Summary

From the point of view of biomedicine, to review the Nobel Prize in Physiology and Medicine, won by Svante Pääbo, a scientist who is recognized for his studies on the DNA of human ancestors, which allows us to better understand genetic evolution towards the “homo sapiens”. It seems that a study with Artificial Intelligence of the eye will help predict coronary risk in minutes, without the need for blood tests or other studies.

As far as Global Health is concerned, it is believed that malaria could be definitively eradicated from the world, with the help of new vaccines.

As for international health policy, alerts in Europe about avian flu and diphtheria, brought by immigrants from Africa and Asia. To highlight the changes in Portugal, which incorporate an independent team to the management of the SNS.

If we talk about national health policy (Spain), the rise in covid cases prevents the Interterritorial Council from approving the abolition of masks on public transport. The health items in the General State Budgets are analyzed with a magnifying glass in the professional press, despite the low weight of the expenses of the Central Administration in the total health expenses. However, it allows to detect some priorities for the Ministry, although the economic items are usually below the challenges: primary care, genomic portfolio, mental health, dental care, primary care infrastructure, etc. The CEOE charges against the Equity Law, which it describes as “unprecedented risk”. The debates and controversies continue in relation to the delays in the incorporation of pharmaceutical innovation in Spain. However, these debates do not usually consider that the approval by the EMA of a medicine does not mean automatic public financing in Spain, according to article 92 of the Law on Guarantees and rational use of medicines, which establishes the “financing selective and not indiscriminate” according to a series of criteria, which are established. AESEG and BIOSIM no longer agree with the plan approved a couple of years ago on generics and biosimilars, but want the new approaches to be included in the Guarantees Law.

In the field of companies, in the international arena, BioNTech signs an agreement with Australia, for the establishment of research centers in that country. As for national news, the growing weight of online pharmacy (prescription drugs excluded by law). HM reinforces itself in Andalusia, incorporating four hospitals in Malaga into its network.

Biomedicine

• A Swedish geneticist working in Germany, Svante Pääbo, receives the Nobel Prize in Physiology and Medicine, for studies of the DNA of the ancestors of humans, which help to understand the evolution towards “homo sapiens” (https://www. .ft.com/content/285ac49d-4643-4aff-8a6c-e5c1460f3631)
• A study shows that Artificial Intelligence screening of the eye helps predict the risk of coronary heart disease in less than a minute, which would allow ophthalmologists and other health professionals to carry out cardiovascular screening without the need for blood tests. or blood pressure (https://www.theguardian.com/society/2022/oct/04/ai-eye-checks-can-predict-heart-disease-risk-in-less-than-minute-finds-study )
• Walking more steps is shown to decrease the percentage of premature deaths. For every 2,000 steps a day, the risk of premature death drops by 8 to 11%, according to a study published in JAMA Internal Medicine (https://www.washingtonpost.com/wellness/2022/10/04/ walk-more-steps-live-longer/)
• Medical care alone will not help slow the spread of type 2 diabetes, present in one in seven Americans, up from one in twenty in the 1970s. The conclusion is that there is no device or medicine capable of counteracting the effects of poverty, pollution, stress, an inadequate food system, living in cities not suitable for walking or poor access to the health system (https:/ /www.nytimes.com/2022/10/05/health/diabetes-prevention-diet.html)

Global Health

• New vaccines are believed to finally eradicate malaria. China and El Salvador were declared malaria-free in 2021; 25 countries hope to be able to do the same in 2025. Currently the bulk of the problem is in Africa. Hopes with the arrival of the two new vaccines: Mosquirix, already approved by the WHO, and the Oxford-AstraZeneca vaccine. On the horizon, the mRNA vaccine, to be developed by BioNTech (https://www.nytimes.com/2022/10/04/health/malaria-vaccines.html)
• Ebola control in Uganda. Without an approved vaccine, Uganda is struggling with initial support measures against the Ebola outbreak declared in September, 2022 (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01924-9/fulltext ?rss=yes)
• The health system in Afghanistan, under the Taliban. Afghanistan had made considerable progress in health before the arrival of the Taliban. One of the problems now is that young women cannot go to secondary education, which threatens their level of health (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01806-2 /fulltext)

International health policy

• COVID-19
  • A study shows that the covid vaccine can alter the menstrual cycle, although without serious consequences (https://www.economist.com/science-and-technology/2022/10/05/a-study-allays-fears-that -covid-vaccines-harm-menstrual-cycles)
  • China, on alert before the explosion of the covid, and the proximity of the communist party congress (https://www.ft.com/content/d9c2b333-0ce1-4444-9f21-54bb48193191)

• Europe
  • The ECDC warns that Europe is suffering the largest bird flu epidemic in history (https://www.elmundo.es/ciencia-y-salud/salud/2022/10/03/633a957021efa0442d8b4570.html)
  • The ECDC warns of a growth in diphtheria cases, mainly among immigrants from Africa and Asia. They have been detected in 7 countries (https://www.consalud.es/pacientes/infecciosas/ecdc-aumento-casos-difteria-fallecido_121224_102.html)

• Other themes
  • American insurers benefit from the public Medicare system, since more than half of those covered by Medicare (over 65 years of age) are covered by the private Medicare Advantage system (https://www.nytimes.com/2022/ 08/10/upshot/medicare-advantage-fraud-allegations.html)
  • Portugal tries to save its public health in a critical state, through a new SNS statute that contemplates the creation of an independent team, where Fernando Araujo, a doctor who until now was president of the board of directors of the Sao Joao hospital in Porto (https ://elpais.com/sociedad/2022-10-01/portugal-intenta-salvar-una-sanidad-publica-en-estado-critico.html)

National health policy

• COVID
  • Covid is on the rise in Spain, with a low hospital impact (https://www.diariomedico.com/politica/la-covid-19-esta-ascendiendo-pero-con-un-impacto-hospitalario-bajo-segun- darias.html)
  • Spain is the only country in Europe that still maintains entry restrictions due to covid (https://theobjective.com/espana/2022-10-08/restricciones-covid-turismos/)
  • The Interterritorial Council, held this week in A Coruña, does not address the removal of masks on public transport (https://www.consalud.es/pacientes/especial-coronavirus/interterritorial-no-aborda-retirada-mascarillas_121309_102. html)

• General State Budgets (impact on health)
  • This is how the 7,049 million euros for health will be distributed in the General State Budget for 2023. The expenses of the central Administration represent a minimal part of health expenses: genomic portfolio, 100 million euros; 24 million, implantation of proton therapy; 44 million, oral health; 173 million, improves Primary Care; 27 million, mental health plan; 500 million, primary care and mental health infrastructures; 1,116 million, fourth dose of covid; 200 million, COVAX program; 50 million for Universities, in order to increase the number of places for medical students by 1,000 (https://www.diariomedico.com/medicina/politica/asi-se-repartiran-los-7049-millones-de-euros- for-health-of-the-general-budgets-of-the-state-of-2023.html)

• Regulatory changes
  • The CEOE charges against the Equity Law, which it describes as “unprecedented risk” (https://diariofarma.com/2022/10/05/la-ceoe-carga-contra-la-ley-de-equidad -is-an-unprecedented-risk)
  • The AEMPS will include in the Law of Guarantees the bases that will govern “strategic medicines” (https://diariofarma.com/2022/10/05/la-aemps-incluira-en-la-ley-de-garantias-las -bases-that-govern-strategic-drugs)

• Health professionals
  • Physicians are considering fleeing Spain, 11,506 have received the certificate of suitability to work abroad in the last five years, although receiving the certificate does not mean that going to work abroad is consumed (https://www.elespanol .com/ciencia/salud/20221008/medicos-huyen-espana-triple-salary-better-schedules/708929502_0.html)
  • More than a dozen scientific societies ask that the scales of autonomous doctors be raised (https://www.diariomedico.com/medicina/profesion/mas-de-una-decena-de-sociedades-cientificas-piden-que -the-scales-of-autonomous-doctors-are-uploaded.html)

• Access to treatments
  • The IDIS Foundation publishes a report, warning of the delay in the incorporation of pharmaceutical innovations in Spain (https://www.actasanitaria.com/tecnologia/idis-senala_2003756_102.html)

• Other themes
  • Plan for generics and biosimilars, the industry against the national plan approved two years ago, which it considers outdated, and points to a different approach to be included in the new Law of Guarantees (https://www.redaccionmedica.com/secciones/ industry/the-industry-kills-the-generics-plan-for-outdated-and-points-to-another-law-7255)
  • The new massive data center of the SNS will have 65 million in 2023 (https://www.redaccionmedica.com/secciones/sanidad-hoy/el-nuevo-centro-de-datos-masivos-del-sns-contara- with-65-million-in-2023-6935)
  • Patients move around Spain, their clinical data does not. “Sometimes we have to serve them blind.” Semergen claims an interconnected clinical history (https://elpais.com/sociedad/2022-10-09/los-pacientes-se-mueven-por-espana-sus-datos-clinicos-no-a-veces-tenemos-que -attend-them-blind.html)
  • Important article by the economist José Luis Lancho in Sanifax: “Managing health care with public officials is doomed to failure, its cost is high and its productivity is low” (Sanifax, October 3, 2022)

Companies

• International News
  • BioNTech signs an agreement with Australia to establish research centers there (https://www.consalud.es/ecsalud/internacional/biontech-acuerdo-centros-investigacion-australia_121265_102.html)
  • Pfizer completes the acquisition of Biohaven Pharmaceuticals (https://www.plantadoce.com/empresa/pfizer-completa-la-acquisition-de-biohaven-pharmaceuticals.html)

• National News
  • The online pharmacy market is close to 300 million euros: personal care, OTC and nutrition products, among the best sellers (https://diariofarma.com/2022/10/04/el-mercado-de-la- online-pharmacy-close-to-300-million-euros-per-year)
  • 24Genetics joins forces with Quirón to sell its genetic tests (https://www.plantadoce.com/empresa/24genetics-se-alias-con-quironsalud-para-vender-sus-test-geneticos.html)
  • Prim acquires two companies in Italy (https://www.plantadoce.com/empresa/prim-se-va-de-compras-y-adquiere-dos-companias-en-espana-e-italia.html)
  • Thor will invest 20 million euros in a health complex in Jerez (https://www.plantadoce.com/empresa/thor-inviertera-veinte-millones-de-euros-en-un-complejo-sanitario-en-jerez. html)
  • HM lands in Malaga with an investment of more than 50 million, adding four hospital centers to its network (https://www.eleconomista.es/salud/noticias/11980434/10/22/HM-Hospitales-aterriza-en- Malaga-with-an-investment-of-more-than-50-million.html)
  • The family loses control of Grifols and a former Ceberus, Steven Mayer, takes the helm of the family empire, in the midst of a stock market crash (https://www.elconfidencial.com/empresas/2022-10-03/victor-grifols -leaves-presidency-steven-mayer_3500511/)
  • Rovi will invest 40 million in a compound production plant in Fraga (https://www.plantadoce.com/empresa/rovi-inviertera-40-millones-en-una-nueva-planta-de-produccion-de-compuestos -en-fraga.html)
  • Sanitas offers the data of its patients admitted to nursing homes for research (https://www.diariomedico.com/empresas/sanitas-ofrece-los-datos-de-los-ingresados-en-sus-residencias-para-investigacion.html )