Posts

7 days in healthcare (May 6th-12th, 2024)

 

Summary

Biomedicine

  • The enigma of the brain: The Economist highlights the enigma that the brain represents, made up of hundreds of trillions of cells that generate precise electrical impulses, which influence thoughts, memory and emotions, recommending 8 books on the subject, of which two They refer to the contributions of Ramón y Cajal, whom he compares with Darwin and Pasteur. The brain will be the focus of scientific advancement in the next 30-50 years.
  • CAR-T therapies, beyond blood cancer: Experiments in mice with this therapy manage to improve survival in brain, pancreas and lung tumors.

Global Health

  • One Health, from slogan to action plan: A group of European agencies, led by the ECDC, which includes the EMA, manage to transform the idea of One Health into an action plan, establishing five major strategic objectives.
  • The WHO Pandemic Treaty advances: WHO member states are about to reach an agreement on the response to pandemics, an agreement that, in principle, should be approved in May 2024.

International health policy

  • The great problem of hospital infections: The ECDC releases a report that shows that more than four million Europeans contract infections each year due to hospital admissions. This confirms the old criterion of hospital ethics: “Do not admit anyone unless it is strictly necessary and, if admitted, let them be in the hospital for the shortest possible time.”
  • Whooping cough is increasing in Europe: The ECDC publishes a report that warns of the increase in whooping cough cases in the European Union.

National Health Policy (Spain)

  • The government proposes new benefits in the SNS: condoms, sun creams and glasses: It is more than doubtful that with the financial tensions of an already very generous system (wide portfolio of services with hardly any co-payment), introducing new benefits without a debate in depth is a priority. Arguably, this has more to do with the political use of the system than with health policy.
  • The Catalan Generalitat will supervise the use of Catalan in its hospitals: CatSalut publishes exhaustive 9-page instructions on the subject. Same comment regarding political use of the system and health policy.
  • 18 patients die every day in Spain from hospital infections: According to a large study presented at the congress of the European Society of Clinical Microbiology and Infectious Diseases, four times more than those who died from traffic accidents. More than half of infections are considered preventable.
  • Workplace accidents increase: 56% in ten years. Both workplace accidents and the number of deaths increase in this period (452 deaths in 2012; 716 in 2022).
  • Innovative medicines take more than 800 days to reach patients in Spain: 621 days pass from the time a therapy is authorized by the European Commission until the Ministry of Health includes it in the list of approved treatments, according to the consulting firm. IQVA. To this figure we must add seven months or a year, depending on autonomy, until the treatment reaches the patients’ hands. In total, around 830 days.

Companies

  • International
    • The reengineering of addiction and the tobacco industry: For decades the tobacco industry has manipulated the design and composition of cigarettes to its benefit. Researchers and policy actors should be prepared to anticipate the tobacco industry’s response, given its long history of exploiting regulatory loopholes, according to an extensive article in the New England Journal of Medicine.
    • BioNTech looks to the future: It hopes that 2026 will be its debut in oncology with mRNA vaccines against cancer.
  • National
    • Vithas has a quality policy: The International Joint Commission accredits the Vithas Hospital of Almería, the fourth accredited hospital in this group.
    • Sanitas leaves the Manises hospital: Public reversal in this hospital. Sanitas leaves with discretion and elegance and leaving behind great management. How these things should be done.
    • Mutua Madrileña warns that Adeslas could leave MUFACE: Mutua Madrileña (50.01% shareholder of Adeslas, along with CaixaBank) warns that it will leave MUFACE if the government does not clearly improve conditions. The three companies that participated in the MUFACE model in these three years (Adeslas, Asisa and DKV) lost 600 million in this period. Logically, the possible departure of Adeslas would be a definitive death blow for the MUFACE model.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (15th-21st, 2024)

 

Summary

From the point of view of Biomedicine, after an extensive study it is detected that in approximately 1 in 10 cases of multiple sclerosis, antibodies are detected in the blood years before the disease develops. It may be too early to draw conclusions about the repercussions of this finding.

As far as Global Health is concerned, plans to expand vaccine production to Africa are facing serious problems. This follows Moderna’s halt to the construction of a €500 million plant in Kenya, although other schemes continue, such as plans including facilities in Rwanda, Senegal and South Africa, carried out by BioNTech. Producing more vaccines in Africa is a moral imperative, says Martin Friede, head of vaccine research at the WHO. Article in Lancet Americas: Corruption, the greatest threat to healthcare. The cases in Peru as a result of the covid-19 pandemic and in Brazil (Rio de Janeiro) are discussed. It seems to be demonstrated, analyzing the experience of the few countries in which cannabis consumption has been legalized for a few years, that its legalization produces an increase in consumption in adults.

In terms of International Health Policy, initiatives in the USA against Chinese biotech companies will harm American patients. The Biosecure Act, which gained bipartisan support in Congress, proposes ending government contracts with biotechnology firms that have agreements with Chinese companies as clients or suppliers. This can greatly harm Americans, since, for example, BGI (Beijing Genomics Institute) is the largest human DNA sequencer in the world and operates in 100 countries. Facilitates the manufacture of prenatal tests and other diagnostic tests. In the United Kingdom, Brexit has exacerbated drug shortages in pharmacies. This is deduced from the study by the Nuffield Trust, a prestigious British health think tank, which released a report analyzing the impact of Brexit on the health system. Also in the United Kingdom there is a report published by Reform, a British think tank committed to public services and the effectiveness of the State, proposing a major organizational change in the health system in England, trying to decentralize and abolishing NHS England, since it is considered that such a centralized system is preventing the transition towards a more preventive model, guided by local needs. The role of NHS England would be assumed by the Department of Health, although with a much more strategic vision. England (with around 57 million people) is considered to be the most centralized healthcare system in Europe, despite devolution processes in Scotland (5.4 million), Wales (3.1 million) and Northern Ireland (1.9 million). This same idea of the problems of large centralization of the NHS is held by Nigel Edwards, former chief executive of the Nuffield Trust and now senior associate. The House of Commons votes in favor of the ban on smoking for those born after 2009, despite the Prime Minister being met with the vote against more than 50 Conservative MPs. A controversial measure whose only precedent is New Zealand and was recently repealed by the new government. In Germany, a commission recommends that abortions be legalized in the first 12 weeks. Although abortions in Germany are regulated by a 153-year-old law and are illegal, in practice they are performed in an accessible way. It is assumed that the current law does not meet current international standards.

If we talk about National Health Policy (Spain), the Ministry of Health seems to focus on issues such as the promise to the white tides of the imminent hearing of the Public Management Law; while the Commissioner of Mental Health prepares a guide to reduce psychotropic drugs, as well as launching more than debatable messages such as that “long-term drug treatments kill. These people live 20 years less”, which generated a negative response from Dr. Celso Arango, from the Gregorio Marañón Hospital; or he tries to change the 24-hour guard system, without really knowing how; “green” anesthesia; announcements that possibly, as intended in the United Kingdom, smoking will be banned for those born after 2009; etc. It does not seem that a very varied set of measures on often non-central issues constitute a strategy of anything. While serious underlying problems remain or worsen, such as waiting lists, which in the Ministry’s last publication reached a record of more than 850,000 people waiting. The Zendal Hospital, of the Community of Madrid, admitted one patient a day in 2023. It is increasingly clear that this hospital, launched without a minimum professional planning project, is a clear example of bad governance. The WHO threatens to break its agreement with the Andalusian School of Public Health, if it is diluted in the new Health Institute. The entity warns that the bilateral agreement signed in 1989 is not “transferable” and that, unless it is negotiated again, the collaboration as an associated center “automatically comes to an end.” The plans of the Andalusian Government in relation to the prestigious Andalusian School of Public Health are difficult to understand. Possibly the most regrettable operation underway in public health in Spain at the moment are the famous OPEs. The temporality wants to be resolved with a system of coverage of places with regional calls, not participating in the selection of the professionals nor the hospitals nor, much less, the services involved. There is a risk of destroying the unit and the configuration of services, which in many cases took years to implement. A real shame, much to the taste of the more traditional administration and the unions. In this sense, the 76 service heads of the 12 de Octubre hospital, in Madrid, have sent a letter to the counselor, warning of the problem of disintegration of services as a consequence of the ongoing OPE. We must see, in this sense, the recommendations of the Commission for Social and Economic Reconstruction, in whose opinion approved in Congress, it is committed to a national qualification for medical specialists and local hiring. In the MIR call, the worst figure is for Family Medicine, with 459 free places in the first round, double that in 2023. Making family medicine attractive – salary-wise and professionally – is indeed an emergency to be addressed and a problem important. The newspaper El Mundo reports on the cheapest health insurance. From ASISA (25.99 euros/month) to Sanitas (51.68). In all of them, hospitalization is included, with some form of co-payment. If this isn’t a price war, it certainly looks a lot like one. It is not surprising then that there are problems with rates for hospitals and professionals.

As for Companies, internationally, funds are moving on the board of Novavax, after the failures in the covid vaccine. In terms of national information, AI will revolutionize mental health, generating 2.5 billion euros in Spain. The largest seller of flu vaccines in Spain entrusts its production to Rovi.

Biomedicine

Global Health

International health policy

  • USA
    • Philip Morris funds smoking cessation plans. Medscape, a leading health information company in the USA, is accused of having accepted courses financed by this company. The criticism is based on the tobacco industry’s history of ignoring scientific teachings about the dangers of tobacco (https://www.bmj.com/content/385/bmj.q830)
    • American movements against Chinese biotech companies will harm American patients. The Biosecure Act, which gained bipartisan support in Congress, proposes ending government contracts with biotechnology firms that have agreements with Chinese companies as clients or suppliers. This can greatly harm Americans, since, for example, BGI (Beijing Genomics Institute) is the largest human DNA sequencer in the world and operates in 100 countries. Facilitates the manufacture of prenatal tests and other diagnostic tests (https://www.economist.com/leaders/2024/04/18/americas-moves-against-chinese-biotech-will-hurt-patients-at-home)
    • Scientists miss action against bird flu outbreaks on American farms (https://www.nytimes.com/2024/04/19/health/bird-flu-usda-cattle.html)

National health policy

  • Central government initiatives
    • Sánchez announces the expansion of the basic screening portfolio from 7 to 11 detectable diseases (https://www.diariomedico.com/medicina/politica/sanchez-anuncia-ampliacion-cartera-basica-cribado-neonatal-7-11- detectable-diseases.html)
    • García announces to the white tides the imminent hearing of the Public Management Law (https://diariofarma.com/2024/04/11/garcia-anuncia-a-las-mareas-blancas-la-inminente-audiencia- of-the-public-management-law-of-the-sns)
    • The Commissioner of Mental Health prepares a guide to reduce psychotropic drugs, as well as launches more than debatable messages such as that “long-term pharmacological treatments kill. These people live 20 years less”, which generated a negative response from Celso Arango , from the Gregorio Marañón Hospital (https://www.diariomedico.com/medicina/politica/comisionado-salud-mental-prepara-guia-prescripcion-psicofarmacos-reducer-consumo.html)

Companies

7 days in healthcare (January 15th-21st, 2024)

covidoriginandChina,

 

Summary

From the point of view of Biomedicine, it is worth highlighting the fact that in China they created the first cloned monkey, which introduces us to the ethical debate of the possible cloning of human beings. Also the fact of the discovery of biomarkers that allow persistent covid to be diagnosed.

As far as Global Health is concerned, it is confirmed that cyber attacks, whose frequency is only growing, are one of the greatest dangers to health systems, which is forcing governments to reinforce security standards.

In terms of International Health Policy, as demonstrated by the American Cancer Society, mortality from cancer is falling in the United States, due to the combined effect of less smoking, earlier diagnoses and more effective treatments. An article in the New York Times summarizes the six reasons why medicines are so expensive in the United States (twice as much as in other high-income countries, such as Germany and the United Kingdom), perhaps the most important being the absence of a centralized price negotiation body, something about to be overcome, given the upcoming Medicare negotiation on these prices. A group of Nobel Prize winners and scientists are addressing the EU to ask for less rigidity in the regulations on genetic modification, in order to protect crops. The ECDC launches RespiCast, a new center for the prevention of respiratory diseases.

If we talk about National Health Policy (Spain), the tripledemic is on the decline, at least as far as the pressure on hospitals is concerned. Although it may seem like an anecdote, the situation of the pediatric ICU in La Paz is a metaphor for human resources policy in the health sector. This ICU remains closed, due to the loss of all medical staff, as a result of the judicial decision that reinstates a former head of the Unit in his position. The Statute leads to the situation where the actions of a single person can put a service, a hospital, a manager, a regional minister and the Ministry in check, indefinitely and without anything happening. It is an extreme case, but it is something that happens every day. In this way, centers that claim to be companies cannot be managed. In the field of transplants, Spain has been a world leader for 32 years in a row.

As for Companies, internationally, Lilly’s leadership among pharmaceutical companies seems destined to last. At the national level, problems at Grifols, which call into question the future of this company, as well as the control by its founding family. Losses by Ribera in its Galician hospitals.

Biomedicine

Global Health

International health policy

National health policy

Companies

 

 

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

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, 16th-22nd, 2023)

 

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 (June 5th-11th, 2023)

 

Summary

From the point of view of Biomedicine, to point out a new drug that gives hope to patients with certain brain tumors (low-grade gliomas). The amino acid taurine, related to the delay of aging. Biological drugs enter the treatment of COPD (chronic obstructive pulmonary disease).

As regards Global Health, the journal Nature publishes a set of articles on the effects of tobacco on health. Although the percentage of smokers has gone down from 1990 to 2019 (not the total number of smokers which has gone up, due to population growth), the battle against tobacco is not won. 14% of deaths globally in 2019 were due to tobacco. Whether nicotine is harmful to health is still being investigated. What is clear is that it is addictive, that is why it is said that you smoke because of the nicotine, but you die because of the tar. Difficult regulations against tobacco in Africa, due to the pressures of the industry and the lack of means. In Malaysia, suicide is going to be decriminalized, which is considered a good strategy for its prevention.

Regarding International Health Policy, regarding the covid, the weekly WHO report published on June 8 speaks of a decrease in new cases and mortality globally in the last 28 days, compared to the 28 days previous. The Lancet warns that this is not the time for complacency about the covid in Europe, since mortality continues to be unacceptably high. Interesting article from the New England Journal of Medicine on the origins of the covid, and the reasons that make it convenient to clarify that origin. In the United States, the debate on the negotiation of the price of medicines by Medicare continues, surely the most important health measure taken in the United States in recent years and which will have an impact not only in that country, but also in the pharmaceutical market, globally. Shortage of many medicines, some oncological in the USA. In the UK the difficult work continues for the report on the management of covid. The EU is discussing legislation to protect the health of sex workers.

If we talk about National Health Policy (Spain), the Ministry of Health submits the emergency MIR to public consultation, a long-standing promise, which surprisingly is launched almost during the electoral period. Psychiatrists denounce the need for these professionals, as Spain is one of the countries in Europe with fewer psychiatrists per 100,000 inhabitants, which contrasts with the increase in demand for mental health. Dentists, on the other hand, denounce from their Professional College, the growth in the number of dentists (26% growth in the last 10 years), having a high number of graduates, due to the proliferation of Dentistry Schools. In this case, on the other hand, it coincides with low dental care activity in Spain, in relative terms with other countries. Oncologists warn of an explosion of cancer cases by 2040, both globally and in Spain.

In the field of Companies, at the international level, Pfizer proposes a change in the payment model for antibiotics, proposing a kind of “subscription payment”, separating the volume from the value. Regarding the national situation, CASER announces growth in dental clinics and Hospitén a considerable investment in the Dominican Republic, where this company of Canary origin is very active.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

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

 

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 27th-April 2nd, 2023)

 

Summary

From the point of view of Biomedicine, the latest issue of The Lancet dedicates a special article and an editorial to chronic pain, which affects millions of people daily; For its part, the New England Journal of Medicine publishes a review and an editorial on Artificial Intelligence in medicine. It seems that humanity will soon break historical records in terms of longevity. It is also worth highlighting the advances that are being announced in regenerative medicine (xenotransplant, 3D organ printing and stem cells).

With regard to Global Health, the most important thing is the WHO’s warning to governments in dedicating efforts to health professionals, since many of them are close to retirement and the needs are increasing for many reasons.

Regarding International Health Policy, in the United States, the FDA authorizes the free sale of Narcan, a nasal spray against opioid overdose, which represents life or death for many people. In the United Kingdom, the popularity of the NHS is the lowest it has been for 40 years, when this type of study began.

If we talk about National Health Policy (Spain), a new replacement in the Ministry of Health. Some consider that this Ministry has become the electoral launching pad for its incumbents (Illa, for Catalonia; Darias, for Las Palmas, and, apparently, Miñones, for Galicia). This approach, together with the short duration of the ministers, is one of the causes that contribute to the loss of prestige, leadership and role of the Ministry of Health, which has a policy of contingency management, but without a true project of transformation of the system, to propose to the different agents. The Minister of Health of Catalonia seems to have a plan to reinforce and retain professionals, something very necessary. I hope this plan works. The EMA has given the green light to the Spanish vaccine against the HIPRA covid, although only as a booster dose to the mRNA vaccines. Important social debate around surrogacy, as a result of the use of this procedure by a “celebrity”. Very different positions on the subject. Perhaps the most correct approach, as a quoted writer does, is to see who this procedure harms, if the parents, the unborn child, or the woman who lends her uterus. If the conclusion is that no one has been harmed, the most reasonable thing to do would be to approve this practice in our country, as it is in so many others.

In the field of Companies, internationally, BioNTech’s sales forecasts plummet, as a result of the lower demand for covid vaccines. At the national level, perhaps the most far-reaching news is the purchase by Viamed (Macquarie) of the Fátima hospital in Seville, after stiff competition with many other interested parties, including Vithas and Sanitas. Hospitales Parque (CASER) is set to grow at the rate of one hospital per year in the next three years.

Biomedicine

Global Health

International Health Policy

  • COVID
    • Data from Gisaid, the global repository of covid genomic data, increases the chances of discovering the origin of covid. Three years into the pandemic, it is still not certain whether the virus arose accidentally from a laboratory or was transmitted through an animal host (https://www.ft.com/content/f0733683-cb6d-4578-915a-aa60d7ba4c1d)

National Health Policy

Companies

7 days in healthcare (February 27th-March 5th, 2023)

 

Summary

From the point of view of Biomedicine, The Economist celebrates medicines against obesity as a great revolution, at a particularly opportune moment, since the WHO is continually warning of the global epidemic of this disease. Psychedelics appear to be making their way into treatments for mental illness. The WHO is working on a new vaccine against bird flu, fearing that this virus will “jump” to humans, which already seems to have occurred in Asia.

With regard to Global Health, the change of management in two entities such as the World Bank and Gavi, very promising. In this last body, for the first time, the representative of a country receiving aid (Nigeria) occupies the maximum responsibility. Solutions are sought for the global shortage of certain medicines. There may be many causes, but it seems that the concentration of production in the geographic area of India and China may be at the root of the logistical problems.

As for International Health Policy, in the United States the battle for abortion, after the ruling of the American Supreme Court, is even transferred to abortion pills, which are trying to be banned in certain states. In the United Kingdom, pharmaceutical companies ask the Government for a tax cut, something that the Government does not seem willing to grant. In Canada, certain establishments are authorized to sell cocaine, in an attempt, we’ll see if it’s effective, to curb overdose problems. Two new clinics for LGBT patients open in Tel-Aviv.

If we talk about National Health Policy (Spain), in terms of covid, the accumulated incidence continues to rise slightly, with a fairly high mortality (around 100 patients a week). The medical conflict continues in several autonomous communities, but with special virulence in Madrid, where there is even a possible strike by hospital doctors, which would be a very important qualitative change. A group of Catalan healthcare workers resorts to the Government’s call to demand Catalan to be able to run for office, where had that bilingualism left off? The Amancio Ortega Foundation donates 30 million for the construction of the first pediatric palliative care center, which will be open to children from all Spanish communities. Despite how hard it is, there are children who are going to die and who are known to die. Those are the recipients of that center. Extremadura reaches an agreement with BIOSIM to promote biosimilars through profit-sharing programs. The wide diffusion of generics and biosimilars, critical for the permanent incorporation of innovation. Great presence at the Barcelona Mobile Fair of health technology, mainly surgical robots and telemedicine solutions.

In the field of companies, at the international level, BioNTech will open a center of excellence in mRNA technology in Israel. In Spain, Grifols takes full control of the biotech company Access Biologicals.

Biomedicine

Global Health

International Health Policy

  • COVID

National health policy

Companies

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

 

Summary

From the point of view of Biomedicine, it is worth highlighting, as the Science article does, the celebration of a decade of CRISPR gene editing technology, whose impact on medicine is only just beginning. Janssen withdraws from the HIV vaccine, a new failure in the attempt to discover a vaccine against this disease. Moderna, on the other hand, presents positive results with a vaccine against bronchiolitis. A new report points to wastewater analysis as fundamental to monitoring threats from a wide variety of diseases, not just covid.

As regards Global Health, The Lancet in an editorial underlines the importance of the One Health concept, this idea of the interdependence between human, animal and ecosystem health. The Economist publishes an editorial and an article on the problems of health systems that are in crisis everywhere in the post-covid era (even in Switzerland!), which is making mortality in Europe have been in the last year 10% higher than in a normal year.

Regarding International Health Policy, in the USA the opponents of abortion are manifested. Problems continue in the NHS, with Sajid Javid, former health secretary, proposing something as unusual in the UK as a co-pay in Primary Care and Emergency. He says an overly religious view of the NHS prevents reforms. Important debate and tensions about the price of medicines in the European continent (UK and EU) in relation to prices in the USA. Pharmaceutical companies, very reluctant to price controls, when they are also in the USA with the application of the Inflation Act, which gradually imposes a negotiation of the price of medicines between the Medicare Administration and pharmaceutical companies.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop. Medical conflicts extend to various autonomous communities (Madrid, Catalonia, Navarra, etc.). The agreement in Aragon should be highlighted, which indicates that it is possible to reach agreements, possibly when they are well negotiated. The Ministry, completely absent from this problem. As for the public system, the statements by Lasquetty, Madrid’s Treasury Councilor, who points to “my own place” as one of the great rigidities of the public system, are very interesting. Conflict also in private health between doctors and insurers, raised in Seville. Abortion enters the national debate, following the picturesque proposals of Vox in Castilla y León, never applied. The Constitutional Court opens its new session with the debate on the recourse to the Law of deadlines presented in its day by the PP. The CIS survey presents health as the second problem that worries the Spanish.

In the field of Companies, internationally, Pfizer’s initiative to sell medicines at cost prices in 45 poor countries must be highlighted. At the national level, the launch by DKV of an insurance product that allows choosing a family doctor is notable. In a context in which insurers actually forget about Primary Care, this is something that deserves to be highlighted.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies