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

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