Summary

From the point of view of Biomedicine, to mark the 70 years since the discovery of the structure of the DNA molecule, which was to revolutionize the field of biology and medicine, allowing in 2003 the development of the human genome and in 2023 the approval of the first drug based on gene therapy. Nature warns that the gene therapy revolution may be threatened if cost is not discussed, proposing regulatory changes and new intellectual property laws.

With regard to Global Health, a Fund was created (similar to that for HIV, tuberculosis or malaria) to fight against hepatitis, that great plague that worldwide causes more than a million deaths a year. Great repercussion of the conflict in Sudan on the health situation in that unfortunate country.

As for International Health Policy, any other international news pales in comparison to the importance of the new proposals from the European Commission regarding the new pharmaceutical regulation. They propose changes to fundamental rules that had worked without modification for more than twenty years. It is difficult to pronounce, given the great weight of the interests at stake: those of patients, those of pharmaceutical research in Europe, those of the pharmaceutical industry, those of the Member States that want to see their pharmaceutical bills reduced. The texts of the new Directive and new Regulation are still proposals, but they will give people talk.

If we talk about National Health Policy (Spain), the new Minister of Health pronounces himself saying that the waiting lists “are not the responsibility of the Government”, a statement that could be considered unacceptable, since someone might think that the Ministry has more responsibilities apart those of compiling and disseminating the lists. The IDIS Foundation publishes its annual report, now in its 13th edition, on “Private healthcare: providing value”, which has become essential in the sector, due to the transparency it gives to the situation of the private sector. The data from the WAIT report are not favorable for Spain, in terms of the average time elapsed since the approval of medicines by the European Agency and their availability in Spain. Our country is among those that accumulate the most delays in this process.

In the field of Companies, at the international level, spectacular news is the purchase by Kaiser Permanente (a giant on the American West Coast) of Geisinger (a smaller operator on the East Coast) to found a customer service system. non-profit community health. In Spain it seems that the INCOSOL model wants to be replicated outside of Spain.

Biomedicine

• The secret of the Watson and Crick (plus Rosalind Franklin and Maurice Wilkins) double helix turns 70. A small article in Nature in April 1953 laid the foundation for the structure of DNA, which was to revolutionize biology and medicine. The advance culminated in 2003 with the complete sequencing of the human genome (and in 2023, with the approval of the first CRISP-based gene therapy) (https://elpais.com/ciencia/2023-04-25/asi-nacio-the-double-helix-of-dna-the-secret-of-life-that-turns-70-years-old.html)
• Nature Warning: The gene therapy revolution threatens to run aground if price is not discussed. This will require regulation and new intellectual property laws (https://www.nature.com/articles/d41586-023-01389-z)
• NEJM Review: Genomics in Clinical Practice. It is clear that genomics is making a difference for patients with rare genetic alterations and their families (https://www.nejm.org/doi/full/10.1056/NEJMe2302643)
• The FDA approves the first pill made from feces (https://www.ft.com/content/862587ed-ae87-4eaf-8419-093366b36717)
• Nature article: New computational approaches facilitate drug discovery. New computational approaches may democratize drug discovery, presenting new opportunities for the cost-effective development of safer and more effective molecules (https://www.nature.com/articles/s41586-023-05905-z/metrics)

Global Health

• A new Fund (similar to the one for HIV, tuberculosis and malaria) to fight hepatitis. Globally there are 350 million people with hepatitis and it kills 1.1 million people a year (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00851-6/fulltext# :~:text=A%20foundation%20focused%20solely%20on,Jacqui%20Thornton%20reports.)
• Hospitals are closed due to intense violence in Sudan (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00849-8/fulltext#:~:text=Health%20care%20across %20Sudan%20has,and%20looting%20of%20essential%20aid.)
• How Africa may be close to vaccine independence (https://www.nytimes.com/2023/04/25/health/africa-vaccine-independence.html)
• The WHO indicates that the situation of Mpox must be monitored, although the situation is encouraging (https://www.consalud.es/pacientes/infecciones/oms-senala-situacion-mpox-es-alentadora-pero-su- vigilance-is-necessary_129335_102.html)

International Health Policy

• USA
  • Fauci looks back and explains what went wrong in the pandemic. It is clear that, despite being the United States the richest country in the world, in the pandemic it did worse than many other countries. And there are the results (https://www.nytimes.com/interactive/2023/04/24/magazine/dr-fauci-pandemic.html)
  • Many American states are trying to restrict transgender treatments (https://www.nytimes.com/2023/04/22/health/transgender-adults-treatment-bans.html#:~:text=the%20main%20story-,Many%20States%20Are%20Trying%20to%20Restrict%20Gender%20Treatments%20for%20Adults,outlawing%20care%20for%20young%20adults.)

• China
  • Chinese censorship rewrites the history of the pandemic. Under pressure from the authorities, Chinese scientists are withholding data, removing genetic sequences from public databases and altering crucial details in the articles they publish (https://www.nytimes.com/2023/04/23/world/europe/chinese-censorship-covid.html)

• France
  • An agreement is about to be reached on the fee for the consultation of general practitioners: 26.50 euros (https://www.lemonde.fr/societe/article/2023/04/24/vers-un-nouveau-fee-for-consultation-chez-le-medecin-generaliste-a-26-50-euros_6170786_3224.html)

• European Union: great debate on the new pharmaceutical policy
  • The EU designs a plan to take control of drug production in the event of a health crisis. Through a “compulsory license” system, it is proposed, a company could be forced to share intellectual property and technical manufacturing know-how (https://www.ft.com/content/b777f019-ff02-41c3-8645-3d06e865f7fd)
  • The EU’s attempt to create a single market for medicines breaks certain industry rules. Try to pass the patent protection time from 10 to 8 years. Lowering the price of medicines can mean savings of 230,000 million euros for member states (https://www.ft.com/content/ace93ce5-7baa-41c5-9f6b-2a01e64914e4)
  • The pharmaceutical industry on the warpath over the EU plan to cut drug patents, says that it will sink research in Europe and will not improve access to drugs (https://www.elespanol.com/invertia/observatories/health/20230427/pharmaceutical-industry-guerra-eu-cut-patent-medicines/759174435_0.html)
  • Farmaindustria criticizes Brussels for its reform, saying that it puts the future of manufacturers at risk (https://www.consalud.es/profesionales/farmaindustria-responde-bruselas-nueva-legislacion-pone-en-riesgo-futuro-manufacturers_129296_102.html)
  • Diariofarma analysis: What does the European pharmaceutical reform consist of? (https://diariofarma.com/2023/04/26/en-que-consiste-la-reforma-farmaceutica-europea)
  • The EU proposes the biggest legislative reform for pharmaceutical companies in 20 years (https://cincodias.elpais.com/companias/2023-04-26/la-ce-plantea-la-mayor-reforma-legislativa-para-las-pharmaceuticals-in-20-years.html#)
  • The texts of what are still Commission proposals: a new Directive and a Regulation: (https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM%3A2023%3A193% 3AFIN&qid=1682545472834) and (https://health.ec.europa.eu/publications/proposal-directive-union-code-relating-medicinal-products-human-use_en)

• Europe
  • Air pollution prematurely kills 1,200 children and adolescents in Europe (https://www.lemonde.fr/planete/article/2023/04/24/la-pollution-de-l-air-tue-encore-prematurement-1-200-enfants-et-adolescents-par-an-in-europe_6170731_3244.html)
  • Europe fears outbreaks of polio and measles due to insufficient vaccination levels (https://elpais.com/sociedad/2023-04-26/europa-teme-brotes-de-polio-y-sarampion-por-los-insuficientes-vaccination-levels.html#)

National health policy

• Public healthcare
  • The new Minister of Health downplays the importance of waiting lists and affirms that “it is not the responsibility of the Government” (https://www.eldebate.com/sociedad/20230424/sanidad-quita-importancia-listas-espera-asegura-non-competition-government_109648.html)
  • 5% of Clínic discharges are under the home hospitalization formula: the home as the new hospital (https://www.diariomedico.com/medicina/empresas/el-5-de-las-altas-del-clinic-son-under-the-formula-of-hospitalization-home.html)

• Private healthcare
  • The IDIS Foundation publishes its annual document: “Private healthcare, contributing value” (https://www.fundacionidis.com/informes/analisis-de-situacion-de-la-sanidad-privada/sanidad-privada-aportando-valor-2023)

• Medical technology
  • The debt with technology manufacturers skyrockets to 731 million euros (https://www.larazon.es/sociedad/deuda-sanidad-fabricantes-tecnologia-dispara-731-millones_202304246445c9887f1ecd00019e2210.html#:~:text=According to%20the%20data%20that%20handles,to%20731%20million%20of%20euros.)

• Pharmaceutical policy
  • The WAIT 2022 report, which has just appeared, establishes the delays in different European countries, including Spain, for the incorporation of medicines. Spaniards have to wait an average of 629 days from the approval by the European Agency until they are available in Spain. Spain in the range of countries with the longest wait. The least expected countries are Germany and Denmark (https://www.abpi.org.uk/media/news/2023/april/efpia-wait-indicator-survey-2022-launches/)

Companies

• International News
  • Kaiser Permanente, about to acquire Geisinger. Kaiser Permanente, the large California-based company with 39 hospitals and 24,000 doctors, is looking to buy Geisinger, a small East Coast group, in order to develop a new company that will drive a nonprofit community health system (https://www.nytimes.com/2023/04/26/health/kaiser-permanente-geisinger.html)
  • Philips expects $600 million in litigation over defective devices (https://www.ft.com/content/3b42213e-ba82-4718-bb4e-f4fbe5f6206d)
  • Lilly requested approval for an obesity drug that could disrupt this market (https://www.ft.com/content/905f5e2e-2696-4a46-9446-5684667824c0)

• National News
  • The new “Incosol” in Marbella will replicate its model outside of Spain (https://www.elconfidencial.com/espana/andalucia/2023-04-30/incosol-marbella-replicar-modelo-fuera-espana_3620679/#:~:text=Ilanga%20Hospitality%2C%20el%20fondo%20de,hotelera%2C%20aun%20without%20official%20denomination.)
  • Top Doctors captures 8 million from the Mars Growth fund (https://www.expansion.com/economia-digital/companias/2023/04/26/64482eac468aebcc018b4582.html)
  • Spain receives 3.2 million doses of the HIPRA vaccine (https://www.consalud.es/pacientes/especial-coronavirus/espana-recibe-primeras-32-millones-dosis-vacuna-espanola-contra-covid-hipra_129381_102.html#)