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Hello to all our health correspondents, and welcome to the latest update from the European Alliance for Personalised Medicine (EAPM). There is news today about improving vaccine confidence in the UK and Europe and how preventing cancer is a priority, so forwards we go, writes EAPM Executive Director Denis Horgan.  

First, a quick word about EAPM’s upcoming events –  regarding our ESMO event, please see the agenda here, register here, and there is of course the upcoming participation of EAPM at the German Presidency conference in October, register by clicking here, and see the agenda by clicking here.

Vaccine confidence boost in UK and Europe, doubts globally

Public confidence in vaccines may be improving in the UK and other parts of Europe but many countries worldwide are seeing growing doubts over immunizations, a new study suggests.  Nations experiencing political instability and religious extremism are seeing increasing scepticism over the safety of inoculations, the researchers said, adding that the spread of misinformation is also posing a global threat to vaccination programmes. The study is based on data from more than 284,000 adults across 149 countries in what is thought to be the largest global vaccine confidence survey identifying “hesitancy hotspots”.  In the UK, confidence in vaccine safety rose from 47% in May 2018 to around 52% in November 2019.  In contrast, the researchers said, countries such as Azerbaijan, Afghanistan, Indonesia, Nigeria, and Pakistan showed a fall in confidence in the importance, safety, and effectiveness of vaccines.  

The findings, published in the journal The Lancet, also raise questions over people’s willingness to be given a COVID-19 vaccination should any of the candidates currently undergoing trials prove successful.  In 2019, the World Health Organization (WHO) declared vaccine hesitancy as one of the top 10 threats to global health.  As the race to find a COVID-19 vaccine continues, the authors said assessing public attitudes on a regular basis and taking swift action when confidence is declining “must be top priority to give the best chance to ensure uptake of new life-saving vaccines”.  Poland was one of the countries in Europe which showed “significant losses” in confidence in vaccine safety – a dip from 64% strongly agreeing that vaccines are safe in November 2018 to 53% by December 2019.  The researchers attribute the fall in confidence to “the growing impact of a highly organized local anti-vaccine movement”.

Cancer prevention ‘like Mrs Columbo’

Concerning the effect that COVID-19 has had and continues to have on the EU and Europe as a whole, and on the incidence of cancer, Health and Food Safety Commissioner Stella Kyriakides said: “COVID-19 has been yet another wake-up call, making us acutely aware of the relationship between our ecosystems and our health and the need to face the facts – the way we live, consume and produce is detrimental to the climate and impacts negatively on our health, and with Europe’s future Beating Cancer Plan, we have made a strong commitment to protect the health of our citizens and our planet.”

And preventing cancer appears to be emerging as the most popular point of emphasis for Europe’s Beating Cancer Plan, with a wry observation on a never-seen character from a 1970s TV detective show. “Prevention is like Mrs Columbo from the 1970s detective show Columbo, joked the Commission’s Hana Horka. “Mrs Columbo was frequently invoked, but viewers never saw her. 

“Likewise, governments have stressed in every single meeting the importance of prevention, but only an average of 3% of the budgets go towards that imperative,” she said. “We will probably not see amazing results of the prevention activities over the next two years,” she added, but said that 30 years “is a more realistic time frame”. SANTE’s Matthias Schuppe said a dashboard is being considered as a way to track the Cancer Plan’s results. “The cancer plan is a political priority for the entire Commission, it’s not just a SANTE priority,” Schuppe said. 

HTA ‘missed opportunity’

The rolling reviews of evidence of a substantial list of potential COVID-19 therapies is the “perfect example of what can be done” when EU countries collaborate on health technology assessment, said EUnetHTA’s Marcus Guardian. In the face of an unprecedented situation, it is essential that researched, timely and reliable information be made available to inform all stakeholders, whether they be healthcare professionals or the general public, to help develop a coordinated response to the Covid-19 pandemic. 

However, shortcomings of the majority of the HTAs have been found, according to reports – although most have supported the adoption of biosimilars, these statements have often been based on reports lacking a systematic literature review and not considering economic issues. 

The authors evaluated each report based on whether they covered safety and effectiveness; economic analysis; financial impact; clinical evidence; quality of evidence; organizational considerations; and ethical, social, and legal considerations. The two full HTAs met all criteria. All full and mini-HTAs included a systematic review of the clinical evidence, compared with just 3% of the rapid reviews. Almost half of rapid reviews failed to evaluate the risk of bias of studies, and this has represented a missed opportunity for an HTA to lead to cost savings, argue experts.

France at ‘worrisome’ point in its second coronavirus wave

According to Scientific Council President Jean-François Delfraissy, speaking on Wednesday (9 September) this week, the ‘worrisome’ situation in France is “much more severe” than Italy, but not yet as bad as in Spain, adding that politicians will need to make “difficult decisions” over the next eight to 10 days to protect the health system in certain regions. However, he suggested measures like closing bars would not be a solution.

UK research funding knocked back by COVID-19

UK university leaders on Wednesday warned MPs that the sector’s high tuition fee model needs an urgent re-think, following the huge loss of revenues caused by the COVID-19 pandemic.  “This pandemic has highlighted a long standing issue,” Nancy Rothwell, chair of the Russell Group of research-led universities, and vice chancellor of Manchester University, told the Science and Technology Committee.  “Our research is only funded to 72% of the full cost. That’s been okay, so long as we’ve had international fees, residency [fees], commercial activities coming in. But the pandemic has opened up the Pandora’s box that we’ve all managed to keep the lid on for a while,” said Rothwell. International students are a “very significant cross-subsidy” for research in the UK, the committee heard.  With both domestic student tuition fees and research funding below many universities’ operating costs, overseas student fees are a vital money-maker.  

“They’re worth £2 billion a year to research activities,” said Julia Buckingham, president and chair of the Universities UK lobby group.  The UK, which operates a commercially-oriented university system like in the US, Australia and Canada, has become increasingly dependent on often-exorbitant tuition fees from international students. As a result, its universities are particularly vulnerable during the crisis compared with continental European universities.

And that is all for this week – do check out the information on the ESMO and German EU Presidency conferences, stay safe, and have an excellent weekend.

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