Summary

From the point of view of Biomedicine, it is worth highlighting the review by The Lancet on lung cancer screening, which shows that the low-dose Scanner is effective in reducing mortality, although there are aspects of cost-effectiveness that they remain as a problem; neural implants in rats open the prospect of brain transplants; the gene therapy revolution, previously abandoned for safety reasons, is now in full swing; and mRNA vaccines, which may be useful for cancer, with fewer side effects than conventional chemotherapy. The debate on check-ups is current, proving, once again, that annual check-ups do not reduce mortality, and despite everything, they are increasingly in demand.

As regards Global Health, The Lancet publishes an editorial in which it tries to change the narrative of little hope until now on cancer, due to the great disparities between countries in this fight.

Regarding International Health Policy, the New England Journal Medicine magazine publishes an article that affects the approach to the new reality of the covid, despite the new perception as a minor nuisance, it continues to represent between 300 and 500 deaths a day in USES. According to The Economist, we will most likely never know the number of deaths from covid in China, since the official mortality figures are not credible. The crisis in the British NHS continues, which seems to have been exacerbated by Brexit. Prime Minister Sunak’s proposals are for more ambulances, more hospital beds and home care. El Mercurio, the leading newspaper in Chile, editorializes on the critical situation of the ISAPRES (health insurers) in that country, which could fall into insolvency, which occurs due to the government’s indifference to this situation.

If we talk about National Health Policy (Spain), the incidence of covid continues to drop, although mortality remains high. World Cancer Day (February 4) coincides with the appearance of interesting publications on the cancer situation in our country, both by SEOM and the OECD. This latest report warns Spain about accessibility problems. The implementation of cancer screening has been uneven, which leads to inequities between autonomous communities. Cancer already represents 10% of public health spending. The celebration of Cancer Day also coincides with two new inaugurations of centers dedicated to this disease: the Cancer Center of the Clínica Universidad de Navarra and the experimental oncology center of the Hospital 12 de Octubre in Madrid. The Ministry of Health of the Valencian Community announces the non-extension of the Denia concession contract. The Government publishes the Regulatory Plan for 2023, the law of the National Public Health Agency among the three health laws planned for 2023.

In the field of Companies, internationally, it should be noted that Pfizer is the first pharmaceutical company to reach revenues of more than $100,000 a year, thanks largely to the boost of the covid vaccine. As far as Spain is concerned, both Vitaldent and IMED are launching new centers. It seems that we are witnessing a fever of new private hospitals (Vithas in Barcelona; Sanitas in Madrid; Viamed in Tarragona; IMED in Alicante; Quirón in Asturias; and a long etcetera).

Biomedicine

• Review of The Lancet: Screening for lung cancer. The usefulness of cancer screening has been much discussed. The review demonstrates a reduction in mortality in cases of screening with low-dose Scanner, compared with normal radiography or no screening. There are doubts regarding some aspects to optimize clinical effectiveness and cost-effectiveness. This approach could be complemented by artificial intelligence and biomarkers. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01694-4/fulltext)
• Neural implants in rats pave the way for treating brain injuries, opening the prospect of brain transplants (https://www.ft.com/content/d8672e07-2276-44cb-b989-7a07790df392)
• First cardiac patients diagnosed using fiber optic technology at St. Bartholomew’s Hospital in London (https://www.ft.com/content/31df3204-d186-48f0-983b-fb0479a66ae8)
• Endometrial cancer: a scalpel capable of detecting malignant cells in real time (https://www.lemonde.fr/sciences/article/2023/02/03/cancer-de-l-endometre-un-bistouri-capable-de-detecter-des-cellules-malignes-en-temps-reel_6160346_1650684.html)
• The gene therapy revolution, the Phoenix bird that rose from its ashes. After the safety problems, we are at a time when new gene therapies are expected to be approved in the coming years and it is a scientific field in full expansion (https://www.eldiario.es/sociedad/revolucion-terapia-genica-bird-phoenix-resurgio-cenizas_1_9910729.html)
• Bispecific antibodies, the penultimate cartridge in the oncology arsenal, still in the clinical trial phase (https://www.elmundo.es/ciencia-y-salud/salud/2023/02/04/63dd431f21efa0417b8b4588.html)
• Can mRNA vaccines also be used to cure cancer? In this case they would be “therapeutic vaccines”, not preventive. Side effects are expected to be fewer than those of conventional chemotherapy. The investigation is advancing fast, but there are still unresolved problems (https://www.elmundo.es/ciencia-y-salud/salud/2023/02/04/63dd521ffdddff75a78b45ad.html)
• Should we have annual medical checkups? Experts warn that they have risks and do not reduce mortality (https://elpais.com/salud-y-bienestar/2023-02-03/deberiamos-hacernos-chequeos-medicos-anuales-los-expertos-advierten-de-that-have-risks-and-do-not-reduce-mortality.html)

Global Health

• Cancer globally: overcoming the narrative of lack of hope. Great disparities between countries in this fight. Childhood cancer, for example, has a survival rate of 80% in developed countries, but only 20% in developing countries (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00234-9/fulltext)
• Investment for equity in global health research. Large differences in equity research in the Global North (USA and Europe), compared to the Global South (https://www.nejm.org/doi/pdf/10.1056/NEJMp2213809)

International Health Policy

• COVID
  • Addressing the new reality of covid. The covid passed, in the popular perception from a terrible threat to a minor inconvenience with a few days of symptoms. The reality, however, is not that and the covid still means between 300 and 500 deaths a day in the USA, equivalent to a mortality higher than that of a serious flu epidemic. To this must be added the effects of persistent covid (https://www.nejm.org/doi/full/10.1056/NEJMp2213920)

• Changes in the United States
  • The implications of the results of the US elections in 2022 in health. Results of a survey conducted by Robert Blendon. It is striking that despite the fact that the United States is the country that spends the most on healthcare, the majority of the population thinks that little is spent. This opinion is very predominant among Democrats, but also in the majority among Republicans (https://www.nejm.org/doi/full/10.1056/NEJMsr2214949)
  • The response of the National Health Institutes (NHI) to covid (https://www.science.org/doi/10.1126/science.adf5167)

• China
  • The Economist wonders if we will ever know how many died in China from covid. The official data cannot be believed. Political discourse talks of much better mortality outcomes than the United States, but this is doubtful. Surely only the “excess mortality” data will allow us to glimpse the real number of deaths in China from the covid. (https://www.economist.com/china/2023/02/02/will-we-ever-know-how-many-people-died-of-covid-19-in-china)

• Serious NHS crisis in the UK
  • How to fix the NHS, asks a report in The Lancet. The NHS has suffered a serious winter crisis, in which serious problems for patients and low staff morale coexist. It seems that Brexit has contributed to make things worse. The LCE-The Lancet propose a budget increase of 102 billion pounds (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00232-5/fulltext)
  • Is the NHS ‘cradle to coffin’ approach broken? Financial Times makes history of the NHS and its perspectives (https://www.ft.com/content/d9db05e7-bb1c-4f38-9a02-bd6b66c9c99b)
  • Sunak’s response to the crisis: more ambulances, more hospital beds and home care. The Prime Minister says NHS waiting lists is one of his top five priorities (https://www.ft.com/content/6fa06598-95e8-4770-b8d4-39e1e8aea0e3)

• Health, at the center of politics in France
  • Medications: the government launches an anti-penury drug plan (https://www.lemonde.fr/economie/article/2023/02/04/medicaments-le-gouvernement-lance-un-plan-anti-penuries_6160494_3234.html)
  • The Senate relaunched the debate on the ratios of staff per number of patients in hospitals (https://www.lemonde.fr/societe/article/2023/02/02/le-senat-relance-le-debat-sur-les-ratios-de-soignants-par-name-of-patients-a-l-hopital_6160217_3224.html)

• Australia
  • Australia, the first country to test psychedelic substances for medical use (https://www.lavanguardia.com/vida/20230204/8733451/australia-primer-pais-aprobar-sustancias-psicodelicas-medico.html)

• Chili
  • The ISAPRES (health insurers), in danger, since the insurers could become insolvent. Editorial of El Mercurio (https://digital.elmercurio.com/2023/02/01/A/3847PP9K/light?gt=040001)

• Turkey
  • Turkish doctors warn of government persecution (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00233-7/fulltext)

National health policy

• COVID
  • The cumulative incidence at 14 days drops to 50.76 points. Mortality remains high: 278 deaths in the last week (https://www.consalud.es/industria/especial-empresas-covid-19/covid-espana-notifica-9053-casos-278-muertes-ia-baja-upto-5076-points_125933_102.html)
  • The mask will only be mandatory from February 8 in health centers, pharmacies and residences (https://www.elmundo.es/ciencia-y-salud/salud/2023/02/02/63dbe445e4d4d8e53f8b4579.html)

• World Cancer Day: February 4
  • The SEOM (Spanish Society of Medical Oncology) publishes the document: Cancer figures in Spain 2023 (https://seom.org/images/Las_cifras_del_Cancer_en_Espana_2023.pdf)
  • 2030 Goal: reach 70% survival in cancer, according to the Spanish Association Against Cancer, which promotes the “Todos contra el cáncer” initiative (https://diariofarma.com/2023/02/02/objetivo-contra-the-cancer-reach-70-of-survival)
  • OECD Publication: National Cancer Profiles: Spain (https://www.oecd-ilibrary.org/social-issues-migration-health/perfiles-nacionales-de-cancer-espana-2023_bab6e2e3-es)
  • The OECD puts homework on Spain in terms of accessibility to cancer. Problems in the distribution of radiotherapy equipment, reconstruction services and access to biomarkers (https://www.consalud.es/dia-mundial-contra-cancer-2023/ocde-pone-deberes-espana-en-accesibilidad-en-cancer-improve-distribution-resources_125922_102.html)
  • The implementation of the screenings has been uneven, which generates inequities between autonomous communities. National strategies are limited to breast, cervical and colorectal cancer, but their implementation has been uneven over the years. (https://www.consalud.es/politica/implantacion-cribados-ha-sido-desigual-en-ccaa-generando-inequidades_125872_102.html)
  • The cost of cancer continues to rise and reaches 10% of public health spending (https://www.plantadoce.com/entorno/el-coste-del-cancer-sigue-subiendo-y-copa-el-10-del-public-health-expenditure-in-spain.html)

• New cancer centers
  • New Cancer Center at the CUN: comprehensive care for cancer patients (https://www.diariomedico.com/medicina/oncologia/nuevo-cancer-center-de-la-cun-atencion-integral-para-el-paciente-oncologico.html)
  • Hospital 12 de Octubre opens a state-of-the-art experimental oncology center, with six experimental laboratories (https://www.lavanguardia.com/vida/20230203/8730848/hospital-12-octubre-estrena-centro-oncologia-experimental-six-laboratories-research.html)

• Medical conflict in public health
  • Ninth attempt to reach an agreement between primary care physicians and pediatricians and regional Madrid government (https://www.larazon.es/madrid/20230201/4fftuaufu5fbfpif65pvluhxzi.html)
  • Demonstration in Madrid on February 12 for Public Health and Primary Care (https://www.actasanitaria.com/opinion/punto-de-vista/madrid-manifestacion-12-febrero-por-sanidad-publica-atencion-primary_2004746_102.html)

• Abortion debate
  • The progressive sector of the Constitutional Court will endorse the abortion law without accepting limitations (https://elpais.com/espana/2023-01-30/la-mayoria-progresista-del-constitucional-avalara-la-ley-del-abortion-without-accepting-limitations.html)

• Public healthcare
  • The Department of Health of the Valencian Community communicates the non-extension of the contract and the reversion regulations of Denia (https://valenciaplaza.com/sanidad-comunica-marina-salud-no-prorroga-contrato-normas-reversion-denia)

• Health professions
  • Spain will lose 40% of midwives in five years and there is no expected replacement (https://www.epe.es/es/sanidad/20230131/espana-perdera-comadronas-cinco-anos-reemplazo-82263554)
  • Interesting article by José Luis Puerta: “What happens to doctors”. Something more than a salary problem and the number of doctors. Precariousness and temporary employment have been the characteristics of the employment policies of the National Health System (https://theobjective.com/espana/2023-02-04/que-pasa-medicos/)

• Regulatory framework
  • The Government publishes the 2023 Annual Regulatory Plan: the government plans to approve three laws and three healthcare decrees (https://www.lamoncloa.gob.es/consejodeministros/resumenes/Documents/2023/310123-PAN2023.pdf)
  • Regulatory Annual Plan, of the 177 regulations provided, only 6 are health: Laws: Law creating the State Agency for Public Health, Law Modifying the Framework Statute and Law on Guarantees and Rational Use of Medicines; Royal Decrees: Network of Epidemiological Surveillance, Health Technology Assessment and Drug Pricing (https://www.diariomedico.com/farmacia/politica/plan-anual-normativo-de-las-177-normas-solo-six-are-sanitary.html)

Companies

• International News
  • Pfizer, the first pharmaceutical company that invoices more than 100 billion dollars a year, the covid vaccine drives this growth (https://cincodias.elpais.com/cincodias/2023/01/31/companias/1675170451_878095.html)
  • GSK: Earnings exceed expectations (https://www.ft.com/content/658adf88-0448-4a51-aff7-adf7952a3aca)
  • Philips announces the abolition of 6,000 jobs, following losses linked to respirators (https://www.lemonde.fr/economie/article/2023/01/30/philips-annonce-la-suppression-de-6-000-emplois-apres-le-rappel-de-respirateurs_6159829_3234.html)
  • Roche reduces its profit in 2022, up to 13.565 billion euros (https://www.plantadoce.com/empresa/roche-reduce-un-9-su-beneficio-en-2022-hasta-13565-millones-de-euros.html)
  • Novartis plummets its profit by 70% in 2022, to 6.955 billion dollars (https://www.plantadoce.com/empresa/novartis-desploma-un-70-su-beneficio-en-2022-hasta-6955-millones-of-dollars.html)

• National News
  • IMED starts the works of its new hospital in Alicante (https://www.plantadoce.com/empresa/imed-arranca-las-obras-de-su-nuevo-hospital-de-alicante.html)
  • Vitaldent boosts its growth in Spain with two new clinics in Murcia (https://www.plantadoce.com/empresa/vitaldent-impulsa-su-crecimiento-en-espana-con-dos-nuevas-clinicas-en-murcia.html)