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EAPM makes first focus of 2021 on lung cancer

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Welcome, dear health colleagues, to the first update of the week from the European Alliance for Personalised Medicine (EAPM). With the publication of the EU’s Beating Cancer Plan imminent (4 February), EAPM has a full focus on lung cancer taking place this week with its members, writes EAPM Executive Director Dr. Denis Horgan.

Screening – most effective way to combat biggest cancer killer

While there may well be any number of worthy schemes and tactics in Europe to combat the terrible damage wreaked by cancer, one of the most promising modus operandi is being neglected for lung cancer – and many Europeans are dying unnecessarily as a consequence.

Lung cancer, the biggest cancer killer, is still on the loose, largely unchecked, and the most effective method for combating it – screening – is being sidelined. Bearing in mind that screening is very important in treating lung cancer because most cases are discovered too late for any effective intervention, this will be the key issue at the heart of EAPM’s engagement this week. Screening is the use of tests or exams to find a disease in people who don’t have symptoms.

Regular chest x-rays have been studied for lung cancer screening, but they did not help most people live longer. In recent years, a test known as a low-dose CAT scan or CT scan (LDCT) has been studied in people at a higher risk of getting lung cancer. LDCT scans can help find abnormal areas in the lungs that may be cancer.

Research has shown that using LDCT scans to screen people at higher risk of lung cancer saved more lives compared to chest x-rays. For higher risk people, getting yearly LDCT scans before symptoms start helps lower the risk of dying from lung cancer.

70% of patients are diagnosed at an advanced incurable stage, resulting in the deaths of a third of patients within three months. In England, 35% of lung cancers are diagnosed following emergency presentation, and 90% of these 90% are stage III or IV. But detecting disease long before symptoms appear permits treatment that forestalls metastasis, drastically improving outcomes, with cure rates above 80%.Given the potential for such a large number of lives to be positively impacted by a timely diagnosis of early-stage treatable disease, the initiation of these programmes should be given the highest priority by healthcare institutions and providers.

The new EU Cancer Screening Scheme envisaged in the BCP should have its vision extended beyond breast, cervical and colorectal cancer screening to lung cancer. The Commission proposal to review the Council recommendation on cancer screening should at last recognise LC screening. The EU Beating Cancer Plan, setting out the European Union’s strategy for cancer care, will be launched on 4 February. EAPM will be publishing a number of publications in the next weeks to coincide with this Commission publication.

European Court of Auditors assesses COVID-19 response

The European Court of Auditors (ECA) has reviewed the EU’s initial response to the COVID-19 crisis and draws attention to certain challenges faced by the EU in its support for member states’ public health actions. 

These include setting an appropriate framework for cross-border health threats, facilitating provision of appropriate supplies in a crisis and supporting the development of vaccines.The EU’s public health competences are limited.   It mainly supports the co-ordination of member state actions (through the Health Security Committee), facilitates procurement of medical equipment (by creating joint procurement framework contracts), and gathers information/assesses risks (through the European Centre for Disease Prevention and Control - ECDC). 

Since the start of the COVID-19 pandemic, the EU took further action to address urgent issues, facilitating the supply of medical equipment and information exchange between member states, as well as promoting testing, treatment and vaccine research. 

It allocated 3 % of its annual budget by 30 June 2020 to support public health related measures.“It was a challenge for the EU to rapidly complement the measures taken within its formal remit and support the public health response to the COVID-19 crisis,” said Joëlle Elvinger, the ECA member responsible for the review. “It is too soon to audit ongoing actions or assess the impact of COVID-19 related public health EU initiatives, but these experiences can provide lessons for any future reform of the EU’s competences in this field.”

Commission calls on member states to ‘scale up’ vaccination ambitions

The European Commission will today (19 January) call on member states to scale up their ambition in the fight against the pandemic by setting a target of vaccinating at least 70% of the EU’s population by summer. According to the draft of its latest recommendations that we’ve seen, the bloc’s executive will also endorse Greece’s proposal for a “vaccination certificate” that’ll allow those who get the jab to travel. For the rest of us, all non-essential journeys should remain off limits for the foreseeable future, the Commission will say. Beyond that, the “communication” is filled with vague pledges to help boost vaccine production capacity and asks member states to do more genome sequencing to track potentially dangerous mutations. Useful as such pledges and targets may be, they can’t overcome government inefficiency in administering vaccines. 

The procedure the world uses to declare health emergencies “need to be brought into the digital age,” the Independent Panel for Pandemic Preparedness and Response said in a report on Monday (18 January): “A system of distributed information, fed by people in local clinics and laboratories, and supported by real-time data gathering and decision-making tools, is necessary to enable reaction at the speed required — which is days, not weeks — to confront epidemic risk.” The use and scale up of digital health solutions can revolutionize how people worldwide achieve higher standards of health, and access services to promote and protect their health and well-being. 

Digital health provides opportunities to accelerate our progress in attaining health and well-being related Sustainable Development Goal (SDGs), especially SDG 3, and achieving triple billion targets for 2023 as articulated in its Thirteenth General Programme of Work (GPW13). The purpose for a Global Strategy on Digital Health is to promote healthy lives and wellbeing for everyone, everywhere, at all ages. To deliver its potential, national or regional Digital Health initiatives must be guided by a robust Strategy that integrates financial, organizational, human and technological resources.

Vaccination certificate

European Commission president Ursula von der Leyen supports the idea of a common vaccination certificate, which can be established by the EU, and issued by the member states to every person who gets vaccinated against COVID-19. In an interview for Portuguese media, Von der Leyen was asked regarding the proposal of the Greek Prime Minister Kyriakos Mitsotakis to introduce a common document that would be issued to EU citizens who receive the vaccine against COVID-19.

 “It is a medical requirement to have a certificate proving that you have been vaccinated,” von der Leyen said, welcoming the proposal of PM Mitsotakis on a mutually recognised vaccination certificate. A week ago, the Greek Prime Minister sent a letter to the European Commission President Ursula von der Leyen, calling on the European Commission to introduce a Coronavirus vaccination certificate in order to facilitate travel between the bloc.

Belgian minister demands fine for travellers who refuse coronavirus test

Belgian Justice Minister Vincent Van Quickenborne has called for a fine to be imposed on travelers who refuse to take mandatory coronavirus tests. As of earlier this month, Belgium requires people who stay in a so-called “red zone” for more than 48 hours to take a test on arrival in the country and a second test after seven days. If travelers do not comply, they should be fined €250, Van Quickenborne said. “Anybody returning to Belgium today must fill out the passenger location form … each traveler receives a code that entitles them to two tests,” Van Quickenborne said. “Our systems know who is not using these codes.”

Coronavirus variant from UK 'must not get out of hand' warns EU

Concerns were also shared during the virtual meeting of EU health ministers of a “significant under-reporting” of the new variant by member states, with the commission urging health ministries to make detection of the mutation a priority. Germany’s Health Minister Jens Spahn cited the UK-detected variant as he stressed the need for people to further reduce their contact with others, saying the country would not be able to lift all measures aimed at curbing the pandemic by the end of the month.

And that is everything from EAPM for now – enjoy a safe start to your week, see you later this week.

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EU has not yet ordered more AstraZeneca vaccines, says internal market commissioner

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Syringes are prepared to administer the AstraZeneca coronavirus disease (COVID-19) vaccine at a new mass vaccination centre in WiZink sports arena in Madrid, Spain, April 9, 2021. REUTERS/Sergio Perez

The European Union has not yet made any new orders for AstraZeneca (AZN.L) vaccines beyond June when their contract ends, European Internal Market Commissioner Thierry Breton (pictured) said on Sunday (9 May).

Breton also said he expected that the costs of the EU’s recent order for more doses of Pfizer-BioNTech (PFE.N) vaccines would be higher than the earlier versions.

The Commission last month launched legal action against AstraZeneca for not respecting its contract for the supply of COVID-19 vaccines and for not having a “reliable” plan to ensure timely deliveries.

"We did not renew the order after June. We’ll see what happens," said Breton, adding that it was "a very good vaccine".

Concerns has risen on potential side-effects of the Anglo-Swedish COVID-19 vaccine.

Europe's medicines regulator said on Friday it is reviewing reports of a rare nerve-degenerating disorder in people who received the shots, a move that comes after it found the vaccine may have caused very rare blood clotting cases. Read more.

Breton said an increase in prices for second generation vaccines could be justified by the extra research required and potential changes to industrial equipment.

The European Union signed a new contract with Pfizer-Biontech to receive 1.8 billion doses of COVID-19 vaccines for 2021-2023, to cover booster shots, donations and reselling of doses, the European Commission said on Friday (7 May). Read more.

“There may be a little extra cost but I will let the competent authorities unveil it in due course,” he told France Inter radio.

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Hoping to lure back tourists, Greece reopens beaches after lockdown

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With widely spaced sun loungers and regular disinfections, Greece reopened its organised beaches on Saturday as the popular Mediterranean holiday destination eases COVID-19 curbs in preparation for the return of foreign visitors this week.

Tourism accounts for about a fifth of Greece's economy and jobs, and - after the worst year on record for the industry last year - the country can ill afford another lost summer. Read more

"We're pinning our hopes on tourism," said Nikos Venieris, who manages a sandy beach in the seafront suburb of Alimos, just outside the capital, Athens, where social distancing measures will remain in place.

"We're one of the places along the Athens riviera ... that receives many tourists so the number of visitors from abroad will play a big role in our finances," he added.

Under current measures, beach managers like Venieris will have to place umbrellas at least four metres (13 feet), carry out regular disinfections and test beach bar employees and other staff for COVID-19.

People enjoy the sun during the official reopening of beaches to the public, following the easing of measures against the spread of the coronavirus disease (COVID-19), in Athens, Greece, May 8, 2021. REUTERS/Costas Baltas
People enjoy the sea during the official reopening of beaches to the public, following the easing of measures against the spread of the coronavirus disease (COVID-19), in Athens, Greece, May 8, 2021. REUTERS/Costas Baltas

Greece fared well in keeping the first wave of the pandemic under control last year but a resurgence in cases pushed health services to the limit and prompted authorities to impose a second lockdown in November.

As infections have fallen and vaccinations gathered pace, authorities have steadily eased restrictions, opening bars and restaurants earlier this week.

On Friday, they announced that museums would reopen next week before the lifting of travel restrictions on vaccinated foreign visitors on May 15.

Greek Prime Minister Kyriakos Mitsotakis has said a combination of widespread testing, immunisation, and the fact that many activities would take place outdoors gave authorities confidence that tourists would be able to visit safely.

For Greek beach lovers, Saturday's reopening of the country's largest beaches was a chance to let off steam after months of lockdown.

"We've been longing for this for six months now, because we're winter swimmers and we've really missed it," said Spiros Linardos, a pensioner, reclining on a sun lounger at Alimos.

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EU calls on US and others to export their vaccines

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European Commission President Ursula von der Leyen speaks during the opening ceremony of an EU summit at the Alfandega do Porto Congress Center in Porto, Portugal May 7, 2021. Luis Vieira/Pool via REUTERS

The European Commission called on Friday (7 May) on the United States and other major COVID-19 vaccine producers to export what they make as the European Union does, rather than talk about waiving intellectual property rights to the shots.

Commission head Ursula von der Leyen told a news conference on the sidelines of a summit of EU leaders that discussions on the waiver would not produce a single dose of COVID-19 vaccine in the short- to medium-term.

"We should be open to lead this discussion. But when we lead this discussion, there needs to be a 360 degree view on it because we need vaccines now for the whole world," she said.

"The European Union is the only continental or democratic region of this world that is exporting at large scale," von der Leyen said.

She said about 50% of European-produced coronavirus vaccine is exported to almost 90 countries, including those in the World Health Organization-backed COVAX program.

"And we invite all those who engage in the debate of a waiver for IP rights also to join us to commit to be willing to export a large share of what is being produced in that region," she said.

Only higher production, removing exports barriers and the sharing of already-ordered vaccines could immediately help fight the pandemic quickly, she said.

"So what is necessary in the short term and the medium term: First of all vaccine sharing. Secondly export of vaccines that are being produced. And the third is investment in the increasing of the capacity to manufacture vaccines."

Von der Leyen said the European Union had started its vaccine sharing mechanism, citing delivery of 615,000 doses to the Western Balkans as an example.

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