Long-term access to vaccination across Europe (L8)

The one with housemate Rich and vaccines

When I was given my working group for Young Gasteiners and saw ‘vaccines’ on our list of sessions to attend, I struggled to think of how I could link this to my interest area of mental health. As far as I was aware they haven’t yet made a vaccine they could’ve given me when born, to stop me freaking out with professional anxiety, have they? I wasn’t sure, but I was willing to find out…

I start by taking a photo and sending it to an old house mate ‘Rich’ who is just finishing a PhD in vaccine use across the UK to make him jealous.  The room starts half empty, I put that down to fact it was the last day of 3 intense days of networking, thinking, making ‘hmmm’ noises, nodding in agreement and … well late night networking, but it soon filled up as the session went on.

Natasha Azzopardi-Muscat moderating says EU is responding to growing concerns, and people’s imagination running wild, with measles outbreaks STILL HAPPENING in our day and age. I think of Rich and how this information would rile him mad, as he is a ‘pro-vaccine’ campaigner.

Kicking off, An Baeyens from the European Commission gave us a refresh on what procurement is at an EU level.  In a nutshell, it appears to be something that ensures all services that public authorities’ commission, have to meet the EU rules.  They are there to ensure best value for money happens….NOT to force member states to privatise healthcare services, so we are told.  Maybe Rich could enlighten me on this when I get home.

Italy in 2017 created a Compulsory Vaccination Law!!  This is a brave and bold step, and a hefty 500 euro fine for non-compliance after primary school age. Since it has started, there has been an obvious increase in vaccinations being had. Carlo Signorelli said that this is constantly on-going in the political realm and looks to stay that way for some time to come. I think Rich would definitely be happy to see something similar to this in the UK…maybe.

Radu Ganescu, in a stunning suit, told us that in Romania, they’ve actually put forward a very similar framework, but this has spurred 2 years of debate to this day.  One off the big debates going on was the idea to suspend healthcare compensation to those families/children who haven’t had a vaccination. Radu finished talking about Romania having the EU presidency next year, for which he simply stated:

“We should go together and push that everyone across Europe has access to vaccine.”

I think I’ll give Rich his details…

Purchasing & awarding are phrases I normally associate with me ‘purchasing’ a chocolate bar to ‘reward’ myself after my run, not in health care. I say this, but I am aware of health economics and financial procurement with Pharma companies, which we get quick tour de force about in relation to vaccine from Tim Wilsdon.

At the start of this session, due to Rich, I did have some baseline knowledge on this topic, but learning about Compulsory Vaccination and worryingly, how the lack of access to vaccinations, due to money and other political spheres is still a thing, further peaked my interest in this topic.

Sadly they still haven’t created a vaccine that would’ve stopped me freaking out at my age (maybe Rich can make one??  He should know how to do that by now??), but what’s exciting, especially with the EU presidency being with Romania soon, is that vaccine’s will get a deserved spotlight, Rich will love it.

This blog was written by the Young Gasteiner Nicholas Morgan

The value of evidence in outcomes-based healthcare (L7)

A Young Gasteiner’s musings on the applications of big data in health

This blog post relates to the ‘The value of evidence in outcomes-based healthcare’ workshop held at the European Health Forum Gastein on the 5th October 2018.

This lunch workshop was organised by IMI Big Data for Better Outcomes (BD4BO), a European research programme that aims to support the transformation of healthcare systems by means of big data. The programme is a collaboration between the European Union, the European Federation of Pharmaceutical Industries and Associations, academia and civil society.

In his introduction to the BD4BO project, Shahid Hanif (Head of Health Data and Outcomes, Association of British Pharmaceutical Industries) described four key enablers required to unlock the potential of big data in improving health outcomes, access, safety and research:

  • Defining a standard set of outcomes with demonstrated value
  • Access to high-quality outcomes data
  • Using data to improve the value of healthcare delivery
  • Increasing patient engagement through the use of digital solutions

Continue reading

Tackling uncertainties for rare diseases (L6)

Go fast or go far?

I am a medical doctor by trade. As all medical doctors will know, the first commandment of being a medical doctor is ‘first, do no harm’. But a very close second is the mantra that evidence is the holy grail, and the holy grail of evidence is the RCT. But what if an RCT is simply not possible, for example if the disease you are studying simply does not have enough patients to conduct one? That is where Real World Evidence (RWE) comes in. Real World Evidence refers to information collected outside of a clinical trial, for example from electronic medical records, and it can help address evidence gaps in the field of rare diseases.

There are about 7000 rare diseases, defined as diseases that affect fewer than 1 in 2000 people. People with rare diseases are often overlooked when it comes to SDG3. To quote Helen Clark, former prime minister of New Zealand: “No country can claim to have achieved universal healthcare if it has not adequately and equitably met the needs of those with rare diseases.” The small number of patients in these diseases, sometimes as few as 50 or 60 worldwide, makes it very hard to generate evidence the traditional way. This leads to heart-breaking examples where drugs or technologies with possible major impact are developed, but access cannot be guaranteed due to the uncertainties surrounding them. We need to address these evidence gaps. Continue reading

Man vs Machine (L5)

AI is risky but rewarding

Gastein this year has overflowed with optimism about the opportunities presented by the use of AI in healthcare. But many people have deep concerns.

This session, organised by Acumen Public Affairs, was a first for the EHFG: a ‘Cambridge Union’-style debate – there is no need to talk of that other place. This means that two speakers propose a motion, which is voted on by the floor. They then speak in favour for ten minutes and two other speakers respond and argue against the motion. The debate is then opened to questions and comments from the floor, to which both sides get a chance to respond. Finally, the proposing side get five minutes to give their closing remarks, followed by the opposing side, and there is a second vote.Brian O’Connor and Rachel Dunscombe proposed the motion: ‘AI in healthcare: the rewards outweigh the risks’. Tamsin Rose and Martin McKee spoke against, and David Rose and his very loud bell kept everyone to time. Continue reading

Sustainable strategies for addressing health inequalities (F12)

A future we could have

Imagine a sunny autumn weekend in a not so distant future. You’ve had a stressful week at work and you could really use a day off to wander a beautiful alpine valley or maybe have a relaxing stroll at the seaside. You leave for your preferred destination by a train in the morning, you have a tasty and healthy meal after spending a majority of the day hiking and taking photos of scenic panoramas. On your return journey, you share the photos with your friends over social media – as is the norm. You arrive back home quite late completely exhausted. But also relaxed and without any anxieties that bothered you throughout the week. Now imagine the train ride, the tasty meal, and the data transferred to upload photos were all free of charge. Well, at the point of service at least. What would our world look like if we accepted the concept of universal basic services? We are already familiar with the concept when it comes to education and healthcare. Would expanding the array of services to include, for example, transportation, nutrition, and communication make our societies more equitable?

Considering universal basic services as an alternative to universal basic income was one of the concluding remarks of Sir Michael Marmot at the forum on sustainable strategies for addressing health inequalities. It definitely is a bold political choice, but could it be sustainable? Could it be effective? It is an interesting food for thought. But much of the discussion during the forum focused on actions that we can do here and now. Continue reading