7 days in healthcare (November 13th-19th, 2023)

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Summary

From the point of view of Biomedicine, The Economist speculates in an article about whether certain regenerated neurons of the dentate gyrus could reverse Alzheimer’s, based on studies in mice. AI, useful in improving the detection of breast cancer.

Regarding Global Health, the WHO points out the rebound in measles worldwide. The number of cases and, above all, mortality are increasing a lot.

In terms of International Health Policy, the United Kingdom encourages the EU and the USA to join its “subscription model” for the development of antibiotics. In practice, it introduces a system of incentives for pharmaceutical companies not linked to the sale of the drug, which can be useful if new antibiotics against resistant bacteria are intended to be of low use. The King’s Fund (an important British health think tank) launches a study in which it analyzes in great detail the inequities in waiting lists. Without a doubt interesting reading in our country. In France, the SNCF (equivalent to our RENFE) launches an interesting initiative to alleviate the problem of medical deserts: build telemedicine centers near the stations.

If we talk about National Health Policy (Spain), the confrontation between private doctors and insurers continues. Without a doubt, the problems of personnel policy do not only occur, as some might think, in the public sector. They also occur in the private sector. The Ministry of Health calls the comments about the transfer of the MIR to certain communities hoaxes. The problem is that this issue appears in the investiture agreements. Success of the PRAN (the plan to reduce antibiotic consumption), obtaining good results in our country, despite continuing to be one of the countries with the highest consumption of antibiotics, both in humans and in veterinary medicine.

In the field of Companies, on an international level, the sale of obesity drugs could be a great boom and reach 100 billion dollars in 2030. On a national level, Quirón is advancing in the approach of building its new hospital in Gijón. Sanitas-BUPA buys a Turkish insurer. The bankruptcy administrator blames KKR for the bankruptcy of the dental company Dentix.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

7 days in healthcare (November 6th-12th, 2023)

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Summary

From the point of view of Biomedicine, Victor R. Fuchs, a pioneer of health economics and possibly the most recognized and prestigious health economist in the world, dies. He always defended universal health coverage for the United States, although he was very aware of the difficulties of its implementation, due, among other circumstances that he explained, to the heterogeneity of American society. And it must be said that he was not wrong in that. The FDA has just approved an oral drug based on the intestinal microbiome, a new horizon in medicine.

As far as Global Health is concerned, although tuberculosis is preventable and treatable, it continues to be the infectious disease with the most mortality globally, after a short period of time in which it was covid. But 40% of the world’s population with tuberculosis is not treated.

In terms of International Health Policy, it seems that the covid pandemic did not damage developed economies as much as initially thought. This seems to be deduced from studies of initials from the United Kingdom and Italy. The EFPIA, the pharmaceutical industry’s association, continues to complain that the new European legislation could end incentives for innovation and put Europe in an even worse relative position than the one it already has with respect to the USA and China. The OECD has just published “Health at a Glance 2023”, a must-read.

If we talk about National Health Policy (Spain), the agreements of the PSOE and Junts (and also those signed with the PNV for the Basque Country and with the BNG for Galicia) contemplate the transfer of powers over the MIR (and in the case of the Basque Country also of the issuance of titles). Some say that constitutional values and democratic principles have been subordinated in the investiture agreements. Obviously, this does not happen with the MIR, but an important value is put at risk: the cohesion of the National Health System, based, among other issues, on the uniformity of the training system and recognition of titles and specialties, being , on the other hand, a highly recognized system. 11 public hospitals appear to be starting a lung cancer screening program. Since this procedure is not recognized in the SNS service portfolio, the innocent question is: who pays for this? Or is it simply a pilot program with special funding? The Community of Madrid proposes a modification of the current Law of Good Government, which required the appointment of managers of health centers by competition and which at the time was approved by broad consensus, to another system that allows the direct appointment of these positions by part of the SERMAS Board of Directors.

In relation to Companies, at the international level, the battle between pharmaceutical companies in relation to obesity continues (the main players are NovoNordisk, Lilly and AstraZeneca). Amazon is relaunching in health, providing health services through One Medical to its premium customers. At the national level, great growth in the 22nd year of dental, ophthalmological and aesthetic clinics. The purchase of the Eugin assisted reproduction clinics from Fresenius by KKR and GED is completed. The latter retains the business in Spain, while KKR will integrate the international business into IVI RMA.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
  • OECD
    • The OECD publishes “Health at a glance 2023”. Main conclusions: healthcare systems are under severe financial pressure; there has been no complete recovery after covid; unhealthy lifestyles cause millions of deaths; Access barriers persist, despite universal coverage in most OECD countries; the quality of care is improving; digital health has immense potential (https://www.oecd.org/health/health-at-a-glance/)

National health policy

Companies

 

 

7 days in healthcare (October 30th-November 5th, 2023)

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Summary

From the point of view of Biomedicine, the FDA opens the door to the first treatment with CRIPSR gene editing, applied in this case to sickle cell anemia. The “liquid biopsy” seems to be able to detect cancer recurrence before any radiological signs. A change is proposed in the regulation of embryo research. The laws and conventions in force do not allow embryos to be investigated in the laboratory beyond day 14. There is a gap until day 28, when embryos from abortions can already be investigated. This seems to prevent us from knowing many elements of organ development and that is what we are trying to modify. Although it is often assumed that dementia is increasing as the population ages, there appears to already be some evidence that the incidence of dementia is decreasing quite significantly.

As far as Global Health is concerned, the director general of the WHO is alarmed by the indescribable situation in Gaza. Nigeria is preparing to vaccinate 8 million girls with the papillomatosis vaccine, related to cervical cancer.

Regarding International Health Policy, in the United States, despite the prohibition of abortion in some states as a consequence of the Dobbs ruling of the Supreme Court, the abortion rate has not decreased a year after this ruling. The Economist considers how it is possible that doctors in the United States earn so much ($350,000/year on average), coming to the conclusion that it is due to an artificial shortage of doctors, due to the few places in Medical Schools, despite that there is no shortage of candidates. In the United Kingdom, the investigation into covid seems to show the disaster in management during the Boris Johnson period. Bad business, although the case of Spain is worse, where, despite promises, no report on the management of the pandemic has been made public. Health changes are on the horizon in Poland, following the arrival of the new government. Kenya, with 53 million inhabitants, joins the movement of so many other countries to move towards universal health coverage.

If we talk about National Health Policy (Spain), the XENOMA project in Galicia is very important, which aims to analyze the DNA of 400,000 Galicians. One of the precedents is the project to analyze the genome of 100,000 Britons, promoted during the David Cameron period and managed by Genomics England. Surely a project of this style should have been promoted at the national level, but it is good that, in the absence of the above, it should be promoted by an autonomous community. Doubts among experts about one of the measures of the PSOE-Sumar agreement on a law to end waiting lists. Without funding, better accounting and prioritization, organizational measures, new incentives and public/private collaboration, no law is capable of solving this problem. After all, a Royal Decree that establishes maximum times for certain procedures has already been in force since 2011, but it is not being complied with. Virtually all autonomous communities are approving increased health budgets for 2024, rising especially in Primary Care. Just because the budgets grow compared to the previous year does not mean that they are higher than the real spending in 2023, which is happening in Madrid, for example. The PSOE-ERC agreement contemplates the transfer of at least 150 million euros/year to Catalonia, for scientific and technical research.

In the field of Companies, on an international level, Google intends to grow in healthcare, based above all on artificial intelligence tools. Regarding the covid vaccine, GSK raises profit forecasts, while Moderna and Pfizer contemplate setbacks. At the national level, Fresenius sells its Quirón business in Peru. The Sant Joan de Deu Hospital in Barcelona creates an artificial intelligence laboratory with Microsoft.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

 

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

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Summary

From the point of view of Biomedicine, Nature magazine analyzes the great impact of Artificial Intelligence in medicine. Interesting article from the New York Times about the possible addictive nature of social networks.

Regarding Global Health, the WHO adds 6.9 million deaths from covid, although warning that the global figure could triple. Major humanitarian and health crisis in Gaza, which is the subject of WHO concern.

In terms of International Health Policy, the NEJM wonders if the introduction of the American government’s law that requires negotiating the price of drugs for Medicare will delay the appearance of new cancer drugs. The conclusion is that, although pharmaceutical companies will look for ways to maintain their profits, delaying the appearance of medications does not seem to be the best strategy, due to the ethical, reputational and financial considerations inherent to the operation. The Economist analyzes how it seems that healthcare has ceased to be the bottomless pit for public accounts, as it was for many years, in which, year after year, its relative weight in the countries’ GDP increased. Although health expenditure increased its share of GDP in the years 20-21, due to the joint effect of health expenditure due to the pandemic and the decline in GDP, it has since fallen to reach 2008 levels. In the United Kingdom, It seems highly unlikely that Prime Minister Sunak will deliver on his promises on NHS waiting lists.

If we talk about National Health Policy (Spain), given the evolution of the negotiations for the investiture and the possible continuity of Sánchez in the government, the national news of the week is the publication of the document “Spain advances”, which contains the agreements of the PSOE with SUMAR on different topics. The general tone of the document is more about promises than progress in certain necessary reforms and this same philosophy permeates the health part. On the other hand, the document does not cover all the topics (it does not talk about Defense, very little about foreign policy or other relevant issues). It gives the impression that this is the part in which SUMAR would intervene. From this point of view, as the health part is developed in some detail, it is assumed that a strong intervention by SUMAR in health is expected, regardless of whether the Ministry of Health is handed over to it. In summary, what is promised is to continue the processing of the Equity Law (which establishes direct public management as the preferred form of management in the SNS), a law is proposed with maximum times for waiting lists and there is talk of new benefits in mental health, oral health (although it seems to limit it to children and adolescents) and visual health. We consider the emphasis on the preferential nature of direct public management negative (there is multiple evidence of the good results of public companies and foundations or health concessions) and regarding the law on the waiting list it will surely not be the best way to solve this problem. We have already seen laws and regulations in some communities that had no effect. Both the PP, in the political sphere, and ASPE and ACES, in the world of health representation, have been against these measures.

In the field of Companies, on an international level, Amazon is torn between promises and realities in healthcare. Although large technology platforms will surely have an increasing role in healthcare (as in the financial world), it seems that they are finding it difficult to enter. Roche reaches an agreement to buy Telavant. At the national level, Ribera reaches an agreement with Microsoft to promote innovation and AI in healthcare. It seems that Grifols is making progress in its therapy against Alzheimer’s.

Biomedicine

Global Health

International health policy

National health policy

Companies

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

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Summary

From the point of view of Biomedicine, the largest research project in the world is taking place in the United Kingdom. It is about collecting information of all kinds from 5 million Britons, to then put that information to work in the preventive, diagnostic, therapeutic, Public Health field, etc. A milestone where the great contribution of AI to health and healthcare will be seen.

In terms of Global Health, The Lancet analyzes the problem of deadly gun violence and the intended approach in the United States, under the leadership of Vice President Kamala Harris. Although we tend to believe that this is a typical and especially acute problem in North American society, the truth is that in many Latin American countries the situation is much more serious: Brazil, Mexico, Guatemala, Venezuela, El Salvador,…

In terms of International Health Policy, a novel approach to smoking in the United Kingdom, where it is being proposed to address this problem from the beginning, slowing down the age of starting to smoke. A report by European pharmacists confirms that the shortage of certain medicines is a problem throughout Europe.

If we talk about National Health Policy (Spain), it is worth highlighting that the Generalitat Valenciana intends to recover the public management of the Manises and Denia hospitals, managed by concession by Sanitas and Ribera, respectively, while at the same time it proposes to continue with the concession of Vinalopó, which ends in 2025, also managed by Ribera. A priori, it seems like a judicious and non-sectarian approach from the Valencian government. The government’s Budget Plan foresees a percentage of GDP for health in 2024 of 6.7%, which contrasts with the results of the latest report of the Health Accounts System (July, 2023), which shows a public health expenditure of 7 .8% of GDP in 2021. Given that, as in the 2010 crisis, measures to reduce health spending (such as lowering staff salaries, freezing substitutions or reducing the price of medicines) are not announced, it is difficult to believe that this objective of 6.7% in public health in 2024 will be met, especially when some communities, such as the Basque Country, are announcing increases in health spending. The Andalusian Health Institute is created, the result of the merger of the Andalusian School of Public Health and the Progreso y Salud Foundation, which lose their status as public companies and, therefore, a certain autonomy. Given the history of the current Andalusian government with public hospital companies, we fear that it is another step towards the “administrativeization” of the public health system. Time will tell if this is progress or setback, but they do not seem to bode well, given the poor results of the operation in the hospital setting.

In the field of Companies, on an international level, the purchase by MSD from Daiichi of several cancer drugs is worth highlighting. At the national level, OHLA is awarded the construction of the new Vithas hospital in Turia. Important commitment of venture capital (Advent) in the field of dental care (Vitaldent), which contrasts with the low commitment of the government in this field, which distances us from Europe, being one of the countries with the least public financing in dental care.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

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

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Summary

From the point of view of Biomedicine, after years of research, scientists have published an atlas of the brain, the most unknown organ and whose knowledge will allow great advances in biomedicine. This week 21 articles have appeared about the brain and its cells. The work is done under the BRAIN Initiative Census Network project. The objectives of this effort were three: first, to understand the cellular components of the brain; second, to know which cells are affected in neurological and psychiatric diseases; and, third, what makes the brain of Homo sapiens different from that of other animals. The brain is the most complex object in the universe and contains around 3,000 types of cells. Until recently it was believed that the human body, including the brain, had only 300 types of cells. Artificial intelligence, new therapeutic vaccines, xenotransplantations and quantum computing, in the focus of monitoring progress in medical sciences.

Regarding Global Health, The Lancet asks in several articles the impact on health of a world with a shortage of work, since until now a job in good conditions was considered important for health. The malaria community welcomes the WHO approval of the new vaccine. Malaria kills half a million children a year, mainly under five years old. This decision is expected to improve access to doses of the vaccine, especially in Africa. 28 African countries are going to introduce this vaccine as part of their immunization program.

Regarding International Health Policy, in the United States pharmaceutical companies agree to negotiate the price of medicines with Medicare, despite the fact that some maintain lawsuits against the American government. In the European Union, the shortage of amoxicillin, a widely used antibiotic, persists. There is also in the EU an increase in deaths due to mental disorders.

If we talk about National Health Policy (Spain), the government puts out to public consultation the draft Royal Decree for the evaluation of health technologies which, among other things, rethinks the economic evaluation of medicines, incorporating the participation of professionals and patients and attempting predictability and transparency in decision-making times.

In the field of Companies, at the international level, it is worth highlighting that the global cannabis market will reach 100 billion in 2030. At the national level, Sanitas is launching an educational experience, which is an example of the importance they give healthcare companies to the issue of training, aware that attracting and retaining talent will be the most important competitive advantage.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

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

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Summary

From the point of view of Biomedicine, Katalin Karikó and Andrew Weissman, awarded the Nobel Prize in Medicine, for their discoveries that allowed the implementation of the mRNA vaccine against covid. When Watson and Crick discovered the structure of DNA in 1953, RNA was not known, not discovered until 1961. DNA is the matrix for RNA and this is the matrix for proteins to be produced in ribosomes. mRNA was later discovered. Dr. Karikó immigrated to the United States from her native Hungary in 1968 to find a therapeutic role for messenger RNA. For 20 years she worked unsuccessfully in that attempt. At the University of Pennsylvania, where she worked, she met Dr. Drew Weissman. They had made RNA, injected it into mice but they got sick and died. After some chemical changes in the RNA they avoided rejection. They believed they were on the path to discovering a new way of making vaccines. They tried to publish it in “Nature”, but the prestigious magazine rejected the work. They published it in 2005 in the minor journal “Immunology”. Two biotechnology companies saw the therapeutic potential of RNA: Moderna, in the United States, and BioNTech, in Germany. In 2013 Katalin Karikó became vice president of BioNTech, there she developed the vaccine against covid that has saved so many lives. In 2022 she left BioNTech to devote more time to research. She has returned to Hungary as a professor at the University of Szeged. Andrew Weissman’s life is less eventful, he is a professor of medicine at the University of Pennsylvania and had worked with Anthony Fauci, the doctor who led American efforts against covid-19. In another vein, The Lancet magazine publishes an experimental work in which a blood test detects tumors in asymptomatic people. It is only a first step, but the day does not seem far away when we can diagnose the existence of a tumor through a blood test.

Regarding Global Health, the WHO approves the long-awaited second vaccine against malaria. It should be noted that the number of cholera cases has doubled between 2021 and 2022, according to the WHO.

Regarding International Health Policy, in the United States, a strike at the important integrated insurer Kaiser Permanente ended without an agreement. The FDA launches a program to accelerate the emergence of therapies against rare diseases. Let’s not forget that most rare diseases have no treatment by 2023. Prime Minister Sunak of the United Kingdom seems determined to set limits on the age at which people start smoking. The EFPIA (European medicines association) appeals in writing to the European Parliament to amend the European pharmaceutical reform, which is underway.

If we talk about National Health Policy (Spain), as is known, the Government has authorized the increase in the number of places in Medical Schools. This initiative has been made against the opinion of the doctors and the Association of Medical Students. Obviously, the issue of health professionals requires planning, precisely what there has not been. Planning cannot be replaced with any measure if it is not well thought out and matured among the various agents of the health system. Andalusia takes a step to promote public/private collaboration, by approving 734 million euros to refer patients to private clinics. As for the Zendal Hospital, it seems that it the purpose of that hospital is already defined. After an investment of 50 million: the Zendal hospital will be a neurorehabilitation hospital. At one point it had been designed as a Covid hospital, something only seen in China and some other low-developed countries, not Europe. There was no functional plan for said hospital. We now do not know which studies have recommended its transformation into a neurorehabilitation hospital and whether the different agents (hospitals, scientific societies, expert groups, etc.) have been consulted.

In the field of Companies, on an international level, KKR finalizes the purchase of Eugin, to create a giant in assisted reproduction. At the national level, HM Hospitals announces the opening of its 9th hospital in Madrid. A story of undoubted success, based on a family initiative.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

7 days in healthcare (September 25th-October 1st, 2023)

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Summary

From the point of view of Biomedicine, The Economist raises the issue of how research on aging makes the prospect of living to 120 years less unimaginable.

Regarding Global Health, The Lancet publishes a study prepared with information from 185 countries that shows how a more “feminist” approach could have saved hundreds of lives of women with cancer. Surprising news from COVAX, the body created to distribute covid vaccines to developing countries: billions of its budget unspent.

Regarding International Health Policy, the pharmaceutical industry warns against the possible harms of the application of the European Union’s pharmaceutical policy, in this case the reduction of medicines against rare diseases. The pharmaceutical policy has not yet been approved, so this sounds like putting the bandage before the wound.

If we talk about National Health Policy (Spain), the news of the week was the failed investiture of Feijóo. In his speech he addressed health problems. Although logically in a discourse of this type the sectoral details must necessarily be brief and what is interesting is the general tone, the poverty of the health discourse is surprising. The proposals are reduced to a shock plan for Primary Care and new medical calls, in addition to a “commission of experts” to address the problems of the sector for which no initial proposal is launched. It does not seem that there is a mature reform program in the PP when it comes to health. The news of the approval of a catalog of biomarkers in the SNS, which will be published electronically, seems like good news.

In the field of Companies, at the international level, the EU’s talks with Moderna for the new supply of covid vaccines should be highlighted. At the national level, Sanitas is reinforced in Andalusia with a new center in Malaga; an Austrian company will create a wellness center in Marbella; and, Atrys Health continues its expansion in Mexico, through an agreement with BUPA.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

7 days in healthcare (September 18th-24th, 2023)

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Summary

From the point of view of Biomedicine, Nature magazine in an article returns to artificial intelligence as an accelerator of the introduction of new medicines, also making the process less expensive. A second patient is implanted with a genetically modified pig heart. The prospects for transplants with animal organs are opening up more and more. Google (Deep Mind) identifies millions of mutations in proteins capable of generating disease, which will allow a much better understanding of numerous diseases.

Regarding Global Health, article in Science about the eradication of polio, which was a goal for the year 2000, but not yet achieved. Despite the success of vaccination campaigns, polio is still present in Afghanistan and Pakistan. Nature magazine warns of the danger that the pandemic treaty will not be concluded by 2024, as was the objective. The need to make vaccines accessible to everyone in all countries and the protection of intellectual property through patents, in contradiction, hinders progress.

Regarding International Health Policy, JAMA reviews the historic negotiation by Medicare of the price of prescription drugs, exposing the reservations of pharmaceutical companies and the different demands presented by each of them to the American government. Prime Minister Sunak is considering the possibility of banning the use of tobacco for new generations, in a way similar to that implemented in New Zealand. A report from the Institute for Public Policy Research (IPPR) states that in the United Kingdom there were 240,000 deaths in the period 2010-2020, which could have been avoided if standards of care on the European average had been applied. This is largely attributed to difficulties in access (in other words, waiting lists).

If we talk about National Health Policy (Spain), after an attempt at regional rebellion, the Ministry has had to withdraw the measure that provided for vaccination of health workers with the Hipra vaccine, not adapted for the new strains. Although the Ministry has not yet made public the announced report on the management of Covid, commissioned from four well-known experts, a group of prestigious academics has just published a valuable report on healthcare at the post-Covid crossroads. Changes in health are announced in both the Community of Madrid and Valencia. Time will tell if these changes address the real problems or remain cosmetic changes, to which some politicians are so accustomed. In Madrid, the final destination of the Zendal hospital does not seem to be clear, apart from its temporary use as a center for ALS. It is the consequence of building a large center without an adequate functional plan. The valuable EPINE report shows that more than 7,000 deaths occurred each year in Spain as a result of nosocomial infections. The conflict between doctors and health insurers, which began in Seville, threatens to spread to other communities, including Madrid.

In the field of Companies, on an international level, Abbot plans to acquire Bigfoot Biomedical at the end of 2023. On a national level, Novo Nordisk plans to open a technological and digital headquarters in Spain, which, if confirmed, would be excellent news.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

 

 

7 days in healthcare (September 4th-10th, 2023)

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Summary

From the point of view of Biomedicine, in an editorial article, the Financial Times comments on the promise of anti-obesity drugs. Despite the clear benefits of the new drugs, there are unresolved issues: first, the limited knowledge of long-term effects; second, the drug is initially expensive. Private patients in the UK are expected to pay £300 a month; and, third, medications should be a complement rather than a substitute for general lifestyle measures. The first human organ created in an animal opens the door to manufacturing spare parts for people.

With regard to Global Health, the new director of Africa CDC publishes in Nature magazine the new policy guidelines of this body, aimed at addressing public health problems in Africa.

Regarding International Health Policy, it is confirmed that the latest versions of the vaccines are prepared for the new variants. Profound administrative reform of healthcare in Portugal, driven by the socialist government and, specifically, by the SNS administrator appointed about a year ago, Fernando Araujo. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” Despite what has been said, the reform has nothing to do with an implementation of the Spanish Alzira model in Portugal, but it is a public reform. Although some of the measures (business configuration of the management units, board of directors, new financing model in which money follows the patient) “sound good”, the truth is that a reform of this caliber carried out no longer without consensus political but without even public debate it is more than doubtful that it can be successful. He also questions the government’s idea of “getting out of the way” of healthcare by delegating changes to an “administrator.”

If we talk about National Health Policy (Spain), commitment of the Ministry of Health with the measures agreed with the pharmaceutical industry, with the participation even of President Sánchez, to ensure the investment of 8 billion euros. It seems that the conditions are to improve access to medicines; enhance R&D; increase industrial capacities and create supply chains for resilient drugs. Although it is logical and desirable for the government to be “business friendly” with companies in general and with pharmaceutical companies in particular, it is doubtful that such an explicit agreement is the best path for both parties. On the other hand, it must not be forgotten, in view of the government’s commitments, that we are in full discussion of European pharmaceutical policy. Certain relevant changes in the Community of Madrid: possibility of requesting any test from Primary Care and facility for non-EU doctors to work in Madrid. The Royal Decree approving the specialty of emergencies comes out in public hearing, something long awaited and promised, but no less controversial and debatable. The general director of Pharmacy, César Hernández, says that “we do not have a general problem of access to medicines”, which can also be controversial in certain environments.

In the field of Companies, at the international level, Novonordisk becomes the most valuable company in Europe according to market capitalization. Lilly tries to get ahead of Novordisk in the obesity market. Regarding national news, HM Hospitales expands its offer in Madrid with a new polyclinic in an area of intense growth such as Vadebebas.

Biomedicine

Global Health

  • New public health model in Africa. Article in Nature by Jean Kaseya, the new director of Africa CDC. 6 proposals: local manufacture of vaccines; improved tracking system; integrated health systems; laboratory network; emergency response design; robust national institutes of public health (https://www.nature.com/articles/d41586-023-02749-5)
  • Cancers in young people (under 50) have risen by 80% in the last three decades, including breast, lung, stomach and colorectal cancers. (https://www.ft.com/content/b3140954-3cd0-4a3e-b554-92efa7ed7538). Original article in the BMJ: https://bmjoncology.bmj.com/content/2/1/e000049#

International Health Policy

  • Portugal
    • Deep administrative reform of healthcare, promoted by the socialist government. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” The reform is attributed to Fernando Araujo, the SNS administrator appointed by the government last year (https://www.portugal.gov.pt/pt/gc23/comunicacao/noticia?i=nova-organizacao-dos-cuidados-de-saude-conheca-a-grande-reforma-do-sns-para-2024)

National health policy

Companies