Summary

From the point of view of Biomedicine, it is worth highlighting the studies that show that certain types of breast cancer, which respond to chemotherapy, will not require surgery. The link between Alzheimer’s and certain viruses is surprising. As for proton therapy, it seems that an increase in its indications (prostate, lung, etc.) is in sight.

As far as Global Health is concerned, the WHO study on a prioritized list of fungal threats should be noted. Cases of resistant tuberculosis, on the rise, which is a big problem with high mortality. Shortage of cholera vaccines. “Nature” magazine considers the possible second term of Bolsonaro in Brazil as a threat to science, democracy, the environment and the world. Said alarm had already been launched by this magazine as a result of his first term.

As for International Health Policy, monkeypox is in clear recession and covid is apparently less serious, possibly due to increased immunity. The truth is that mortality and cases requiring hospitalization are falling. Plan in the United Kingdom so that pharmacies can collaborate in the treatment of minor disorders (hypertension, high cholesterol, etc.)

If we talk about National Health Policy (Spain), a surprising proposal from ASPE to the Ministry of Health for the homologation of foreign doctors through a kind of two-year express MIR. The problem is surely more complex and it should be considered that we are one of the countries with the most doctors per 1,000 inhabitants and the most Faculties of Medicine. To analyze the shortage by areas and specialties, as well as the expansion of nursing work. It is doubtful that exporting quality doctors after an excellent MIR and importing foreign doctors with an express MIR is the solution. Perhaps the salary and working conditions of Spanish doctors should also be considered. Also striking is the new approach of the PSOE in terms of the Trans law, which tries to involve judges in changing sex between 12 and 15 years, compared to the bill approved by the Council of Ministers, which did not contemplate this possibility. AESEG, very willing to increase the use of generics, through regulatory and price changes.

In the field of Companies, at the international level, the extensive job cuts at Philips are striking, after its withdrawal of devices for sleep apnea. As for Spain, Sanitas publishes a study on mental health, which shows that the private health sector is agile in its response to a serious problem, which has become more evident after covid. Orange’s agreement with Mapfre confirms the great interest of telecommunications platforms in the world of health and their need to ally with traditional operators.

Biomedicine

• A new study (Dr. Henry Kuerer, The Lancet Oncology) suggests that some breast cancers that respond well to chemotherapy may avoid surgery (https://www.nytimes.com/2022/10/25/health /breast-cancer-surgery.html)
• Some evidence for the role of a virus in Alzheimer’s disease, according to Prof. Itzhaki of Oxford. According to this theory, it would be an interaction between the common herpes virus (HSV-1) and the chickenpox virus (VZV) (https://www.ft.com/content/6d0185f6-21e8-4fe3-9776-a2170af99e82)
• Proton therapy, against more types of cancer. It opens the way not only for pediatric cases, but also for tumors of the lung, esophagus, liver, breast and prostate. (https://www.larazon.es/salud/20221027/3m3o3k3ejnf2rnn7ndirp6x5zy.html)
• Researcher Philippe J Sansonetti, winner of the second “Abarca Prize” for medical sciences. He comes from the Institut Pasteur and is considered one of the founders of Cellular Microbiology and known for his studies on the pathogenesis of the Shigella bacteria, which causes bacillary dysentery (https://www.elespanol.com/ciencia/investigacion/20221025/ researcher-philippe-sansonetti-abarca-prize-medical-sciences/713428861_0.html)

Global Health

• The WHO establishes a list of fungal threats, to guide research, development and public health. It is the first effort to prioritize fungal pathogens and they are classified into three categories: critical, high and low priority (https://www.who.int/publications/i/item/9789240060241)
• Cases of resistant tuberculosis on the rise, for the first time in 20 years, according to a WHO report. 10.6 million people developed the disease and there were 1.6 million deaths(https://www.ft.com/content/ddde76cf-6b83-4f79-be3e-247d5a987d95)
• Shortage of cholera vaccines. Increased demand and low production have led to one dose instead of two (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02116-X/fulltext)
• A missed Ebola vaccine can help the outbreak (https://www.science.org/doi/10.1126/science.adf4959)
• According to the magazine “Nature”, a second term for Bolsonaro in Brazil would represent a threat to science, democracy and the environment, as it has been in his first term. Similarities between Trump and Bolsonaro (https://www.nature.com/articles/d41586-022-03388-y)
• Polio returns to the USA, after a decline in vaccination (https://www.ft.com/content/3852baaa-58bf-4061-9255-88ccc46a2fe1)
• Doctors return to the single antibiotic pill to fight the rise of syphilis (https://www.ft.com/content/f6e341d6-b7fc-41ba-94f5-bb1e556b87dd)
• Climate change is already hitting the health of Europeans, deaths from heat and tropical infections are on the rise (Lancet Countdown 2022 study) (https://www.eldiario.es/sociedad/europa-sufre-impacto-change-climatico- health-growth-deaths-heat-tropical-infections_1_9652690.html)
• Stroke epidemic: cases will increase by 34% in the next decade in Europe (https://www.epe.es/es/sanidad/20221027/epidemic-ictus-casos-aumentaran-proxima-decada-europa-77780280)

International health policy

• Monkeypox
  • Important NEJM Review on Monkeypox (https://www.nejm.org/doi/full/10.1056/NEJMra2208860)
  • Most of those hospitalized for monkeypox in the US were HIV positive (https://www.nytimes.com/2022/10/26/health/monkeypox-hiv.html)
  • Monkeypox in recession, while lessons are learned for future outbreaks. There have been 29 deaths worldwide, out of 73,000 cases (https://www.ft.com/content/804104fc-14d4-40c8-9007-bb84c4b0e44d)

• COVID-19
  • Scientists discuss the suspicion that the covid virus may be a laboratory product. Although the official theory is that it is a zoonosis from the Wuhan market, a “preprint” was published on October 20 claiming that the virus is a product of genetic engineering (https://www.economist.com/science-and -technology/2022/10/27/scientists-dispute-a-suggestion-that-sars-cov-2-was-engineered)
  • Has covid become less serious? Although the short answer is “no”, the truth is that deaths and hospital admissions are falling, perhaps due to the increase in immunity of the general population (https://www.bmj.com/content/bmj/379/ bmj.o2516.full.pdf)
  • BQ.1.1, the new subvariant of covid in constant progression (https://www.lemonde.fr/planete/article/2022/10/25/covid-19-bq-1-1-le-nouveau-sous -variant-d-omicron-in-constant-progression_6147207_3244.html)
  • The EMA warns of another wave of covid in the coming weeks due to the subvariants of the omicron (https://www.elconfidencial.com/tecnologia/ciencia/2022-10-26/nueva-ola-covid-19-coronavirus- subvariants-omicron_3512933/)
  • China confines 28 cities, including Wuhan, and more than 200 million people (https://www.consalud.es/pacientes/especial-coronavirus/china-volve-confinar-city-wuhan-new-cases-covid_122114_102 .html)

• The debate on abortion following the annulment of the Roe v Wade judgment in the USA
  • Restrictions on abortion and mental health. The restrictions are especially severe for historically marginalized groups: mental illness and substance abuse patients (https://www.nejm.org/doi/full/10.1056/NEJMms2211124?query=featured_home)

• Other themes
  • Pharmacies in the UK will help with minor ailments from next year, including high blood pressure, high cholesterol, contraception and minor illnesses. NHS England Project (https://www.bmj.com/content/379/bmj.o2523)
  • Debate on the shortage of doctors in France (https://www.lemonde.fr/societe/video/2022/10/23/pourquoi-y-a-t-il-une-penurie-de-medecins-en-france_6147002_3224.html)

National health policy

• COVID
  • The incidence of covid remains at 220 points with 80 deaths in a week (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-suma-23753-casos-80-muertes- ia-holds-220-points_122202_102.html)

• Public health system
  • Madrid increases its health budget by 11% for 2023 (https://www.plantadoce.com/publico/madrid-incrementa-un-11-su-presupuesto-para-sanidad-en-2023-hasta-97896-millones .html)

• Private healthcare
  • ASPE requests express medical homologation of foreign doctors with a two-year MIR (https://www.redaccionmedica.com/secciones/privada/la-homologacion-medica-expres-con-un-mir-de-2-anos- at-the-table-of-darias-2189)

• Regulatory changes
  • Pediatricians also oppose the Trans law (https://www.vozpopuli.com/espana/pediatras-oponen-ley-trans-falta-consenso-debate-sanitarios-padres.html)
  • Important change of criteria: the PSOE wants to require judicial authorization for the change of sex of minors between 12 and 15 years of age (https://www.epe.es/es/igualdad/20221028/ley-trans-menores-psoe- 77845378)

• Other themes
  • The Ministry of Health approves treatments for metastatic breast cancer (https://www.consalud.es/pacientes/sanidad-tratamientos-cancer-mama-metastasico_122189_102.html)
  • AESEG wants a regulatory boost and a 10% rise in prices to reactivate generics. They say that in Spain we are at 41% of generics in units and 20% in economic value, while in Europe they are at 65% in units and 25% in values. The data in Spain have remained unchanged since 2015 (https://www.redaccionmedica.com/secciones/industria/rescate-del-impulso-normativo-y-adjustment-de-precio-para-reactivar-al-generico-7423)

Companies

• International News
  • Philips cuts 4,000 jobs worldwide after withdrawing its sleep apnea devices (https://elpais.com/economia/2022-10-24/philips-recorta-4000-empleos-en-todo-el -world-after-the-recall-of-its-sleep-apnea-devices.html)

• National News
  • Sanitas publishes a study on the state of mental health in Spain (https://www.consalud.es/pacientes/sanitas-comprometido-con-salud-mental-en-espana-2005_122024_102.html)
  • Kuwait entrusts Ribera Salud for the implementation of public/private hospitals in the country (https://www.elespanol.com/invertia/observatorios/sanidad/20221027/kuwait-encarga-empresa-espanola-ribera-hospitales- public-private/713928665_0.html)
  • Vitaldent continues to expand its presence in Spain with centers in Ourense and Calpe (https://www.plantadoce.com/empresa/vitaldent-continua-agrandado-su-presencia-en-espana-con-centros-en-ourense-y -calpe.html)
  • ASG Homes is preparing a 2,000-unit “senior living” platform in Spain (https://www.ejeprime.com/residencial/asg-homes-prepara-una-plataforma-de-senior-living-de-2000-unidades -in-spain.html)
  • Quirónsalud, the first hospital group in the world to obtain the Joint Commission International Enterprise accreditation (https://www.plantadoce.com/empresa/quironsalud-primero-en-obtener-la-acreditacion-joint-commission-international-enterprise.html )
  • Sha Wellness – the business of the Bataller family, which has a wellness center in Alicante – enters the hotel business with Marriott (https://cincodias.elpais.com/cincodias/2022/10/28/fortunas/1666967788_133470. html)
  • Orange -following Movistar and Vodafone- lands in health with its agreement with Mapfre (https://www.expansion.com/empresas/tecnologia/2022/10/25/63572366e5fdea922e8b4605.html)
  • Competition fines the pharmaceutical company MSD for abuse of its vaginal ring patent (https://cincodias.elpais.com/cincodias/2022/10/25/companias/1666689603_699850.html)
  • Almirall obtains the green light from the EU for its dermatological drug, with which it expects a sales potential of 450 million euros (https://www.eleconomista.es/salud/noticias/12013577/10/22/Almirall-obtiene -green-light-the-EU-for-your-drug-dermatology.html)