Summary

From the point of view of Biomedicine, the New England Journal of Medicine begins a series on the usefulness of wearable technology, the set of devices or instruments that are worn and transmit information about health, which could be useful in monitoring , diagnosis and treatment of various diseases or clinical situations. There is every impression that this technology will be part of the future and what the NEJM intends is to clarify its usefulness and indications in various diseases and specialties, starting with diabetes. Regarding CAR-T therapies, until now used in hematological processes, it is envisioned that they could also be useful in solid tumors.

Regarding Global Health, great prominence of the issue of health in the COP28 meeting, from two perspectives: the reduction of CO2 emissions, which can be harmful to health; and the emissions from the health system itself, which is a major polluter. It is confirmed in a new and extensive study carried out in Australia that the younger generations have worse mental health.

Regarding International Health Policy, in the United States an executive order by President Biden on AI, not specifically directed at the health sector, will, however, have an impact on this sector and the Ministry of Health is already preparing specific regulations. In China, it seems to be ruled out that the increase in respiratory infections is due to a new virus, but rather to common bacteria and viruses. The United Kingdom’s genetic database, UK Biobank, is about to reveal results, which seem to have an impact on new therapies. In France the price of a pack of tobacco is rising, despite this country’s failures in the fight against smoking. The new conservative government of New Zealand annuls the 2022 law, which prohibited the sale of tobacco from 2027. Austria launches a new health reform, which reinforces the digital route as access to the health system. Concern of several health groups in Argentina, given the health announcements of the new president-elect, Javier Milei.

If we talk about National Health Policy (Spain), the government of the Generalitat of Catalonia reactivates the results center, a model initiative in terms of transparency in the health sector, which had been largely paralyzed since the “procés”. All the data until 2022 has already been presented. Biosim demands new forms of purchasing and management adapted to biosimilars. Problems in the last research institute recognized by the Carlos III Health Institute, that of Asturias. Strong tensions for months between the management of ISPA (the Health Research Institute of the Principality of Asturias) and FINBA, a Foundation with a majority of private companies, which seeks to exercise control over ISPA. Unusual proposal from the Catalan medical colleges, which aims to introduce a “quota” for non-Catalans who aspire to study medicine in Catalonia.

In the field of Companies, on an international level, AstraZeneca is allying itself with AI Biologics. The linking of pharmaceutical companies with AI companies seems to be a general trend. At the national level, Vivanta confirms an ERE.

Biomedicine

• A series begins at the NEJM on “wearable” health technology. This technology is “worn” by the patient and can be used for disease monitoring, diagnostics, alerts or other clinical services. It comprises a wide range of devices, platforms to monitor physiology and health conditions (https://www.nejm.org/doi/full/10.1056/NEJMe2303219)
• “Wearable” technology and diabetes. The contributions of “wearable” technology in diabetes are presented (https://www.nejm.org/doi/full/10.1056/NEJMra2215899)
• CAR-T therapies and solid tumors: first positive results. The so-called CAR-T consists of extracting lymphocytes from the patient, genetically modifying them so that they recognize and attack cancer cells and then reintroducing them into the patient. Until now they have been used in hematological tumors, but there are prospects for their usefulness in solid tumors as well.
• (https://www.diariomedico.com/medicina/hematologia/terapias-car-t-y-tumores-solidos-primeros-resultados-positives.html)
• Immunotherapy increases the survival of women with cancer by 41% (https://www.lavanguardia.com/vida/20231202/9422192/inmunoterapia-aumenta-41-survivencia-mujeres-cancer-cervix.html#:~:text=Add%20a%20drug%20of%20immunotherapy,d%27Hebron%20(VHIO).)

Global Health

• Health in focus at COP28 meeting (https://www.theguardian.com/environment/live/2023/dec/03/cop28-live-health-in-focus-at-dubai-climate-talks)
• Most COP28 countries recognize the need to lower emissions for health (https://www.google.es/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjflbqc_PKCAxVjhf0HHTo_B-IQFnoECBEQAw&url=https%3A%2F%2Fwww.elindependiente.com%2Ffuturo%2Fmedio-ambiente%2F2023%2F12%2F02%2Fla-majority-of-the-countries-of-the-cop-recognize-the-need-)
• The decarbonization of the health sector at COP28. 4.5% of the carbon footprint in Spain comes from the healthcare sector (https://www.consalud.es/profesionales/descarbonizacion-sector-sanitario-cop28_137480_102.html)
• The teachings of the atomic bomb. The results of the Radiation Effects Research Foundation (RERF), which analyzes the effects of the atomic bombs dropped on Japan, are presented. The death toll is estimated to be between 90,000 and 120,000 in Hiroshima and between 60,000 and 80,000 in Nagasaki. This organization analyzes the short and long term effects of nuclear radiation (https://www.nejm.org/action/showPdf?downloadfile=showPdf&doi=10.1056/NEJMp2309581&loaded=true)
• Climate change influences new cases of malaria, complicating the fight against the disease (https://www.nytimes.com/2023/11/30/health/malaria-climate-change.html#:~:text=Global%20Health-,Climate%20Change%20Drives%20New%20Cases%20of%20Malaria%2C%20Complicating%20Efforts%20to,once%20free%20of%20the%20illness.&text=Stephanie%20Nolen%20has%20travele)
• Egypt managed to end hepatitis, now trying to help the rest of Africa (https://www.nytimes.com/2023/11/28/health/hepatitis-c-cure-egypt.html#:~:text=Global%20Health-,Egypt%20Wiped%20Out%20Hepatitis%20C.%20Now%20It%20Is%20Trying%20to,reach%20most%20of%20the%20region.)
• Worse mental health among young people, according to a study done in Australia. The work coincides with the conclusions in other countries in which a deterioration of mental health is seen in the younger generations (https://elpais.com/salud-y-bienestar/2023-11-27/un-estudio-confirms-that-new-generations-have-worse-mental-health.html). Access to the original article: https://www.pnas.org/doi/10.1073/pnas.2303781120
• Bangladesh is facing the worst dengue epidemic ever recorded in the country (https://www.lemonde.fr/planete/article/2023/12/02/le-bangladesh-fait-face-a-la-pire-epidemie-de-dengue-never-enregistree-dans-le-pays_6203559_3244.html)

International health policy

• USA
  • An executive order from President Biden on AI that affects healthcare. Although the order is aimed primarily at the government and non-health sectors, the health sector will also be affected, when it says that unfair practices, violations of privacy or discrimination will be combated. The Secretary of Health will carry out an evaluation of all health practices with AI (https://jamanetwork.com/journals/jama/fullarticle/2812613)
  • A key part of Obamacare, in danger. The party that forced companies to offer preventive medicine is threatened by a ruling, following the lawsuit of millionaire doctor Steven Hotze (https://www.economist.com/united-states/2023/11/30/a-key-part-of-obamacare-is-in-jeopardy)
  • Suicides with firearms reach record numbers in the USA. The increase is 10% in 2022, compared to 2019. It is believed that there is an exacerbation of risk factors, such as social isolation, alcohol and drugs (https://www.nytimes.com/2023/11/30/health/suicide-guns-cdc.html)

• China
  • American officials rule out a new type of virus in respiratory infections in China, the cause is common viruses and bacteria (https://www.nytimes.com/article/china-respiratory-illness-pneumonia.html#:~:text=A%20surge%20of%20children%20has,was%20common%20viruses%20and%20bacteria.)

• United Kingdom and the National Health Service
  • Waiting lists in England harm 8,000 people and caused 112 deaths last year, according to a study by NHS England (https://www.theguardian.com/society/2023/nov/26/nhs-england-care-delays-harmed-8000-people-and-caused-112-deaths-last-year#:~:text=NHS-,NHS%20care%20delays%20in%20England%20harmed%208%2C000,caused%20112%20deaths% 20last%20year&text=Almost%208%2C000%20peopl)
  • The UK genetic database, about to reveal important data. The first results of the UK Biobank, the result of the collaboration of the government, the Wellcome Trust (the largest non-profit biomedical organization) and 4 pharmaceutical companies, will be disseminated. It is believed that the results can boost the development of therapies from cardiac pathology to cancer. It is the largest genetic sequencing revelation in history (https://www.ft.com/content/adb936b9-45b0-4256-a888-894794fc83f5)

• France
  • France will raise the price of a pack of tobacco to 12 euros and will prohibit smoking on beaches, parks and around schools. Despite its high price, the French are among the OECD smokers and anti-smoking plans have failed (https://www.elmundo.es/ciencia-y-salud/salud/2023/11/29/6566f7b6e9cf4af1048b45cc.html#)

• New Zealand
  • The new government of New Zealand will eliminate the law that was going to prohibit the sale of tobacco from 2027. The law had been approved in 2022 and the new conservative government intends to eliminate it, amid protests from health defense associations (https://www.elmundo.es/ciencia-y-salud/salud/2023/11/27/65649f97e85eced7038b4597.html#)

• Austria
  • New health reform that reinforces outpatient and digital care. The plan approved on November 23 is for 2024-2028. The plan seeks to reinforce digital access to the system (without gatekeeping functions) and alleviate tensions in the hospitalization sector, by reinforcing outpatient activity. The program is supported financially by €14 billion for health and long-term care (https://eurohealthobservatory.who.int/monitors/health-systems-monitor/analyses/hspm/austria-2018/new-health-care-reform-2024-2028-strengthens-digital-and-ambulatory-care)

• Argentina
  • Article from The Lancet: Concern in the Argentine health system, after the election of Javier Milei. Doctors, scientists and abortion rights activists worried. In the president-elect’s program is to subject abortion to a referendum, lower the level of the Ministry of Health to a secretariat and create universal health insurance, proportional to the patients’ ability to pay (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02692-2/fulltext#:~:text=Argentine%20doctors%2C%20scientists%2C%20and%20abortion,the%20La%20Libertad%20Avanza%20coalition.)

National health policy

• Catalonia: results center
  • The results center is reactivated. This center is a model of transparency of the health system, it presented data since 2008 and its activity was interrupted during the so-called “procés”. From now on, the data is available until 2022 (https://www.diariomedico.com/medicina/politica/cataluna-salud-reactiva-la-central-de-resultados-sanitarios.html)

• Biosimilars
  • Biosim calls for purchasing and management models adapted to the reality of biosimilars (https://diariofarma.com/2023/11/27/biosim-reclama-modelos-de-compra-y-gestion-adaptados-a-la-reality-of-biosimilars)

• New public hospital in the Balearic Islands
  • Baleares will invest 20.6 million euros in a new hospital center in Felanitx (https://www.plantadoce.com/publico/baleares-inviertera-206-millones-de-euros-en-un-nuevo-centro-hospitalario-en-felanitx#:~:text=Advertising-,Baleares%20willinvest%2020%2C6%20million%20of%20euros%20in%20a%20new,to%20care%20%20chronic%20patients.)

• Problems in health research in Asturias
  • Health scientists criticize the changes in the Health Research Institute (ISPA), recognized by the Carlos III Health Institute. Tensions of months between ISPA and FINBA, a foundation with a majority of private companies, directed by Dr. Blanco, which seeks to exercise political control over ISPA, generating many tensions among scientists (https://www.lne.es/asturias/2023/11/30/cientificos-hospitalarios-critican-cambios-instituto-95287336.html)

• Study medicine in Catalonia
  • It is intended to give preference to Catalans to study medicine in Catalonia. It seems that the Catalan Medical Colleges want to restrict non-Catalan students who can study medicine in that community to 30-35%. Strong opposition from the WTO (https://www.redaccionmedica.com/secciones/estudiantes/los-medicos-tildan-de-provincialismo-el-cupo-catalan-al-grado-de-medicina-4360)

Companies

• International News
  • Novo Nordisk looking for flexible pricing for obesity drugs (https://www.ft.com/content/7134ecfe-fcca-450f-89cc-f986553eb6db)
  • Abbvie pays 9.2 billion to grow in cancer with ImmunoGen (https://www.expansion.com/empresas/industria/2023/11/30/6568fea6468aebe1548b4574.html)
  • AstraZeneca partners with AI Biologics, for the development of medicines (https://www.ft.com/content/3d8a0ec6-5b04-486f-af2b-15de1486ffaf)

• National
  • Mediquo is committed to the international market and aims to double its sales in 2024 (https://www.plantadoce.com/empresa/mediquo-apuesta-por-el-mercado-internacional-y-apunta-a-duplicar-sus-sales-in-2024#:~:text=Advertising-,Mediquo%20bet%20on%20the%20international%20market%20and%20aims%20to%20double,to%20its%20bet%20in%20Latin American)
  • Laboratorios Rubió grows 40% and opens subsidiaries in the USA and Italy (https://www.expansion.com/catalunya/2023/11/26/6563a3a3468aeb773f8b4665.html)
  • The Vivanta clinics present an ERE (https://theobjective.com/economia/2023-12-03/rescate-gobiernos-vivanta-ere/#:~:text=Logo%20de%20la%20red%20de%20establecimientos% 20%20Vivanta.)