Posts

7 days in healthcare (February 19th-25th, 2024)

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Summary

From the point of view of Biomedicine, the mega-study of 250,000 genomes made public by the National Health Institutes of the USA stands out. This is in line with carrying out genome studies combining it with electronic medical record data from very large groups initiated in the United Kingdom by Genomics England and also developed in Iceland and Japan. A very promising way to improve knowledge of many diseases. New treatments for type 1 diabetes, based on the transplant of insulin-producing beta cells, obtained from stem cells, neutralizing the immune reaction. Gene therapy is the great promise for many rare diseases, currently without treatment. The problem to be solved is the high price of the treatments. At the present time, saying breast or prostate cancer is almost saying nothing. The treatment of tumors is no longer based on their anatomical origin, but rather on their molecular characterization. Bispecific antibodies that act on two targets at the same time, useful in hematological and solid tumors. The FDA approves a drug to prevent the amputation of fingers and limbs.

As far as Global Health is concerned, long covid was understood as a sequel to covid, but an article in The Economist states that covid is not the only infectious disease that leaves pathological conditions that are difficult to label. An article in Health Affairs places the solution to the obesity epidemic as a joint effort of prevention and treatment.

In terms of International Health Policy, more than half of USA’s rural hospitals do not offer childbirth services, which means that pregnant women have to be treated in centers located 30-40 minutes from their home, sometimes more. This is related to the high maternal and infant mortality in the USA, higher than that of most developed countries. The 4th anniversary of Brexit encourages the debate about whether it was good or bad for the National Health Service. The truth is that the NHS is worse now than before Brexit (waiting lists, professional strikes, etc.) and the difficulty of recruiting health professionals from the EU has increased. The investigation was also damaged. Increasing funding for the NHS was one of the arguments used by Brexiteers. France addresses the carbon footprint in the health system, within the general “France Nation Verte” program. Germany legalizes recreational cannabis, with one of the most liberal laws in Europe, after Malta and Luxembourg. More than controversial attempt in Germany to take control of non-communicable diseases from the Robert Koch Institute, one of the most prestigious organizations in German health, to give it to another organization, created as a result of covid. The European Medicines Agency recommends approving a drug against ALS.

If we talk about National Health Policy (Spain), as a result of a specific scandal, the entire problem of purchasing masks and other materials during covid is introduced into the national debate. Precisely everything related to the purchase of these materials was somewhat overlooked by the report “Evaluation of the Performance of the Spanish National Health System in the face of the covid-19 pandemic”, dated April 30, 2023, although published by the Ministry of Health in December of that year. It is already serious that an issue such as the problems of purchasing materials are not analyzed in the report, as if this had not been one of the most serious problems in the management of covid. The PNV requests the return of the text of the Public Health Agency law. That this law was going to have problems with the nationalist parties, always opposed to the creation of cohesion bodies in the National Health System, was something known. Surely this will mean delays in the appearance of the law and, what may be more serious, affect its content and functions. There is a risk that the announced Agency will be little more than an empty shell. The government creates the Extreme Temperature Observatory to analyze the health impact of climate change. The Basque Country approves a new Mental Health Plan 2023-2028. The EU denounces the high level of interim contracts in the Spanish public health system. At the current time, 43% of contracts are interim.

As for Companies, internationally, AstraZeneca reveals successes in the treatment of lung cancer. Indian drugmakers make versions of Novo Nordisk’s anti-obesity drug. At the national level, Sanitas intends to open a new hospital in Barcelona. Fever of construction of private hospitals in Valencia: Vithas, Quirón, IMED and Ascires in that race.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
    • Brexit and health. January 31, 2024 was celebrated as the 4th anniversary of the United Kingdom’s effective departure from the European Union. The Lancet asks whether or not that was good for the NHS, with two possible answers: the easy one, which says there is no evidence; and the difficult one, which confirms that the NHS is in fact worse now than before, as demonstrated by the long waiting lists and the continuous strikes by health professionals. What is certain is that it has become difficult to recruit doctors from the EU. At present, the majority of foreign doctors hired in the NHS are from outside the EU. Research plans were also negatively altered. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00157-0/abstract)
    • The government changes its policy and plans to double the number of medical students in 2031 (https://ground.news/article/government-u-turn-on-plans-to-double-number-of-medical-students-in-england)

National health policy

Companies

7 days in healthcare (January 30th- February 5th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting the review by The Lancet on lung cancer screening, which shows that the low-dose Scanner is effective in reducing mortality, although there are aspects of cost-effectiveness that they remain as a problem; neural implants in rats open the prospect of brain transplants; the gene therapy revolution, previously abandoned for safety reasons, is now in full swing; and mRNA vaccines, which may be useful for cancer, with fewer side effects than conventional chemotherapy. The debate on check-ups is current, proving, once again, that annual check-ups do not reduce mortality, and despite everything, they are increasingly in demand.

As regards Global Health, The Lancet publishes an editorial in which it tries to change the narrative of little hope until now on cancer, due to the great disparities between countries in this fight.

Regarding International Health Policy, the New England Journal Medicine magazine publishes an article that affects the approach to the new reality of the covid, despite the new perception as a minor nuisance, it continues to represent between 300 and 500 deaths a day in USES. According to The Economist, we will most likely never know the number of deaths from covid in China, since the official mortality figures are not credible. The crisis in the British NHS continues, which seems to have been exacerbated by Brexit. Prime Minister Sunak’s proposals are for more ambulances, more hospital beds and home care. El Mercurio, the leading newspaper in Chile, editorializes on the critical situation of the ISAPRES (health insurers) in that country, which could fall into insolvency, which occurs due to the government’s indifference to this situation.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop, although mortality remains high. World Cancer Day (February 4) coincides with the appearance of interesting publications on the cancer situation in our country, both by SEOM and the OECD. This latest report warns Spain about accessibility problems. The implementation of cancer screening has been uneven, which leads to inequities between autonomous communities. Cancer already represents 10% of public health spending. The celebration of Cancer Day also coincides with two new inaugurations of centers dedicated to this disease: the Cancer Center of the Clínica Universidad de Navarra and the experimental oncology center of the Hospital 12 de Octubre in Madrid. The Ministry of Health of the Valencian Community announces the non-extension of the Denia concession contract. The Government publishes the Regulatory Plan for 2023, the law of the National Public Health Agency among the three health laws planned for 2023.

In the field of Companies, internationally, it should be noted that Pfizer is the first pharmaceutical company to reach revenues of more than $100,000 a year, thanks largely to the boost of the covid vaccine. As far as Spain is concerned, both Vitaldent and IMED are launching new centers. It seems that we are witnessing a fever of new private hospitals (Vithas in Barcelona; Sanitas in Madrid; Viamed in Tarragona; IMED in Alicante; Quirón in Asturias; and a long etcetera).

Biomedicine

Global Health

International Health Policy

  • COVID
    • Addressing the new reality of covid. The covid passed, in the popular perception from a terrible threat to a minor inconvenience with a few days of symptoms. The reality, however, is not that and the covid still means between 300 and 500 deaths a day in the USA, equivalent to a mortality higher than that of a serious flu epidemic. To this must be added the effects of persistent covid (https://www.nejm.org/doi/full/10.1056/NEJMp2213920)
  • Changes in the United States
    • The implications of the results of the US elections in 2022 in health. Results of a survey conducted by Robert Blendon. It is striking that despite the fact that the United States is the country that spends the most on healthcare, the majority of the population thinks that little is spent. This opinion is very predominant among Democrats, but also in the majority among Republicans (https://www.nejm.org/doi/full/10.1056/NEJMsr2214949)
    • The response of the National Health Institutes (NHI) to covid (https://www.science.org/doi/10.1126/science.adf5167)

National health policy

Companies