national level, there are rumors that KKR and CVC could be trying to buy Quirónsalud, currently in the hands of the German group Fresenius, which has recently changed its CEO. The Murcian company Vócali develops the Inbox Medical software for transcription of medical reports.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

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

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Summary

From the point of view of biomedicine, to review the articles in The Economist on advances in knowledge of the brain, which will have a great impact on the appearance of new drugs and pain therapy.

With regard to Global Health, the WHO report of September 21, which places cancers, cardiovascular conditions and diabetes as responsible for three quarters of global mortality.

In terms of international health policy, an important initiative in France to offer three preventive consultations free of charge by the public system: at 25, 45 and 65 years of age. The EU launches a plan for the elimination of tuberculosis in Europe.

If we talk about national health policy (Spain), great debate around the Equity Law. What should have been just a law to correct the access deficiencies of the Montón Law, is being flamboyantly called “Equity” (as if accessibility guaranteed equity, not having a single provision to improve equity), and It is used to introduce the aspirations of Unidas Podemos to annul Law 15/97, approved almost unanimously at the time. The IDIS Foundation has warned of the damage to assistance and, specifically, the waiting lists, if some precepts of the Law are approved. It seems that the Catalan consortiums are going to respect each other, which is important, but it is also important to preserve and reinforce public/private concerts throughout the national territory.

At the corporate level, from an international point of view, the shares of the large vaccine manufacturers (especially Moderna, BioNTech and Novavax) plummeted, as a result of President Biden’s announcement that “the pandemic has been feared”. In Spain, it should be noted that Moderna will install its first quality laboratory outside the United States in Madrid.

Biomedicine

Global Health

International health policy

National health policy

Companies