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Healthcare innovation ETF breaks out as medical robots, wearables and telemedicine lead fight against Covid-19

Healthcare innovation ETF breaks out as medical robots, wearables and telemedicine lead fight against Covid-19



Companies providing innovative healthcare equipment and services have experienced breakaway stockmarket performance recently, with further gains expected as healthcare providers increasingly look to capitalize on advances in technology and science to deliver healthcare outcomes more effectively and efficiently amid the ongoing coronavirus pandemic.

Healthcare innovation ETFs

Healthcare innovators have outperformed the broader sector by more than 11% over recent months.

This is the view of Anthony Ginsberg, Founder and Managing Director of GinsGlobal Index Funds, who recently shared his thoughts on opportunities in the innovative healthcare space in a webcast entitled “The Future of Healthcare: How Innovation in Smart Technology and Life Science is Reshaping Healthcare” hosted by ETF Strategy in partnership with HANetf.

Ginsberg is the co-creator of the HAN-GINS Indxx Healthcare Innovation UCITS ETF (WELL) which provides exposure to firms operating within eight innovative healthcare industries: bioinformatics, bioengineering, genome sequencing, healthcare trackers, nanotechnology, neuroscience, robotics, and medical devices.

The fund tracks the Indxx Advanced Life Sciences & Smart Healthcare Thematic Index which currently includes 107 constituents, sourced from both developed and emerging markets, that derive at least half of their revenue from these innovative, high-growth industries.

The ETF, which comes with an expense ratio of 0.59%, is listed on the London Stock Exchange in US dollars (WELL LN) and pound sterling (WELP LN), on Xetra (W311 GY) and Borsa Italiana (WELL IM) in euros, and on SIX Swiss Exchange in Swiss francs (WELL SW).

According to Ginsberg, WELL offers a significantly different profile compared to traditional healthcare sector funds. In particular, the fund is less exposed to ‘Big Pharma’ stocks as these companies have moved to outsource their research and development to smaller specialist firms.

WELL also stands apart from biotechnology ETFs which may have as few as 30 holdings with concentrated risk in the largest constituents. By contrast, WELL seeks out high-growth segments beyond biotechnology and employs a single-issuer cap of 4.5% at each June rebalance.

This strategy has paid off this year with the fund notably outperforming the broader healthcare sector in recent months.

Following the stockmarket-wide sell-off in February and March, healthcare stocks experienced a sharp rebound as investors priced in potential profits arising from future Covid-19 treatments. From the market’s bottom on 23 March, the S&P 500 Health Care Index gained 36.1% to 27 April, outpacing the 28.8% rise for the S&P 500 over the same period.

However, as initial results from Covid-19 drug trials proved indecisive, political pressure on pharmaceutical companies to put patients before profit has grown and hospitals continue to operate below capacity in anticipation of a potential resurgence in cases, thus putting pressure on the sector’s traditional revenue streams such as elective surgeries, the momentum behind sector’s initial rally has petered out with the S&P 500 Health Care Index rising just 0.3% between 27 April and 3 July.

WELL, on the other hand, has continued to stride ahead, climbing a further 11.5%. It is now up 9.3% year-to-date, outpacing broad healthcare funds such as the iShares S&P 500 Health Care Sector UCITS ETF (IUHC LN) which returned 0.4% (see chart below).

Healthcare innovation ETFs performance covid-19

According to Ginsberg, the ETF has continued to make gains because investors have shifted their focus from short-term jubilation to long-term fundamentals.

What makes the ETF’s underlying holdings so attractive is that they effectively harness contemporary technologies, such as cloud computing, artificial intelligence (AI), and the internet of things, in order to capture long-term healthcare trends.

He notes that the healthcare AI market, already valued at over $50 billion, is expected to reach $150bn by 2026, according to a study conducted by Accenture. While AI applications within healthcare include reducing dosage error, analyzing clinical trials, connecting machines, detecting fraud, and assisting with administrative workflow, Accenture highlights robotic surgery and telemedicine as the two segments most likely to benefit from incorporating AI technologies.

Robotic-assisted procedures are already the gold standard in surgery with incisions being, on average, one-fifth the size of those made by a human hand. This remarkable precision leads to quicker recoveries and shorter hospital durations, helping to reduce hospital expenses by as much as half.

While the significant cost of investing in robotic equipment had initially acted as a barrier to adoption, Ginsberg notes that companies such as Intuitive Surgical, which manufactures and leases its Da Vinci robotic systems, are helping hospitals bridge that gap sooner.

Due to these dynamics, a study by Fortune Business Insights found that the global market for surgical robotics is expected to swell from $1.5bn in 2018 to over $6.8bn by 2026.

Fortune predicts similar growth rates for the telehealth market which stood at $50bn in 2018 but could reach over $260bn by 2026. Ginsberg thinks that number could be even higher as Covid-19 leads to a permanent behavioural shift in favour of remote screening.

Highlighting the effectiveness of telemedicine, Ginsberg notes that patients arriving at London’s Moorfields eye hospital now undergo an initial AI diagnostic that has been proven to provide superior predictive modeling compared to examination from an ophthalmologist.

Despite such impressive feats, Ginsberg believes telemedicine is still in its infancy. With US insurance companies recently moving to include telemedicine within their policies, Ginsberg forecasts a spike in demand that will drive further adoption and innovation for the segment.

Turning to healthcare trackers, Ginsberg points out that medical wearables extend beyond the Fitbit varieties that have become popular in the consumer discretionary market. From blood pressure monitors to biosensors, ECG trackers to emergency pendants, and pulse oximeters to pill dispensers, medical wearables are having a far-reaching effect that is directly helping to save patients’ lives. The segment is expected to enjoy a 40% compound annual growth rate (CAGR) over the next five years, reaching a market size above $87bn.

Biotechnology is still an important feature for the ETF which gains most of its exposure to the segment through investing in genetic sequencing firms. By quickly sequencing the genetic code of Covid-19, these companies were at the forefront of our initial understanding of the current pandemic.

The opportunities in genetic sequencing are further highlighted by how the cost of sequencing a human genome has fallen dramatically from over $100 million in 2001 to just $1,000 today. These reduced costs have made genetic sequencing a realistic avenue for people looking to obtain valuable medical information for future care. The industry has boomed and is expected to grow at a CAGR above 20% over the next four years. Biotech company Regeneron, WELL’s largest holding before the recent June rebalance, has soared 68.1% YTD.

When asked about how the upcoming US elections could impact WELL’s performance, Ginsberg said that the Democrats appear to be on course to retake the Presidency and retain Capitol Hill, while control of the Senate is likely to be hotly contested.

Ginsberg did concede that the Democrats are likely to block large M&A activity which, historically, has delivered pockets of share price growth, but notes that a Democrat victory could offer a tailwind due to the party’s progressives viewing health care as a basic human right.

The Democrats would likely seek to reinvigorate Obamacare by extending cover to the 40% of US citizens that are still uninsured or under-insured. Under such reforms, further pressure will be put on companies to find innovative solutions to keep costs low.

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Analyst reviews Apple stock price target amid challenges

Here’s what could happen to Apple shares next.



They said it was bound to happen.

It was Jan. 11, 2024 when software giant Microsoft  (MSFT)  briefly passed Apple  (AAPL)  as the most valuable company in the world.

Microsoft's stock closed 0.5% higher, giving it a market valuation of $2.859 trillion. 

It rose as much as 2% during the session and the company was briefly worth $2.903 trillion. Apple closed 0.3% lower, giving the company a market capitalization of $2.886 trillion. 

"It was inevitable that Microsoft would overtake Apple since Microsoft is growing faster and has more to benefit from the generative AI revolution," D.A. Davidson analyst Gil Luria said at the time, according to Reuters.

The two tech titans have jostled for top spot over the years and Microsoft was ahead at last check, with a market cap of $3.085 trillion, compared with Apple's value of $2.684 trillion.

Analysts noted that Apple had been dealing with weakening demand, including for the iPhone, the company’s main source of revenue. 

Demand in China, a major market, has slumped as the country's economy makes a slow recovery from the pandemic and competition from Huawei.

Sales in China of Apple's iPhone fell by 24% in the first six weeks of 2024 compared with a year earlier, according to research firm Counterpoint, as the company contended with stiff competition from a resurgent Huawei "while getting squeezed in the middle on aggressive pricing from the likes of OPPO, vivo and Xiaomi," said senior Analyst Mengmeng Zhang.

“Although the iPhone 15 is a great device, it has no significant upgrades from the previous version, so consumers feel fine holding on to the older-generation iPhones for now," he said.

A man scrolling through Netflix on an Apple iPad Pro. Photo by Phil Barker/Future Publishing via Getty Images.

Future Publishing/Getty Images

Big plans for China

Counterpoint said that the first six weeks of 2023 saw abnormally high numbers with significant unit sales being deferred from December 2022 due to production issues.

Apple is planning to open its eighth store in Shanghai – and its 47th across China – on March 21.

Related: Tech News Now: OpenAI says Musk contract 'never existed', Xiaomi's EV, and more

The company also plans to expand its research centre in Shanghai to support all of its product lines and open a new lab in southern tech hub Shenzhen later this year, according to the South China Morning Post.

Meanwhile, over in Europe, Apple announced changes to comply with the European Union's Digital Markets Act (DMA), which went into effect last week, Reuters reported on March 12.

Beginning this spring, software developers operating in Europe will be able to distribute apps to EU customers directly from their own websites instead of through the App Store.

"To reflect the DMA’s changes, users in the EU can install apps from alternative app marketplaces in iOS 17.4 and later," Apple said on its website, referring to the software platform that runs iPhones and iPads. 

"Users will be able to download an alternative marketplace app from the marketplace developer’s website," the company said.

Apple has also said it will appeal a $2 billion EU antitrust fine for thwarting competition from Spotify  (SPOT)  and other music streaming rivals via restrictions on the App Store.

The company's shares have suffered amid all this upheaval, but some analysts still see good things in Apple's future.

Bank of America Securities confirmed its positive stance on Apple, maintaining a buy rating with a steady price target of $225, according to

The firm's analysis highlighted Apple's pricing strategy evolution since the introduction of the first iPhone in 2007, with initial prices set at $499 for the 4GB model and $599 for the 8GB model.

BofA said that Apple has consistently launched new iPhone models, including the Pro/Pro Max versions, to target the premium market. 

Analyst says Apple selloff 'overdone'

Concurrently, prices for previous models are typically reduced by about $100 with each new release. 

This strategy, coupled with installment plans from Apple and carriers, has contributed to the iPhone's installed base reaching a record 1.2 billion in 2023, the firm said.

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Apple has effectively shifted its sales mix toward higher-value units despite experiencing slower unit sales, BofA said.

This trend is expected to persist and could help mitigate potential unit sales weaknesses, particularly in China. 

BofA also noted Apple's dominance in the high-end market, maintaining a market share of over 90% in the $1,000 and above price band for the past three years.

The firm also cited the anticipation of a multi-year iPhone cycle propelled by next-generation AI technology, robust services growth, and the potential for margin expansion.

On Monday, Evercore ISI analysts said they believed that the sell-off in the iPhone maker’s shares may be “overdone.”

The firm said that investors' growing preference for AI-focused stocks like Nvidia  (NVDA)  has led to a reallocation of funds away from Apple. 

In addition, Evercore said concerns over weakening demand in China, where Apple may be losing market share in the smartphone segment, have affected investor sentiment.

And then ongoing regulatory issues continue to have an impact on investor confidence in the world's second-biggest company.

“We think the sell-off is rather overdone, while we suspect there is strong valuation support at current levels to down 10%, there are three distinct drivers that could unlock upside on the stock from here – a) Cap allocation, b) AI inferencing, and c) Risk-off/defensive shift," the firm said in a research note.

Related: Veteran fund manager picks favorite stocks for 2024

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Major typhoid fever surveillance study in sub-Saharan Africa indicates need for the introduction of typhoid conjugate vaccines in endemic countries

There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high…



There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high burden combined with the threat of typhoid strains resistant to antibiotic treatment calls for stronger prevention strategies, including the use and implementation of typhoid conjugate vaccines (TCVs) in endemic settings along with improvements in access to safe water, sanitation, and hygiene.

Credit: IVI

There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high burden combined with the threat of typhoid strains resistant to antibiotic treatment calls for stronger prevention strategies, including the use and implementation of typhoid conjugate vaccines (TCVs) in endemic settings along with improvements in access to safe water, sanitation, and hygiene.


The findings from this 4-year study, the Severe Typhoid in Africa (SETA) program, offers new typhoid fever burden estimates from six countries: Burkina Faso, Democratic Republic of the Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria, with four countries recording more than 100 cases for every 100,000 person-years of observation, which is considered a high burden. The highest incidence of typhoid was found in DRC with 315 cases per 100,000 people while children between 2-14 years of age were shown to be at highest risk across all 25 study sites.


There are an estimated 12.5 to 16.3 million cases of typhoid every year with 140,000 deaths. However, with generic symptoms such as fever, fatigue, and abdominal pain, and the need for blood culture sampling to make a definitive diagnosis, it is difficult for governments to capture the true burden of typhoid in their countries.


“Our goal through SETA was to address these gaps in typhoid disease burden data,” said lead author Dr. Florian Marks, Deputy Director General of the International Vaccine Institute (IVI). “Our estimates indicate that introduction of TCV in endemic settings would go to lengths in protecting communities, especially school-aged children, against this potentially deadly—but preventable—disease.”


In addition to disease incidence, this study also showed that the emergence of antimicrobial resistance (AMR) in Salmonella Typhi, the bacteria that causes typhoid fever, has led to more reliance beyond the traditional first line of antibiotic treatment. If left untreated, severe cases of the disease can lead to intestinal perforation and even death. This suggests that prevention through vaccination may play a critical role in not only protecting against typhoid fever but reducing the spread of drug-resistant strains of the bacteria.


There are two TCVs prequalified by the World Health Organization (WHO) and available through Gavi, the Vaccine Alliance. In February 2024, IVI and SK bioscience announced that a third TCV, SKYTyphoid™, also achieved WHO PQ, paving the way for public procurement and increasing the global supply.


Alongside the SETA disease burden study, IVI has been working with colleagues in three African countries to show the real-world impact of TCV vaccination. These studies include a cluster-randomized trial in Agogo, Ghana and two effectiveness studies following mass vaccination in Kisantu, DRC and Imerintsiatosika, Madagascar.


Dr. Birkneh Tilahun Tadesse, Associate Director General at IVI and Head of the Real-World Evidence Department, explains, “Through these vaccine effectiveness studies, we aim to show the full public health value of TCV in settings that are directly impacted by a high burden of typhoid fever.” He adds, “Our final objective of course is to eliminate typhoid or to at least reduce the burden to low incidence levels, and that’s what we are attempting in Fiji with an island-wide vaccination campaign.”


As more countries in typhoid endemic countries, namely in sub-Saharan Africa and South Asia, consider TCV in national immunization programs, these data will help inform evidence-based policy decisions around typhoid prevention and control.




About the International Vaccine Institute (IVI)
The International Vaccine Institute (IVI) is a non-profit international organization established in 1997 at the initiative of the United Nations Development Programme with a mission to discover, develop, and deliver safe, effective, and affordable vaccines for global health.

IVI’s current portfolio includes vaccines at all stages of pre-clinical and clinical development for infectious diseases that disproportionately affect low- and middle-income countries, such as cholera, typhoid, chikungunya, shigella, salmonella, schistosomiasis, hepatitis E, HPV, COVID-19, and more. IVI developed the world’s first low-cost oral cholera vaccine, pre-qualified by the World Health Organization (WHO) and developed a new-generation typhoid conjugate vaccine that is recently pre-qualified by WHO.

IVI is headquartered in Seoul, Republic of Korea with a Europe Regional Office in Sweden, a Country Office in Austria, and Collaborating Centers in Ghana, Ethiopia, and Madagascar. 39 countries and the WHO are members of IVI, and the governments of the Republic of Korea, Sweden, India, Finland, and Thailand provide state funding. For more information, please visit



Aerie Em, Global Communications & Advocacy Manager
+82 2 881 1386 |

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US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever… And Debt Explodes

US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever… And Debt Explodes

Earlier today, CNBC’s…



US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever... And Debt Explodes

Earlier today, CNBC's Brian Sullivan took a horse dose of Red Pills when, about six months after our readers, he learned that the US is issuing $1 trillion in debt every 100 days, which prompted him to rage tweet, (or rageX, not sure what the proper term is here) the following:

We’ve added 60% to national debt since 2018. Germany - a country with major economic woes - added ‘just’ 32%.   

Maybe it will never matter.   Maybe MMT is real.   Maybe we just cancel or inflate it out. Maybe career real estate borrowers or career politicians aren’t the answer.

I have no idea.  Only time will tell.   But it’s going to be fascinating to watch it play out.

He is right: it will be fascinating, and the latest budget deficit data simply confirmed that the day of reckoning will come very soon, certainly sooner than the two years that One River's Eric Peters predicted this weekend for the coming "US debt sustainability crisis."

According to the US Treasury, in February, the US collected $271 billion in various tax receipts, and spent $567 billion, more than double what it collected.

The two charts below show the divergence in US tax receipts which have flatlined (on a trailing 6M basis) since the covid pandemic in 2020 (with occasional stimmy-driven surges)...

... and spending which is about 50% higher compared to where it was in 2020.

The end result is that in February, the budget deficit rose to $296.3 billion, up 12.9% from a year prior, and the second highest February deficit on record.

And the punchline: on a cumulative basis, the budget deficit in fiscal 2024 which began on October 1, 2023 is now $828 billion, the second largest cumulative deficit through February on record, surpassed only by the peak covid year of 2021.

But wait there's more: because in a world where the US is spending more than twice what it is collecting, the endgame is clear: debt collapse, and while it won't be tomorrow, or the week after, it is coming... and it's also why the US is now selling $1 trillion in debt every 100 days just to keep operating (and absorbing all those millions of illegal immigrants who will keep voting democrat to preserve the socialist system of the US, so beloved by the Soros clan).

And it gets even worse, because we are now in the ponzi finance stage of the Minsky cycle, with total interest on the debt annualizing well above $1 trillion, and rising every day

... having already surpassed total US defense spending and soon to surpass total health spending and, finally all social security spending, the largest spending category of all, which means that US debt will now rise exponentially higher until the inevitable moment when the US dollar loses its reserve status and it all comes crashing down.

We conclude with another observation by CNBC's Brian Sullivan, who quotes an email by a DC strategist...

.. which lays out the proposed Biden budget as follows:

The budget deficit will growth another $16 TRILLION over next 10 years. Thats *with* the proposed massive tax hikes.

Without them the deficit will grow $19 trillion.

That's why you will hear the "deficit is being reduced by $3 trillion" over the decade.

No family budget or business could exist with this kind of math.

Of course, in the long run, neither can the US... and since neither party will ever cut the spending which everyone by now is so addicted to, the best anyone can do is start planning for the endgame.

Tyler Durden Tue, 03/12/2024 - 18:40

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