AIReF – Ignacio Riesgo

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7 days in healthcare (April 4-10, 2022)

11/04/2022/in The Health Week /by ignacioriesgo

SUMMARY

From the point of view of biomedicine, it is worth highlighting the fact, highlighted by the journal Nature, that the WHO took more than two years to recognize the airborne transmission of covid. A new generation of vaccines that prevent cancer can make tumors disappear before they appear, according to an article in Science. The natural experiment from South Korea and Hong Kong shows that the “omicron” variant can be fatal in unvaccinated people.

As far as Global Health is concerned, the situation in Ukraine gives us difficult lessons in global health, explains the editor of The Lancet. It should be noted that the black American population already exceeds the white population in mortality from opioids. Until now, deaths from this cause occurred mainly in “non-colleged educated” whites.

Regarding international health policy, the European health agencies (EMA and ECDC) say that it is too early for the second “booster” of the covid vaccine. Ten years of “Choosing Wisely” the revolution in medical practice that tries to minimize worthless or low value health interventions.

If we talk about national health policy (Spain), the appearance of the 2022 Health Barometer (First wave) is important. It should be noted that waiting lists are the main concern of the population; the delay in a high percentage of cases to see a primary care physician; and that the positive perception of the public system decreases, while that of the private system increases. Report on health professionals, which says that within five years there will be a shortage of 9,000 doctors.

In the field of companies, from the international point of view, Moderna’s agreement with the non-profit entity IAVI to apply mRNA technology to various diseases should be highlighted. SpainCares confirms that Spain is not in an advantageous position with regard to health tourism.

BIOMEDICINE

The WHO took two years to recognize that COVID is transmitted through the air, after repeatedly denying it, Nature article (https://www.nature.com/articles/d41586-022-00925-7)
New generation of cancer-preventing vaccines can wipe tumors before they form, article in Science (https://www.science.org/content/article/new-generation-cancer-preventing-vaccines-wipe -tumors-form)
“Better, broader and safer: Using Health Data for Research and Analysis”, a major British Government report on the use of data to improve medical practice (https://www.gov.uk/government/publications/ better-broader-safer-using-health-data-for-research-and-analysis)
Outbreaks in Asia show that the “ómicron” variant is deadly in unvaccinated people, as shown by natural experiments in Hong Kong and South Korea (https://www.economist.com/graphic-detail/2022/04/ 09/asias-outbreaks-show-that-omicron-is-deadly-in-unvaccinated-people)
Precision drugs, effective against breast cancer (https://vigourtimes.com/breast-cancer-precision-drugs-make-inroads-against-stubborn-tumours/)
Coming medical advances: 1. Fight antimicrobial resistance; 2. Precision oncology; 3. Nanotechnology; 4. Gene editing; 5. Microbiome; 6. Robotic surgery; 7. Stop aging; 8. New horizons transplants; and 9. Neuroscience revolution (https://elpais.com/eps/2022-04-06/es-medicina-no-ciencia-fiction.html)

GLOBAL HEALTH

Ukraine: Hard Lessons for Global Health (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00653-5/fulltext)
Black Americans have surpassed whites (traditionally more affected) in opioid mortality (https://www.economist.com/united-states/2022/04/09/black-americans-have-overtaken-white -victims-in-opioid-death-rates)
Doctors Without Borders denounces that Russia bombed a hospital in Mikolaiv on Monday (https://www.telecinco.es/informativos/internacional/medicos-sin-fronteras-bombardeos-hospitales-mykolaiv_18_3309870266.html)

INTERNATIONAL HEALTH POLICY

COVID

o The United States donates more than 100 million doses of covid vaccine for children (https://www.ft.com/content/3e5f9359-67a5-4f24-971e-51761119899b)

o Shanghai residents beg for food and medicine as authorities lock down the city (https://www.ft.com/content/3e439a10-860b-4ae6-9070-ad8546da8850)

o Olaf Scholz, German Chancellor, fails in Parliament with his plan to make the vaccine mandatory (https://www.ft.com/content/7d0610bf-3cf9-4edd-a392-e9d97dc9fade)

o COVID deaths rise in the UK, with infections at record highs (https://www.theguardian.com/world/2022/apr/05/covid-related-deaths-rise-england-infections-record-high )

o The European health agencies (EMA and ECDC) say that it is too early for the second covid vaccine “booster” (https://www.nytimes.com/2022/04/06/world/europe/covid-second- booster-europe.html)

Other themes

o Ten years of “Choosing Wisely”, which revolutionized medical practice based on recommendations of “do not do”, to reduce low-value health care (https://www.nejm.org/doi/full/10.1056/ NEJMp2200422)

o Life expectancy in the US continues to decline in 2021, despite covid vaccines (https://www.washingtonpost.com/health/2022/04/07/life-expectancy-covid/)

o Oklahoma passes one of the toughest anti-abortion laws in the US, following a Republican strategy (https://www.ft.com/content/cee6a170-fa23-47cb-b554-d457d68f225b)

o Important report by the Nuffield Trust on the recovery of health systems after covid, analyzing the situation in several countries (https://www.nuffieldtrust.org.uk/research/health-system-recovery-from-covid-19- international-lessons-for-the-nhs)

o Great impact in the United Kingdom of the Ockenden Report, on maternity care, with the detection of serious problems, published by the British Government (https://www.gov.uk/government/publications/final-report-of- the-ockenden-review/ockenden-review-summary-of-findings-conclusions-and-essential-actions)

NATIONAL HEALTH POLICY (SPAIN)

COVID

o Decrease in the incidence of covid: up to 420.17 cases per 100,000 inhabitants over 60 years of age, according to the new measurement method (https://www.redaccionmedica.com/directo/coronavirus-ultimas-noticias/20220410)

o The mask will no longer be mandatory indoors on April 20 (https://www.elmundo.es/ciencia-y-salud/salud/2022/04/06/624d770121efa0ed708b45bb.html)

o COVID only worries 30% of Spaniards, according to the COSMO Spain study, coordinated by the Carlos III Health Institute (https://www.actasanitaria.com/salud-mental/covid-19-solo-pretrabajo-30 -spanish-two-years-pandemic_2002232_102.html)

Other themes

o The 2022 Health Barometer (First wave) appears (https://datos.cis.es/pdf/Es3357mar_A.pdf). Some data of interest: the waiting lists, the worst valued by the Spanish (https://www.lavanguardia.com/vida/20220407/8184215/listas-espera-peor-valorado-espanoles-barometro-sanitario-2022.html ); 55% of patients take more than 7 days to get an appointment with their family doctor (https://www.lavanguardia.com/vida/20220408/8185940/55-pacientes-tarda-mas-7-dias-conseguir- family-doctor-appointment.html); lowers the positive perception of the public system and increases that of the private (https://www.diariofarma.com/2022/04/07/cis-baja-la-percepcion-positiva-del-sistema-publico-y-aumenta-la-de-la-privada)

o Within five years there will be a shortage of almost 9,000 doctors (https://www.lavanguardia.com/vida/20220404/8174200/cinco-anos-faltaran-9000-medicos.html), according to the report “Supply-need for medical specialists 2021- 2035”, prepared by Patricia Barber and Beatriz González López-Valcárcel (https://cgcom.es/sites/default/files//u395/2022informeofertanecesidadespecialistasmedicos2021_2035.pdf)

o “Case of masks” a loot of 2,000 million for the purchase of material during the state of alarm (https://elpais.com/espana/2022-04-10/caso-mascarillas-un-botin-de-2000-millones -in-the-law-of-the-jungle.html)

o WAIT Report: Spain falls in time for access to new medicines (https://www.diariofarma.com/2022/04/06/espana-ha-autorizado-el-53-de-los-farmacos-aprobados -in-europe-between-2017-y-2020), to see the WAIT report: https://www.efpia.eu/media/602652/efpia-patient-wait-indicator-final-250521.pdf

o Published the “Report on the initial budgets of the Public Administrations” (AIREF, April 7, 2022) (https://www.airef.es/wp-content/uploads/2021/04/PRESUPUESTOS-INICIALES/Informe-Ptos -initials-2021-.pdf)

o Spain leads the world consumption of benzodiazepines (https://www.elperiodico.com/es/sociedad/20220402/espana-lidera-consumo-mundial-benzodiazepinas-13438583)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

International News

o Moderna reaches an agreement with IAVI (non-profit association) to apply mRNA to various diseases (https://www.plantadoce.com/empresa/moderna-llega-a-un-acuerdo-con-iavi-para-aplicar -mRNA-for-various-diseases.html)

o Pfizer buys the British biotech company ReViral for 481 million euros (https://www.expansion.com/empresas/industria/2022/04/08/624fd580468aebc31f8b46bb.html)

National News

o David Medina (Spaincares): “In the tourism-health binomial, we are not in the top ranking” (https://www.plantadoce.com/adn/david-medina-spaincares-en-el-binomio-turismo-salud -we-are-not-at-the-top-of-the-ranking.html)

o Savana closes a round of 23 million euros, hand in hand with Conexo Ventures (https://www.plantadoce.com/empresa/savana-cierra-una-ronda-de-23-millones-de-euros-de- the-hand-of-connected-ventures.html)

o Sanitas shoots up sales of health insurance by 47%, with 377,000 new policies (https://cincodias.elpais.com/cincodias/2022/04/07/companias/1649322015_528839.html)

o PharmaMar and CNIO allocate 1.2 million euros to testing breast cancer drugs (https://www.plantadoce.com/empresa/pharma-mar-y-el-cnio-destinan-12-millones-de- euros-to-test-drugs-against-breast-cancer.html)

o Miranza underpins its expansion, reaching 80.6 million euros (https://www.plantadoce.com/empresa/miranza-apuntala-su-expansion-tras-incrementar-sus-ventas-un-35-hasta-806 -millions-of-euros.html)

o Farmasierra celebrates its 25th anniversary, reinforcing R&D (https://www.diariomedico.com/farmacia/industria/empresas/farmasierra-celebra-su-25-aniversario-advancing-towards-a-model-industria-40. html)

o Pfizer will export gene therapies from Spain to America (https://www.eleconomista.es/salud/noticias/11706685/04/22/Pfizer-exportara-a-America-terapias-genicas-desde-Espana.html)

7 days in healthcare (February 21-27, 2022)

28/02/2022/in The Health Week /by ignacioriesgo

SUMMARY

From the point of view of biomedicine, Bill Gates predicts another pandemic, although he estimates that he will catch us better prepared. Also to highlight the questioning of the traditional form of clinical trials. The latter is important, since Spain has become a power in clinical trials and it is important to analyze whether it is the right bet.

In terms of global health, it should be noted that COVAX has distributed exactly half of the COVID vaccines that it had as its objective. A great inequity in the distribution of vaccines in the world and, now, also of medicines against COVID.

As for international health policy, great controversy in the United Kingdom due to the lifting of all restrictions against COVID.

In national health policy (Spain), the incidence of COVID is low, although we continue with high mortality and without antivirals. The Ministry of Health takes the expansion of the service portfolio to a public hearing. Medical uneasiness before the reform of the Abortion Law, a BIOSIM proposal to promote the use of biosimilars and controversy over the financing of orphan drugs.

With regard to companies, it should be noted that the manufacture of Ventolín and Nolotil pollutes more than the automotive industry, which indicates how far the pharmaceutical industry has to go in implementing the United Nations Sustainable Development Goals. Also that Quirónsalud has exceeded the turnover of 4,000 million and Fresenius is open to incorporating new shareholders both in Quirónsalud and Eugin.

BIOMEDICINE

Bill Gates predicts a new pandemic with another pathogen and says that humanity could manage it better and offer vaccines sooner (https://www.consalud.es/ecsalud/internacional/bill-gates-predice-pandemia-patogeno-covid_110537_102.html)
Abortions with pills, authorized up to 10 weeks, now account for more than half of abortions in the United States, a more accessible and less invasive method (https://www.nytimes.com/2022/02/24/health/abortion-pills-us.html)
A total renewal of clinical trials, invented in 1941 by Archie Cochrane, is proposed. Too expensive, some cover up to 100 countries and according to Nature only 5% are reliable and 95% are useless (https://www.economist.com/britain/2022/02/26/clinical-trials-are-ailing)
New research points to the Wuhan market, versus a laboratory, as the origin of the pandemic (https://www.nytimes.com/interactive/2022/02/26/science/covid-virus-wuhan-origins.html )

GLOBAL HEALTH

COVAX distributed 1,000 million vaccines by January 2022, half of its goal (https://elpais.com/planeta-futuro/2022-02-25/covax-distribuyo-mil-millones-de-vacunas-hasta-enero-de-2022-la-mitad-de-su-objetivo.html)
Given the inequality in access to vaccines, they propose that it be seen as a global good. The first successful peer-reviewed trial was published in December 2020. Today 62% of the population have received at least one dose, which is quite a feat. But while in rich countries the vaccine reached 90%, only 11% of the population in poor countries have received a dose (https://www.nejm.org/doi/full/10.1056/NEJMe2202547)
After the differences in vaccines, there are also differences in access to effective treatments for COVID. Pfizer has allowed the manufacture of a generic of Paxlovid in 95 countries, but excludes 47% of the world’s population, such as Argentina, Brazil, Iraq, Lebanon, Malaysia and Thailand (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00372-5/fulltext?dgcid=raven_jbs_etoc_email)
The WHO creates a hub to facilitate the manufacture of medicines in poor countries (https://www.ft.com/content/9f215fd0-f28d-4a77-83a5-616ed31631e4)
WHO establishes a global biofabrication center in the Republic of Korea (https://www.plantadoce.com/entorno/la-oms-establece-un-centro-global-de-biofabricacion-en-la-republica-de-corea.html)
The WHO designates six countries (Egypt, Kenya, Nigeria, Senegal, South Africa and Tunisia) to manufacture the mRNA vaccine in Africa (https://www.plantadoce.com/entorno/la-oms-designa-a-seis-paises-la-produccion-de-vacunas-de-arnm-en-africa.html)
The EU strategy for vaccination in Africa: factories and research centers, but without releasing patents (https://elpais.com/sociedad/2022-02-22/la-estrategia-de-la-ue-para-la-vacunacion-en-africa-fabricas-y-centros-de-investigacion-pero-sin-liberar-patentes.html)

INTERNATIONAL HEALTH POLICY

Scientists and doctors say it is too soon to lift all restrictions in the UK (https://www.bmj.com/content/376/bmj.o469)
How “hospitalization at home” has been useful for the NHS to fight covid (https://www.ft.com/content/76a8dab5-ea99-4eeb-ab2f-d03c2d7b7424)
The focus on covid has delayed advances in other diseases for years, according to experts (https://www.ft.com/content/5fdba002-0268-4004-aa4c-bd314ea82a99)
Hong Kong’s attempt to live without covid causes chaos (https://www.economist.com/china/2022/02/25/hong-kongs-refusal-to-live-with-covid-19-is-causing-chaos)
Quit rates of up to 400 a week among stressed NHS staff (https://www.theguardian.com/society/2022/feb/26/stressed-nhs-staff-quit-at-record-rate-of-400-a-week-fuelling-fears-over-care-quality)
The decriminalization of abortion in Colombia up to the 24th week opens a debate on the deadlines (https://elpais.com/sociedad/2022-02-26/la-despenalizacion-del-aborto-hasta-la-semana-24-en-colombia-abre-un-debate-sobre-los-plazos.html)

NATIONAL HEALTH POLICY (SPAIN)

COVID

o The incidence of COVID continues to drop to 613 cases per 100,000 inhabitants (https://elpais.com/sociedad/2022-02-24/ultima-hora-del-coronavirus-hoy-en-espana-y-el-mundo-en-directo.html)

o 245 deaths in the sixth wave and still without antivirals (https://www.larazon.es/sociedad/20220225/3eq7hmpczjfe3ct7ruk3tz56wi.html)

o The subvariant of the stealthy “ómicron” accelerates its expansion in Spain (https://www.larazon.es/sociedad/20220224/3zfep56h6bf7jktf4fqvbnj3yq.html)

Political announcements

o The Ministry of Health takes out the draft order for the expansion of the service portfolio for a public hearing. Opinions in this regard can be sent via email informacion.publica@mscbs.es until March 10 (https://www.consalud.es/politica/sanidad-saca-audiencia-publica-orden-ministerial-actualiza-cartera-comun-sns_110420_102.html)

o AIReF announces a study on MUFACE spending in its plan for 2022 (https://www.airef.es/es/noticias/la-airef-publica-su-plan-de-actuaciones-2022-con-una-apuesta-clara-por-la-sostenibilidad-y-la-evaluacion/)

Other issues

o The medical groups, against the reform of the abortion law, propose the obligatory nature of performing it in public hospitals (https://www.larazon.es/sociedad/20220225/onwymfclwbbyfiamuan5il533e.html)

o Biosim presents 14 proposals to stimulate the use of biosimilars (https://www.diariofarma.com/2022/02/24/biosim-plantea-14-propuestas-para-fomentar-el-uso-de-los-biosimilares )

o Great controversy over the financing of orphan drugs, while the Ministry publishes a report with improvements in financing since 2016 (https://www.diariofarma.com/2022/02/23/sanidad-publica-un-analisis-sobre-la-financiacion-acceso-y-gasto-de-los-medicamentos-huerfanos-desde-2016) others insist that more than 50% of these medicines are not publicly funded (https://www.redaccionmedica.com/secciones/industria/el-50-de-los-medicamentos-huerfanos-estan-sin-financiar-en-espana-7267)

o The strategic health reserve today has 466 million masks and 955 respirators (https://www.elindependiente.com/espana/2022/02/27/la-reserva-estrategica-de-sanidad-cuenta-hoy-con-466-millones-de-mascarillas-y-955-respiradores/)

COMPANIES, EMPLOYERS AND OTHER AGENTS IN THE SECTOR

The manufacture of Ventolín and Nolotil pollutes more than the automotive industry (https://www.epe.es/es/sanidad/20220223/fabricacion-ventolin-nolotil-contamina-industria-movil-13279923)
Quirónsalud grows 16% and reaches a turnover of 4,000 million in 2021 (https://www.plantadoce.com/empresa/el-dueno-de-quironsalud-crece-un-16-en-espana-y-supera-los-4000-millones-en-2021.html)
Fresenius plans to find partners for Quirónsalud and Eugin (https://www.expansion.com/empresas/2022/02/23/62154a58e5fdeaa50a8b4642.html).
IMED hospitals is reinforced in Murcia, with the purchase of Gesalud Mediterráneo (https://www.plantadoce.com/empresa/imed-hospitales-se-refuerza-en-murcia-con-la-compra-de-gesalud-mediterraneo.html)
Twenty organizations ask the Government for global access to the HIPRA vaccine (https://www.eldiario.es/sociedad/ong-piden-gobierno-licencia-vacuna-hipra-no-sea-exclusiva_1_8769137.html)
Sandoz launches a new oncology generic in 19 EU countries (https://www.plantadoce.com/empresa/sandoz-lanza-un-nuevo-generico-oncologico-a-19-paises-de-europa.html)
Merck closes the purchase of the American company Exelead for 780 million dollars (https://www.plantadoce.com/empresa/merck-cierra-la-compra-de-la-estadounidense-exelead-por-780-millones-de-dolares.html)
Ed Lilly invests 700 million in the creation of the Genetic Medicine Institute, located between Boston and New York (https://www.hechoencalifornia1010.com/eli-lilly-invierte-700-millones-de-dolares-en-la-creacion-de-su-instituto-de-medicina-genetica/)
The Spanish-Irish company Abi Health lands in China and Japan to extend its telehealth service (https://www.plantadoce.com/empresa/abi-health-aterriza-en-china-y-japon-para-extender-su-servicio-de-telesalud.html)
Acciona, awarded the construction and operation contract in Chile for 207 million euros (https://www.europapress.es/economia/noticia-acciona-adjudica-construccion-operacion-hospital-chile-207-millones-euros-20220222124313.html)

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