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7 days in healthcare (March 18th-24th, 2024)

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Summary

From the point of view of Biomedicine, the transplant to a man of a genetically modified pig kidney stands out, a medical milestone that could lead to dialysis being declared obsolete, which would be an extraordinary advance and an improvement in the quality of life for hundreds of thousands of patients, currently dependent on the machine several times a week for their survival. Also notable is the beginning of a clinical trial on a vaccine for tuberculosis. The current BCG vaccine offers protection to infants and young children, but does not protect adults and adolescents from pulmonary tuberculosis. If the results are good, this vaccine can be transformative.

As far as Global Health is concerned, a study warns of serious declines in birth rates globally, which will mean that by 2050 it will fall below population replacement, which will have important social and labor changes.

Regarding International Health Policy, a great paradox in the USA, although abortion is prohibited in 14 states and restricted in many others, in 2023 there were more abortions than ever, many of them non-instrumental and through the abortion pill, already responsible of 60% of abortions. China is facing a population decline, a phenomenon that has already begun. The one-child policy, in force for 36 years, is only one of the causes of this phenomenon. The European Union is advancing in the approval of pharmaceutical legislation, contemplated with reluctance by both the EFPIA and Medicines for Europe (the two large European pharmaceutical associations). The Lancet sees the upcoming European elections as an opportunity to put health policy higher on the EU agenda.

If we talk about National Health Policy (Spain), three important initiatives of the Ministry of Health: anti-smoking plan, modification of the medical guard regime and waiting lists. In all three cases there may be problems due to the powers and regulations of the autonomous communities. From the point of view of the regions, the OPE of Asturias stands out, which brings together 19,000 candidates. Although logically, temporality was and is a serious problem of public healthcare, which needed a solution, the way to do it through macro-OPE’s (consolidating the position in property, and with hegemony of the administrative and union logic, above the professional and autonomy of organizations) does not seem to be the best. This type of mass examination is more reminiscent of previous calls for the “military service”, when it was in force, than the professional selection for complex organizations, in which the professional qualification, the needs of the different organizations, the projects of the services, etc. should be taken into account.

As for Companies, on an international level, China is seen as the large market for anti-obesity drugs. Bayer wants to renew its portfolio, entering into cell and genetic therapies. As for Spain, the CNMV has released its report on Grifols, with several objections to its accounts. Faes Farma is preparing to grow in Latin America. For its part, DKV, the health insurer, wants to concentrate on group insurance.

Biomedicine

Global Health

International health policy

National health policy

Companies

7 days in healthcare (September 4th-10th, 2023)

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Summary

From the point of view of Biomedicine, in an editorial article, the Financial Times comments on the promise of anti-obesity drugs. Despite the clear benefits of the new drugs, there are unresolved issues: first, the limited knowledge of long-term effects; second, the drug is initially expensive. Private patients in the UK are expected to pay £300 a month; and, third, medications should be a complement rather than a substitute for general lifestyle measures. The first human organ created in an animal opens the door to manufacturing spare parts for people.

With regard to Global Health, the new director of Africa CDC publishes in Nature magazine the new policy guidelines of this body, aimed at addressing public health problems in Africa.

Regarding International Health Policy, it is confirmed that the latest versions of the vaccines are prepared for the new variants. Profound administrative reform of healthcare in Portugal, driven by the socialist government and, specifically, by the SNS administrator appointed about a year ago, Fernando Araujo. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” Despite what has been said, the reform has nothing to do with an implementation of the Spanish Alzira model in Portugal, but it is a public reform. Although some of the measures (business configuration of the management units, board of directors, new financing model in which money follows the patient) “sound good”, the truth is that a reform of this caliber carried out no longer without consensus political but without even public debate it is more than doubtful that it can be successful. He also questions the government’s idea of “getting out of the way” of healthcare by delegating changes to an “administrator.”

If we talk about National Health Policy (Spain), commitment of the Ministry of Health with the measures agreed with the pharmaceutical industry, with the participation even of President Sánchez, to ensure the investment of 8 billion euros. It seems that the conditions are to improve access to medicines; enhance R&D; increase industrial capacities and create supply chains for resilient drugs. Although it is logical and desirable for the government to be “business friendly” with companies in general and with pharmaceutical companies in particular, it is doubtful that such an explicit agreement is the best path for both parties. On the other hand, it must not be forgotten, in view of the government’s commitments, that we are in full discussion of European pharmaceutical policy. Certain relevant changes in the Community of Madrid: possibility of requesting any test from Primary Care and facility for non-EU doctors to work in Madrid. The Royal Decree approving the specialty of emergencies comes out in public hearing, something long awaited and promised, but no less controversial and debatable. The general director of Pharmacy, César Hernández, says that “we do not have a general problem of access to medicines”, which can also be controversial in certain environments.

In the field of Companies, at the international level, Novonordisk becomes the most valuable company in Europe according to market capitalization. Lilly tries to get ahead of Novordisk in the obesity market. Regarding national news, HM Hospitales expands its offer in Madrid with a new polyclinic in an area of intense growth such as Vadebebas.

Biomedicine

Global Health

  • New public health model in Africa. Article in Nature by Jean Kaseya, the new director of Africa CDC. 6 proposals: local manufacture of vaccines; improved tracking system; integrated health systems; laboratory network; emergency response design; robust national institutes of public health (https://www.nature.com/articles/d41586-023-02749-5)
  • Cancers in young people (under 50) have risen by 80% in the last three decades, including breast, lung, stomach and colorectal cancers. (https://www.ft.com/content/b3140954-3cd0-4a3e-b554-92efa7ed7538). Original article in the BMJ: https://bmjoncology.bmj.com/content/2/1/e000049#

International Health Policy

  • Portugal
    • Deep administrative reform of healthcare, promoted by the socialist government. 31 management units (ULS, local health units) are created, which will be public business entities, with a board of directors, and a financing model in which money follows the patient. All hospitals will be assigned to one of these units. Strong criticism for the government’s secrecy in this reform, which has been carried out without prior consultation. The doctors’ order says that the reform will be a “complete disaster.” The reform is attributed to Fernando Araujo, the SNS administrator appointed by the government last year (https://www.portugal.gov.pt/pt/gc23/comunicacao/noticia?i=nova-organizacao-dos-cuidados-de-saude-conheca-a-grande-reforma-do-sns-para-2024)

National health policy

Companies

 

 

 

7 days in healthcare (November 21st-27th, 2022)

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Summary

Most notably from the Biomedicine standpoint, the FDA is approving a drug that could delay the onset of type 1 diabetes, the devastating disease that often occurs in adolescents. Also the preclinical study that seems to foreshadow a universal flu vaccine. Likewise, the minirobot designed by Apple capable of taking medicines to the brain, that organ until now practically inaccessible to drugs.

With regard to Global Health, the COP27 summit is considered in an article in The Lancet a “collective failure”, given the lack of agreement on the lower use of fossil fuels. We must also note the race for the production of vaccines in several African countries.

Regarding International Health Policy, mortality from covid remains high and is very worrying in some countries, mainly Japan, Brazil, India, China, the Russian Federation, South Korea and Spain. The covid-zero policy is generating problems and discontent in a country where public demonstrations are as controlled as in China. The nurses’ strike in the United Kingdom is a historic event in that country, which will undoubtedly will have consequences.

If we talk about National Health Policy (Spain), mortality from covid remains high in Spain (260 cases in the last week). At this time Spain has 0.6 deaths per 100,000 inhabitants, a fairly high mortality, although lower than other European countries, such as France, Greece, Denmark, Norway, Croatia, Estonia and Luxembourg, according to WHO data. The waiting lists for June 30 are published by the Ministry of Health. A real national problem and a serious delegitimization of the public system, which some minimize. The strike of Primary Care doctors continues in Madrid, while the conflict threatens to spread to other autonomous communities. The rise in the electricity bill threatens the profitability of private hospitals, according to ASPE.

In the field of Companies, at the international level, Amazon is making a new foray into healthcare, this time with the “Amazon Clinic” platform, a telemedicine service that will be extended to 32 American states and offers virtual care for 20 clinical conditions. At the national level, news at HM Hospitales, with the new hospital in Rivas; in Recoletas, which extends to Salamanca; and, in Sanitas, which intends to create its own clinical analysis laboratory.

Biomedicine

Global Health

International Health Policy

National health policy

Companies

  • International News
    • Amazon makes a new attempt at healthcare. The offers of the big technological platforms are diversified: Apple tries to monitor through the iPhone; Microsoft, offers computer services to companies; Alphabet (Google), relies on wearables. Amazon launches the most ambitious offer, with “Amazon Clinic”, an online service that will operate in 32 American states and that offers virtual care for 20 clinical conditions, from acne to allergies (https://www.economist.com/ business/2022/11/20/amazon-makes-a-new-push-into-health-care)
    • The big pharma aims for 50,000 million dollars in medicines against obesity, a disease that affects 650 million people in the world, as demand grows. Lilly will submit a drug for authorization (https://www.ft.com/content/f28e8ca1-87a7-4c14-8b05-0ead0e831c0f)

 

 

7 days in healthcare (October 31st-November 6th, 2022)

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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

Global Health

International health policy

National health policy

Companies