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| SNEAK PEEK |
— At the World Health Assembly today, countries will speak about how to more sustainably finance the World Health Organization.
— The U.S. has stockpiled Ebola treatments, preventing access in countries that desperately need them, argues Doctors without Borders.
— Access to health care varies across Europe, but the Czech Republic is doing well on several fronts, the EU Observatory on Health Systems and Policies says.
Welcome to Thursday’s Morning Health Care! We all try to live sustainably. Now you can continue in the afterlife. A Dutch company is growing coffins in a mold with mycelium — the root-like structure of mushrooms — and hemp fiber. They take just a week to grow and, once six feet under, 45 days to biodegrade – compared with years to grow and rot for wooden coffins. Nearing the end? AP has more.
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| DRIVING THE DAY |
SUSTAINABLE WHO FINANCING: Countries at the World Health Assembly (WHA) will today discuss the possibility of a replenishment model to fund the World Health Organization (WHO), an idea that emanated from the working group on sustainable financing. That group helped shape the decision to increase assessed country contributions to the organization to 50 percent of the core budget by the end of the decade (recap here).
What it could mean: The WHO Secretariat has proposed that the replenishment mechanism has investment rounds, with the first round to be held in the second half of 2024 so as not to clash with other global health fund replenishment rounds in 2025 (getting ahead of the pack we see …). The replenishment would cover a four-year period, and a WHO investors’ forum would bring together the people who usually finance the WHO — countries and other organizations — to discuss the WHO’s program of work.
What else is on at WHA today? Other topics on the agenda include polio eradication, substandard and falsified medical products, and the prevention of sexual exploitation, abuse and harassment within the WHO itself.
On the sidelines: In the morning, the Wellcome Trust is hosting an event on the infectious disease R&D ecosystem, and the Bill and Melinda Gates Foundation, Gavi, UNICEF, and others are hosting an event on building a world without cervical cancer.
At lunchtime, the official WHO roundtable is on ending TB by 2030, with senior officials from Zambia, Brazil and Indonesia speaking, as well as the WHO’s Hans Kluge and the Polish ambassador Zbigniew Czech. Outside the Palais, you can go to the Global Fund, African Union and SADC’s event on health financing reforms. In the evening, there’s an African Union event on health security. See all the other events here.
ICYMI: On Wednesday, Botswana’s former health minister and now co-chair of the Global Preparedness Monitoring Board (GPMB) Joy Phumaphi told an event hosted by Pandemic Action Network and Spark Street Advisors that “we are here today because the world has repeatedly failed to prevent and respond to pandemics.” She said we shouldn’t be waiting for diplomats to agree on a new treaty before making sure we are ready for the next health crisis. Instead, the GPMB wants countries to carry out a simulation exercise on the treaty and the International Health Regulation amendments before they are adopted so that we can see how effective they would actually be.
No thanks: Dutch MEP Rob Roos (Conservatives and Reformists) has made his view on the pandemic treaty clear, worrying that an unelected body, the WHO, will manage it, and that WHO is too heavily influenced by China and Big Pharma.
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| GLOBAL HEALTH |
ACCESS TO EBOLA TREATMENTS: There are two treatments for Ebola but access to them is at a standstill more than two years since their approval, says Doctors Without Borders in a new report. The organization says the U.S.’s emergency stockpile of Ebola treatments contains nearly all currently available treatments. “As a result, these treatments have not been adequately rolled out as lifesaving public health tools for people in countries where outbreaks occur and are instead retained primarily as biosecurity tools,” according to the report. As for the U.N./ WHO global stockpile, Doctors Without Borders says it is still under discussion, with no details on the format, size, governance or price.
R&D effort: An argument is often made that when research is publicly funded, the benefits should be accessible to all at an affordable price. Doctors Without Borders’ report found the “role, scale and breadth of public contributions were particularly noteworthy in the case of treatments for [Ebola].” In particular, they point to the publicly funded Pamoja Tulinde Maisha clinical trial that showed the superior efficacy of the two Ebola treatments.
**A message from PPTA: Compensating donors with a small, fixed monetary allowance increases the volume of plasma collected and has no impact on its quality, or the safety of PDMPs. The European Medicines Agency states that regardless of whether donors are compensated, the safety of plasma-derived medicinal products is not impacted.**
| PHARMACEUTICALS |
EPC’S TAKE ON THE PHARMA LEGISLATION: The pharmaceutical industry doesn’t love the European Commission’s pharmaceutical legislation proposal, but the sector might not have many other places to turn, notes the European Policy Centre’s Elizabeth Kuiper in her analysis of the text.
Besties with Beijing: Increasingly, companies are touting the rise of China as a hub for innovative pharmaceuticals. The subtext is clear: One part a warning to Europe to not make its rules too restrictive lest it fall behind a key rival in the R&D race; another part a reminder that there are greener pastures to decamp to if Brussels turns the screws on the industry too much. But Kuiper warns that China may not be all it’s cracked up to be. The country, for example, eventually supported a TRIPS waiver on COVID vaccines.
Stuck in the middle with you: Meanwhile, Morning Health notes that one traditional pharma stalwart seems to be turning — at least in part — on the sector. The Biden Administration’s Inflation Reduction Act, with its beefed up negotiating provisions for Medicare, has been greeted with horror on the part of industry reps.
EUROPE’S GENERICS PROBLEM: On the topic of China, European medicines manufacturers are warning that a Taiwan Strait crisis could be a disaster for the continent’s supply of medicines. Over the past twenty years, Europe has steadily outsourced the polluting business of generics medicine manufacturing. Many low value-added generic medicines, as well as pharmaceutical ingredients, are now made in Asia — some only in China. But while these medicines aren’t innovative or huge moneymakers the way that cutting-edge branded treatments are, they are routinely used by patients and hospitals. Drug shortages experienced during the pandemic, or this winter, could be a taster of what far more widespread stockouts look like in a geopolitical crisis. More from Carlo here.
| HEALTH SYSTEMS |
BARRIERS TO HEALTH CARE: European countries are often praised globally for their access to health care. But that doesn’t mean everyone has access. Ewout van Ginneken, from the European Observatory on Health Systems and Policies outlined a long list of barriers to access to health care for patients across Europe during a webinar on Wednesday.
Coverage barriers: Does a person have insurance or not? Are all the benefits included in the benefit package? What kind of costs are covered and is there a great deal of cost-sharing that could also hamper access, he asked. “Even if you have all these covered and you’re good to go, then there are barriers in terms of geographics,” he said.
Location: Maybe a provider is too far away, or a patient doesn’t have transport to get there, he said.
Organizational: Once with a provider, waiting lists and problems with the workforce can prevent a patient from receiving care.
Discrimination: “Even if you make it into the doctor’s office, there can be problems with care denial, because of perhaps discrimination or one’s own inability to formulate a care request,” van Ginneken said. Encountering any of these barriers, “you will have an unmet need,” he said.
Surprise smile: In Spain, Portugal, Norway and Italy dental “coverage is quite limited,” said Juliane Winkelmann, also of the European Observatory on Health Systems and Policies. However, in the Czech Republic, Austria and Germany, the benefit basket is “quite comprehensive, even covering dental cleaning, restorative care, prosthesis,” she said.
The Czech Republic also got name-checked for having lower out-of-pocket medicines payments. A woman in her 60s with co-morbidities would have a 20 percent risk of being a catastrophic spender in Bulgaria, around 10 percent risk in Germany, but only 4 percent risk in Czechia, “where there’s not only low fixed co-payments and caps, but there are also exemptions for vulnerable groups,” said Jon Cylus, also from the Observatory.
RIGHT ON CUE: Czech lawmakers also made moves to cut barriers to health care for refugee children on Wednesday. Members of the Senate Committee on Health unanimously voted in favor of recommending that the Senate approve a bill to amend laws that would affect incoming Ukrainians, including foreign minors in the public health insurance system, reports pharmacy news service, zdravotnickydenik.
PRIVATE GAINS: In the U.K., increasing numbers of patients are going private as the National Health Service buckles under pressures including post-pandemic waiting lists. The latest Private Healthcare Information Network (PHIN) data shows a record number of private health care admissions — around 207,000 — in the fourth quarter of 2022, driven by growth in insured treatments and NHS use of private services. The figures bring 2022 private admissions to the highest since records began at 820,000, up 5 percent on pre-pandemic levels.
Among the beneficiaries: U.K. insurer Aviva reported a jump in sales of its private medical cover on Wednesday, which rose 25 percent to £33 million in the first quarter of the year, reported the FT. “Whilst the NHS does a great job for millions of people, there are people who would like to accelerate their treatment, or give themselves that confidence that should something happen to them, they want to have that accelerated treatment,” Aviva’s chief executive Amanda Blanc said.
| MENTAL HEALTH |
BACK TO THE START: The EU’s strategy on mental health is now, once again, expected on June 7, according to the tentative agenda of the College of Commissioners dated to May 23. The date has changed a few times, but Morning Health hopes — for the sake of everyone’s mental health — that this one sticks.
| WHAT WE’RE READING |
Tech millionaire injected with son’s blood in quest for youth, from The Times.
STAT mulls over whether AI will soon diagnose politicians’ mental health conditions from afar.
Paralyzed man walks using device that reconnects brain with muscles, reports The Guardian.
**A message from PPTA: Most countries provide some form of compensation for whole blood and plasma donation. This covers expenses incurred and recognises inconveniences related to donating. In four EU countries (Austria, Czechia, Germany, Hungary), privately-owned centres apply compensation as a fixed-rate allowance ,in accordance with national legislation. All forms of plasma donor compensation in place in the EU are compatible with the principle of ‘voluntary unpaid donation’. The European Medicines Agency notes that “it is important to recognize that a very substantial proportion of the total plasma used in the manufacture of PDMPs used in Europe originates from paid or remunerated donations. A requirement for unpaid or non-remunerated donors would create major supply problems and product shortages without any justification on grounds of safety”.**
