Posts

7 days in healthcare (January 29th-February 4th, 2024)

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Summary

From the point of view of Biomedicine, the use of gene therapy based on CRISPR for the treatment of hereditary angioedema should be highlighted. Great debate regarding Elon Musk’s brain chip, in general the scientific community has expressed serious reservations about this initiative. Beginning of the first trials with mRNA-based therapy in cancers of different types in the United Kingdom.

As far as Global Health is concerned, the beginning of routine malaria vaccination can without exaggeration be considered a historic event, given the high mortality of this disease in children in Africa. The WHO warns about the prospects for great growth in cancer globally and the notable differences in its prognosis, especially in breast and cervical cancer.

In terms of International Health Policy, the NHS England initiative is especially interesting, allowing pharmacies to prescribe certain medications and carry out some care practices, which is expected to result in a decrease of 10 million primary care consultations. The results of this experience deserve to be followed, since it could be part of the solution to Primary Care also in Spain. EU document on cancer in Europe, highlighting inequities in its approach.

If we talk about National Health Policy (Spain), it is worth continuing to comment on the intervention of the Minister of Health in the Health Commission of Congress. Although now it seems that nothing is important, the truth is that this intervention is one of the most relevant of any minister who reaches her position. The intervention has some lights and many shadows. Lights: recovery of a certain will for strategic direction of the SNS and decision to address the great problem of waiting lists (this is notable, since it contrasts with other ministers, who used to rather assume that everything was transferred and , therefore, the role of the Ministry was minimal). Shadows: very negative, offensive and unacceptable mentions of private healthcare, with arguments and quotes that are intellectually inconsistent and lacking rigor; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, apart from doubts about its real content (no one hides the fact that the Agency does not make the influential nationalist parties very happy), the Ministry of Health gets out of the way to decide the location, handing over the baton to the Ministry of Territorial Policy and Democratic Memory, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals?; medicines, no mention of the Strategic Plan of the pharmaceutical industry (in which the President of the Government himself had committed himself); Oral health, where is the economic memory? What care model will be followed? Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? In another order of things, in the Valencian Community the reversion to the public sector of the Denia concession has been completed and that of Manises will soon be granted, something to which the Administration has every right, once the concession contract has ended. The mentions of the concept of “expropriation”, used by some concessionaire company, are extemporaneous. Now, the official press release from the Ministry announces a very notable increase in staff in that hospital in Denia. Logically, uncontrolled growth in health spending, if it is not justified, cannot be the public alternative to concessions. Notable growth in the price of health insurance premiums in Spain, although its price must probably continue to be low, compared to other European countries. Something to analyze.

As for Companies, on an international level, Novo Nordisk was surprised by the great demand in Europe for medicines against obesity. In terms of national news, the pharmaceutical distributor HEFAME has experienced great growth in recent years and is considering expanding throughout Spain. At Grifols, the board is considering excluding the family from the company’s strategic decisions.

Biomedicine

Global Health

International health policy

  • European Union
    • Document on inequalities in the EU regarding cancer: “Beating cancer inequalities in the EU” Emphasis on prevention and early detection (https://www.oecd.org/health/beating-cancer-inequalities-in-the-eu -14fdc89a-en.htm)
    • The EU fined the pharmaceutical industry 780 million for anti-competitive practices between 2018 and 2022 (https://www.elespanol.com/invertia/observatorios/sanidad/20240130/ue-multo-millones-industria-farmaceutica-practicas-anticompetitivas /828667294_0.html#:~:text=The%20European%20Commission%20investigated%20one, euros%20for%20the%20laboratories%20involved.)
    • Brussels calls to promote vaccines against human papillomavirus (HPV) and hepatitis B throughout the EU (https://elpais.com/sociedad/2024-01-31/bruselas-llama-a-impulsar-las -vaccines-against-human-papillomavirus-hpv-and-hepatitis-b-across-the-eu.html#:~:text=Brussels%20has%20launched%20this%20Wednesday, the%20Hepatitis%20B%20(HBV).)

National health policy

  • Appearance of the Minister of Health before the health commission of the Congress of Deputies, on January 26, 2024
    • Lights and shadows in the appearance. Lights: recovery of a certain will for strategic direction of the SNS and willingness to address the great problem of waiting lists. Shadows: very negative and unacceptable mentions of private healthcare, with intellectually inconsistent arguments and quotes; staunch defense of direct public management, compared to other forms of public management; Public Health Agency, the ministry gets out of the way to decide the location, as if it were not also a health decision; Framework Statute, where are the negotiations with professionals and patient associations?; medications, no mention of the Strategic Plan of the pharmaceutical industry; Oral health, where is the economic memory?; Is the inclusion of glasses in public provision, given the financial strains of the system, a reasonable priority? Is there prior consensus with other agents on this measure? (https://www.youtube.com/watch?v=xlGfsMiuQDo)

Companies

 

7 days in healthcare (August 14th-20th, 2023)

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Summary

From the point of view of Biomedicine, surely the most far-reaching news is the success obtained with a transplant to a brain-dead human of a genetically modified pig kidney, which worked perfectly, both from the point of view of renal function and of non-rejection. This represents great hope for transplants, especially in the United States where transplant waiting lists are very long. It is estimated that some 5,000 people in the USA die each year waiting for a kidney transplant. The idea is to request authorization from the FDA to carry out a clinical trial.

As far as Global Health is concerned, an interesting WHO summit in India on traditional medicine (which includes treatments as varied as Ayurveda, yoga, homeopathy and complementary therapies), although we don’t have to expect much from the results. The truth is that traditional medicine is followed by billions of people and the WHO wants to see how it integrates with conventional medicine. The Lancet comments that malnutrition is the greatest risk for tuberculosis. In fact between 1900 and 1940 the incidence of tuberculosis plummeted, in the absence of any effective treatment or vaccines, simply because of improved socioeconomic conditions.

As for International Health Policy, two Chinese manufacturers are making “copycats” of weight-loss drugs, threatening Western companies in their development in this huge obesity market. An international study (United States, Germany and Switzerland) warns of the “cancer premium” in the price of medicines, which reaches up to three times that of medicines for other diseases, this price not being justified either by the manufacturing process or by because of the research, but, fundamentally, because of the extreme concern and anguish in the face of this disease. Although the study refers to those countries, this phenomenon occurs in all nations, including Spain.

If we talk about National Health Policy (Spain), denounce the low rates of insurers with doctors. Although the matter will surely have many nuances, the truth is that the low rate of insurers (20 euros on average for a first consultation and 10 for a subsequent one) make this model of care provision very unstable. La Rioja proposes with the new government of the PP to have a Faculty of Medicine. The map of the Faculties of Medicine in Spain has been highly denounced both by the Association of Medical Students and by the Medical Deans’ Conference. We have a ratio of medical schools per population that is second only to South Korea, of course much higher than that of France, the United Kingdom and Germany, which should be our benchmarks. The peculiar distribution of powers between the State, the communities and the Universities has led to this certainly anomalous situation. The pharmaceutical industry has become the leading export sector in Spain, ahead of the automobile industry, which traditionally led the ranking. A complete success for this industry, of which there are 173 production plants, most of them in Catalonia, followed by Madrid.

In the field of Companies, at the international level, Novartis plans to separate from Sandoz (its division for generics and biosimilars), following the same path as Pfizer with its Upjohn generic business, which it merged with Mylan to form Viatris. Various private equity firms interested in the operation. At the national level, it is worth highlighting the large increase in Ferrer’s profit.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

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

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Summary

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.

Biomedicine

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) (https://gacetamedica.com/opinion/a-new-territorial-council-of-the-sns/)

Companies

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

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Summary

From the point of view of Biomedicine, important editorial and several articles in The Economist on the problems of reproduction and in vitro fertilization. Since this technique began, 45 years ago, more than 12 million children have been born thanks to it. The issue is extremely important considering that one in six people suffer from infertility. IVF is experiencing an extraordinary “boom”. Important article from The New York Times on the demographic changes that will give rise to a whole new world in terms of population distribution. Some skepticism about the effects of Donamebad on the evolution of Alzheimer’s.

When it comes to Global Health, The Economist looks at why the malaria vaccine has taken so long to develop. This is apparently due to cycle changes of the Plasmodium parasite. Singapore is a world leader in the marketing of cultured meat, which is possibly called to change many things in our eating habits.

Regarding International Health Policy, the WHO in its weekly covid monitoring newsletter on covid warns that, although the number of new cases and mortality are falling, this disease continues to be a threat, which requires maintenance of surveillance systems and periodic reports. The National Health Service, despite its deep crisis, continues to be a benchmark in terms of reflections on health and health systems. This time the King’s Fund is publishing a report on the kind of participatory leadership needed in the healthcare system.

If we talk about National Health Policy (Spain), we want to highlight the interesting book “Conversations for better health”, which consists of deep and nuanced reflections on many topics, carried out by two consolidated values in Spanish healthcare arena (Jesús María Fernández Díaz and José Martínez Olmos): the importance of Public Health, the need for the Public Health Agency, the opacity of our system in terms of information on results and quality, financing, co-payment, the challenges of Primary Care, the necessary new care model, the contributions of digital health, etc. When improvisations and light comments abound, often made from advertising or simple communication, this conversation between two experienced experts, who treasure experience and knowledge, is a must read. It can be purchased on Amazon.

In the field of Companies, internationally, there are two great opportunities for the pharmaceutical industry, one in the short term, such as all medications against obesity and Alzheimer’s, and another in the longer term, such as anti-aging therapies.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

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

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Summary

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.

Biomedicine

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 (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01411-3/fulltext)
  • 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 (https://www.nature.com/articles/d41586-023-02207-2)
  • 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 (https://www.nejm.org/doi/full/10.1056/NEJMp2304600)

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 (https://apps.who.int/iris/handle/10665/370545)
  • 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 (https://www.health.org.uk/news-and-comment/news/joint-letter-to-political-leaders-in-england-on-future-of-nhs)
    • 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 (https://www.ft.com/content/a0b5a2ad-06a4-499d-8195-b4d6a3f65f7a)

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 (https://www.pp.es/sites/default/files/documentos/programa_electoral_pp_23j_feijoo_2023.pdf)
  • 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 (https://www.psoe.es/media-content/2023/07/PROGRAMA_ELECTORAL-GENERALES-2023.pdf)
  • 23 J Elections: SUMAR’s health program

Companies

 

7 days in healthcare (January 30th- February 5th, 2023)

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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

Global Health

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)

National health policy

Companies

7 days in healthcare (January 23rd-29th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting, as the Nature article does, that among the 7 most promising technologies for 2023, at least three are directly related to biomedicine. It seems that not only neurons have a role in brain function, but also a relevant role of glial cells in certain disorders is beginning to be recognized.

As regards Global Health, the WHO requests 2.5 billion dollars to deal with health emergencies, particularly in Yemen, Afghanistan, Syria and Ethiopia.

As for International Health Policy, a consensus began to be created three years after the start of the pandemic that, although not totally overcome, it is no longer the emergency that it was. The problems in China with the covid continue. The crisis in the NHS is the biggest for many years. Basically, there are two positions: the one that seems to be held by the current conservative government that the system is unsustainable without co-payments and very profound changes; or the one represented by The Lancet, which says that the system is perfectly viable, if it is provided with more resources. What is clear is that the UK lags behind other European countries in many resources (hospital beds etc.). Two good news in terms of health policy are led by countries that are not usually at the forefront on these issues: the smoking ban in Mexico and the mental health law in Nigeria. Tensions between governments and pharmaceutical companies over the price of medicines are increasing and this time they are not only in Europe, but also in the United States (the largest pharmaceutical market).

If we talk about National Health Policy (Spain), the incidence of covid continues to drop, although mortality remains high (above 250 deaths per week). The medical conflict in public health continues, mainly in Primary Care. While there are communities that have reached agreements (Andalusia, Navarra, Aragon, Extremadura), in others (Madrid, Catalonia) there does not seem to be any sign of agreement, which makes us think and we will have to draw conclusions about different behaviors of the Administrations and of medical leaders. Conflict also between private health doctors and health insurers. It seems that the Equity Law is going ahead, after Darias’ agreement with Podemos. Interesting agreement in Madrid so that hospital specialists can also take leave. Aragon proposes that the issue of health be dealt with in the President’s Conference, which seems reasonable, given the seriousness of the problems, although the document of said community does not contain great innovative elements. After the more than debatable success of the operations in Alzira and Torrevieja, it seems that the Valencian government also wants to rescue Denia. At this point, a deeper and more articulate justification of political decisions should be demanded.

In the field of Companies, at the international level, it is necessary to highlight the great activity of private equity companies worldwide in the field of health, as revealed by the Bain report. In Spain, Ribera Salud leaves Extremadura. Important investments in our country from Bayer and Novartis are confirmed

Biomedicine

Global Health

International Health Policy

National health policy

Companies

7 days in healthcare (14th-20th November, 2022)

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Summary

From the point of view of Biomedicine, the promising advances in the clinical trial of monoclonal antibodies against malaria are noteworthy. Although malaria has declined remarkably in the last 20 years, progress stopped in 2014. 6 African countries suffer 55% of global malaria cases. There is no doubt that the world would be much better without this disease.

As regards Global Health, the COP27 summit approves what was a general demand: the creation of a fund to help countries vulnerable to warming, although it does not agree to end fossil fuels. Faced with the opinion of the Director General of the WHO to hail the Qatar soccer championship as good for health, The Lancet is more skeptical, pointing out, among other things, that it had already shown in 2021 that the Olympic Games do not contribute to the generalization of the practice of physical exercise among the population.

Regarding International Health Policy, it seems that China is beginning to soften the covid-zero policy with regulations that are not as draconian as up to now. The American CDC initiates the changes, after the report that was made that demonstrated notable failures during the pandemic. The pharmaceutical industry warns in the United States and the United Kingdom that a change in price conditions in the first country and an increase in taxes in the second, could harm investments and, consequently, innovations in medicines.

If we talk about National Health Policy (Spain), the incidence of covid has risen in the last week, after two weeks of decline. With the announced change of the Minister of Health, Spain will have the sad record of having five Ministers of Health (Montón, Carcedo, Illa, Darias and the new one) in five years. Not surprisingly, the Ministry of Health has become a contingency management ministry, rather than the driver of transformative system change. If any of those ministers, which is quite doubtful, had had any transformation approach, he would not have had time to even raise it. It is not surprising that, in these circumstances, the Ministry of Health has not had the opportunity to rule on the conflict between Primary Care doctors, as if it did not affect it, when local circumstances aside, the working and professional conditions of healthcare personnel at Primary Care are a national problem. It confirms what was already known: that Spain is among the countries with the most doctors per 1,000 inhabitants in the world. Important and necessary organizational revolution at the Vall d’Hebrón hospital in Barcelona, ​​creating 32 areas of knowledge. The approach will be presented at the next meeting of the European University Hospitals Alliance (EUHA).

In the field of Companies, at the international level, obesity is seen as the expected Eldorado of Big Pharma. In Spain, Sanitas acquires a hospital in Mexico; Ribera buys a hospital group in Murcia; and, Imed considers the construction of three new hospitals: Valencia, Alicante and Barcelona.

Biomedicine

Global Health

International Health Policy

National health policy

  • Other themes
    • Francesc Moréu, a well-known health manager, updates his document published in 2020 entitled: “A new health model for a new society” to November 2022. The fundamental thesis is that the health sector was created for another society and the fact that in-depth reforms have not been carried out for more than 40 years is creating problems for patients and professionals (https://drive.google.com/ uc?export=download&id=1W3l4Lz6gH3s-cG7rlKX_2kqKlsorkCy0)

Companies

 

7 days in healthcare (October 17th-23rd, 2022)

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Summary

From the point of view of biomedicine, the announced “vaccine against cancer” should be highlighted, which could be prepared before 2030. Although not strictly a vaccine, it represents a promising treatment against this disease based on mRNA technology, the same used for covid vaccine.

Regarding Global Health, an important announcement by the WHO about the dangers of a sedentary lifestyle, which could produce 500 million chronic patients in 2030. The WHO dedicates 2,600 million in its next strategy 2022-2026 for the eradication of polio .

Regarding international health policy, an important debate introduced by The Economist on the massive use of antidepressants, when only in 15% of cases do they have an effect other than placebo. Opioids in the United States and antidepressants worldwide are examples of the misuse of medications, which can lead to, and in many cases lead to, health problems. The post-pandemic horizon has generalized a hybrid work model (face-to-face and online) for office professionals.

If we talk about national health policy (Spain), the pressure on hospitals due to covid remains low, despite a slight rise in this disease. Intense debate on the flight of Spanish doctors to other countries, attracted by better salary and professional conditions. No matter how much the number of MIR vacancies and Faculties of Medicine increases, the problem will not be solved if working conditions are not acted upon. Teleconsultations seem to consolidate in Primary Care, already being more than 50% of the visits. The Trans law is the subject of great controversy. Most psychiatrists and psychologists, against. Obviously, we are in favor of the position of the WHO by removing from the list of diseases already in 2018 these cases of having a gender identity other than biological sex and wanting to change the morphology of their body. We welcome that there is a law on the subject as in most Western civilized countries. But one thing is that and another that 14-year-olds can choose sex without a psychological evaluation carried out by experts, who can rule out cases. Irreversible problems may occur. There is a certain consensus that the current wording of the law does not sufficiently protect minors.

In the field of companies, at the international level, we must welcome the first agreement with a pharmaceutical company (Novartis) to produce an anticancer drug as a generic that is still protected by patent, for its production in developing countries. As far as Spain is concerned, the continuous growth of health insurance should be highlighted, which in 2022 until September grows considerably more than the insurance as a whole.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (October, 10th-16th, 2022)

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Summary

From the point of view of biomedicine, to review the advances in knowledge of the human organ that, to a large extent, remains a mystery, the brain: the implantation of human cells in mice, which can send signals and the creation of a kind of synthetic intelligence, by verifying that nerve cells in a dish can learn. In the United States, it is found that mortality from breast cancer has decreased a lot, due to early detection and better treatments. Something that is not exclusive to the United States and that surely also occurs in Spain.

As far as Global Health is concerned, the serious health problems, for very different reasons, in Pakistan, Somalia, Syria and Lebanon must be highlighted.

Regarding international health policy, there is great concern in the WHO and other organizations about the effects of persistent covid. Threat of hospitals in Germany by covid. The Economist introduces the debate on the legalization of cocaine, which it strongly defends, considering that the problems of an illegal market far outweigh those that could arise in a controlled market. Put the simile of whiskey and cigarettes.

If we talk about national health policy (Spain), the rise in the incidence of covid continues, although in Spain without notably affecting hospitals. Promising launch of the Neurotechnology Center in Madrid.

In the field of companies, at the international level, the WTO (World Trade Organization) continues with its efforts to free the patents of medicines related to covid. As far as Spain is concerned, HIPRA suffers a new delay in the approval of its vaccine by the EMA, which practically excludes it from the fourth dose vaccination campaign.

Biomedicine

Global Health

International health policy

  • European Union
    • A step forward towards a Europe of health. The reinforcement of the ECDC (European Center for Disease Prevention and Control), the EMA (European Medicines Agency) and the creation of the Health Emergency Preparedness and Response Authority, constitute important steps towards a European policy of health, something not contemplated in the founding European treaties (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01980-8/fulltext)
  • The debate on the legalization of cocaine
  • New Code of Medical Ethics
    • Approved the new International Code of Medical Ethics of the World Medical Association. After the initial version of this Code in 1949, a new wording has been approved at the General Assembly of the World Medical Association, held in Berlin in October 2022 (https://jamanetwork.com/journals/jama/fullarticle/2797507)

National health policy

Companies