Country Correspondent: Sonĵ Hall

The Texas Medical Center and the Australian government have signed an agreement to collaborate in medical research and clinical trials. The partnership will position Australian researchers to innovate in the fields of precision medicine, genomics, rare cancers, and brain cancers by sharing ideas and experiences with American colleagues. The medical center houses the world’s largest children’s and cancer hospitals, while the Australian billion-dollar medical research industry is expected to triple in size in the next five years. Last year, the Australian government established an AUD 20 billion (USD 14.3 billion) endowment fund in medical research, which represents the single-largest investment in medical research in the country’s history.

• Medical research collaboration between Australian and United States researchers

Correspondent: Sonĵ Hall

In October 2018, the World Health Organization declared that Australia has eliminated rubella, an infectious disease that can result in miscarriage, stillbirth, or lifelong complications for babies. Australia operates a free, national vaccination program for all babies and children, at a cost of AUD 420 million (USD 300 million) a year. This investment, combined with state regulations that require school-age children to be vaccinated, has resulted in nearly 95 percent of five-year-olds having been vaccinated against Rubella and a range of other contagious diseases. This month also saw the release of SmartVax, the Australian government’s real-time surveillance program for tracking adverse reactions to all vaccinations. In 2014, Australia eliminated measles, another childhood disease.

• Rubella officially eliminated from Australia
• Vaccine side effects: Australia's world-first surveillance system

Country Correspondents: Roosa Tikkanen, Danielle Rodin

In the summer of 2018, the Ontario government announced that it was freezing the number of new overdose prevention sites until a review of the effectiveness of these facilities had been conducted. The move led to protests by more than 800 health care providers and 120 advocacy groups, including the Canadian Medical Association. These advocates called the move “potentially fatal” and “unnecessary,” referring to evidence showing that supervised consumption sites reduce fatal overdoses, the spread of HIV and hepatitis C, and public drug use. In October, Ontario Health Minister Christine Elliot announced plans to continue funding these sites, stating that “the evidence clearly demonstrated that these sites were necessary.” In 2017, 1,261 people died from an opioid overdose in Ontario, up from 867 in 2016.

• Ontario health providers protest pause on overdose prevention
• Ontario government to keep funding overdose-prevention sites

Country Correspondents: Roosa Tikkanen, Danielle Rodin

British Columbia has signed a bilateral agreement with the Canadian government that will channel more than CAD 71 million (USD 51 million) toward substance use disorder treatments. The 2018 federal budget allocated CAD 150 million (USD 107 million) as an Emergency Treatment Fund, which provides matching funds to provinces as part of efforts to address the opioid crisis. The province will use the funds to expand access to recovery services, including youth programs, injectable opioid agonist drugs, inpatient treatment beds, and supportive recovery options. In 2017, one of eight Canadians reported having used opioid pain relievers in the past year; of this number, 3 percent reported “problematic” use.

• The governments of Canada and British Columbia are providing more than $71.7 million in innovative treatment options for people with substance use disorders
• Health Canada Releases Latest Federal Data on Tobacco, Alcohol and Drug Use - Results point to the need for continued work to help Canadians lead healthier lives

Country Correspondent: Paul Dourgnon

In October 2018, the French Ministry of Health convened a meeting to assess the extent of misuse of opioid pain medications and consider potential solutions. At the same time, the French Observatory of Analgesic Medicines, a new agency set up in November 2017, released data showing that the number of opioid overdoses among chronic-pain patients in France exceeded deaths among illicit drug users. During the past 10 years, the number of prescriptions for strong painkillers, including fentanyl and morphine, have more than doubled in France, while hospitalizations for overdoses have increased by 67 percent and overdose fatalities by 46 percent. Experts point to the need to invest in more pain treatment units and convince health authorities that France is facing a public health crisis that needs to be addressed.

• Décès liés aux opioïdes: «En France, on a plus d’overdoses chez les patients douloureux chroniques que chez les usagers de drogue» (in French)
• Prescription opioid analgesic use in France: Trends and impact on morbidity–mortality

Country Correspondent: Paul Dourgnon

France’s 2019 Social Security Budget bill states that starting in 2020, patients who refuse generic drug prescriptions without a valid medical reason will have higher out-of-pocket costs for these drugs through the country’s public health insurance. In addition, doctors will have to provide a written justification when prescribing brand-name drugs instead of generics. Since 2013, 80 percent of brand-name drugs are substituted for generics in France. The public health insurance system is expected to save up to EUR 100 million (USD 113 million) from lower reimbursement of brand-name drugs and the resulting increases in generic drug consumption.

• Médicaments: les patients refusant les génériques moins bien remboursés en 2020 (in French)

Country Correspondent: Paul Dourgnon

In September 2018, French President Emmanuel Macron announced a new “health transformation strategy” that positions health care as a pillar of his 21st-century welfare state. The plan's 54 measures includes the creation 400 new positions for general practitioners, who would divide their time between their practices and hospitals. In addition, 4,000 medical assistants would be introduced by 2022 to conduct simple medical procedures, assist patients in navigating the medical system, and perform some administrative tasks. The plan also devotes additional investments to create a unique electronic health record for each patient and end the national cap on the number of medical students.

• Standing by France's social contract: Macron's health reform

Country Correspondent: Michael Laxy

German patients enrolled in a “family-physician contract,” in which their family physician acts as a gatekeeper to specialty services, have longer life expectancies and lower hospitalization rates, according to a new study. These contracts were introduced in 2004 and now enroll around 4.8 million Germans. The evaluation, which was based on claims data of more than 1.3 million people in the Baden-Wurttemberg region, also showed that enrollees had lower rates of unnecessary imaging for chronic back pain, higher influenza vaccination rates among adults age 60 and older, and lower rates of severe complications from diabetes compared with people not enrolled. The evaluation also found that the contracts led to cost savings from reduced hospitalizations and specialty visits and lower medication use.

• Hausarztzentrierte Versorgung: Patienten geht es besser (in German)

Country Correspondent: Roosa Tikkanen

In October 2018, health ministers from 47 countries came together to discuss the shared mental health challenges facing their nations in the first-ever Global Ministerial Mental Health Summit, held in London. The event was hosted by the Organisation for Economic Co-operation and Development and the U.K. Department of Health and Social Care, with support from by the World Health Organization. The summit produced a Global Declaration that documents political leaders’ commitment as well as coordinated action to reduce the stigma of mental illness, expand access to prevention and treatment, and develop innovative, evidence-based solutions. In addition to ministers, the event attracted delegates from 61 countries including researchers, policymakers, patients, members of royal families and celebrities, and U.K. Prime Minister Theresa May.

• World’s first global ministerial mental health summit to be held in London
• UK to host world’s first Global Ministerial Mental Health summit 9-10 October 2018
• CGMH at the Global Ministerial Mental Health Summit

Country Correspondent: Margje Haverkamp

The Dutch nonprofit Blood Institute, Sanquin, has partnered with Riot Games, a developer that produces the League of Legends, one of the world’s most popular video games, to attract young male donors. Dutch gamers who scheduled an appointment to donate blood between August and December 2018 at a Sanquin center and sent in a selfie received a free “skin” (a graphic file used to change a character’s appearance). The campaign was marketed with the hashtag #MyFirstBlood, ahead of the European League of Legends Championship Series held in September 2018. The initiative was a success; by the end of September, 1,000 gamers, mostly young men ages 18 to 35, had donated.

• Riot Games partner with Sanquin on blood donation campaign
• Dutch blood bank urges League of Legends gamers to back #myfirstblood
• Gamers worden bloeddonoren met #myfirstblood (in Dutch)
• Sanquin strikt duizend gamers als bloeddonor (in Dutch)

Country Correspondent: Margje Haverkamp

Paul Blokhuis, the State Secretary for Health in the Netherlands, has promised to create a national phone number for people to call when they are worried about a person experiencing a mental health crisis. The number will transfer to a regional call center, where staff can set up an emergency referral to a psychiatrist for medication adjustment or a home health visit. The move is expected to ease the burden on the national emergency number 112, which is not equipped to deal with mental health crises.

• Landelijk nummer voor verwarde mensen (in Dutch)

Country Correspondents: Roosa Tikkanen, Jennifer Schulz Moore, Aisha Gomez

The Smile NZ Free Dental Day, held in September 2018, provided free treatments to low-income patients across New Zealand. In its fourth year, the event saw 78 dentists volunteering across 55 dental practices to treat up to 925 low-income Kiwis with an urgent dental problem. Patients received treatments for fillings, tooth restorations, extractions, fluoride applications, and pain relief. Unlike medical fees, dental fees for adults are not subsidized by the New Zealand government, making dental care unattainable for many. The annual event, organized by the Southern Cross Health Trust and the New Zealand Dental Association, has provided treatments to more than 2,200 people since 2015.

• Free dental care for low income Kiwis
• Smile NZ Free Dental Day

Country Correspondent: Marianne Storm

Like many other countries, Norway is exploring new ways of paying for expensive new drug therapies. In an effort to negotiate lower prices for certain medicines, Norwegian Health Minister Bent Høie has signed a letter of intent with Denmark to cooperate on price negotiations with drug manufacturers. The hope is that Norway and Denmark —small countries with 6 million or fewer residents each — will have more leverage when negotiating jointly.

• Norge og Danmark inngår avtale om felles forhandlinger om legemiddelpriser (in Norwegian)

Country Correspondent: Ulrika Winblad

During the past few years, several private companies in Sweden have begun offering basic health care through virtual meetings with physicians, nurses, and other clinicians. Recently, these telehealth providers have begun partnering with supermarket chains to open “Minute Clinics” near supermarkets, where people can be examined by nurses or receive telemedicine consultations with physicians. There are currently eight Minute Clinics, and more will open as a result of a SEK 500 million (USD 54 million) investment by the ICA Group, owner of the largest supermarket chain in Sweden, in the digital care company Min Doktor, one of the largest digital care providers in Sweden.

• Icas investering ska ta Min Doktor till glesbygden (in Swedish)
• ICA Gruppen och Apotek Hjärtat satsar på tillgänglig vård med Min Doktor (in Swedish)

Country Correspondent: Ulrika Winblad

More than 720 Swedish general practitioners (GPs) have signed a petition stating that if more resources are not invested in the primary health care sector, it will collapse. The physicians fear they will not be able to handle the prevention and care of chronically ill patients, which in turn will add to the workload within specialist, acute, or hospital care. They are also concerned about their working environment, with about one of five GPs having taken leave because of stress-related conditions in the past five years. The physicians call for the different political parties to come together to reach consensus on a national strategy for recruiting and retaining primary care physicians, more time set aside for research and training, and a maximum cap of 1,500 registered patients per full-time GP.

• Över 700 läkare i upprop för en nationell plan för primärvården (in Swedish)

Correspondent: Lars Hemkens

The standard premiums for Swiss mandatory health insurance for adults age 18 and older will increase on average by 4.0 percent in 2018, the Swiss government announced — more than the 3.7 percent per year seen over the past 10 years. Premiums for children and for young adults ages 19–25 years will increase even more, by 5.0 percent and 4.4 percent, respectively. These average increases do not reflect regional variation, however. Eight cantons will see a smaller increase of only 3.0 percent for adult premiums, while four cantons will see a full 5.0 percent increase.

• Swiss health insurance premiums to rise four percent on average in 2018
• Wachstum der Gesundheitskosten: Standardprämie 2018 steigt um 4,0 Prozent

The standard premiums for Swiss mandatory health insurance for adults age 18 and older will increase on average by 4.0 percent in 2018, the Swiss government announced — more than the 3.7 percent per year seen over the past 10 years. Premiums for children and for young adults ages 19–25 years will increase even more, by 5.0 percent and 4.4 percent, respectively.

Country Correspondent: Lars Hemkens

Results of the 2017 national health survey in Switzerland, released in October 2018, showed that the proportion of overweight and obese people has remained constant, at 31 percent and 11 percent, respectively, over the past 10 years. However, rates of overweight and obesity have increased since 1992, from 25 percent and 5 percent, respectively. The survey also revealed a strong social gradient, with 21 percent of people who have completed only compulsory schooling being obese, in contrast to just 8 percent of those with higher qualifications. Overall, the majority of Swiss people age 15 and older report being in good health, including two-thirds of adults age 75 and older. The 2017 survey included 22,134 persons; it has been carried out every five years since 1992.

• Schweizerische Gesundheitsbefragung 2017 (in Swedish)
• Number of smokers has remained stable for 10 years, change in alcohol consumption behaviour

Country Correspondent: Partha Das

Loneliness has been described as a health epidemic in the U.K., with 1.4 million adults age 50 or older reporting that they often felt lonely in 2016–17. Chronic loneliness has been associated with health risks, including an increased risk of developing Alzheimer’s disease later in life. A new analysis by the charity Age UK using data from the English Longitudinal Study of Ageing showed that older adults are nearly four times more likely to often feel lonely if they are in poor health than are those in good or excellent health. The report makes several policy recommendations for the government’s loneliness strategy, such as including a “loneliness test” in future policy proposals to measure their potential impacts on social networks and community resources. The number of lonely older adults is predicted to increase by nearly 50 percent in the next 10 years, to more than 2 million by 2025.

• All the Lonely People: Loneliness in Later Life

Country Correspondent: Partha Das

In October 2018, just months after appointing its first minister for loneliness, the U.K. has appointed Jackie Doyle-Price as minister for suicide prevention. The role will focus on raising the profile of mental health issues in Britain so that they are prioritized as much as physical health. Both appointments are part of a broader campaign to cope with mental health problems following a decade-long austerity budget. In addition, the U.K. government has pledged additional support in the form of specialist teams to address mental health issues in schools and tools to assess students’ psychological well-being. Suicide is the leading cause of death for men under age 45, and one-quarter of young people who require mental health services are unable to get help, according to a government report. The creation of the new post was announced in conjunction with the U.K. hosting the global mental health summit in London.

• World Mental Health Day: PM appoints suicide prevention minister
• Theresa May appoints first ever minister for suicide prevention
• U.K. Appoints Minister for Suicide Prevention

Editorial Team

Editor: Roosa Tikkanen

Co-editor: Molly Fitzgerald

Project manager: Aisha Gomez

Country Correspondents

Australia — Sonĵ Hall

Canada — Danielle Rodin

Europe/International — Roosa Tikkanen

France — Paul Dourgnon

Germany — Michael Laxy

Netherlands — Marthe Haverkamp

New Zealand — Jennifer Moore

Norway — Marianne Storm

Sweden — Ulrika Winblad

Switzerland — Lars Hemkens

United Kingdom — Partha Das