Posts

7 days in healthcare (February 19th-25th, 2024)

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Summary

From the point of view of Biomedicine, the mega-study of 250,000 genomes made public by the National Health Institutes of the USA stands out. This is in line with carrying out genome studies combining it with electronic medical record data from very large groups initiated in the United Kingdom by Genomics England and also developed in Iceland and Japan. A very promising way to improve knowledge of many diseases. New treatments for type 1 diabetes, based on the transplant of insulin-producing beta cells, obtained from stem cells, neutralizing the immune reaction. Gene therapy is the great promise for many rare diseases, currently without treatment. The problem to be solved is the high price of the treatments. At the present time, saying breast or prostate cancer is almost saying nothing. The treatment of tumors is no longer based on their anatomical origin, but rather on their molecular characterization. Bispecific antibodies that act on two targets at the same time, useful in hematological and solid tumors. The FDA approves a drug to prevent the amputation of fingers and limbs.

As far as Global Health is concerned, long covid was understood as a sequel to covid, but an article in The Economist states that covid is not the only infectious disease that leaves pathological conditions that are difficult to label. An article in Health Affairs places the solution to the obesity epidemic as a joint effort of prevention and treatment.

In terms of International Health Policy, more than half of USA’s rural hospitals do not offer childbirth services, which means that pregnant women have to be treated in centers located 30-40 minutes from their home, sometimes more. This is related to the high maternal and infant mortality in the USA, higher than that of most developed countries. The 4th anniversary of Brexit encourages the debate about whether it was good or bad for the National Health Service. The truth is that the NHS is worse now than before Brexit (waiting lists, professional strikes, etc.) and the difficulty of recruiting health professionals from the EU has increased. The investigation was also damaged. Increasing funding for the NHS was one of the arguments used by Brexiteers. France addresses the carbon footprint in the health system, within the general “France Nation Verte” program. Germany legalizes recreational cannabis, with one of the most liberal laws in Europe, after Malta and Luxembourg. More than controversial attempt in Germany to take control of non-communicable diseases from the Robert Koch Institute, one of the most prestigious organizations in German health, to give it to another organization, created as a result of covid. The European Medicines Agency recommends approving a drug against ALS.

If we talk about National Health Policy (Spain), as a result of a specific scandal, the entire problem of purchasing masks and other materials during covid is introduced into the national debate. Precisely everything related to the purchase of these materials was somewhat overlooked by the report “Evaluation of the Performance of the Spanish National Health System in the face of the covid-19 pandemic”, dated April 30, 2023, although published by the Ministry of Health in December of that year. It is already serious that an issue such as the problems of purchasing materials are not analyzed in the report, as if this had not been one of the most serious problems in the management of covid. The PNV requests the return of the text of the Public Health Agency law. That this law was going to have problems with the nationalist parties, always opposed to the creation of cohesion bodies in the National Health System, was something known. Surely this will mean delays in the appearance of the law and, what may be more serious, affect its content and functions. There is a risk that the announced Agency will be little more than an empty shell. The government creates the Extreme Temperature Observatory to analyze the health impact of climate change. The Basque Country approves a new Mental Health Plan 2023-2028. The EU denounces the high level of interim contracts in the Spanish public health system. At the current time, 43% of contracts are interim.

As for Companies, internationally, AstraZeneca reveals successes in the treatment of lung cancer. Indian drugmakers make versions of Novo Nordisk’s anti-obesity drug. At the national level, Sanitas intends to open a new hospital in Barcelona. Fever of construction of private hospitals in Valencia: Vithas, Quirón, IMED and Ascires in that race.

Biomedicine

Global Health

International health policy

  • United Kingdom and the National Health Service
    • Brexit and health. January 31, 2024 was celebrated as the 4th anniversary of the United Kingdom’s effective departure from the European Union. The Lancet asks whether or not that was good for the NHS, with two possible answers: the easy one, which says there is no evidence; and the difficult one, which confirms that the NHS is in fact worse now than before, as demonstrated by the long waiting lists and the continuous strikes by health professionals. What is certain is that it has become difficult to recruit doctors from the EU. At present, the majority of foreign doctors hired in the NHS are from outside the EU. Research plans were also negatively altered. (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00157-0/abstract)
    • The government changes its policy and plans to double the number of medical students in 2031 (https://ground.news/article/government-u-turn-on-plans-to-double-number-of-medical-students-in-england)

National health policy

Companies

7 days in healthcare (May 22nd-28th, 2023)

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Summary

From the point of view of Biomedicine, to point out the cerebral signs in the orbito-frontal cortex detected in chronic pain, which opens the possibility of implanting devices to alleviate pain. An AI-based digital bridge enables paraplegics to walk, raising hope that neurotechnology can help overcome numerous disabilities. The contribution of AI in the interpretation of radiological images is the subject of an extensive review in the New England Journal Medicine. Science magazine publishes advances in regenerative medicine, which helps to recover tissues damaged in many diseases.

With regard to Global Health, The Economist shows with its model that global deaths are 5% above the pre-pandemic era, speculating about whether the stress on health systems due to the covid could have left many people without treatment, which would have increased mortality. Child labor, so present even in developed countries, is the subject of an analysis by The Lancet. The WHO, for its part, warns that the next pandemic may be even deadlier than covid.

As for International Health Policy, the most striking thing is both the editorial and the article that The Economist dedicates to the National Health Service. He goes on to say that although the NHS may need more money, money alone would not solve its problems, calling for “a radical change of focus”, but not like those that some are calling for to move closer to social insurance-type models such as in Germany and France, which he considers unnecessary. He believes that the change consists of orienting the system more towards health, as its name indicates, and less towards disease. Less focus on hospitals and more on community health; from treatment to prevention; and valuing the results more than the activity inputs.

If we talk about National Health Policy (Spain), to highlight the change of political sign, with the departure of the PSOE and the arrival of the PP, in the governments of the Valencian Community, Cantabria, the Balearic Islands, Extremadura and Aragon. This is going to have health consequences. Although it is early to tell, it will surely give continuity to the concession model in the Valencian Community. The latest weekly report from the WHO on covid shows that Spain is currently the country in Europe with the highest mortality per 100,000 inhabitants from this disease. The Community of Madrid has a serious problem attracting professionals, leaving many positions for primary care doctors and paediatricians vacant. Debate on training in the SNS, for important professional associations, such as FACME, the SNS by itself will not be able to maintain teaching professionals without collaboration with the industry. The Government of Navarra is investigating several doctors for breach of exclusivity, apparently only in force in Navarra, Galicia and Asturias. It is surprising that the form of application of a national law depends on the political sign of the autonomous governments.

At the Business level, internationally, Pfizer reaches an agreement with the EU to reduce the supply of covid vaccines. At the national level, it should be noted that HIPRA, after two months of approval of its vaccine, only sells it in Spain.

Biomedicine

Global Health

International Health Policy

National health policy

  • AIDS
    • According to the report of the Carlos III Health Institute, 92.5% of people living with HIV in Spain would know their infection diagnosis; 96.6 are receiving antiretroviral treatment and 90.4 have suppressed viral load. The decrease in the undiagnosed fraction is the data that presents the greatest evolution in this report (https://www.isciii.es/Paginas/Inicio.aspx)

Companies