Posts

7 days in healthcare (June, 10th-16th, 2024)

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Summary

Biomedicine

  • 40 years after the discovery of Helicobacter pylorii. The discovery of Helicobacter pylorii 40 years ago revolutionized the treatment of gastritis, peptic ulcer and stomach cancer, leading to Barry Marshall and Robin Warren being awarded the Nobel Prize in Medicine in 2005. This discovery transformed an incurable disease into one treatable with antibiotics. However, Helicobacter pylorii has a global prevalence of 35% among children and adolescents, especially in poor countries. This requires strengthening essential measures to reduce infection, such as hygiene education, water treatment and other health measures.
  • The Lancet Editorial: Taking persistent physical symptoms seriously. These complex symptoms are incorrectly treated by health systems. Recognizing that they were misguided by the traditional biomedical model, in 1977 the biopsychosocial model was proposed, which has been criticized. Now a new model is proposed, as a starting point for a correct approach to this problem.
  • The future of academic medicine. Academic medicine is in crisis globally, as demonstrated by commercial pressures and useless research and publications, which consume a lot of money. However, academic medicine is basic and science is the basis of medical practice and medical education. Evidence-based medicine, including research and practice, is the core element of academic medicine. The British Medical Journal launches a new global commission on the future of academic medicine.

Global Health

  • Hopes for a pandemic treaty, despite the failure to meet the deadline. Along with the extension of the Pandemic Treaty deadline to 2025, an important partial agreement was reached: the review of rules to prevent the global spread of some infections. Even in the global Treaty, much progress was made, which allows for a certain optimism.
  • Vaccine manufacturing is promoted in Africa. The African Vaccine Manufacturing Accelerator (AVMA), a new $1 billion+ initiative, an innovative financing mechanism designed by GAVI, offers African producers financial incentives to produce vaccines. The initiative will be launched at a high-level event in Paris.
  • 10 years after the 2014-2016 Ebola epidemic in Africa. The crisis initially affected Guinea, Liberia and Sierra Leone and it took months to identify the cause and almost three years to contain it, after claiming thousands of lives. The epidemic revealed weak health systems, poor detection mechanisms and inadequate response. Since then, work has been done on preparation for these risks, response mechanisms and international collaboration.

International health policy

  • Forecasts for 2023-32 healthcare expenditures in the United States. Healthcare spending is projected to grow faster than GDP growth over the next decade, reaching 19.7% of GDP in 2032 (from 17.3% in 2022). This indicates a large increase in the use of health services, linked to an increase in coverage that is estimated at 93.1% this year.
  • The King’s Fund summarizes the manifestos of the different parties (Labour, Conservative and Liberal-Democratic) on health ahead of the elections. The different proposals are analyzed in relation to: social care reform; access to hospitals; access to primary care and community services; access to dental care; additional funding commitments; investments in capital and buildings; social care funding; training and selection of personnel; support to social services personnel; international recruitment and migration; prevention, inequities and public health; mental health, learning disabilities and autism; cancer; maternity and women’s health services; medicines, research and life sciences; digital transformation and technology; and, other proposals.
  • “Aid in dying” in France. With the dissolution of the National Assembly, the “aid in dying” law is delayed indefinitely. With the call for elections, a very advanced legislative process declines, preceded by a great national debate with the personal intervention of President Macron.
  • Advanced practice nursing in Belgium. A Royal Decree establishes the functions of advanced practice nursing, in an attempt to define different profiles of nurses and make the profession more attractive. Maybe a good lesson for Spain.
  • Four industries responsible for 2.7 million deaths in Europe each year (7,400 per day): tobacco, alcohol, ultra-processed foods and fossil fuels.

National Health Policy (Spain)

  • Public Management and Integrity Law. Competence doubts complicate the processing of this Law, which is surely good news, given the government’s intentions.
  • Approved the law creating the Andalusian Health Institute. This is a new entity that brings together the Andalusian School of Public Health (EASP), the Progreso y Salud Foundation, as well as the General Secretariat of Public Health and R&D&I of the Ministry of Health, and will take the legal form of an agency. administrative and will have the nature of a public research organization. The headquarters will be in Seville, in the Ministry. Although we do not know the effects that this reform will have, the PP’s history in Andalusia of making public health companies disappear does not allow us to conceive much hope, on the contrary.
  • Adeslas threatens to leave MUFACE if conditions do not improve. Given that Adeslas does not usually make statements lightly, it must be considered that there is a real risk of the system disappearing.
  • Controversy over waiting for medications. Spain increases the wait for medicines, but improves availability, according to the WAIT report, prepared by the consulting firm IQVIA for the European Federation of Pharmaceutical Industries. The report says that in two years Spain has gone from 53% to 62% availability (compared to 88% in Germany or 77% in Italy), but the waiting time has gone from 629 to 661 days, almost two years of delay. On the other hand, César Hernández, general director of the Common Portfolio of the SNS and Pharmacy, criticizes the report and says that we are the country with the most access. The report does not take into account access through the mechanism provided for in RD 1015/2009, as well as medicines that arrive through clinical trials. Although the situation of access to medicines can surely be improved – and not only by the Ministry, but also by the intervention of the autonomous communities and hospitals – it does not seem that this issue is one of the most serious problems of the system, compared to what some they proclaim.
  • Public Health Agency. The Health Commission of June 19 will not address the State Public Health Agency, which will not be analyzed by this Commission until after the summer. This is interpreted as another milestone in the long history of delays of this initiative.
  • Center for Minority Diseases in Barcelona. Agreement between the Sant Joan de Deu Hospital and the Amancio Ortega Foundation for the launch of this center that will have financing of 60 million euros and will have a space of 14,000 square meters in a six-story building. With various genomics, metabolomics and radiomics platforms. The center will be part of the Red Única, a network made up of 30 hospitals throughout Spain and promoted by the Sant Joan de Deu Hospital and the Spanish Federation of Rare Diseases. Another great success for the Sant Joan de Deu Hospital, which many of us are already accustomed to.

Companies

  • International
    • Approved a new drug against Alzheimer’s. FDA panel approves Lilly’s Alzheimer’s drug. The modest benefits of Lilly’s drug donanemab outweigh the risks, the panel unanimously concludes.
  • National
    • Ribera incorporates the Covadonga Hospital in Gijón, with this incorporation there will now be six Spanish communities in which Ribera is present (Valencian Community, Murcia, Madrid, Galicia, Extremadura and Asturias).
    • Terafront Pharmatech, the Spanish semi-public pharmaceutical company, will have its own factory. Terafront will manufacture its own therapies and has chosen to build its own facilities, compared to other options being considered.

Biomedicine

Global Health

International health policy

National health policy

  • CSIC Biomedicine Strategic Plan
    • The CSIC presents its Strategic plan in Biomedicine. This plan is based on 10 strategic axes, among which are: strengthening internal communication and collaboration between researchers; create new collaborative structures with companies, hospitals and universities; increase the presence of the CSIC in key international organizations; improve knowledge transfer to industry and the health sector; attract or retain young talent: Key actions: the creation of a Rare Diseases Network; the creation of a OneHealth Bassoon Library; the creation of the Biomed Transfer Services Network (https://www.consalud.es/saludigital/innovacion-tecnologica/csic-presenta-plan-estrategico-biomedicina-liderar-innovacion-en-salud_144755_102.html)
  • Center for minority diseases in Barcelona
    • Agreement between the Sant Joan de Deu Hospital and the Amancio Ortega Foundation for the launch of this center that will have financing of 60 million euros and will have a space of 14,000 square meters in a six-story building. With various genomics, metabolomics and radiomics platforms. The center will be part of the Red Única, a network made up of 30 hospitals throughout Spain and promoted by the Sant Joan de Deu Hospital and the Spanish Federation of Rare Diseases (https://www.diariomedico.com/medicina/investigacion/primer-step-creation-pioneer-center-minority-diseases.html)

Companies

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

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Summary

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

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

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

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

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

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (July 11th-17th, 2022)

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Summary

From the point of view of biomedicine, the finding that there are plans to produce vaccines in cases of pandemic in 100 days should be highlighted. If it is confirmed, it will be a positive consequence of the terrible covid pandemic, in the same way that wars sometimes produce technological advances.

With regard to Global Health, the efforts of the WHO to create a hub for the production of vaccines with mRNA technology in poor countries should be noted, given the failure of other initiatives, based more on goodwill than on realistic approaches.

As for International Health Policy, there is already evidence of the vaccines that have saved the most lives in the world. The first was that of AstraZeneca-Oxford, followed by that of Pfizer-BioNTech.

If we talk about National Health Policy (Spain), the wave of covid continues to grow, with an increased impact on hospitals, although it seems that we are already close to the “peak” of this wave. Plans for a new dose of the vaccine for those over 60 years of age. Important changes are announced in Madrid’s healthcare, given the seriousness of the problems in waiting lists, primary care and emergencies. Let’s hope that the plan is effective and does not remain in one more advertisement, to which we are so accustomed. It seems that the State Public Health Center will be created immediately, which is great news, if it is done well. The fact that it will not be an independent Agency (AIREF model) may lead to skepticism.

In the field of companies, it seems that a new pill is in sight, announced as almost miraculous, against obesity.

Biomedicine

Global health

  • Nature: A vaccine hub for low-income countries. WHO initiative to produce mRNA vaccines in low-income countries, given the failure of “charity”. Issues over the global vaccine market, global trade rules, and intellectual property (https://www.nature.com/articles/d41586-022-01895-6)
  • The war in Ukraine. the devastation of health and human rights. Between February-24 and June-24, the WHO reported 323 attacks on health facilities, with 76 deaths and 59 injuries (https://www.nejm.org/doi/full/10.1056/NEJMp2207415)

International health policy

National health policy

Companies