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7 days in healthcare (April, 1st-7th, 2024)

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Summary

From the point of view of Biomedicine, the report published by the French National Academy of Medicine on generative AI systems in health is worth highlighting. It makes 10 recommendations, the first of which is that all health professionals should be trained in the use of generative AI. It seems that anti-obesity medications (initially, anti-diabetes) may be the closest thing to a universal panacea. There is already evidence that they can have benefits in many other diseases: heart, kidney, liver, brain (Alzheimer’s and Parkinson’s), as well as other organs.

With regard to Global Health, concern continues over the difficulties of advancing the Pandemic Treaty. The Treaty aims to prevent governments, institutions and populations from the errors of the covid-19 pandemic. In this sense, a more than interesting article by Mariana Mazzucato on aspects related to innovation, intellectual property (IP), public/private collaboration and financing. The Lancet speaks out in an editorial against the use of starvation (the total lack of food and mass famine) as a weapon of war, as we have seen in the war in Sudan and currently in Gaza, where Israeli action is taking on dimensions of destruction of Gaza, with the consequent health and humanitarian problems. Prostate cancer cases will double between 2020 and 2040.

Regarding International Health Policy, the French Prime Minister, Gabriel Attal, proposes a fine of five euros for those who miss scheduled medical appointments. But possibly the most far-reaching news is President Petro’s actions in healthcare in Colombia, with the intervention of the two largest EPS (Health Promotion Entities). This breaks the approach of the Colombian health system based since 1993 on Law 100, which established public/private collaboration through the EPS, companies that received public aid and were in charge of providing health services to their insured population. There is no doubt that the proliferation of populist governments in Latin America is a threat against any form of public/private collaboration in healthcare, as is also the case in Chile where ISAPRES (private insurers that receive public aid) are also threatened. The universalization of health coverage – something absolutely defensible and one of the great advances of our time, today in full expansion – leads some to interpret this as a monopoly of health care by the State and even a colonization of the management model by the traditional Administration, thus breaking a desirable freedom of choice, as well as a certain competition for the coexistence of different management models.

If we talk about National Health Policy (Spain), the Interterritorial Council of the National Health System unanimously supports the Comprehensive Plan for the Prevention and Control of Smoking. However, the Plan is fundamentally a roadmap and a declaration of intentions, some of which will have to be materialized through laws, with the uncertainty regarding the approval of new laws generated by the situation of the current legislature. The plan aims to increase smoke-free spaces (not specified); avoid promoting tobacco products; access to smoking cessation programs; equate electronic cigarettes with conventional tobacco; and, increase taxes on tobacco. The most controversial thing may be to equate electronic cigarettes with conventional tobacco, since the risks and damage to health are not comparable. A recent article in the New England Journal of Medicine states that there is sufficient evidence to show that switching from cigarettes to e-cigarettes reduces exposure to tobacco toxins, reduces respiratory symptoms and reverses physiological changes related to smoking cigarettes. The Government’s Regulatory Plan for 2024 announces four laws in the health field: 1. statute-framework; 2. law of guarantees; 3. alcohol consumption prevention law; and, 4. law on public management of health services. Same comment regarding the uncertainty regarding the approval of laws. Among these laws does not appear that of the State Public Health Agency, already being processed in Parliament. Of note is the meeting at the Ministry of Health of a representation of the same with representatives of doctors who work for health insurers. Regardless of the outcome of this meeting, it was not common until now for the Ministry of Health to enter into the problems of private healthcare. But welcome if there is a change in this regard.

As for Companies, internationally, drug shortages have recently reached unprecedented levels in several European countries and last year reached a ten-year high in the USA. Regarding national information, Grifols admits changes in its debt level and Recoletas is expanding to several regions through its reproductive business.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (April 3rd-9th, 2023)

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Summary

From the point of view of Biomedicine, vaccines against cancer and heart disease, based on mRNA technology, which are looming on the horizon 2030, seem to be the next great advance in medicine, potentially saving millions of lives. The Economist dedicates an article and an editorial to demonstrate the weak evidence for the therapy of gender transitions in adolescents, especially when they include pharmacological or surgical medication. Contrary to what had been a very popular assumption, moderate alcohol consumption does not produce health benefits, according to a study of more than 40 years published by the JAMA Network Open. Rather the opposite is true.

As regards Global Health, the WHO, born after the Second World War, is celebrating its 75th anniversary. He has emerged from the pandemic with injuries and issues, but acutely aware of his mission, purpose, and need for change. One of the problems it encounters is the discrepancies between countries in the discussion of a treaty on pandemics, which it intends to be approved in 2024. The Lancet publishes several articles on the commercial determinants of health, a subject of great interest. interest. Four industries – tobacco, unhealthy eating, oil and fossil fuels, and alcohol – are responsible for a third of deaths each year globally.

As for International Health Policy, in the United States, a federal judge in Texas has just banned the use of an abortion drug, which had been approved by the FDA more than 20 years ago. In France, the citizens’ convention, made up of 184 citizens chosen by lot, has just ruled in favor of euthanasia and assisted suicide, although with certain “red lines”. Macron wants to discuss the bill before the summer.

If we talk about National Health Policy (Spain), surgical waiting lists set a new record, according to the report made public by the Ministry of Health, with data as of December 31, 2022. Almost 900,000 people waiting for a surgical intervention. An absolutely delegitimizing element of the system. As is well known, the Ministry only makes public the waiting lists for surgical intervention or specialist consultations, but not for special tests (radiology, radiotherapy, ultrasound, etc.), on which there are no national data, although there are some autonomous communities. Interesting article published in Gaceta Sanitaria on the economic impact of including dental care in public coverage. This is an issue that the majority political parties have been pronouncing in favor of for several years, but nothing has been done on it. Spain is possibly the European country with the least percentage of its health spending devoted to dental care. The declarations of the Minister of Health of Catalonia are surprising, justifying the dismissal of the nurses who criticized the Catalan C1. Since this type of statement about specific dismissals is not common among regional ministers, it is to be assumed that there is an important political background. The decision of Navarra and Asturias to launch public companies, one for medical transport and another for a hospital laundry, is also surprising. Wouldn’t there have been the possibility of resorting to private initiative to solve these needs, perhaps more efficiently than through a public company?

In the field of Companies, internationally, agreement between Medtronic and Davita to launch Mozarc. At the national level, it is worth noting the start of work on the Viamed hospital in Tarragona, and the separation of the “pharmacy” and “chemistry” areas of the company Esteve.

Biomedicine

Global Health

International Health Policy

National Health Policy

Companies