Summary

From the point of view of Biomedicine, the start of human trials of drugs discovered by Artificial Intelligence should be highlighted, something that is attracting the attention of all Big Pharma companies.

With regard to Global Health, it should be noted that COP27, the major international conference on climate change, will be held in Cairo on November 7 and 8. His opening coincides with the editorial in The Economist in which he says that the goal of keeping the temperature from rising 1.5º is totally unrealistic, proposing various alternatives. Ukraine’s health system prepares for nuclear disaster. Cholera outbreaks in various parts of the world.

Regarding International Health Policy, the WHO publishes a document on the development of telemedicine in Europe, identifying the problems of the user, technology and infrastructure as the main obstacles to its development. Problems in the British and French health systems.

If we talk about National Health Policy (Spain), the CESM denounces the proliferation of contracts for doctors without a MIR system. Surprisingly, there is no exact figure for how many doctors practice in Spain without MIR. Serious tensions in the Madrid healthcare system, mainly in out-of-hospital emergencies, although not only. It seems that the politics of confrontation prevails, which is neither positive nor desirable. There are no good memories of the famous “white tides” in Madrid, which should not be reactivated. The debate on the delay in access to medicines continues. The Ministry of Health affirms that part of this delay is due to pharmaceutical companies, which prioritize some countries over others in their marketing requests. At the national level, mention must be made of the death of Dr. Fernando Alonso-Lej, the great introducer of the MIR system in Spain and, therefore, deserving of maximum recognition.

In the Corporate arena, internationally J&J acquires a cardiac device company. In our country, it should be noted that the private sector builds more than 80% of nursing homes.

Biomedicine

• A study finds the first evidence of the relationship between low levels of serotonin and depression. The studies come from Imperial College and King’s College, London (https://www.theguardian.com/society/2022/nov/05/study-finds-first-evidence-of-link-between-low-serotonin-levels -and-depression)
• A biotechnology company, Verge Genomics, supported by Merck, Lilly and the private equity firm BlackRock, begins human trials against ALS with drugs discovered by Artificial Intelligence. Big Pharma is very interested in these advances (https://www.ft.com/content/0006ae3f-7064-4aa6-98cd-8912f544acc5)
• A study promoted from Spain, published in Nature, achieves a global consensus that there are covid reservoirs from which new variants could still emerge (https://www.nature.com/articles/s41586-022-05398-2)
• An experimental gene therapy in mice “turns off” neurons involved in epileptic seizures, according to a study published in Science. Refractory epilepsy affects some 100,000 people in Spain (https://www.elmundo.es/ciencia-y-salud/salud/2022/11/03/6363e79dfc6c8386458b45fc.html)

Global Health

• A certain pessimism at the opening of the COP27 climate summit in Egypt (November 7-8, 2022). It is intended to maintain the objective of not exceeding 1.5º of global warming (https://www.ft.com/content/b49f6f7b-eb49-41a3-a0ea-f14a5ab9b404)
• The objective of not exceeding 1.5º of global warming is considered unrealistic, according to an editorial in The Economist. For several reasons: 1st, lowering emissions will require much more money; 2nd, fossil fuels will not be abandoned overnight; 3rd, since the 1.5th goal will not be achieved, efforts must be redoubled to adapt to climate change; 4th, technologies to “suck” carbon dioxide, now in their infancy, will need more attention (https://www.economist.com/leaders/2022/11/03/the-world-is-missing-its- lofty-climate-targets-time-for-some-realism)
• Global warming: Urgent action needed to protect health, The Lancet editorial (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02028-1/fulltext)
• The Lancet 2022 report on global warming: Health at the expense of fossil fuels (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01540-9/fulltext)
• Julio Frenk’s article in The Lancet: Reinforced multilateralism in health after covid. Six lessons from the pandemic, including that there are no effective local responses to the pandemic, without global solutions (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01943-2/fulltext)
• Ukraine’s health system prepares for nuclear disaster. Measures have been taken in hospitals, clinics and other health facilities, as well as storage of medicines, in case of need (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02156- 0/full text)
• Cholera outbreaks are breaking out around the world, spurred on by droughts, floods and armed conflict, at the same time that vaccines are in short supply. Outbreaks have been described in the Caribbean, Africa, the Middle East, and South Asia (https://www.nytimes.com/2022/10/31/health/cholera-outbreaks-vaccine.html)

International health policy

• Monkeypox
  • Despite the drop in cases, the WHO estimates that there are still reasons for concern (https://www.lemonde.fr/planete/article/2022/11/01/variole-du-singe-malgre-une-baisse -des-cas-l-oms-estimate-qu-il-reste-des-raisons-de-s-inquieter_6148116_3244.html)

• COVID-19
  • Account of a ten-day stay in a Chinese detention center on covid (https://www.ft.com/content/77622627-9433-445a-a763-a547b77b58ed)
  • China closes Disney Shanghai due to covid 19 and confines all its visitors (https://elpais.com/sociedad/2022-11-01/confinados-en-el-parque-de-atracciones-miles-de-visitantes-quedan -stuck-in-disneyland-shanghai-after-a-sudden-closure-due-to-covid.html)

• The development of telemedicine in Europe, according to the WHO
  • Main barriers to telemedicine in Europe: user problems, technology and infrastructure (https://www.consalud.es/tecnologia/tecnologia-sanitaria/barreras-telemedicina-europa_122430_102.html)
  • Original article in the Journal of Medical Internet Research (https://pubmed.ncbi.nlm.nih.gov/36301602/)

• The crisis of the British National Health Service
  • The British have the worst access to healthcare in Europe (https://www.ft.com/content/de8fc348-0025-4821-9ec5-d50b4bbacc8d)
  • Young British people go to Eastern countries to train as doctors. The most popular destinations: Bulgaria and Georgia. In 2021, only 12,000 of 102,000 native candidates managed to study medicine and dentistry at British Universities (https://www.economist.com/britain/2022/11/03/young-britons-head-to-eastern-europe-to- train-as-doctors)
  • The UK lags behind other European countries in cancer survival, according to a study published in The Lancet Oncology and conducted by the International Cancer Benchmarking Partnership (https://www.ft.com/content/e5999ea6-fa60 -4b0c-993b-4e88033ba6ea)

• The crisis of the health system in France
  • Unrest in pediatric services, the government announces measures considered insufficient (an aid of 400 million euros) (https://www.lemonde.fr/societe/article/2022/11/03/crise-des-services- de-pediatrie-le-gouvernement-annonce-des-mesures-jugees-insuffisantes_6148275_3224.html)
  • The shortage of occupational doctors worries human resources departments (https://www.lemonde.fr/emploi/article/2022/11/02/la-penurie-de-medecins-du-travail-inquiete-les -services-de-ressources-humaines_6148157_1698637.html)

National health policy

• COVID
  • Report from last Friday: the incidence of covid drops to 185 points, with 161 deaths in one week. 3,363 admitted patients, of which 195 in ICU beds (https://www.consalud.es/pacientes/especial-coronavirus/covid-19-espana-suma-17875-nuevos-casos-161-muertes-ia-desciende -185-points_122464_102.html)

• Health professions
  • Physicians contracted without MIR. There is no exact figure for how many doctors practice without MIR in Spain, although there may be thousands, according to the CESM. Usual practice in the autonomous communities for primary care. (https://www.consalud.es/especial-mir/contratar-medicos-sin-especialidad-mir-espana-riesgo-paciente_122409_102.html)
  • The Ministry of Health, through the General Director of Professional Regulation, defends its efforts to avoid the lack of doctors. It is expected that by 2027 there will be a deficit of 9,000 professionals, being able to reach equilibrium in 2035. A dozen new faculties, on hold (https://www.diariomedico.com/medicina/medico-joven/mir/sanidad-defiende -its-efforts-to-advance-the-balance-between-doctors-supply-and-needs.html)

• Tensions in the public healthcare system in Madrid
  • Out-of-hospital emergencies destroy Madrid’s health system (https://www.epe.es/es/sanidad/20221104/urgencias-extrahospitalarias-madrid-huelga-78127654)
  • The Minister of Health accuses the left of boycotting out-of-hospital emergencies (https://www.epe.es/es/sanidad/20221104/consejero-sanidad-madrid-left-boicotear-urgencies-out-of-hospital-78150767)
  • Editorial of El País: “Health, Madrid as a symptom” (https://elpais.com/opinion/2022-11-05/madrid-como-sintoma.html)
  • Change of criteria regarding the La Paz hospital, the new renovated hospital will not be built “in situ”, but on the land near the Autonomous University (https://elpais.com/espana/madrid/2022-11-03 /ayuso-changes-the-criterion-again-and-now-plans-to-build-from-scratch-the-hospital-of-peace-on-the-grounds-of-the-school-of-medicine -of-the-autonomy.html)

• The debate on access to medicines
  • The Ministry of Health announces how it will speed up the approval of innovative drugs, “with great potential for improvement”, through the revision of the current Medicines Law (https://www.consalud.es/politica/ministerio-sanidad/ health-fast-processes-approve-innovative-pharmaceuticals-potential-improvement_122236_102.html)
  • The Ministry of Health blames pharmaceutical companies for the delay in approving treatments, due to commercial interests of the pharmaceutical companies themselves (https://www.eleconomista.es/salud/noticias/12016974/10/22/Sanidad-culpa- to-the-pharmaceuticals-of-the-delay-in-approving-treatments.html)
  • Darias, in the Health Commission of the Congress: 97% of the oncological drugs authorized by the EC are authorized in our country (https://elglobal.es/politica/darias-el-97-de-los-medicamentos- oncological-authorized-by-the-ec-are-marketed-in-our-country/)

• Private healthcare
  • ASPE publishes a report on private hospitals in Spain. 271 private hospitals have some kind of concert. The prices of the concerts are 50% lower than the average public prices (https://aspesanidadprivada.es/i-informe-aspe-el-precio-medio-concertado-de-los-hospitales-privados-es-un -50-more-competitive-than-the-public-health-care/)

• Other themes
  • The WHO confirms the first two cases of avian influenza in humans in Spain (https://www.rtve.es/noticias/20221104/oms-confirma-primeros-casos-gripe-aviar-humanos-espana/2408006.shtml)
  • The number of suicides in Spain, very high (https://www.elconfidencial.com/espana/2022-11-01/entrevista-jose-luis-carrasco-salud-mental_3513004/)
  • Dr. Fernando Alonso-Lej dies, creator of the MIR system in Spain at the General Hospital of Asturias in the early 1960s (https://www.diariomedico.com/medicina/medico-joven/mir/muere-fernando -alonso-lej-creator-of-the-system-mir.html)
  • “The health system is sinking”, an article by Miguel A. Martínez González, professor at the Department of Preventive Medicine and Public Health at the University of Navarra. The title may be a bit misleading, but what it comes to say is that there is no healthcare system that is capable of withstanding bad health habits. The proposal to replace the emphasis on risk factors with 8 “positive health” metrics is discussed: 1. thinness; 2. no smoking; 3. exercise; 4. healthy eating; 5. tension control; 6. cholesterol control; 7, glucose control; and, 8. sleeping 7-9 hours (https://www.almendron.com/tribuna/el-sistema-sanitario-se-hunde/)

Companies

• International News
  • CVS and Walgreens close to reaching $10 billion settlement to close opioid case (https://www.nytimes.com/2022/11/02/health/cvs-walgreens-opioids-settlement.html )
  • J&J will pay 16.7 billion dollars for a cardiac device company (https://cincodias.elpais.com/cincodias/2022/11/01/companias/1667304410_803238.html)

• National News
  • Werfen, from the Rubiralta family, buys Immucor for 2 billion dollars to strengthen itself in the United States (https://www.plantadoce.com/empresa/werfen-acquire-la-estadounidense-immucor-por-2000-millones-de-dolares.html)
  • The private sector builds more than 80% of the new places in nursing homes (https://cincodias.elpais.com/cincodias/2022/11/03/companias/1667494362_752588.html)
  • Healthcare Assets will launch a neurorehabilitation center in Madrid (https://www.plantadoce.com/empresa/healthcare-activos-pondra-en-marcha-un-centro-de-neurorrehabilitacion-en-madrid.html)
  • Genesis Care sells three of its clinics in Spain for 27 million euros (https://www.plantadoce.com/empresa/genesiscare-vende-tres-de-sus-clinicas-en-espana-por-27-millones-de-euros.html)