Summary

From the point of view of Biomedicine, it seems that for the first time, apart from the complicated bariatric surgery, medicine will have a treatment for obesity, this disease that affects more than 1 billion people worldwide. With GLP-1 it seems that we are entering the phase of effective drugs against obesity. Generative AI, which is capable of generating new algorithms, based on the patterns and structure of the data, is called to play an important role in health care. It seems that cancer is growing at younger ages. The WHO declares the polypill, developed by the CNIC and Ferrer, as an “essential medicine”.

With regard to Global Health, a call by the editors of the most important scientific journals in the world, through a common article, for health professionals to get involved in the fight against the risk of nuclear war, since it seems that we are in a situation of risk not seen since the Cold War. The WHO detects progress in tobacco control in many countries, through the WHO Framework Agreement for Tobacco Control, signed 20 years ago.

Regarding International Health Policy, in the United States a cyberattack forces the paralyzation of the activity of several hospitals. In the United Kingdom, new diagnostic centers are being created to increase the capacity to carry out tests and reduce the waiting list. Of the 13 centers announced, 8 will be privately financed and managed. The waiting list is a political priority for Prime Minister Sunak.

If we talk about National Health Policy (Spain), the incidence of covid has risen since July. It is extremely striking that a new registry multiplies by four the official number of maternal mortality in Spain. Maternal mortality is precisely one of the indicators most taken into account when establishing the health of a country. The Health Accounts System document has been published, which updates the data with those of 2021. Between 2017 and 2021 there has been a 25% increase in health spending, including public and private. The MUFACE system is doubly threatened, firstly because of its high losses and, secondly, because the SUMAR program, Sánchez’s possible partner in a new government, is sponsoring its disappearance. The agreement signed in Aragon for the constitution of the new PP-Vox government contemplates resorting to public/private collaboration to address the waiting list. It should be noted that the integration of the workforce of the former Health Agencies of Andalusia has been completed, which affects 3,500 workers, who may be integrated as permanent statutory employees. An important regression, which reinforces the most rigid aspects of the public health system, precisely what the public hospitals with the configuration of public companies, unfairly called by the PP in Andalusia as “chiringuitos”, had tried to overcome with remarkable success. A blunder, not to use euphemisms, both from the Andalusian government and from the party that supports it. Information from the old management teams ensures that the deterioration is already taking place. If, rightly, an audit is required to see the results of the reversals of the concessions in the Valencian Community, something similar will have to be done in due course with these Andalusian hospitals.

In the field of Companies, internationally, Amazon launches a new documentation service based on generative AI. The pharmaceutical companies that had made cash with the covid vaccine are deflating, something that was already discounted by the market. At the national level, a new incursion of Magnum Partners into health, by buying the nutraceutical company Martínez Nieto. Apax acquires 50% of Palex, a company that had become a target for many funds, and which will surely herald a consolidation of the medical technology distribution sector.

Biomedicine

• Editorial in Science: Beating the wave of obesity. Obesity affects more than 1 billion people globally and many more are overweight. In 2023 the World Obesity Foundation predicted that the global economic cost would be 4.32 trillion dollars. Until now medicine had nothing to offer. Now glucagon-like peptides (GLP-1), initially to treat type 2 diabetes, show that appetite decreases, satiety increases and kilos are lost. Doubts persist, but it seems that we are entering the phase of effective drugs against obesity (https://www.science.org/doi/10.1126/science.adj9953)
• A lawsuit alleges that drugs used to lose weight cause “gastric paralysis” (https://www.ft.com/content/0f0d222c-3b73-41d7-9f3b-e17879930691)
• Science Article: Will Unpredictable Side Effects Cloud the Promise of New Alzheimer’s Drugs? There seem to be two problems: brain swelling (ARIA-E, for edema) and brain hemorrhage (ARIA-H, for hemorrhage) (https://www.science.org/content/article/will-unpredictable-side-effects-dim-promise-new-alzheimer-s-drugs)
• Generative AI and its impact on healthcare. Generative AI has algorithms that, in view of the patterns and structure of the data, is capable of generating new algorithms. Great potential in healthcare (https://medicalfuturist.com/generative-ai-explained-its-impact-and-future-in-healthcare/)
• AI in breast cancer screening as good as two radiologists (https://www.theguardian.com/society/2023/aug/02/ai-use-breast-cancer-screening-study-preliminary-results )
• Cancer hits hardest in the early part of life. Although two thirds of cancers are diagnosed over the age of 65, we are seeing an increase in cancer among young people in the developed world, particularly of the breast, colon, and pancreas (https://www.theguardian.com/commentisfree/2023/aug/04/cancer-is-striking-more-people-in-the-prime-of-their-lives-what-can-we-do-better)
• The Spanish polypill for the heart, declared an essential medicine by the WHO. This pill contains three active ingredients (acetylsalicylic acid, ramipril and atorvastatin) and has proven to be effective in cardiovascular events, reducing mortality by 33%, as demonstrated in the article published in the NEJM. Ferrer and the CNIC develop this pill, with the collaboration of Dr. Valentín Fuster (https://www.alimente.elconfidencial.com/bienestar/2023-08-01/polipildora-cardiovacular-lista-medicamentos-esenciales_3711628/)
• New drugs are not always better (https://elpais.com/salud-y-bienestar/2023-08-05/como-de-valiosos-son-los-farmacos-mas-novedosos-lo-nuevo-no-is-always-better.html). Original article: https://www.bmj.com/content/382/bmj-2022-074166#:~:text=Among%20FDA%20approved%20indications%20with,had%20high%20therapeutic%20value%20ratings.

Global Health

• Nuclear war risk reduction and healthcare professionals. Article published simultaneously in the most important scientific journals: British Medical Journal, The Lancet, JAMA and New England Journal of Medicine, among others. It is assumed that we are at risk of nuclear war in a situation not seen since the cold war (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01526-X/fulltext)
• Progress in tobacco control in many countries. Twenty years have passed since the signing by many countries of the WHO Framework Agreement for Tobacco Control, with the notable exceptions of Argentina, Morocco and the USA. Many countries are moving forward. Sweden will probably be the first European country to have “tobacco free” status. New Zealand’s initiative banning tobacco among young people and Canada’s putting an alarm note on every cigarette are being followed with interest (https://www.thelancet.com/journals/lancet/article/PIISt0140-6736(23)00051-X/fulltext)
• Leprosy emerges again in the USA and nobody knows why (endemic in Florida) (https://www.elespanol.com/ciencia/salud/20230804/lepros-emerge-nuevo-eeuu-nadie-sabe-enfermedad-sigue-present/783921662_0.html)
• Measles, polio and diphtheria are increasing in Europe (https://www.consalud.es/pacientes/infeccionesas/sarampion-polio-diphtheria-alcanzan-maximos-covid-en-europa-900-mas-casos_133036_102.html )
• More than 130 countries affected by dengue (https://www.lemonde.fr/planete/article/2023/08/03/plus-de-130-pays-affectes-par-la-dengue-dont-l- expansion-progressive-semble-ne-connaitre-aucune-limite_6184334_3244.html)

International Health Policy

• COVID19
  • Weekly covid report published by WHO, 3 August 2023. While five WHO regions have shown a decrease in cases and deaths, the Western Pacific region has shown an increase in cases and a decrease in deaths. covid is still a major threat. Maintaining surveillance and reporting is critical (https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19—3-august-2023)

• USA
  • Amid signs of rising covid cases, researchers brace for the “new normal” (https://www.nytimes.com/2023/08/02/health/covid-rise.html)
  • A cyberattack forces the paralyzation of the activity of several hospitals in the USA. Affected Prospect Medical Holdings, which manages 16 hospitals (https://www.redaccionmedica.com/secciones/sanidad-hoy/un-ciberataque-obliga-a-paralizar-la-actividad-de-varios-hospitales-en-eeuu-6931#)
  • For the first time, the FDA approves a pill for postpartum depression, which affects half a million women a year in the USA. (https://www.nytimes.com/2023/08/04/health/postpartum-depression-pill-fda.html)

• United Kingdom and National Health Service
  • New diagnostic centers to increase exploratory testing capacity in England. This will increase the diagnostic capacity by more than 750,000 tests and more than half of these centers will be financed by private capital. The government announced 13 of these centers, of which 8 will be managed by the private sector. Sunak has made NHS waiting lists a priority (https://www.ft.com/content/1f050548-feed-41dd-8775-0ad902a4bf96)
  • Primary care physicians want to receive fast track access to screening for heart problems and cancer. This is expected to affect one million patients and ease the pressure on hospitals (https://www.theguardian.com/society/2023/aug/03/gps-to-get-power-to-fast-track-patients-for-heart-and-lung-checks)
  • The NHS withdraws its financial support for the Oxford-based Cochrane Initiative UK (https://www.bmj.com/content/382/bmj.p1756)

• Israel
  • Israeli doctors protest. Along with many other professionals, they oppose the Netanyahu government’s plans to weaken the Supreme Court and, with it, liberal democracy (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00563-9/fulltext#:~:text=Israeli%20doctors%20say%20they%20will,an%20erosion%20of%20liberal%20democracy.)

National health policy

• COVID
  • The incidence of covid has risen 150% since July and reaches 75 cases per 100,000 inhabitants (https://www.elmundo.es/ciencia-y-salud/salud/2023/08/04/64ccf082e4d4d8c5048b45c5.html# )

• Maternal mortality in Spain
  • A new registry reveals that maternal mortality in Spain is four times higher than the official data. The registry of the Spanish Group for Obstetric Safety (GESO), raises the number of deceased women per 100,000 live births to 13.76, instead of the 3.26 collected by the INE and sent to international organizations. The new registry incorporates data from 60 Spanish hospitals of all sizes (https://elpais.com/sociedad/2023-07-31/un-nuevo-registro-revela-que-la-mortalidad-materna-en-espana-is-four-times-higher-than-the-collected-in-official-data.html)

• Increase in travelers with tropical diseases
  • Spanish hospitals detect a sudden increase in travelers with tropical diseases (https://elpais.com/sociedad/2023-08-05/los-hospitales-espanoles-detectan-un-subito-aumento-de-viajeros-con-tropical-diseases.html#)

• The publication of the Ministry of Health appears: System of Health Accounts 2021
  • Health spending in Spain has increased by 25% in recent years, going from 105,431 million euros in 2017 to 131,984 in 2021. In this period, public spending grew more than private (https://medicinaresponsable.com/health-actuality/increased-health-expenditure-spain?utm_source=Independent+&utm_medium=Referral&utm_campaign=August4Actualidad&utm_id=Partnership&utm_content=Expenditure). Access to the official publication of the Ministry: https://www.sanidad.gob.es/estadEstudios/estadisticas/sisInfSanSNS/pdf/SCSprincipalesResultados.pdf

• MUFACE
  • Civil servants fear that a new coalition led by Sánchez will mean the disappearance of MUFACE, which appears explicitly in the SUMAR program, apparently a personal bet by Errejón (https://www.vozpopuli.com/espana/funcionarios-fear-new-coalition-sanchez-assume-liquidation-muface.html)
  • Insurers will lose 567 million for the attention to employees of the MUFACE model (https://www.abc.es/economia/mutuas-perderan-567-millones-atencion-funcionarios-20230731192330-nt.html#)

• Public/private collaboration in health
  • PP and Vox sign a commitment in Aragon for greater public/private collaboration, particularly in the management of the waiting list (https://www.consalud.es/autonomias/aragon/aragon-acuerdo-sanidad-pp-vox_133126_102.html)

• Public healthcare
  • Following an agreement with the CESM, SERGAS creates a new supplement that Galician doctors who work simultaneously with the private sector will receive. It will be 720 euros gross per month, compared to 900 for the specific supplement. It will affect 630 doctors out of the 7,000 public health staff of doctors in Galicia (https://www.lavozdegalicia.es/noticia/galicia/2023/08/01/principio-acuerdo-medicos-trabajan-sanidad-publica-privada-cobren-specific-complement/00031690881098622629677.htm)

• Regression in terms of “new forms of management”
  • Andalusia finalizes the integration of the workforce of the health agencies, through which 6,500 workers from the old Agencies may become permanent statutory workers (https://wwew.plantadoce.com/publico/andalucia-finaliza-la-integracion-del-labor-staff-of-health-agencies.html#:~:text=2023%20-%2011%3A25-,Andalusia%20ends%20the%20integration%20of%20labor%20staff%20of%20health%20agencies,Process% 20b)

Companies

• International News
  • Amazon launches a new documentation service based on generative AI (https://www.healthcaredive.com/news/amazon-generative-ai-clinical-documentation-healthscribe/688996/)
  • The pharmaceutical companies that made cash with the covid are deflating after the pandemic. Logically, the problem will affect less to companies with a highly diversified business (Pfizer, AstraZeneca, J&J) and much more those in which the covid vaccine represented the core of their business (Moderna, BioNTech) (https://elpais.com/economy/2023-08-04/the-pharmaceuticals-that-made-cash-due-to-covid-deflate-after-the-pandemic.html)
  • The collapse in sales of the covid vaccine causes Moderna losses of 1.260 billion dollars in the second quarter (https://cincodias.elpais.com/companias/2023-08-03/el-desplome-en-las-sales-of-vaccines-of-the-covid-cause-to-modern-1260-million-of-loss-in-the-second-quarter.html#)
  • GSK sues Pfizer for RSV vaccine patent infringement (https://www.eleconomista.es/salud/noticias/12394911/08/23/gsk-demanda-a-pfizer-por-infraccion-de-patente-about-the-vrs-vaccine.html)
  • Biogen acquires Reata Pharmaceuticals for 6.655 billion euros (https://www.consalud.es/salud35/internacional/biogen-adquiere-reata-pharmaceuticals-supera-expectativas_133110_102.html)

• National News
  • Magnum Capital enters the Murcian Martínez Nieto, dedicated to food supplements and natural cosmetics (https://www.eleconomista.es/capital-riesgo/noticias/12396002/08/23/magnum-capital-entra-en-la-murciana-martinez-nieto-dedicated-to-the-food-sector.html)
  • Apax goes ahead of CVC and buys 50% of Palex for 500 million (https://www.expansion.com/empresas/2023/07/30/64c6c727e5fdea254e8b45f4.html)
  • Alantra fattens Health in Code with Genologica and prepares its sale in 2024 (https://www.expansion.com/empresas/2023/07/31/64c7e23f468aeb15738b4634.html)