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7 days in healthcare (December 25th-31st, 2023). Happy New Year

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Summary

From the point of view of Biomedicine, 2023 definitely seems to be the year where the great impact of artificial intelligence on health has become completely clear. The example of a stethoscope that incorporates AI and substantially modifies the one invented 200 years ago is nothing more than an example of this great change. Scientific journals explore what 2023 has represented (anti-obesity medications and awareness of the impact of climate change on health, among others), as well as analyze the advances that are foreseen for 2024 (surely the HIV vaccine and the cure cholesterol, among many others).

Regarding Global Health, The Lancet dedicates its last issue of 2023 to exposing a series of photos related to health experiences in Nigeria.

Regarding International Health Policy, an interesting article in JAMA magazine that will cause controversy: it relates the increase in medical errors in American hospitals to their acquisition by private equity companies. It is one year since the end of the covid-zero policy in China and the Financial Times analyzes how that experience is remembered in that society.

If we talk about National Health Policy (Spain), our country says goodbye to 2023 with the experience of three different Ministers of Health (Darias, Miñones and now García). It is evident that this dance of ministers (in 45 years there have been 28 Ministers of Health) can guarantee, in the best of cases, the continuity of the “ordinary administration”, but not the promotion of large renewing projects of change. SESPAS asks the Ministry to launch the Public Health Agency in 2024. The Ministry of Health of the Regional Government of Andalusia has experienced a serious crisis that led to the resignation of both the Vice-Minister and the Manager of the SAS. It seems that the underlying issue was the approach to addressing the waiting list and the involvement or not of the private sector in that resolution. If so, regardless of the anecdote of this moment, what it reflects is a very deep problem: the absence of a clear policy towards the private health sector on the part of the Popular Party. Madrid wants to promote a pharmaceutical hub, an issue in which Catalonia is by far in the lead.

In the field of Companies, on an international level, the great growth of the hair transplant market stands out, which already moves 8.7 billion euros annually. It seems that it is a nascent industry, but on the rise. The fever of anti-obesity drugs has meant that there are now 188 candidates, of which 25 are in advanced phase (III or IV). When it comes to national news, the fever of corporate operations in hospitals continues. Ribera, Quirón, Viamed and Vithas, the great protagonists.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (July 10th-16th, 2023)

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Summary

From the point of view of Biomedicine, there is little doubt that Artificial Intelligence will revolutionize medicine: from diagnosis, to the robotic-AI combination for surgical procedures, rehabilitation aid, support in the fight against infectious diseases, development of new drugs, etc. There will be few areas of medicine that are not affected by the development of Artificial Intelligence.

As regards Global Health, The Lancet insists on the WHO-Europe notice on the need to decontaminate the air, since pollution contributes to the appearance of a large number of diseases and premature deaths. This time, 12 African countries are going to receive 18 million doses of the malaria vaccine. Now one can dream of the disappearance of malaria – that secular plague – from our planet.

Regarding International Health Policy, the American regulator approves the first contraceptive pill that will be dispatched (in pharmacies, supermarkets and online) without the need for a prescription. Although the “pill” could be used in the USA for 50 years, until now it was always under medical prescription. It is believed that this measure will contribute to reinforcing women’s reproductive rights, which were so affected by the US Supreme Court ruling that repealed the previous interpretation of the federal constitutional right to abortion, leaving this regulation in the hands of the states. Great controversy as a result of the WHO declaration of the possible carcinogenic effects of aspartame, a sugar substitute widely used in many beverages, including Coca-Cola. The WHO statement is not without controversy.

If we talk about National Health Policy (Spain), to highlight the private health agreement in Madrid, with a rise of 15% in four years. The private provision employers address a decalogue of petitions to the new government. One of them is not addressed so much to the government as to health insurers, by requesting that relations between insurers and health centers be regulated in writing. The Coordinates Institute reveals the very different development of the right of choice in health in the national territory. On the other hand, the Minister of Health presents the new citizen folder. According to him “with one click you can access the medical history”. This of presenting a project of this magnitude a week before the elections cannot be taken very seriously.

In the field of Companies, internationally, Moderna has established itself in China. As for national news, Quirón announces a new hospital in Badajoz and Viamed the expansion of its hospital in Zaragoza. The funds, interested in radiodiagnostic companies, a sector so far very fragmented. ALSA, the bus company of Asturian origin, together with the Asturian health transport company Trasinsa, agree to launch a new health transport operator: SANIR.

Biomedicine

Global Health

International Health Policy

  • USA
    • The American regulator (FDA) approves the first contraceptive pill for sale without a prescription. It is called Opill and it will be available in pharmacies, supermarkets and online from 2024. The manufacturer is Perrigo, an American-Irish consortium. This pill can be used with a prescription for 50 years. The change is that, from now on, it is freely dispensed (https://www.nytimes.com/2023/07/13/health/otc-birth-control-pill.html)

National health policy

Companies

 

7 days in healthcare (April 3rd-9th, 2023)

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Summary

From the point of view of Biomedicine, vaccines against cancer and heart disease, based on mRNA technology, which are looming on the horizon 2030, seem to be the next great advance in medicine, potentially saving millions of lives. The Economist dedicates an article and an editorial to demonstrate the weak evidence for the therapy of gender transitions in adolescents, especially when they include pharmacological or surgical medication. Contrary to what had been a very popular assumption, moderate alcohol consumption does not produce health benefits, according to a study of more than 40 years published by the JAMA Network Open. Rather the opposite is true.

As regards Global Health, the WHO, born after the Second World War, is celebrating its 75th anniversary. He has emerged from the pandemic with injuries and issues, but acutely aware of his mission, purpose, and need for change. One of the problems it encounters is the discrepancies between countries in the discussion of a treaty on pandemics, which it intends to be approved in 2024. The Lancet publishes several articles on the commercial determinants of health, a subject of great interest. interest. Four industries – tobacco, unhealthy eating, oil and fossil fuels, and alcohol – are responsible for a third of deaths each year globally.

As for International Health Policy, in the United States, a federal judge in Texas has just banned the use of an abortion drug, which had been approved by the FDA more than 20 years ago. In France, the citizens’ convention, made up of 184 citizens chosen by lot, has just ruled in favor of euthanasia and assisted suicide, although with certain “red lines”. Macron wants to discuss the bill before the summer.

If we talk about National Health Policy (Spain), surgical waiting lists set a new record, according to the report made public by the Ministry of Health, with data as of December 31, 2022. Almost 900,000 people waiting for a surgical intervention. An absolutely delegitimizing element of the system. As is well known, the Ministry only makes public the waiting lists for surgical intervention or specialist consultations, but not for special tests (radiology, radiotherapy, ultrasound, etc.), on which there are no national data, although there are some autonomous communities. Interesting article published in Gaceta Sanitaria on the economic impact of including dental care in public coverage. This is an issue that the majority political parties have been pronouncing in favor of for several years, but nothing has been done on it. Spain is possibly the European country with the least percentage of its health spending devoted to dental care. The declarations of the Minister of Health of Catalonia are surprising, justifying the dismissal of the nurses who criticized the Catalan C1. Since this type of statement about specific dismissals is not common among regional ministers, it is to be assumed that there is an important political background. The decision of Navarra and Asturias to launch public companies, one for medical transport and another for a hospital laundry, is also surprising. Wouldn’t there have been the possibility of resorting to private initiative to solve these needs, perhaps more efficiently than through a public company?

In the field of Companies, internationally, agreement between Medtronic and Davita to launch Mozarc. At the national level, it is worth noting the start of work on the Viamed hospital in Tarragona, and the separation of the “pharmacy” and “chemistry” areas of the company Esteve.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies

 

 

7 days in healthcare (March 7th-12th, 2023)

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Summary

From the point of view of Biomedicine, the geneticist Francisco J Ayala, one of the great Spaniards of science, with important contributions in the field of the human genome and other diseases, dies. Some obscure episodes, not fully clarified, pointed to him as a target of the “me too” initiatives. It is increasingly clear that gene therapies will soon explode and will be useful in multiple hematological, cardiac, ocular, muscular and even neurodegenerative processes. An ethical reflection is essential, which ensures, on the one hand, that these treatments are accessible, and, on the other, the limits of these treatments. It seems that we are closer to having specific treatments against fatty liver, a serious disease responsible for tens of thousands of deaths.

As regards Global Health, young people, including adolescents, with gender dysphoria are growing all over the world. There is no accepted professional consensus on how to approach these situations. It seems increasingly clear that inequality in the face of covid vaccines responsible for thousands of deaths from this disease. Although there is no absolute consensus, it seems increasingly clear that smartphones and social networks are responsible for serious mental health problems among young people. 24/7 access to these technologies minimizes face-to-face contact between young people.

Regarding International Health Policy, the WHO maintains the covid as a “health emergency of international concern”. In the United States, the budget presented by Biden – which will not be approved – proposes a significant increase in funds for Medicare. Problems continue for the Walgreens pharmacy chain for not selling abortion pills in 21 states. The USA plans to eliminate hepatitis C, almost a decade after highly effective therapies for this disease appeared. Concern in the United Kingdom about the interruption of the improvement in life expectancy for a decade, before the covid, contrary to what is happening in France or Denmark, for example. Australia is preparing to tackle a health reform, after the preparation of an independent report, a model that could well be inspiring for Spain. Newsweek magazine publishes its well-known ranking of the best hospitals in the world. The Mayo Clinic, in Rochester, and the Cleveland Clinic, in Cleveland, considered the best hospitals in the world. Among the first hundred there are 6 Spaniards, all of them public, except one private: the Clínica Universidad de Navarra (CUN).

If we talk about National Health Policy (Spain), in terms of covid, the accumulated incidence continues to rise slightly, with a fairly high mortality (139 patients in one week). In Castilla y León, the health areas will have access to a team on rare diseases. Serious concerns among psychiatrists about the large increase in cases of gender dysphoria. The actors in the cyber attack on the Hospital Clínic de Barcelona request a ransom of 4.5 million dollars, which the Administration refuses to deliver. Some Catalan doctors are organized to attend only in Catalan, something against repeated court rulings and the Generalitat’s own protocols.

At the Corporate level, at the international level, investors are rubbing their hands at the prospects of big business in anti-obesity drugs. Morgan Stanley has quantified what this can mean in billions of dollars worldwide. Pfizer places its vaccine against covid as the drug with the highest income in the world. At the national level, Quirón reaches an agreement with the City Council for the construction of its hospital in Gijón and Hospitén announces the construction of a new hospital in Madrid with a large investment of 160 million euros. Thus, the boom in new private hospitals continues, for which there is a real race in which several actors participate (Quirón, Viamed, Vithas, Hospitén, Imed, and others). Hipra will return aid to the covid vaccine in ten years.

Biomedicine

Global Health

International Health Policy

  • Best hospitals in the world
    • Newsweek magazine publishes its traditional ranking of the best hospitals in the world. The first three are: the Mayo Clinic in Rochester, the Cleveland Clinic in Cleveland, and the Massachusetts General Hospital in Boston. Among the first 100 are 6 Spanish hospitals: La Paz, (53); Barcelona Clinic (62); October 12 (72); Vall d’Hebrón (83), Gregorio Marañón (90) and the CUN (97) (https://www.newsweek.com/rankings/worlds-best-hospitals-2023)

National health policy

Companies