Posts

7 days in healthcare (June, 19th-25th, 2023)

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Summary

From the point of view of Biomedicine, ethical problems continue to be discussed as a consequence of the creation of embryos without eggs or sperm. Until now, an embryo required an egg and a sperm, but this new approach would allow, in hypothesis, to solve problems of infertility or pregnancy loss, but it is a matter to regulate very carefully. Two studies in Nature seem to show that the Y chromosome makes men more vulnerable to tumors.

With regard to Global Health, The Lancet focuses on the great threat of diabetes, since it is estimated that in 2050 there will be 1.3 billion diabetics, a disease related to obesity, diet, tobacco, alcohol and sedentary lifestyle. Inequalities in access to morphine are denounced, with the United States and Europe almost completely monopolizing its use. An important issue, since this drug has a relevant role in the treatment of pain and in palliative care.

Regarding International Health Policy, according to the weekly WHO report, covid is declining in both the number of cases and deaths in all WHO regions of the world. Only in the African region is there a slight increase in the number of deaths, with a decrease in the number of new cases. In the United States, the commercialization of meat grown in the laboratory is approved. One of the authorized establishments belongs to the Spanish philanthropist José Andrés. Also in the United States, not minor problems continue as a result of the annulment of the Roe v Wade ruling that transfers the authorization of abortion to the states. In the United Kingdom, the problems with the emergency services continue and a strike of resident doctors is called. New health insurance law in South Africa, which appears to represent progress towards universal coverage in that country.

If we talk about National Health Policy (Spain), according to the WHO weekly bulletin, Spain is the country in Europe with the highest mortality from covid. The government and the communities agree to abolish the mandatory nature of masks in health centers and pharmacies. Ayuso, proclaimed President of the Community of Madrid, after the last elections. Absence of great news in the announcements of health measures for this legislature. As was already known, Spain is consolidating itself as a world power in clinical trials, an achievement no less.

In the field of Companies, internationally, Walmart (the largest supermarket chain in the USA) enters the primary care business, with 32 centers in 5 states. Walmart was already in healthcare, but it was with small clinics for minor care. Significant company purchases by Merck MSD and Lilly, which seems to confirm that M&A activity in pharmaceutical companies is reviving. In the Spanish national arena, ASEBIO announces an increase in investment in R&D by biotech companies in 2022.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

 

 

 

7 days in healthcare (February 13th-19th, 2023)

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Summary

From the point of view of Biomedicine, it is worth highlighting the reference in the British Medical Journal on the questionable value of colorectal cancer screening, according to a double-blind study of the results of colonoscopy, with a large population followed up, without detecting reductions in the mortality from this type of cancer. The first vaccine against the syncytial virus, responsible for many deaths, both newborns and adults, is presented. The results of a test that detects prostate cancer with great precision, with a simple blood test, are published.

With regard to Global Health, the New England Journal Medicine published an article on the correct path to eradicate polio, which is once again a problem in many countries, defending universal immunization against polio, in instead of virus eradication strategies. The Lancet reviews the One Health strategy, this approach that links climate change, animal health and human health as something that cannot be addressed separately. It is detected that poor countries desperately need access to cheap generics, since in these countries, due to less competition between manufacturers, generics are more expensive than in developed countries. Malaria is spreading across Africa as climate change allows the geographic spread of the mosquitoes that transmit it.

Regarding International Health Policy, there is a great debate in the United States about the future of Social Security and Medicare, with very opposed positions between Democrats and Republicans. In the UK, the number of people waiting more than 18 weeks for treatment exceeds three million in England alone. In France, the very open debate on euthanasia continues with wide participation, with the involvement of President Macron himself. In Chile, the crisis in the private health sector threatens the entire Chilean health system. The collapse of the Isapres (Chilean health insurers) would mean that 3.2 million people would pass into the already congested public Fonasa system. Poland bans energy drinks for those under 18, a move welcomed by doctors in that country. The European Commission finalizes the European pharmaceutical strategy, with new approaches towards generics and orphan drugs. The EFPIA, the European employers’ association for pharmaceutical companies, criticizes what is becoming known about this reform, considering it harmful to competitiveness.

If we talk about National Health Policy (Spain), the cumulative incidence of covid continues to rise slightly. From a regulatory point of view, two important laws are approved: the so-called “trans law” and the new abortion law. From various sectors of the healthcare industry, objections had been made to certain elements of both laws, the consequences of which will have to be expected. As far as the medical conflict is concerned, it is increasingly clear that the conflict in Madrid is one thing and another in the other communities. Although the problems of Primary Care are national, and therefore the national government cannot inhibit itself as it is doing, what is specific to Madrid is the way in which the Community government approaches it, which simply attributes it to a “conspiracy of the left”, which contributes to its exacerbation, prolongation and expansion (it is also announces conflict among hospital doctors). Both the international press (Financial Times, Le Monde) and the national one (Zarzalejos in El Confidencial and others) strongly criticize this approach by the Community of Madrid, which has published a decalogue of excellence in Madrid’s healthcare, strongly criticized for its inaccuracies. In other communities, on the other hand, with all the difficulties, agreements are being reached. The national government also uses this conflict to enter into health, trying to neutralize criticism of the “yes is yes” law. Those who want politics out of healthcare don’t know what they’re saying. On the contrary, we need a political debate on high altitude and adult health. Just the opposite of what is happening. Private insurance policies are rising in price, something that the sector had been demanding for years.

At the Corporate level, at the international level, it is proposed that health information (largely from the NHS) be the basis of a British sovereign wealth fund, in the same way that a Norwegian sovereign wealth fund is based on information about oil. Grifols announces a savings plan that includes 2,300 layoffs, which has been highly received by the Stock Market, significantly raising the shares of this company.

Biomedicine

Global Health

International Health Policy

  • Chili
    • The crisis in the private sector threatens the entire Chilean health system. A 2010 court ruling prevents adjusting policies by age and sex. Although the measure had not been implemented, it seems that the government wants to do so. The collapse of the Isapres (health insurers in Chile) would mean that 3.2 million people would pass into the already congested public Fonasa system (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00321-5/fulltext)

National health policy

Companies

7 days in healthcare (October 24th-30th, 2022)

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Summary

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

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

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

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

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

Biomedicine

Global Health

International health policy

National health policy

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 (July 4th-10th, 2022)

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Summary

From the point of view of biomedicine, to highlight the finding that cancer drugs significantly reduce the mortality of patients hospitalized for covid.

With regard to Global Health, an important WHO report on mental health, the last of said organization on the same subject dates back to 2001. The Lancet publishes an interesting article on road safety: no less than 1.35 million deaths a year and 50 million injuries depend on that security. Compared to what was usual in the years before covid and the war in Ukraine, hunger has grown in the world, moving us away from the Sustainable Development Goals. The development of health systems in Africa collides with the shortage of professionals.

Regarding international health policy, it should be noted that the USA has just bought 2.5 million vaccines against monkeypox. The WHO and the EMA warn of the new wave of covid. New “centaurus” subvariant of covid, originating in India, but already widely disseminated. Biden signs an executive order, in order to protect abortion rights. The United States doubles the use of telehealth since the outbreak of the pandemic.

If we talk about national health policy (Spain), the wave of covid continues to grow, with an increased impact on hospitals. New approved version of the Framework Statute of Health Personnel, which tries to avoid prolonged temporary periods, which was necessary, but consolidating the statutory regime, which we believe is not good news and in line with what the public health system needs , although perhaps the unions. First regulation in relation to nursing prescription, long awaited. Important report from the Platform of Patient Organizations, showing how chronic patients suspend the health care they receive. Javier Murillo, the undisputed leader in the health insurance sector, warns about the risk of disappearance of administrative mutualism (MUFACE model), since it continuously produces losses. The CAPFF, chaired by the prestigious economist Félix Lobo, releases his report, demanding changes in the regulation of the price of medicines in the SNS, to reinforce “legal certainty.”

In the field of companies, FEFE gives us the news that the pharmaceutical industry already sells more in hospitals than in primary care, a great change. The ASEBIO Report highlights the growth of the sector both in business volume and in investments. It seems that HIPRA, the Spanish vaccine against covid, is getting closer to being approved by the EMA.

Biomedicine

Global health

International health policy

National health policy

Companies

 

7 days in healthcare (June 27th-July 3rd, 2022)

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Summary

From the point of view of biomedicine, surprising finding that the flu vaccine helps prevent Alzheimer’s.

As far as Global Health is concerned, the ravages of the war in Ukraine are noted. Most of the morbidity and mortality is not caused by direct military action, but by problems of assistance and malnutrition. Interesting article in The Lancet about the need to put an end to a global problem: the marriage of girls under 18 years of age, which is also the cause of many health problems.

Regarding international health policy, it should be noted that the WHO is concerned about the possible spread of monkeypox among children and pregnant women. Regarding covid, a study among the G10 countries (Spain is not included) demonstrates the outstanding performance of Canada in its fight against covid, second only to Japan. Almost unanimity among the scientific and opinion press on the negative consequences of the annulment of the Roe v Wade ruling, leaving the legalization of abortion in the hands of the American States. It is insisted that previous experience shows that the ban does not change the number of abortions, but rather their safety. Condemns also from the American Medical Association (the American medical colleges) and the Association of American Medical Colleges (which represents the academic medical world in the USA). More online health care is expected as a result of the digitalisation plan of the British NHS.

If we talk about national health policy (Spain), given the increase in the incidence of covid and the increase in cases of hospitalization and deaths, Minister Darias recommends the use of masks indoors. Doubts about the credibility of this recommendation, after months minimizing the impact of covid and talking about “flu”. It was approved the so-called “Trans law”, which has consequences on the SNS. Significant opposition in Catalonia (both from the government and from associative entities, such as the UCH) to the Equity Law project approved by the government.

In the field of companies, regardless of their utility or not, great growth in the activity of vendors of “traditional medicine”, which in China have the support of the government. Spanish health technology companies request a plan, given the supply crisis and the increase in costs.

Biomedicine

Global health

International health policy

National health policy

Companies