Summary

From the point of view of Biomedicine, the use of gene therapy based on CRISPR for the treatment of hereditary angioedema should be highlighted. Great debate regarding Elon Musk’s brain chip, in general the scientific community has expressed serious reservations about this initiative. Beginning of the first trials with mRNA-based therapy in cancers of different types in the United Kingdom.

As far as Global Health is concerned, the beginning of routine malaria vaccination can without exaggeration be considered a historic event, given the high mortality of this disease in children in Africa. The WHO warns about the prospects for great growth in cancer globally and the notable differences in its prognosis, especially in breast and cervical cancer.

In terms of International Health Policy, the NHS England initiative is especially interesting, allowing pharmacies to prescribe certain medications and carry out some care practices, which is expected to result in a decrease of 10 million primary care consultations. The results of this experience deserve to be followed, since it could be part of the solution to Primary Care also in Spain. EU document on cancer in Europe, highlighting inequities in its approach.

If we talk about National Health Policy (Spain), it is worth continuing to comment on the intervention of the Minister of Health in the Health Commission of Congress. Although now it seems that nothing is important, the truth is that this intervention is one of the most relevant of any minister who reaches her position. The intervention has some lights and many shadows. Lights: recovery of a certain will for strategic direction of the SNS and decision to address the great problem of waiting lists (this is notable, since it contrasts with other ministers, who used to rather assume that everything was transferred and , therefore, the role of the Ministry was minimal). Shadows: very negative, offensive and unacceptable mentions of private healthcare, with arguments and quotes that are intellectually inconsistent and lacking rigor; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, apart from doubts about its real content (no one hides the fact that the Agency does not make the influential nationalist parties very happy), the Ministry of Health gets out of the way to decide the location, handing over the baton to the Ministry of Territorial Policy and Democratic Memory, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals?; medicines, no mention of the Strategic Plan of the pharmaceutical industry (in which the President of the Government himself had committed himself); Oral health, where is the economic memory? What care model will be followed? Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? In another order of things, in the Valencian Community the reversion to the public sector of the Denia concession has been completed and that of Manises will soon be granted, something to which the Administration has every right, once the concession contract has ended. The mentions of the concept of “expropriation”, used by some concessionaire company, are extemporaneous. Now, the official press release from the Ministry announces a very notable increase in staff in that hospital in Denia. Logically, uncontrolled growth in health spending, if it is not justified, cannot be the public alternative to concessions. Notable growth in the price of health insurance premiums in Spain, although its price must probably continue to be low, compared to other European countries. Something to analyze.

As for Companies, on an international level, Novo Nordisk was surprised by the great demand in Europe for medicines against obesity. In terms of national news, the pharmaceutical distributor HEFAME has experienced great growth in recent years and is considering expanding throughout Spain. At Grifols, the board is considering excluding the family from the company’s strategic decisions.

Biomedicine

• Why we should change the way we name cancers. Classifying metastatic cancers by organ of origin is not correct, according to precision medicine criteria that use the tumor’s molecular profile to guide therapies (https://www.statnews.com/2024/01/31/oncology-name-cancer-by-genetics-not-organs-expert-says/#:~:text=Naming%20cancers%20solely%20by,European%20Society%20of%20Medical%20Oncology.)
• The efficiency of computerized diagnostic systems. Although the spread of electronic medical records has led to more and more clinical decision support systems, a systematic review in 2020 of 115 studies shows that there is an average improvement in the care process of just over 5%. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02839-8/fulltext)
• Alzheimer’s disease can rarely be transmitted by medical treatments. Treatment in childhood with contaminated growth hormone can cause the disease years later (https://www.economist.com/science-and-technology/2024/01/29/alzheimers-disease-may-rarely-be-transmitted-by-medical-treatment)
• Why women have more autoimmune diseases, study points to the X chromosome (https://www.nytimes.com/2024/02/01/health/women-autoimmune-disease-x-chromosome.html)
• Scientists use gene editing with CRISPR to treat hereditary angioedema. The result of the trial has been published in the NEJM (https://www.ft.com/content/7d9a5157-2c77-46c6-9e56-37d7a9f47b60)
• According to a study, being thin reduces the risk of prostate cancer by 35% (https://www.theguardian.com/society/2024/jan/30/getting-fitter-can-reduce-prostate-cancer-risk-by-35-study-finds)
• Elon Musk’s brain chip could be the beginning of “cyborgs” (https://www.elindependiente.com/futuro/2024/01/31/el-chip-cerebral-de-elon-musk-podria-ser-the-beginning-of-cyborgs/)
• Remote monitoring and the “hospital at home”. Remote physiological monitoring is the basis of the hospital at home (https://www.amjmed.com/article/S0002-9343(23)00664-2/fulltext)
• The first cancer patients in the UK to receive experimental treatment with a revolutionary mRNA-based treatment. The trial is in early phase and may take years before it is available to patients (https://www.theguardian.com/science/2024/feb/04/first-uk-patients-experimental-messenger-mrna-cancer-therapy-treatment#:~:text=A%20revolutionary%20new%20cancer%20treatment,cancer%20and%20other%20solid%20tumors.)

Global Health

• Routine malaria vaccination begins. Immunization against malaria began on January 23 in Cameroon. Gavi says 3 million children are expected to receive the vaccine in 20 countries in 2024. Malaria claims more than half a million lives of children under 5 in Africa alone. This vaccination represents a historic event (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00194-6/fulltext#:~:text=Starting%20in%20Cameroon%2C%20over%203,on%20Jan%2022%20in%20Cameroon.)
• Cervical cancer kills 300,000 people a year. What needs to be done to speed up its elimination. It can be prevented through vaccination and cured if diagnosed early (https://www.nature.com/articles/d41586-024-00241-2)
• Cholera spreads in Africa aggravated by floods and pollution (https://elpais.com/noticias/colera/)
• The WHO predicts that cancer cases will grow by 77% by 2050. The WHO warns of inequalities in treatment with radical differences in the prognosis of breast or cervical cancer. Population growth, population aging and other factors (alcohol consumption, tobacco and obesity) among the factors that explain this notable increase (https://elpais.com/salud-y-bienestar/2024-02 -01/the-who-predicts-that-cancer-cases-will-grow-on-77-by-2050.html)

International health policy

• USA
  • Syphilis is increasing in the USA. Cases have grown 80% since 2018, according to the CDC. The disease had been considered eradicated from the USA. More than 207,000 cases were diagnosed in 2022, of which 3,700 cases of congenital syphilis (https://www.nytimes.com/2024/01/30/health/syphilis-cdc.html#:~:text=Syphilis%2C%20once%20nearly%20eliminated%20in,for%20which%20data%20are%20available.)
  • Alternative therapies such as acupuncture and meditation, on the rise. More than a third of Americans complement conventional medicine with treatments until now considered alternative. In 2022, 37% of adults were using unconventional treatments, compared to 19% in 2002, according to a recent work published in the journal JAMA (https://www.nytimes.com/2024/02/02/health/medical-alternative-meditation-acupuncture.html)

• United Kingdom and the National Health Service
  • According to some experts, the next government should declare the NHS a national emergency. The group of experts and professionals has been brought together by the British Medical Journal and the reasons given are underfunding, a shortage of professionals and greater demands from an aging population (https://www.theguardian.com/society/2024/jan/31/next-government-should-declare-nhs-a-national-emergency-experts-warn)
  • England will save 10 million medical appointments with the actions of pharmacies. From this Wednesday, pharmacies in England will be able to prescribe certain drugs and carry out primary care actions for patients, without them having to go to their GP. 9 out of 10 pharmacies are in this program. Pharmacies will receive a fixed amount, plus 15 pounds (17 euros) for each consultation (https://www.diariomedico.com/farmacia/comunitaria/inglaterra-ahorrara-10-millones-citas-medicas-actuaciones-farmacias.html)
  • Brexit after four years, a health failure (https://www.consalud.es/politica/brexit-cuatro-anos-despues-ha-sido-fracaso-punto-vista-sanitario_139725_102.html)

• France
  • Crisis in hospitals, the deficit of CHUs (University Hospital Centers) has tripled in one year (https://www.lemonde.fr/societe/article/2024/01/29/crise-de-l-hopital-le-deficit-des-chu-a-triple-en-un-an_6213719_3224.html)
  • Chemotherapy at home, without due recognition (https://www.lemonde.fr/m-le-mag/article/2024/02/01/la-chimiotherapie-a-domicile-aux-bons-soins-des-prestataires-de-sante_6214184_4500055.html)
  • The flu epidemic is intensifying, while the vaccination campaign is prolonged (https://www.lemonde.fr/societe/article/2024/01/31/l-epidemie-de-grippe-s-intensifie-la-campagne-de-vaccination-est-prolongee_6214106_3224.html)

• Italy
  • Italy increases coverage for eating disorders after protests (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00195-8/fulltext)

• Malta
  • Malta terminates a hospital concession to a private group (https://eurohealthobservatory.who.int/monitors/health-systems-monitor/updates/hspm/malta-2017/malta-s-hospitals-concession-agreement-with-a-private-consortium-has-been-terminated)

• OECD
  • Declaration on resilience of health systems (https://www.quotidianosanita.it/allegati/allegato1706536989.pdf)

• European Union
  • Document on inequalities in the EU regarding cancer: “Beating cancer inequalities in the EU” Emphasis on prevention and early detection (https://www.oecd.org/health/beating-cancer-inequalities-in-the-eu -14fdc89a-en.htm)
  • The EU fined the pharmaceutical industry 780 million for anti-competitive practices between 2018 and 2022 (https://www.elespanol.com/invertia/observatorios/sanidad/20240130/ue-multo-millones-industria-farmaceutica-practicas-anticompetitivas /828667294_0.html#:~:text=The%20European%20Commission%20investigated%20one, euros%20for%20the%20laboratories%20involved.)
  • Brussels calls to promote vaccines against human papillomavirus (HPV) and hepatitis B throughout the EU (https://elpais.com/sociedad/2024-01-31/bruselas-llama-a-impulsar-las -vaccines-against-human-papillomavirus-hpv-and-hepatitis-b-across-the-eu.html#:~:text=Brussels%20has%20launched%20this%20Wednesday, the%20Hepatitis%20B%20(HBV).)

National health policy

• Appearance of the Minister of Health before the health commission of the Congress of Deputies, on January 26, 2024
  • Lights and shadows in the appearance. Lights: recovery of a certain will for strategic direction of the SNS and willingness to address the great problem of waiting lists. Shadows: very negative and unacceptable mentions of private healthcare, with intellectually inconsistent arguments and quotes; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, the ministry gets out of the way to decide the location, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals and patient associations?; medications, no mention of the Strategic Plan of the pharmaceutical industry; Oral health, where is the economic memory?; Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? (https://www.youtube.com/watch?v=xlGfsMiuQDo)

• Reversals of concessions in the Valencian Community
  • The health area of Denia returned to public management last Thursday and that of Manises will do so in May (https://www.20minutos.es/noticia/5212829/0/area-salud-denia-vuelta-gestion-publish-this-Thursday-manises-will-mayo/)

• Dentists in public health
  • Public health only has 1,500 dentists for 47 million Spaniards, although public dentists have increased by 45% since 2018, they are only 3.5% of all those in the country (https://www.eldiario.es/sociedad/sanidad-publica-cuenta-1-500-dentistas-47-millones-espanoles_1_10860174.html)

• Lung cancer in women
  • Tobacco consumption weighs down the numbers of lung cancer in women, which will almost triple in 2024 (https://www.elmundo.es/ciencia-y-salud/salud/2024/01/29/65b7aa4321efa020438b45b0.html)

• Health insurance
  • Significant price increase in health insurance premiums in Spain. It seems that the increase in premiums has been 8.4% compared to December 2022. This is the largest increase in all of Europe (https://www.elconfidencial.com/mercados/finanzas-personales/2024-02-02/make-health-insurance-private-lead-price-rise-europe_3822621/)

• World cancer day
  • Statements by the president of the SEOM: “In 40 years, cancer survival has doubled, and now 60% of patients are still alive” (https://www.diariomedico.com/medicina/oncologia/40-anos-survival-cancer-spain-duplicated-now-60-patients-are-still-alive.html)
  • When early detection of cancer in Spain is not equitable (https://www.larazon.es/salud/when-deteccion-precoz-cancer-espana-equitativa_2024020465bceb06c3cb3000011d70e4.html)

• Familial cancer
  • A project in Spain in which nine centers participate seeks to identify the mutations that cause the presence of familial cancer (https://elpais.com/salud-y-bienestar/2024-02-04/un-millonario-proyecto-contra-familial-cancer-wants-to-take-thousands-of-people-out-of-genetic-purgatory.html)

• Comprehensive cancer centers
  • The Ministry foresees that there will be 30 comprehensive cancer centers in 2028 (https://www.diariomedico.com/medicina/politica/ministerio-sanidad-preve-centros-integrales-cancer-ronden-30-2028.html)

• Framework Statute
  • The Minister of Health sets the date for reform of the Framework Statute in 2024 (https://www.redaccionmedica.com/secciones/ministerio-sanidad/garcia-situa-el-nuevo-estatuto-marco-en-2024-contra-the-patches-of-sns-9645)

• Clinical trials
  • Spain, European leader in clinical trials. According to the European Medicines Agency, of the 1,944 clinical trials authorized in the EU, Spanish centers participated in 845, ahead of Germany and France (https://www.plantadoce.com/entorno/espana-lider-europea-en-clinical-trials-with-new-drugs)

• Hospital Clínic de Barcelona
  • The new Hospital Clínic, closer (https://www.diariomedico.com/medicina/politica/futuro-hospital-clinic-barcelona-mas-cerca.html)

Companies

• International News
  • Novo Nordisk surprised by the high demand in Europe for weight loss drugs (https://www.ft.com/content/bbbe8543-263c-4e5b-a567-2ef05f2b3138)
  • Philips suspends the sale of CPAP and other respiratory devices in the USA (https://www.nytimes.com/2024/01/29/health/philips-cpap-breathing-devices.html)
  • Novartis increases its profits by 42% and is close to 8,000 million (https://www.redaccionmedica.com/secciones/industria/novartis-aumenta-sus-beneficios-un-42-y-roza-los-8-000-million-euro-4460#:~:text=The%20pharmaceutical%20Novartis%2C%20with%20headquarters, more%20in%20the%20drugs%20with)

• National
  • Hefame gained a 22% market share in 9 years and is considering expanding throughout Spain (https://diariofarma.com/2024/02/02/hefame-gano-un-22-de-cuota-de-market-in-10-years-and-plans-its-expansion-to-all-of-spain#)
  • Fresenius completes the sale of Eugin (https://www.plantadoce.com/empresa/fresenius-complete-la-desinversion-en-eugin-tres-anos-despues-de-comprarla#:~:text=La%20multinacional %20german%20of%20services,%20euros%2C%20including%20%20benefits.)
  • Bayer sells its Sant Joan Despí center to Stoneshield for 200 million euros (https://www.plantadoce.com/empresa/bayer-vende-su-centro-de-sant-joan-despi-a-stoneshield-por-200-million-euro)
  • Audika purchases two new hearing centers in Catalonia and the Valencian Community (https://www.plantadoce.com/empresa/audika-compra-dos-nuevos-centros-auditivos-en-cataluna-y-la-comunidad-valenciana#:~:text=The%20company%20of%20health%20hearing, of%20expansion%20on%20national%20scale.)
  • The Ministry opens up to reveal the price that a pharmaceutical company (Gilead) wants to hide (https://www.eldiario.es/sociedad/sanidad-abre-primera-vez-revelar-precio-medicamentos-farmaceutica-quiere-ocultar_1_10887469. html)
  • The Grifols board agrees that the family should step aside from strategic management (https://www.elconfidencial.com/empresas/2024-02-02/consejo-grifols-acuerda-apartar-familia-gestion-estrategica_3822150/)