7 days in healthcare (July 24th-30th, 2023)



From the point of view of Biomedicine, the mRNA vaccine for cancer and regenerative medicine seem to be the great promises in medical advances.

As regards Global Health, The Lancet dedicates an editorial to the need for a broader vision of women’s health, beyond maternal health. The most prevalent disease problems in women are the same as in men, but need insight into specific, poorly understood risks.

As for International Health Policy, the battle continues in the United States for the application of the new pharmaceutical policy that allows Medicare to negotiate the price of drugs, something that until now had been banned. This negotiation will begin in 2024 and it is expected that on September 1, 2023 the medicines on which it will be negotiated will be known. In a movement that seems to be ahead of events, several pharmaceutical companies (Janssen, Merck, Astellas Pharma and BMS) file a lawsuit against the American government. Apart from other possible considerations, it seems difficult to maintain that the price of medicines is much higher in the United States than in other countries, and not only in developing countries, but also in Europe. In the United Kingdom, the British Medical Journal focuses on the financing of pharmaceutical and medical technology companies to British scientific societies. For this, more transparency is required.

If we talk about National Health Policy (Spain), the political changes derived from the regional elections establish a new configuration of the Interterritorial Council, which will be numerically dominated by the PP (which will count, including the Canary Islands Coalition) 12 seats in the Council, by 3 of the PSOE (Castilla-La Mancha, Navarra, Asturias), 1 from the PNV (Basque Country) and 1 from ERC (Catalonia). The Radar Healthcare organization publishes a new ranking of healthcare systems and awards Spain a very favorable position in terms of quality. In general, these types of rankings must be looked at with a magnifying glass and consider the type of indicators analyzed and another series of circumstances. A biased and unprofessional interpretation of the international rankings on the Spanish health system has meant, in practice, a brake on the reforms. If we are so well, why reform anything? It is known that Spain is one of the OECD countries that devotes less public funding to dental care. What we did not know and what is now clear is that it has even dropped very significantly in the last decade, going from 5,245 million euros in 2010 to 3,681 in 2020. It seems clear that Spain, which globally has organized vaccination against covid very well However, it has failed to develop a vaccine: the HIPRA vaccine was delayed much longer than expected and the announced intranasal vaccine no longer even has a release date. It is difficult to compete with vaccines that appear less than a year after the onset of the disease, as has happened in the case of covid, with long development of vaccines that take years.

In the field of Companies, internationally, the president of Novartis (company of European origin) says that the price reform in the United States of medicines represents a threat to Public Health. At the national level, it is worth noting that spending on biosimilars has exceeded 1 billion euros in 2022, due to the fact that the patent for several biological drug molecules has expired and biosimilars have appeared.


Global Health

International Health Policy

National health policy

  • Changes in the Interterritorial Council
    • Changes in the political sign of the autonomous communities completely modify the political weights in the Interterritorial Council. The popular ones will have 12 seats (with the Canary Islands Coalition), compared to 3 for the socialists (Castilla-La Mancha, Navarra and Asturias), 1 for the PNV (Basque Country) and 1 ERC (Catalonia) (


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



From the point of view of Biomedicine, the contribution of Artificial Intelligence to medical diagnosis is reviewed by JAMA magazine. It seems clear that AI is not going to replace the so-called Narrative Medicine, that ability of the doctor to communicate and to listen and interpret the history of the patients. Interesting advances in the field of  a simple way to diagnose pre-eclampsia and Parkinson’s.

With regard to Global Health, more and more importance is given to loneliness and its consequences on health, according to an editorial in The Lancet. Hunger and famine as a product of human activity, especially armed conflicts, is treated by Nature. Concern regarding the AIDS situation in sub-Saharan Africa, where anti-retroviral therapy has barely reached.

Regarding International Health Policy, in the United States, the FDA approves the first drug to slow down the progression of Alzheimer’s. In the UK, three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) are addressing both the government and the opposition calling for solutions to the critical situation of the NHS. They denounce a decade of underfunding, which has led the UK to have far fewer human and material resources than most European countries. An interesting subscription model for antibiotics is being considered in the United Kingdom. Pharmaceutical companies will receive 20 million pounds per antibiotic put on the market, regardless of the prescription. In France, the Cour des comptes publishes documents to promote home palliative care and the development of advanced practice nursing. An interesting WHO-Europe document on hospitals and their challenges is published.

If we talk about National Health Policy (Spain), the beginning of the general elections on July 23, has made the different parties have made their programs public, including the health ones. The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title on emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about financing, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration. The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities are difficult to identify. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to the waiting lists does not go through a time guarantee law but rather resources and productivity of the public system and an updated and agile system of collaboration with the private sector. SUMAR incorporates the Podemos program: creation of a public pharmaceutical company; end of the MUFACE model; deprivatization plan, including cleaning, catering and laundry; progressive elimination of the pharmaceutical co-payment; they also announce a law on waiting lists. The Vox program represents an amendment to the whole: recentralization of health, recovering powers in health matters; approach waiting lists; repeal of the euthanasia and abortion law; strong criticism of the WHO, which they accuse of dependence on China. At the national level, the other great news is the alarm given by the insurers involved in the MUFACE model (Adeslas, Asisa and DKV) regarding the fact that its financing is generating large losses, unaffordable in the long term.

In the field of Companies, internationally, large pharmaceutical companies (Merck, BMS) are suing the American government for what they consider lowering prices, as a consequence of the anti-inflation law. In Spain, Ribera continues to bet on public/private collaboration, but this time in Portugal.


Global Health

  • Editorial of The Lancet: Loneliness as a health problem. In the UK and Japan there are loneliness ministers. The health damages are clear: cardiovascular disease, hypertension, diabetes, infectious diseases, depression and anxiety. Loneliness is not the same as being alone and can affect all ages (
  • Hunger and famines are not accidents, but facts created by human action. Around 200 million people experience acute food insecurity. Especially Afghanistan, Burkina Faso, Ethiopia, Mali, Sudan and Syria. Hunger and conflict are connected (
  • HIV in Africa. Antiretroviral therapy has transformed AIDS into a chronic disease. But in sub-Saharan Africa, where 70% of AIDS patients live, few have access to this therapy, which greatly decreases life expectancy in the area (

International Health Policy

  • COVID19
    • Weekly covid report published by the WHO, July 6, 2023. The African region has shown a slight increase in deaths with a decrease in cases. The remaining five WHO regions show a decrease in both the number of cases and deaths (
  • United Kingdom and National Health Service
    • Three health think tanks (King’s Fund, Nuffield Trust and The Health Foundation) address government and opposition on NHS issues. They are betting that the next election will end short-term politics in the NHS. The recovery of NHS services and waiting lists must be a priority. They denounce a decade of underfunding. They welcome the long-term plan on personnel, published last week. They point out that life expectancy is the second worst (before only the USA) of the 19 health systems analyzed in the King’s Fund report (
    • The NHS intends to roll out the subscription model for antibiotics. Under the new proposal pharmaceutical companies would receive £20m for their new antibiotics, regardless of how many may be prescribed (

National health policy

  • 23 J elections: the health program of the PP
    • The PP dedicates 24 measures to health. The strong points are: the Primary Care Shock Plan (although the title urgent and emergencies is debatable); the State Public Health Agency; the Agency for Innovation and Quality (similar to NICE); digitization; palliative care; and, the mental health strategy. A new General Health Law is announced. Although the current law has many obsolete points, the legal technique of addressing a new law (instead of partial reforms in relation to different issues) is debatable. There is a risk of opening a very large melon, of generating long delays and of putting health into the same dynamic as education (a law for each new government). Conspicuous absences: nothing about funding, no mention of waiting lists (one of the most serious problems in the system), dental care (an area in which we are very far from Europe) and nothing about public/private collaboration (
  • 23 J elections: the health program of the PSOE
    • The PSOE program continues to identify public service with public management, thus distancing itself from any form of public/private collaboration. Many measures are contemplated, seeming more like a government plan than an electoral program, so the priorities do not look good. The star measure seems to be announcing a law on waiting lists. Laws on waiting lists have never been effective in any autonomous community. The solution to waiting lists does not go through a time guarantee law but resources and productivity of the public system and an updated and agile system of collaboration with the private sector (
  • 23 J Elections: SUMAR’s health program



7 days in healthcare (April 17th-23rd, 2023)



From the point of view of Biomedicine, this week, exceptionally, two important advances in Spain are mentioned. On the one hand, the important investigations of the team led by Dr. Obeso, at HM Hospitales, on how to “open” the blood-brain barrier, that barrier that, among other things, prevented the arrival of drugs to the brain. It seems that in this way possibilities could be opened for the treatment of Parkinson’s. On the other hand, at the Vall d’Hebrón Hospital in Barcelona, the first robotic lung transplant was approached through a small incision.

As far as Global Health is concerned, there is a great alarm, highlighted by UNICEF and The Lancet magazine, about the drop in immunizations in children after the covid. Although the covid highlighted the efficacy of the vaccines, it brought the side effect of this drop in immunizations globally. In Uganda, the new anti-homosexuality law takes repression against this sexual option to an extreme, endangering anti-HIV campaigns in that country. The G7, to be held in Japan in May, emphasizes various health issues, including the importance of universal health coverage and the need for resilient health systems.

Regarding International Health Policy, the WHO warns of the non-solution of the covid problem, since in the last 28 days there were 23,000 deaths and 3 million new cases globally, even with reduced test figures. High mortality in the USA, with around 245 deaths per day. In the United States, the government is preparing to finalize the guidelines for negotiating the price of drugs in Medicare in July, something totally new in that country and that is shocking the pharmaceutical industry. The American Supreme Court rectifies its previous decisions and allows the abortion pill mifepristone to continue to be used, amid abundant criticism of the Court, for having questioned something that the FDA had already authorized more than 20 years ago. According to The Economist, the annulment of the Roe v Wade ruling caused the number of abortions in the USA to drop by 6%. In the United Kingdom, the consequences in the NHS of the multiple and continuous strikes and conflicts of health personnel continue. The German government is clashing with other European governments in its efforts to reduce the timeframe for generics to appear, calling into question the pharmaceutical investment model, according to some.

If we talk about National Health Policy (Spain), the incidence of covid continues to rise, amid controversies about the advisability or not of suppressing masks where they are still mandatory (health centers, social health centers and pharmacies). Conflicts with health personnel continue in several autonomous communities. In public healthcare, quite important allocation of resources by the Ministry to primary care and mental health. In private health, in the first quarter of the year there was a growth of 7.5% in the policies of private health insurers. “Voting with your feet” is called that figure. The IDIS Foundation focuses, through an interesting publication, on an important problem: the mental health situation in our country. Since we have few problems, Catalonia insists on an artificial conflict: the use of Catalan in the healthcare system in that autonomous community. Both in Aragon and in Castilla-La Mancha, two initiatives of dubious utility and even suspected of electoralism are launched. In Aragon, a national debate on health is proposed through a very typical document of those that come out in the autonomous communities that could be summarized as “More money for health without reforms.” As for Castilla-La Mancha, a law on waiting lists is promoted, when the terminal state of the legislature suggests that it will not be approved.

In the field of Companies, internationally, Nestlé is accused of manufacturing unhealthy products, due to their high load of fat, sugar and salt. Merck makes a major investment buying Prometheus Biosciences for $11 billion. At the national level, Moderna opens a laboratory in Madrid.


Global Health

International Health Policy

National health policy


7 days in healthcare (March 7th-12th, 2023)


From the point of view of Biomedicine, the geneticist Francisco J Ayala, one of the great Spaniards of science, with important contributions in the field of the human genome and other diseases, dies. Some obscure episodes, not fully clarified, pointed to him as a target of the “me too” initiatives. It is increasingly clear that gene therapies will soon explode and will be useful in multiple hematological, cardiac, ocular, muscular and even neurodegenerative processes. An ethical reflection is essential, which ensures, on the one hand, that these treatments are accessible, and, on the other, the limits of these treatments. It seems that we are closer to having specific treatments against fatty liver, a serious disease responsible for tens of thousands of deaths.

As regards Global Health, young people, including adolescents, with gender dysphoria are growing all over the world. There is no accepted professional consensus on how to approach these situations. It seems increasingly clear that inequality in the face of covid vaccines responsible for thousands of deaths from this disease. Although there is no absolute consensus, it seems increasingly clear that smartphones and social networks are responsible for serious mental health problems among young people. 24/7 access to these technologies minimizes face-to-face contact between young people.

Regarding International Health Policy, the WHO maintains the covid as a “health emergency of international concern”. In the United States, the budget presented by Biden – which will not be approved – proposes a significant increase in funds for Medicare. Problems continue for the Walgreens pharmacy chain for not selling abortion pills in 21 states. The USA plans to eliminate hepatitis C, almost a decade after highly effective therapies for this disease appeared. Concern in the United Kingdom about the interruption of the improvement in life expectancy for a decade, before the covid, contrary to what is happening in France or Denmark, for example. Australia is preparing to tackle a health reform, after the preparation of an independent report, a model that could well be inspiring for Spain. Newsweek magazine publishes its well-known ranking of the best hospitals in the world. The Mayo Clinic, in Rochester, and the Cleveland Clinic, in Cleveland, considered the best hospitals in the world. Among the first hundred there are 6 Spaniards, all of them public, except one private: the Clínica Universidad de Navarra (CUN).

If we talk about National Health Policy (Spain), in terms of covid, the accumulated incidence continues to rise slightly, with a fairly high mortality (139 patients in one week). In Castilla y León, the health areas will have access to a team on rare diseases. Serious concerns among psychiatrists about the large increase in cases of gender dysphoria. The actors in the cyber attack on the Hospital Clínic de Barcelona request a ransom of 4.5 million dollars, which the Administration refuses to deliver. Some Catalan doctors are organized to attend only in Catalan, something against repeated court rulings and the Generalitat’s own protocols.

At the Corporate level, at the international level, investors are rubbing their hands at the prospects of big business in anti-obesity drugs. Morgan Stanley has quantified what this can mean in billions of dollars worldwide. Pfizer places its vaccine against covid as the drug with the highest income in the world. At the national level, Quirón reaches an agreement with the City Council for the construction of its hospital in Gijón and Hospitén announces the construction of a new hospital in Madrid with a large investment of 160 million euros. Thus, the boom in new private hospitals continues, for which there is a real race in which several actors participate (Quirón, Viamed, Vithas, Hospitén, Imed, and others). Hipra will return aid to the covid vaccine in ten years.


Global Health

International Health Policy

  • Best hospitals in the world
    • Newsweek magazine publishes its traditional ranking of the best hospitals in the world. The first three are: the Mayo Clinic in Rochester, the Cleveland Clinic in Cleveland, and the Massachusetts General Hospital in Boston. Among the first 100 are 6 Spanish hospitals: La Paz, (53); Barcelona Clinic (62); October 12 (72); Vall d’Hebrón (83), Gregorio Marañón (90) and the CUN (97) (

National health policy


7 days in healthcare (December 12th-18th, 2023)



From the point of view of Biomedicine, The Lancet commemorates the 200th anniversary of the birth of Pasteur, the creator of the germ theory. Even today a high percentage of deaths are from infections. Promising results of an mRNA vaccine against melanoma, presented by Moderna and Merck.

As far as Global Health is concerned, it is worth highlighting the article published in Nature that says that without a strategy and global financing of vaccines, the world will be unable to successfully face new epidemics.

As for international health policy, the discouraging news of China’s abandonment of the covid-zero policy continues, when the country is not prepared and is most likely to suffer high mortality. The CDC quantifies the deaths from persistent covid in the USA. The conflict of nurses in the NHS continues, which coincides with the appearance of a report from the Institute for Fiscal Studies in the United Kingdom that attributes the problems of the NHS to underfunding of the system. New Zealand, the second country in the world to announce a ban on tobacco sales.

If we talk about national health policy (Spain), in terms of covid, the incidence continues to decrease, what has not completely decreased, or has decreased very slowly, is mortality (236 deaths in the last week). After confinement in a unit of the Regional Ministry of Health, the strike committee of primary care doctors in Madrid decided to continue the strike, extending the conflict to a demonstration, along the lines of the “white tides”.

In the field of companies, internationally, it seems that Jeff Bezos and Bill Gates are making an important bet in the field of neurotechnology with the company Synchron. As far as national news is concerned, perhaps highlighting that it seems that the hopes placed on the Spanish HIPRA vaccine are fading.


Global Health

International Health Policy

National health policy





7 days in healthcare (February 21-27, 2022)


From the point of view of biomedicine, Bill Gates predicts another pandemic, although he estimates that he will catch us better prepared. Also to highlight the questioning of the traditional form of clinical trials. The latter is important, since Spain has become a power in clinical trials and it is important to analyze whether it is the right bet.

In terms of global health, it should be noted that COVAX has distributed exactly half of the COVID vaccines that it had as its objective. A great inequity in the distribution of vaccines in the world and, now, also of medicines against COVID.

As for international health policy, great controversy in the United Kingdom due to the lifting of all restrictions against COVID.

In national health policy (Spain), the incidence of COVID is low, although we continue with high mortality and without antivirals. The Ministry of Health takes the expansion of the service portfolio to a public hearing. Medical uneasiness before the reform of the Abortion Law, a BIOSIM proposal to promote the use of biosimilars and controversy over the financing of orphan drugs.

With regard to companies, it should be noted that the manufacture of Ventolín and Nolotil pollutes more than the automotive industry, which indicates how far the pharmaceutical industry has to go in implementing the United Nations Sustainable Development Goals. Also that Quirónsalud has exceeded the turnover of 4,000 million and Fresenius is open to incorporating new shareholders both in Quirónsalud and Eugin.






o The incidence of COVID continues to drop to 613 cases per 100,000 inhabitants (

o 245 deaths in the sixth wave and still without antivirals (

o The subvariant of the stealthy “ómicron” accelerates its expansion in Spain (

  • Political announcements

o The Ministry of Health takes out the draft order for the expansion of the service portfolio for a public hearing. Opinions in this regard can be sent via email until March 10 (

o AIReF announces a study on MUFACE spending in its plan for 2022 (

  • Other issues

o The medical groups, against the reform of the abortion law, propose the obligatory nature of performing it in public hospitals (

o Biosim presents 14 proposals to stimulate the use of biosimilars ( )

o Great controversy over the financing of orphan drugs, while the Ministry publishes a report with improvements in financing since 2016 ( others insist that more than 50% of these medicines are not publicly funded (

o The strategic health reserve today has 466 million masks and 955 respirators (



7 days in healthcare (January 17-23, 2022)



From an international point of view, the article published in The Lancet should be highlighted, in which mortality due to antimicrobial resistance, one of the most important causes of death in the world, is analyzed at a global level. Also the demand of the British Medical Journal that the scientific community have access to all the original data on the clinical trials of vaccines, since at this time these data are only accessible to employees of pharmaceutical companies. The Economist analyzes if the mandatory nature of the vaccine works, concluding that it does. It looks like all the COVID restrictions in England are going to end soon. The European Union gives more powers to the EMA, in case of having to manage future health crises.

As for the national news, the pandemic is still unchecked, in very high numbers and with high mortality; the debate on treating the covid as influenza continues, with opposing positions, those who are against it and those who defend it; the Ministry of Health wants to advance in the recertification, in dialogue with the FACME and the Organization of Medical Orders; The situation of health insurance in 2021 is presented, which did not stop growing, until the sector as a whole reached a turnover of close to 10,000 million euros; the Madrid College of Physicians signs a controversial agreement with UNIPROMEL, in theory to “defend doctors in free practice”, but, more possibly, with the intention of reinforcing the current weakened board of directors.

As far as companies are concerned, perhaps the most outstanding news is the sale by IBM of Watson Health, the artificial intelligence solution, designed to solve diagnostic and therapeutic problems, which had had so many problems in some centers such as MD Anderson from Houston. Although it was a good and ambitious idea, it was possibly ruined by short-termism, hyperselling and not taking enough into account the complexities of medicine and medical practice.


  • The Lancet publishes an article on the mortality of antimicrobial resistance. 204 countries and territories are analyzed in 2019. 4.95 million deaths from antimicrobial resistance were found in 2019. Antimicrobial resistance is one of the most important causes of death in the world (The Lancet, 20 January 22)
  • The British Medical Journal, after the Tamiflu experience, asks that the original data (raw data) from the clinical trials of vaccines be accessible to all researchers, not just those from the pharmaceutical industry, as is the case now (BMJ, January 19, 22)
  • The WHO gives the green light to the wider use of the third dose against COVID (FT, January 21, 22)
  • The fourth dose of the vaccine, infective in the extension of the “ómicron” variant, according to an Israeli study (FT, January 18, 22)
  • The Economist analyzes if the compulsory nature of the vaccine works. After analyzing the cases of Canada, France, Italy and Germany, he concludes that it works (The Economist, January 22, 22)
  • The covid passport strengthens the economy and vaccination (FT, January 18, 22)
  • Bill Gates warns against a pandemic potentially worse than COVID and calls on governments to spend billions of dollars to prevent it. He also says that this effort can contribute to improving the prevention and treatment of current extended diseases: HIV, tuberculosis, malaria (FT, January 19, 22)
  • All restrictions in England may end in March, according to the British Prime Minister’s plans (The Guardian, 17 January 22)
  • The EU approves the reform that gives more powers to the EMA in the management of future health crises (The Objective, 20 January 22)
  • Italy registers an increase in vaccination, after making it mandatory for those over 50 years of age (El País, January 17, 22)


  • Situation of the pandemic

o COVID, still unchecked, breaks a new record of 3,418 cases per 100,000 inhabitants (El País, January 21, 22)

o The ICUs are at the limit of their structural capacity but far from the worst moments (El País, January 17, 22)

  • Debate about dealing with the covid as if were “flu”

o Two opposing positions:

 “Gripalizing the covid or how to believe we are winners”, article by Santiago Cervera, January 15, 22)

 Antonio Zapatero is committed to self-care and not to restrictions (El Español, January 17, 22)

  • Sick leave

o Processed 21,000 sick leaves and registrations in Madrid in the first days of the new system (El País, January 20, 22)

o The doctors accuse Escrivá of violating the law with the casualties, by giving in the same act for 7 days (La Razón, January 17, 22)

  • Recertification

o The Ministry of Health commits with FACME and the WTO to promote professional recertification (Acta Sanitaria, January 21, 22)

  • Situation schools

o The avalanche of school confinements puts families on the ropes (El País, January 21, 22)

  • Health insurance

o Health insurance grows by 4.93% in 2021 and totals 9,849 million euros (Acta Sanitaria, January 18, 22)

o According to forecasts by Javier Murillo, health insurance will grow in 2022 by around 5.5-6% (presentation at ICEA)

o MJ Montero (Finance Minister): great support for the MUFACE system (MUFACE Magazine, nº 252, winter 2021)

  • Other issues

o Organ transplants overcome the slump of 2020 and grow 8% in 2021 (El País, January 21, 22)

o Argimón presents the 2021-2025 health plan (Consalud, January 20, 22)

o Health, forced by Transparency to deliver to Farmaindustria the minutes of the Pharmacy Commission of the Interterritorial Council (diariofarma, January 16, 22)

o The MIR exam will bring together candidates from 4 continents and 88 countries (redacción Médica, January 20, 22)

o The Madrid College of Physicians signs an agreement with UNIPROMEL, “to defend free practice physicians” (Official Note ICOMEM, January 21, 22)

o Health awards 81 linear accelerators, in compliance with the INVEAT plan, three lots: Ab Salud, Varian and Elekta (ConSalud, January 18, 22)


  • IBM sells Watson Health to an investment firm. The sale was preceded by resounding failures of this artificial intelligence tool for medical diagnosis and treatment (WSJ, January 21, 22)
  • Moderna intends to launch a joint COVID-flu vaccine in two years (The Guardian, January 17, 22)
  • Djokovic has 80% of the shares in a Danish biotech firm (QuantBioRes) that intends to release a vaccine against COVID (The Guardian, January 19, 22)
  • Pfizer becomes the largest provider of the pandemic and it is estimated that it will double its income (, January 17, 22)
  • Pfizer, AstraZeneca and the Chinese Sinopharm and Sinovac will manufacture 70% of the COVID vaccines (CincoDías, January 20, 22)
  • Merck entrusts the manufacture of its pill against COVID to 27 manufacturers (PlantaDoce, January 20, 22)
  • More than 100 laboratories in Asia and Africa could manufacture vaccines for Pfizer and Moderna (El Independiente, January 19, 22)
  • The “telecos” take advantage of the pandemic to add clients in telemedicine (El Independiente, January 19, 22)
  • AstraZeneca, the most widely used COVID vaccine in the world that is no longer administered in Spain (El Español, January 21, 22)
  • St John of God (important hospital network in Spain, until now divided into three “provinces”) consolidates its management structure at the national level (Acta Sanitaria, January 20, 22)
  • Acciona, Sacyr and OHLA bid for a new hospital in Chile for 265 million euros (PlantaDoce, January 16, 22)
  • Dental Residency, objective by 2022 to double billing and provide coverage to 250,000 residents (PlantaDoce, January 20, 22)
  • The EMA asks HIPRA to show greater efficiency than Pfizer, if it wants to be part of the European Union’s portfolio (El Economista, January 18, 22)
  • HIPRA will carry out the last clinical trial of its vaccine at HM Hospitals (El Economista, January 17, 22).
  • Viamed is preparing an offer for one of the “Catholic” hospitals in Madrid: San Francisco and Beata María Ana (Sanifax, January 21, 22)
  • ASISA renews its Board of Directors with three members, one internal and two independent directors (Europa Press, January 20, 22)
  • Mercadona offered the Government to sell tests in its establishments at 2.90 euros. The Government preferred to keep pharmacies as the only test point of sale (Sanifax, January 20, 22)
  • Lilly publishes an overview of start ups in health in Spain (Lilly, January 22)

7 days in healthcare (January 10-16, 2022)



From the international point of view, several issues stand out. In the first place, the agreement of the French Assembly taken on Sunday, January 16, to prevent the access of the unvaccinated to leisure and restaurant premises; also Quebec’s initiative to introduce special taxes on the unvaccinated; the WHO’s opinion that it is too early for COVID “flu” policies, as proposed by Spain; the calculation by ISGlobal (Barcelona) that COVID has already left 17 million deaths globally; and the big push for research on neurodegenerative diseases.

As for national news, the SEMFYC (one of the Primary Care medical societies) editorial had a great impact defending the “flu” policies of COVID and, therefore, the minimization of measures, encouraging, consciously or unconsciously, the “light” negationism. This position was quickly adopted by the central government and certain authorities of the Community of Madrid. The central government even tried to lead this position at the international level. Rejection of this idea by other Primary Care societies, a large number of experts, the WHO and the EU. Meanwhile, the incidence of COVID continues to rise to figures never seen in other waves (2,923 cases per 100,000 inhabitants). The price of antigen tests is regulated, after multiple requests from various groups. It is agreed to extend the third and fourth doses. Serious problems regarding sick leave, for which solutions are articulated about the legality of which is in doubt. The purchase of COVID medicines is announced. Ayuso Plan to stimulate the birth rate in Madrid.

As far as companies and other actors are concerned, a group of scientists in Texas announce a vaccine against COVID, which, according to them, it will be cheaper, easier to make and patent-free. Pfizer announces that it will have a new vaccine against the “ómicron” variant ready in March


  • France: the Assembly approves by 215 votes against 58 the law that prevents the access of the unvaccinated to leisure and restaurant venues (Le Monde, Jan 16, 22)
  • Quebec’s plan on special taxes on the unvaccinated is well received in Europe. the argument is: “10% of the population cannot overload 90%”. Cold reception at the federal level in Canada and in other provinces. However, in Europe it is not receiving a bad reception: Greece and Austria already fine the unvaccinated, Italy is studying it, France extends the “covid passport” (BMJ, Jan 14, 22)
  • Fourth dose in Israel, which had already been announced for the immunosuppressed, is now being extended to health professionals and those over 60 years of age (Lancet Respir Med, Jan 11, 22)
  • The WHO considers that it is too early to treat COVID-19 as endemic, contradicting the Spanish government’s proposal, and predicts that half of Europeans can be infected (FT, Jan 11, 22)
  • COVID-19 pushed millions of Indians into poverty (The Economist, January 12,22)
  • Some experts predict a new COVID wave at the beginning of the summer (The Guardian, Jan 14, 22)
  • China’s zero COVID policy is creating problems for the manufacturing and distribution chain sectors (FT, Jan 16, 22)
  • Beijing reports the first case of the “ómicron” variant (The Guardian, Jan 15, 22)
  • COVID would have already left 17 million dead in the world (the official figures are 5.5 million), according to a study by the Barcelona Institute for Global Health, sponsored by the La Caixa Foundation (Diario Médico, Jan 15, 22)
  • The Epstein-Barr virus may play a role in the development of multiple sclerosis (NYT, Jan 13, 22)
  • The Economist looks at how healthcare is evolving into a consumer product (The Economist, Jan 15, 22)
  • Great boost to research on neurodegenerative diseases, with 260 drugs under development: Alzheimer’s, Amyotrophic Lateral Sclerosis (ALS), Huntington’s, multiple sclerosis, multiple systemic atrophy, Parkinson’s and others (Diariofarma, Jan 14, 22)


  • Incidence of COVID and evolution of the sixth wave

o As of January 13, 2022, the 14-day cumulative incidence of COVID amounts to 2,923 cases/100,000 inhabitants. It is not clear if the peak of the wave has been reached or if we are still going up. In any case, the figures are very high (Official data Ministry of Health, update to  Jan 13, 22)

o Almost half of the Spanish provinces have ICUs at very high risk (El País, Jan 12, 22)

o The debate on those hospitalized “for” COVID and “with” COVID is introduced (El Independiente, Jan 10, 22)

  • “Influenzaization of the pandemic”

o An editorial in a journal of the SEMFYC (Spanish Society of Primary and Community Care Physicians), one of the three scientific societies of Primary Care, advocates the “influenza” approach  of the COVID, avoiding counting individual cases and omitting general measures of protection (AMF-SEMFYC, Towards the end of the exceptionality, Jan 10, 22)

o The other scientific societies of Primary Care, as well as most of the experts, took a stand against the previous proposal, at least until the sixth wave was passed.

o Notwithstanding the foregoing, both the President of the Government and Minister Darias, and certain representatives of the Community of Madrid, expressed their agreement with the approach as “influenza”

o Not only that, but that approach was taken to the WHO, which showed its disagreement. Spain wants to lead this debate in the EU (El Periódico de España, Jan 12, 22)

  • Regulation of the price of antigen tests

o The government (Interministerial Commission on the Price of Medicines) limits the price of antigen tests to 2.94 euros and they will continue to be sold only in pharmacies, with entry into force on Saturday, January 15, 2022. The price is 50% more expensive than in France and Germany (El País, Jan 13, 22)

o During the free sale period, the gross margin for pharmacies was 25-50% (El Economista, Jan 13, 22)

o FEFE expresses its “deep discomfort” at having to sell the tests at a loss (diariofarma, Jan 14, 22)

  • The third and fourth doses are extended

o The Ministry of Health announces a fourth dose for patients at risk and will extend the third to those over 18 years of age (La Razón, Jan 13, 22)

  • Purchase of COVID medications

o Spain closes an agreement with Pfizer to buy 344,000 doses of its drug against COVID

o The regions were unaware of this and ask for an equitable distribution (El Español, Jan 11, 22)

  • Serious problem with sick leave

o COVID causes more than 10,000 sick leaves per day in Spain (El Independiente, Jan 11, 22)

o This situation collapses health centers

o A system is put in place so that discharge and discharge (after 7 days) take place in the same act. Madrid calls for a regulatory change, to which the Government does not seem willing (El Economista Jan 12, 22)

  • Ayuso Plan to stimulate the birth rate in Madrid

o It is intended to go from 50,000 to 70,000 births/year in the region. The plan consists of aid of 500 euros, flexible working hours, deductions and support for assisted reproduction (La Razón, Jam 10, 22)

  • Other themes

o FACME disagrees with the recertification plan of the Ministry of Health, which launched a tender to hire a consultant (Official note from FACME,  Jan 13, 22)

o Teachers facing the return to classes, doubts with the new protocol and fears (El País, Jan 10, 22)

o A court condemns the Generalitat Valenciana to compensate the toilets for not giving them the means of protection (El País, Jan 11, 22)

o Ingesa attempts an agreement on biosimilars, which does not have the agreement of BIOSIM (diariofarma, Jan 9, 22)


  • A group of scientists in Texas announce a vaccine (CORBEVAX) that is cheaper, easier to make and patent-free (The Guardian, Jan 15, 22)
  • GSK rejects UNILEVER’s offer of 50,000 million pounds for its consumer division (FT, Jan 15, 22)
  • Medicare introduces major restrictions on the use of Biogen’s drug against Alzheimer’s (NYT, Jan 11, 22)
  • Adeslas will enter 1,655 million euros for MUFACE and ASISA 1,268 (PlantaDoce, Jan 12, 22)
  • Vivanta adjusts its network of centers, putting its beauty business up for sale (PlantaDoce, Jan 12, 22)
  • Pfizer says that it will have a new vaccine against “ómicron” ready in March (Redacción Médica, Jan 10, 22)
  • Merck acquires the US company EXELEAD for 789 million dollars (PlantaDoce, Jan 7, 22)
  • Medtronic reaches an agreement to acquire Affera (ConSalud, Jan 14, 22)
  • Eugin acquires the Delaware Institute of Reproductive Medicine (PlantaDoce, Jan 10, 22)
  • Caser Residencial acquires a new social health center in Laguna de Duero (PlantaDoce, Jan 13, 22)

7 days in healthcare (December 20-26, 2021)




From an international point of view, possibly the most interesting is the summary of the year 2021 by The Lancet; also the studies that seem to show that the “omicron” variant is not only more contagious (which was already known), but that it produces a milder form of disease; the NEJM analyzes Amazon’s health offering; and finally, Israel’s attempts to move forward with the fourth dose.

As for national news, the most relevant thing is the great increase in the pandemic in Spain, which fundamentally translates into pressure on Primary Care and Emergencies, not so much in hospitals; the attitude of the central government in the Conference of Presidents of not imposing restrictive measures, in contrast to what is being done in other European countries; and the failures of the strategic reserve in health, which is causing a great shortage of antigen tests at this time.

With regard to companies and other agents in the sector, it is important to highlight that Europe approves the Novavax vaccine, which would already be the fifth vaccine approved in Europe. Also the authorization of the Merck pill by the FDA for high risk covid. From the point of view of corporate movements, perhaps the most relevant is the purchase of CERNER by Oracle, which may revolutionize the field of hospital informatics.



  • Farhat Yaqub summarizes for The Lancet the most notable events of 2021 in health: the COVID-19 pandemic, which had produced 3.3 million deaths globally as of December 10, 21, more than in 2020; COVID vaccination, with more than 8.4 billion doses administered through December 11; Biden instead of Trump, one of Biden’s first actions was to sign the executive order for the US to return to the WHO; the health impact of the conflict in Ethiopia; the effects of the decline in UK development aid; the COP 26 meeting in Glascow, which put climate change on the health agenda; the crisis in Afghanistan, the most serious current humanitarian crisis; abortion laws: legal in Argentina, banned in Honduras, severe restrictions in Texas; restrictions also in China; the approved malaria vaccine; severe shortage of midwives (The Lancet, Dec 18 21)
  • Three studies (England, Scotland and South Africa) show that the “omicron” variant produces milder COVID, with much less chance of being admitted to hospital (British Medical Journal, 23 Dec 21)
  • A NEJM article looks at Amazon’s healthcare offering: a combination of telemedicine and home care. Three main actions: mobile app; home assessment by a nurse; distribution of medication at home in two hours. A hybrid experience online and in person (NEJM, 23 Dec 21)
  • COVID vaccines are less effective against the “omicron” variant, says the EMA (FT, Dec 20 21)
  • Israel May Give Fourth Vaccine Dose, Despite Expert Reservations (NYT, Dec 23 21)
  • The “omicron” variant responsible for 75% of the cases in the USA (FT, Dec 21, 21)
  • The “omicron” variant has revealed a world not yet prepared for pandemics (FT, Dec 22 21)
  • US military announce SpFN, a valid vaccine against all variants of the coronavirus, including “omicron” (La Razón, Dec 22 21)
  • The “omicron” variant causes the cancellation of almost 5,000 flights around the world during the days of Christmas Eve and Christmas (CincoDías, 25 Dec 21)

National News

  • The incidence of COVID shoots up to 911 cases per 100,000 inhabitants in the last 14 days (El País, 23 Dec 21)
  • Germany declares Spain as a high-risk territory due to COVID (El País, 23 Dec 21)
  • Sánchez prioritizes the economy in the sixth wave and avoids any restrictive measure in the Conference of Presidents, apart from the mandatory nature of outdoor masks and certain possibilities of hiring professionals without recognized degrees (La Razón, Dec 24 21)
  • Feijóo, Moreno, Urkullu and Aragonés consider that the mask on the street is not enough (El Confidencial, Dec 22 21)
  • Harsh criticism from the General Council of Medical Associations in the absence of measures against COVID: “they seek formulas to avoid the burden of responsibility and fear to implement measures that contradict or further anger citizen-voters” (La Vanguardia, Dec 24 21 )
  • The ICUs of ten communities are already at “high risk” due to patient occupation (Aragon, Asturias, Balearic Islands, Cantabria, Castilla y León, Catalonia, Valencian Community, Navarra, Basque Country and La Rioja) (Vozpópuli, Dec 24 21)
  • The sixth wave will leave 9,000 dead in Spain, according to a study by the University of Washington (IHME, Covid 19 Results Briefing, Spain, December 23, 21)
  • The strategic health reserve falls short and does not alleviate the shortage of tests (El Periódico de España, Dec 25 21)
  • Spain has practiced a hundred euthanasias since the approval of the new law (The Objective, Dec 18 21)
  • Strong statements by President Díaz-Ayuso: “In some health centers, not everyone wants to work and pitch in” (El País, Dec 21, 21)
  • SEMERGEN demands that Díaz-Ayuso reconsider her statements about primary care (ConSalud, Dec 22 21)

Companies, employers and main health actors


  • Europe approves the Novavax vaccine. It would be the fifth COVID vaccine approved in Europe, after those of Pfizer-BioNTech, Moderna, AstraZeneca and Janssen (FT, Dec 20 21)
  • Biogen cuts the price of its Alzheimer’s drug in half, due to low sales and divisions by experts about its benefits (FT, Dec 20 21)
  • Merck’s COVID pill is FDA cleared for high-risk adults (NYT, Dec 23, 21)
  • FENIN report on the hospital technological profile, with data updated to December 2020. FENIN has been conducting this study since 2009 (FENIN, Dec 21)
  • “MiQuirónsalud”, the portal that the hospital group makes available to its patients, exceeds four million users (ConSalud, Dec 21 21)
  • Oracle buys CERNER for more than 28,000 million euros to grow in health (PlantaDoce, Dec 22 21)
  • Atrys Health acquires 100% of Simm Molecular, which is dedicated to medical diagnosis in nuclear medicine (PlantaDoce, Dec 17 21)
  • Health in code and the Portuguese Algarve Biomedical Center sign an agreement for genetic diagnosis (PlantaDoce, Dec 22 21)
  • MBA (a medical technology company very oriented to orthopedics-traumatology and based in Asturias), until now owned by Alantra, is acquired by the Swedish group Addlife for 111 million euros (Medical Writing, 23 Dec 21)
  • Viamed, owned by the Macquarie fund, acquires the Fuensanta hospital in Madrid, until now owned by the Merina family. With this, Viamed now reaches 12 hospitals in Spain (PlantaDoce, 23 Dec 21)

7 days in healthcare (November 29-December 5, 2021)



From the international point of view, it is worth highlighting the beginning of the work of the WHO for the approval of a Treaty on pandemics. It seems that the alarm about the new “‘ ómicron “variant is lowered, after the WHO announcement that there had been no case of death. We must be attentive to the program of the new German coalition government, and its impact on the health system. It seems that its actions are concentrated in the pharmaceutical sector. The failure, for various reasons, of the COVAX platform for immunization of low- and middle-income countries is confirmed.

At the national level, the growth of COVID continues to figures that are already beginning to be worrying, despite the advantage over other European countries. The council of ministers approves the Mental Health Strategy, a plan that, unlike the one approved a few years ago on Primary Care, does have funding, despite having aroused reservations among experts. The council of ministers also approves the PERTE for health. As of December 13, the vaccines for children will be available.

Regarding companies, it should be noted that both Pfizer and Moderna are preparing to adapt their vaccines to the new COVID variant.




  • The WHO agrees on December 1, 2021 to begin negotiating an international agreement on how countries should prevent, prepare for and react to pandemics. The agreement is to hold a meeting before March 1, 2022 and discuss a draft before August 1, 2022 (British Medical Journal, Dec 2, 21)
  • A law to introduce dental care in Medicare is discussed in the American Congress (NEJM, 2 Dec 21)
  • An article is published that compares the evolution and behavior in 24 months of a large number of people from the Veterans Administration vaccinated with Moderna and Pfizer-BioNTech (NEJM, Dec 1 21)
  • The need for the health sector to contribute to decarbonization continues to be present (NEJM, Dec 2 21)
  • The WHO warns of a high risk due to the new “omicron” variant (FT Nov 29, 21)
  • WHO says there have been no deaths from the new “omicron” variant, despite its expansion (The Guardian, 4 Dec 21)
  • The “ómicron” variant, with a wide worldwide diffusion: apart from its origin in South Africa, and the expansion to 11 European countries, also present in Canada, Brazil, Australia and Saudi Arabia, among others (CNN Español, Dec 1 21)
  • Van der Leyden calls to discuss the mandatory nature of the vaccine (FT, Dec 1 21)
  • Analysts say that the economic impact of the “omicron” variant will not be important (FT, Nov 29, 21)
  • The program of the new German coalition government has an impact on the healthcare and pharmaceutical sector. Most important measures: price containment in medicines, push for healthcare digitization and use of medical data for research (Covington, Nov 29 21)
  • Biden rules out a new lockdown to tackle the new “omicron” variant (FT, Nov 29, 21)
  • The United Kingdom urgently calls a meeting of the G7 to discuss the problem of the new variant (La Razón, 28 Nov 21)
  • The new variant presents more than 50 mutations over the original from Wuhan (La Razón, Nov 29, 21)
  • COVAX has only distributed 26% of the promised covid vaccines for 2021. The most unanimous explanation is that rich countries have monopolized the market (El Español, Dec 4, 21)
  • The EMA would need three to four months to approve vaccines if they have to be modified by “omicron” (El Confidencial, Nov 30, 21)
  • Europe steps on the accelerator with the third doses in full uncertainty for the new variant (, Nov 29, 21)
  • The lack of vaccines, logistical limitations and the rejection of part of the population hinder immunization in Africa (El País, 28 Nov 21)
  • Germany imposes a de facto confinement to the unvaccinated: leisure and commerce will be banned (El País, 2 Dec 21)
  • Agreement between the Council and the European Parliament to strengthen the role of the ECDC (El Global, 30 Nov 21)



  • COVID cases continue to rise, reaching an AI (cases per 100,000 in the last 14 days) of almost 250 (El Confidencial, Dec 3, 21)
  • Health advises limiting participants in social events during Christmas after the advance of COVID (La Razón 1 Dec 21)
  • The government does not have a “legal plan B” before the “omicron”, it trusts everything to vaccination and rejects restrictions that could affect the economy (La Razón, Dec 1 21)
  • The Government defends the need for an International Treaty on Pandemics, as stated by Minister Darias during the Extraordinary Assembly of the WHO in Geneva (ConSalud, 29 Nov 21)
  • The Council of Ministers approves the Mental Health Strategy 2022-2026, the last was of 2009. It is criticized by experts (Spanish Society of Psychiatry, Spanish Society of Dual Pathology) for its lack of ambition, although the effort of consensus. Among the criticisms is the lack of standards such as professional ratios, number of beds in children’s and adolescent hospitals, waiting lists, etc. It has financing of 100 million euros for the next three years, 30 million for 2022. Intervention in the workplace, the approach to suicide and the gender perspective, among the novelties of this Strategy (El Mundo, Dec 4, 21)
  • The council of ministers officially approves the PERTE for health. Investment of more than 1,400 million euros, between 2021 and 2023. These investment agendas are articulated through tenders, the creation of an investment, development and innovation (R + D + i) structure for advanced online therapies, launch of a public-private investment vehicle in advanced therapies (public-private commercial company) with the participation of companies with production capacity in Spain, elements of early coordination and identification of capacities and needs of the National Health System, public procurement innovative and pre-commercial, agreements with communities, private initiatives and co-programmed projects and public tenders (PlantaDoce, Nov 30 21)
  • The Interterritorial Council of December 2 addresses the Royal Decree of Specialties, so that it is approved before the end of 2021. It contemplates approving new specialties and reviewing access to specific training areas (ConSalud, Nov 30, 21)
  • Pfizer vaccines for children, available from December 13 (ConSalud, Dec 1 21)
  • AESEG presents a report “The sector of generic drugs in the economic and social reconstruction of Spain”, in which it advocates a differential price of generics in relation to brands (AESEG, Dec 1 21)



  • Continuity of care, interoperability, innovation and the promotion of the SDGs (Sustainable Development Goals), among the objectives of the IDIS Foundation for 2022 (ConSalud, 2 Dec 21)
  • Teladoc Health grows 81% in the third quarter (PlantaDoce, Dec 1 21)
  • Pfizer and Moderna are preparing to adapt their vaccines to the new “omicron” variant (El Global, Nov 29, 29)
  • Merck’s COVID Treatment (Molnupiravir), Endorsed by FDA (NYT, Nov 30 21)
  • HM Hospitales will have a new space of 1,000 square meters in Valdedebas (PlantaDoce, Nov 30, 21)
  • HIPRA relies on its covid vaccine to grow 13% in 2021 (PlantaDoce, Dec 1 21)
  • The major private equity companies (CVC, Advent, Cinven, PAI, KKR,…) prepare offers for around 1,500 million for IVI (CincoDías, Nov 30, 21)