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The challenges and opportunities of the #RefugeeCrisis

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The refugee crisis has become a rising challenge and it has been stirring global politics, and there is no easy solution from a historical point of view. During World Refugee Day on 20 June this year, the United Nations released the latest data and statistics on the causes of refugee crisis. The data shows that there are more than 70 million individuals who were forcibly displaced worldwide because of wars, conflicts or persecutions. This has doubled the number of refugees in 20 years. Most of the displaced originate from countries like Syria, Afghanistan, South Sudan, Myanmar and Somalia.

The world today is now polarized to two extremes; the one side is a stable world and the other is turbulent. The stable world plays the role of a savior. On the other hand, a turbulent world is composed of those who despair. They look forward to stabilize the world but only when it is advantageous for them. However, it works the other way when they are seeking opportunities.

Clearly, not everyone understands that stability is the key to success.

In early June this year, Walter Lübcke, president of the Regierungsbezirk of Kassel in Germany was shot at home. During the investigation period, there were many political figures including the mayor of Cologne, who received death threat. As Lübcke was known for supporting the refugee policy of German Chancellor Angela Merkel, the police speculated that his murder might be related to the extreme right-wing forces in Germany. This murder case has caused the German society to be wary of the far-right.

An annual report by the United Nations reveals that the number of refugees worldwide has reached a new high last year. The United Nations High Commissioner for Refugees (UNHCRhas spoken out against the lack of co-operation on the refugee issue in some countries. Apart from 68.5 million refugees, there are still a large number of migrants abroad who are looking for a better working and living condition. According to data estimated by International Organization for Migration (IOM), the number of migrants worldwide has reached 258 million. Among the 68.5 million refugees, 41.3 million were internally displaced and 25.9 million were fleeing from wars and persecutions. There is an increase of 500,000 from the previous year. Based on the data published by UNHCR, one-third of the world’s refugees have actually fled to the poorest countries in the world but the rich countries have only received 16% of the refugees in total. There is a recent exile occurred in Central America where violence and hunger have caused people to flee to countries such as Honduras, Nicaragua, El Salvador and Guatemala. One of their destination is the United States. However, as they are not welcomed by President Donald Trump, most of the refugees are stranded at the U.S.-Mexico border.

China has also created the largest number of refugees in world history, and the recent wave of refugees occurred in the 1950s and 1960s in the last century. Refugees are undoubtedly a crisis for countries with stable structures because integration of the refugees to the society requires huge costs and it may affect the stability of the society’s structure. Nevertheless, refugees may not always be a crisis. World history is actually created by refugees and the most typical refugee country is the United States. Therefore, the refugee crisis can be a problem or an opportunity to others, based on the country’s development conditions.

After the Second World War, France welcomed a large number of writers and artists who had lost their home because of the war. Hence, Picasso and Sartre laid the conditions for the post-war French Renaissance. Besides that, Israel has congregated a large number of elite talents from all over the world, which contribute to today’s modern Israel. The former Soviet Union and Eastern Europe were just the opposite. Many cultural and technical talents perished, and this not only caused national strength of these regions to shrink, but also reduced the population. The Middle East used to be the most important cultural and artistic base but now it has the largest number of refugees in the world. The whereabouts of the few hundred thousand of Arab cultural elites remain unknown.

In summary, the refugee crisis will continue. This is an endless problem to every country and no one can stay out of it.

coronavirus

EAPM and ESMO bring innovations to health policymakers

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For the eighth year in succession, the European Alliance for Personalised Medicine (EAPM) has held a high-level conference series alongside the annual ESMO Congress, writes EAPM Executive Director Denis Horgan.

The EAPM conference was opened with the announcement that the following article was published and contributed to by more than 40 experts across the EU on how to bring Greater Accuracy to Europe’s Healthcare Systems: The Unexploited Potential of Biomarker Testing in Oncology.  Please click here to have access.

Sessions include: Session I: Tumor Agnostic, Session II: Biomarkers and Molecular Diagnostics, and Session III: Utilising Real-World Evidence in a health-care setting.  The conference runs from 08.00 – 16.00. Here is the link to the agenda. The conference aims to bring  key recommendations to the EU level, so as to shape the EU Beating Cancer Plan, EU health Data Space, the updating EU Pharmaceutical Strategy as well as the EU Health Union. 

The conference is held following the first State of the Union address by European Commission President Ursula von der Leyen on Wednesday (16 September) – in her first annual address, von der Leyen said the coronavirus pandemic had underlined the need for closer cooperation, stressing that people were “still suffering”.

For me, it is crystal clear – we need to build a stronger European Health Union,” she said. “And we need to strengthen our crisis preparedness and management of cross-border health threats.” Von der Leyen said her commission would try to reinforce the European Medicines Agency and European Centre for Disease Prevention and Control.

And she also raised the importance of the European Beating Cancer Plan as well as European Health Data Space. “This will show Europeans that our Union is there to protect all,” she said.

Fabrice Barlesi, medical director of Gustave Roussy, said: “RCTs are no longer the way to go. A way ahead could be EU support for trialing a new drug and delivering data to a centralised registry, which could give good consolidated data from across Europe.”

Divided into three sessions, the EAPM conference at the ESMO Congress, as mentioned,  dealt with such diverse issues as tumour agnostics, biomarkers and molecular diagnostics and real-world evidence in a health-care setting. Concerning cancer, specifically tumours, the congress stated that  tissue-agnostic cancer drugs are antineoplastic medicines that treat cancers based on the mutations that they display, instead of the tissue type in which they appear.

These drugs include, for example, Entrectinib, Pembrolizumab and Larotrectinib. Former Spanish health minister and MEP Dolors Moseratt highlighted her support for the work of EAPM and looks forward to getting the recommendations of the outcomes from the conference.  “The European added value of health is obvious. It would avoid duplication and enable a better allocation of resources. And it will minimize the risk of fragmented access to therapy across member states.”

And the EAPM conference is at pains to seek the best ways forward for the implementation of Real-World Evidence (RWE) into health care in Europe – looking to find consensus with key decision makers, including at member state level, not least with representatives in the European Parliament, on how to proceed in this area. RWE for health care is a simple concept – harnessing various health data in real time to help make faster and better medical decisions.

Real-World Evidence is an umbrella term for different types of health-care data that are not collected in conventional randomised controlled trials, including patient data, data from clinicians, hospital data, data from payers and social data.

Rosa Giuliani, consultant in medical oncology at the Clatterbridge Cancer Center, said: “Key elements to advance the use of TACs is to conduct dialogue that transcends silos, and to explore re-engineering of the development pathway.” And, as far as biomarkers and molecular diagnostics are concerned, a lot has been said about testing, and often the lack of it, in terms of the COVID-19 outbreak, with different countries adopting different strategies and, also, having different resources when it comes to acquiring necessary kits.

The key focus in the ESMO session was on better and more equitable access to biomarkers and molecular diagnostics across Europe.  This is a must, but, as the attendees acknowledged, we’re a long way short of it. Access to personalised medicine and new diagnostic technologies can help resolve many inefficiencies, such as trial-and-error dosing, the potential for increased hospitalisation time due to adverse drug reactions and the problem of late diagnoses. It may also enhance the effectiveness of therapies through better tailored treatment administration.

In conclusion for the morning session, Giuseppe Curigliano, associate professor of Medical Oncology at the University of Milano, and head of the division of Early Drug Development, at the European Institute of Oncology said: “A real challenge to overcome is the different endpoints between investigators and payers. Policy frameworks and co-operation is essential.” The session in the afternoon will focus on utilizing real-world evidence in a health-care setting.

A report will be available next week. 

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EU's Barnier still hopes trade deal with Britain possible, sources say

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The European Union’s Brexit negotiator told the bloc’s 27 national envoys to Brussels that he still hoped a trade deal with Britain was possible, stressing that the coming days would be decisive, diplomatic sources with the bloc told Reuters, write and

Michel Barnier addressed the gathering on Wednesday (16 September) and the three sources either participated in the discussion behind closed doors or were briefed on its content.

“Barnier still believes a deal is possible though the next days are key,” said one of the EU diplomatic sources.

A second diplomat, asked what Barnier said on Wednesday and whether there was still a chance for a new agreement with the UK, said: “The hope is still there.”

The first source said tentative concessions offered by the UK on fisheries - a key point of discord that has so far prevented agreement on a new EU-UK trade deal to kick in from 2021 - were “a glimmer of hope”.

Reuters reported exclusively on Tuesday (15 September) that Britain has moved to break the deadlock despite that fact that publicly London has been threatening to breach the terms of its earlier divorce deal with the bloc.

A third source, a senior EU diplomat, confirmed the UK offer but stressed it was not going far enough for the bloc to accept.

Brexit talks descended into fresh turmoil this month over Prime Minister Boris Johnson’s plans to pass new domestic laws that would undercut London’s earlier EU divorce deal, which is also aimed at protecting peace on the island of Ireland.

US Democratic presidential candidate Joe Biden warned Britain that it must honour the Northern Irish peace deal as it extracts itself from the EU or there would be no US trade deal for the United Kingdom.

The third EU source, who spoke under condition of anonymity, said that the bloc would take a more rigid line in demanding a solid dispute settlement mechanism in any new UK trade deal should Johnson press ahead with the Internal Market Bill.

“There is unease about what Britain is doing but Barnier has stressed he will keep negotiating until his last breath,” said a fourth EU diplomat, highlighting the bloc’s wariness about being assigned blame should the troubled process eventually fail.

Asked about an estimate by Societe Generale bank, which put at 80% the probability of the most damaging economic split at the end of the year without a new deal to carry forward trade and business ties between the EU and the UK, the person said:

“I would put it around the same mark.”

Barnier is due to meet his UK counterpart, David Frost, around 1400 GMT in Brussels on Thursday.

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Brexit

Biden warns UK on #Brexit - No trade deal unless you respect Northern Irish peace deal

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US Democratic presidential candidate Joe Biden warned the United Kingdom that it must honour the Northern Irish peace deal as it extracts itself from the European Union or there would be no US trade deal, write and

“We can’t allow the Good Friday Agreement that brought peace to Northern Ireland to become a casualty of Brexit,” Biden said in a tweet.

“Any trade deal between the US and UK must be contingent upon respect for the Agreement and preventing the return of a hard border. Period.”

Johnson unveiled legislation that would break parts of the Brexit divorce treaty relating to Northern Ireland, blaming the EU for putting a revolver on the table in trade talks and trying to divide up the United Kingdom.

He says the United Kingdom has to have the ability to break parts of the 2020 Brexit treaty he signed to uphold London’s commitments under the 1998 peace deal which ended three decades of sectarian violence in Northern Ireland between pro-British Protestant unionists and Irish Catholic nationalists.

The EU says any breach of the Brexit treaty could sink trade talks, propel the United Kingdom towards a messy exit when it finally leaves informal membership at the end of the year and thus complicate the border between Northern Ireland and EU-member Ireland.

The EU’s Brexit negotiator told the bloc’s 27 national envoys that he still hoped a trade deal with Britain was possible, stressing that the coming days would be decisive, three diplomatic sources told Reuters.

Michel Barnier addressed the gathering on Wednesday and the three sources either participated in the discussion behind closed doors or were briefed on its content.

“Barnier still believes a deal is possible though the next days are key,” said one of the EU diplomatic sources.

Johnson told The Sun that the EU was being “abusive” to Britain and risking four decades of partnership.

He said the UK must “ring-fence” the Brexit deal “to put in watertight bulkheads that will stop friends and partners making abusive or extreme interpretations of the provisions.”

Societe Generale analysts said on Thursday they now see an 80% chance that Britain and the EU will fail to strike a trade deal before the end of the year.

Biden, who has talked about the importance of his Irish heritage, retweeted a letter from Eliot Engel, chair of the Foreign Affairs Committee of the US House of Representatives, to Johnson calling on the British leader to honour the 1998 Good Friday peace deal.

Engel urged Johnson to “abandon any and all legally questionable and unfair efforts to flout the Northern Ireland protocol of the Withdrawal Agreement.”

He called on Johnson to “ensure that Brexit negotiations do not undermine the decades of progress to bring peace to Northern Ireland and future options for the bilateral relationship between our two countries.”

Engel said Congress would not support a free trade agreement between the United States and the United Kingdom if Britain failed to uphold its commitments with Northern Ireland.

The letter was signed by Representatives Richard Neal, William Keating and Peter King.

Johnson is pushing ahead with his plan.

His government reached a deal on Wednesday (16 September) to avert a rebellion in his own party, giving parliament a say over the use of post-Brexit powers within its proposed Internal Market Bill that breaks international law.

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