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The post-Covid New Normal: a golden opportunity for the NHS?

I recently had the pleasure of attending the PING Conference 2022, which had the tagline of ‘The Golden
The post The post-Covid New Normal: a golden…

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I recently had the pleasure of attending the PING Conference 2022, which had the tagline of ‘The Golden Age for Life Sciences Innovation’. In part, this was due to it being held at The Old Palace at Hatfield House, a location steeped in history and formerly the residence of Queen Elizabeth I, with whom ‘a golden age’ is often associated.

However, it also reflected the optimistic tone of the event, organised by VWV, which aimed to present some rays of light for the future as we (hopefully) emerge from the COVID pandemic.

Aspirations for the UK in life sciences

George Freeman, minister for science, research and innovation at the Department for Business, Energy and Industrial Strategy, opened proceedings by reminding us of some of the UK’s recent achievements and aspirations for the future.

Notable highlights include the central role the UK has played in the field of genomics, with over 500 thousand patients now in the biobank, and the recent RECOVERY trial – the world’s largest clinical trial into treatments for Covid-19, with more than 40,000 participants across 185 trial sites in the UK.

But it is clear there is still much to do, and Freeman reminded us of the billions being invested into UK life sciences to drive three imperatives:

  • Faster access to patients for research
  • Faster access for patients for interventions
  • Data on all aspects, including stratification of patient types

Within those, two things are critical for him: helping NICE become the “world class benchmark agency for HTA”, and a focus on ‘disease missions’ that bring together digital technology with the NHS’s network.

Reducing complexity across the NHS

Matthew Whitty, NHSE innovation and life sciences director, followed on, opening by stating, “Research and innovation cannot be a sexy side project for the NHS… it must be core to brilliant care today and better care tomorrow.”

He then outlined five key areas of focus to help reduce complexity in the NHS, thereby increasing efficiency and innovation through:

  1. Better horizon scanning for new diagnostics and treatments, building on the rapid C19 programme;
  2. reinforcing the UK’s reputation as a leading global centre for research and encouraging more companies to conduct research here, through closer cooperation between the NIHR and NHS, plus embedding it into adjacent strategies, such as the nursing strategy;
  3. more rapidly integrating NICE-approved medicines, diagnostics and devices into care;
  4. greater emphasis on systems and workforce across the NHS, including more education programmes around the adoption of innovation and initiatives such as the Clinical Entrepreneurs Programme, which allow innovators to develop and test solutions while still working within the NHS;
  5. a renewed focus on industry support to make it easier for companies to navigate the UK research environment, with the ‘NHS Innovation Service’ sitting at the core of this.

While Whitty deftly deferred a question around the impact of Brexit on funding to his government colleagues, he does see supporting the workforce as the most pressing priority, along with the need to manage press around the NHS as it innovates.

Accelerating access for patients

Dr Sam Roberts, the new chief executive of the National Institute for Health and Care Excellence (NICE), as of February 2022, discussed the challenges of access to medicines within a health system that is under immense pressure off the back of the pandemic.

Self-proclaiming that she is “naturally cheery by nature, as a South African”, Roberts thinks NICE is doing ‘ok’, despite the occasional negative press at home and feels that its perception outside the UK is more positive.

Indeed, she emphasised that the work done on ensuring access to novel CAR-T therapies was the ‘poster child’ for how it should be done – engaging early with industry partners and collecting informative real-world evidence to guide decision-making.

In view of this, Roberts does not see big changes to the plans already set out by her predecessor in the ‘NICE strategy 2021-2026’ report, however, she does want particular focus on four areas:

  1. Improving the usefulness and usability of NICE’s guidelines by developing digital living guidelines recommendations in breast cancer;
  2. providing quicker assessments of early value to identify the most promising medical devices, diagnostics and digital products;
  3. expanding NICE’s capacity for technology appraisal guidance for medicines by 20% through developing a more proportionate approach;
  4. starting an internal transformation of the way NICE works.

On the latter two points, she outlined how NICE is moving to having a ‘semi-skimmed’ appraisal process for certain interventions, which is being trialled this year, as a lighter version of the current ‘full fat’ approach. In addition, NICE is investigating models around how to bring ‘disease area blueprints’ into the HTA process to take a more holistic approach in specific indications.

Driving predictive health and encouraging innovation

In the second half of the event, the presentations turned more towards the cutting-edge of digital innovation and how to encourage a vibrant start-up ecosystem.

Andy Roddam provided a glimpse of his work as CEO of Our Future Health, a bold initiative that is aiming to get 10% of the UK population – around five million people – to share their health data in the hope of using artificial intelligence to help drive earlier disease detection, prevention and intervention.

The initiative is already well underway and working with ‘traditional’ life science companies, technology/wearable players and those on the frontline of patient contact. For example, it is already partnering with Boots to recruit patients and aligning awareness with routine procedures, such as blood tests, to encourage diversity of uptake.

For sure, Our Future Health is incredibly ambitious, but without better prediction and early intervention, the NHS will continue to face an increasing backlog of patients to treat, so let’s all hope it can succeed (and do get in touch if you can help!).

For initiatives like this, and the broader transformation of the NHS, a vibrant start-up ecosystem is critical, and so the final words went to two investors with some sage advice to entrepreneurs.

Tim Rea (head of Early Stage Investments at BGF) and Alun Williams (investment director at Parkwalk Advisors) have collectively invested well over half a billion into around 200 companies. They see a tough period coming up for smaller companies in view of the global economy and urge them to have a ‘survival plan’ in place for the next two years that allows for no additional fund-raising.

But that said, they do see a lot of good innovation and provided some clear advice for those seeking investment: make sure you have a solution to a problem (and not vice versa), make sure you can tell a good story and think about what’s in it for the investors.

So, with all that said, are we really in a golden age for UK life sciences?

Well, if you come back to the story of Queen Elizabeth I it’s clear that things are very tough right now. We’re probably still aligned to the stage of her life where she was imprisoned, wondering if she would face execution the next day.

But perhaps, with right determination, collaboration and creativity, UK life sciences might come to look back on COVID as a turning point, rather like Elizabeth seeing off the threat of invasion from a foreign fleet, and now remembered as a great monarch.

A golden age? Perhaps. A golden opportunity to innovate out of necessity? Absolutely.

About the author

Dr Paul Tunnah is chief content officer and UK managing director for Healthware Group, a global health innovation and technology leader providing transformational advisory and technology services for commercial, medical, and R&D operations of life-sciences and digital health companies, combined with design and development of digital medicines and digital therapeutics products.

Prior to this, he founded the industry-leading publication, pharmaphorum, in 2009, which also provides broader content communications and marketing services to enable more effective customer engagement. He is a recognised author, speaker, moderator and industry advisor with a passion for helping organisations tell authentic stories that resonate, co-create solutions and unlock the power of digital and social media in connecting with stakeholders and understanding markets.

Dr Tunnah holds a BA in Biochemistry and DPhil in Biological Sciences from Oxford University, where his work focused on identification of novel anticancer therapies. Connect with Dr Tunnah at https://www.linkedin.com/in/paultunnah/ or https://twitter.com/ptunnah

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Analyst reviews Apple stock price target amid challenges

Here’s what could happen to Apple shares next.

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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 Investing.com

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.

More Tech Stocks:

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…

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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 https://www.ivi.int.

 

CONTACT

Aerie Em, Global Communications & Advocacy Manager
+82 2 881 1386 | aerie.em@ivi.int


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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…

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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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