Show me the money, Gastein says

—  Gastein day 1 kicks off with a plea to ramp up investment in health — and ways to do it.
— Can tech help to close the gender health gap? Some think so, but only if its funded and reaches all in need.
— Is COP29 the breakthrough year for health and climate policy? Not so fast…
Welcome to Wednesday’s Morning Health Care! The hysteria over the pint’s future continues in the U.K. One writer says he was “shaking with anger” when he heard about a study that suggested serving two-thirds measures could improve public health. 
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IT’S GO TIME, GASTEIN: The European Health Forum Gastein kicked off on Tuesday under a cloudy sky in the picturesque Austrian spa town of Bad Hofgastein, attracting health aficionados from all over Europe (and beyond). Helen, Claudia and Mari were there to chat with the participants and follow the first panels of the day, including a session on gender health equity, on navigating a digital childhood, and on EU investments for health.
It’s all about the money: Investing in health seems like a no brainer, yet it proves to be increasingly challenging as health priorities shift to the background, overshadowed by other juicier topics. But panelists at the “Unlocking EU investment potential for health” session in Gastein stressed the need to commit to long-term investment into health care systems.
“The case for investing in health is a good case,” Nick Fahy, research group director at RAND Europe said. So despite the impact of the pandemic, “why do we still have to make that case” in 2024, he asked. 
Why is it so hard? “We see health as a good in its own right,” he said, referring to the kind of people who attend Gastein. But others take more convincing, especially when there’s a real challenge in demonstrating concrete returns on investments — unlike in other fields. 
Proving its worth: That’s especially true these days, said Belgium’s Health Minister Frank Vandenbroucke. Governments are facing “many competing challenges … maybe more so in the recent past,” he said. That means health ministers have to convince fellow members of government of the need to invest in the sector. The consensus on the Gastein panel was that cold hard data would be key to proving its worth.
The EU’s great hope in solving that problem? The European Health Data Space. Marco Marsella, a director in DG SANTE’s digital, EU4Health and health systems unit, said the incoming piece of legislation, which will share health data within the EU, will provide access to data that will help in this cause. That’s particularly the case on the European Health Data Space’s “secondary” data, which it is hoped will be shared and used for research purposes.
SOCIAL MEDIA LOVE-IN: Is social media good or evil when it comes to young people’s mental health. Anyone watching a panel on the topic, the final discussion of the day, would likely have come away with the former opinion. With speakers representing Youtube, a young people’s gaming alliance in Sweden, our new TikTok doc in the European Parliament as well as the latest research in the field.
First, the facts: Kathrin Karsay, assistant professor at the University of Vienna, pointed out that from a survey of 1,000 young people in Austria, 75 percent say they are following influencers; and they estimate that 50 percent of their content is created by these people. “Thirty percent say they follow health influencers specifically, although we know, especially with mental health, it’s also the lifestyle influencers talking about mental health. Why? Because when we talk to influencers, they tell us it’s clickable content,” Karsay said. So, it’s also commercial.
Building trust: There’s no easy way to earn people’s trust online with public health content. It takes time, said András Kulja, an MEP doctor and TikTok influencer. His first video, which he painstakingly did himself — earning a fist bump from Götz Gottschalk, head of health at YouTube Germany — his wife said was awful. Now, he’s mastered how to speak in a relatable and fun way about health.
But but but: It takes seven-to-eight hours to make a one-minute video, he said.
How to get health content trending? “It’s already there. It’s super trending,” said Gottschalk. “A lot of doctors or health professionals already learned to do very engaging content.”
Dr Google: “A lot of people speak about Dr Google,” Gottschalk said. “There was never a plan at Google headquarters to say, ‘let’s make Dr Google.’ These (health) queries, which is searches in all language, just keep piling up.”
The good news: Gottschalk and his team consulted experts including at the World Health Organization, to identify what good health content looks like so Youtube can flag credible sources.
‘ADDICTION-LIKE’ SOCIAL MEDIA USE COMMON AMONG ADOLESCENTS: On the other side of the coin, there is concern about social media addiction. And problematic and “addiction-like” gaming and social media behavior is on the rise among adolescents in Europe, a new study published today from the World Health Organization has found.
More than one in 10 adolescents struggle to control their use of social media and experience negative consequences, with girls (13 percent) reporting higher levels than boys (9 percent). Boys (16 percent) are more likely to show signs of problematic gaming than girls (7 percent).
MENTAL HEALTH IN DIGITAL SINGLE MARKET: The European Parliament’s committee on the Internal Market and Consumer Protection is preparing questions for Henna Virkkunen, nominee for executive vice president for tech sovereignty, security and democracy. The committee is interested in mental health (maybe this is the health-in-all-policies approach in action), draft written questions obtained by our colleague Louise Guillot revealed. The questions focus on how the commissioner is going to tackle the mental health pandemic among children and minors driven by online platforms and cyberbullying. 
**A message from MedTech Europe: Empowering women and improving their reproductive health. That’s the #PowerOfMedtech.**
TACKLING GENDER HEALTH GAP: Technology is one way to help squeeze the gender health gap, Gastein delegates heard on the first panel of the conference, along with plenty of shocking stats around women’s health. Here’s a small taster, thanks to Sabine Ludwig, professor of diversity in medicine at Medical University of Innsbruck:
— Every day, there are 800 pregnancy deaths.
— Women suffer worse side effects from chemotherapy, resulting in more treatment being stopped and worse outcomes — because these drugs were not tested enough on women.
— And few people in the audience knew women’s heart attack symptoms: nausea, jaw pain and back ache. Even among health care professionals, this is not well known, leading to later diagnoses.
AI health tech can help: Health apps can help bridge some awareness gaps, while predictive AI models can help predict outcomes. But while investors are flocking to AI start-ups, women’s health firms are struggling.
Funding gap: 70 percent of women’s health start-ups have women founders, pointed out Tatiana Klimanova, director of FemTech Lab, which supports women’s health tech entrepreneurs. But of the $42 billion invested in health tech in 2023, only 2 percent went to female health.
Why? “A combination of systematic bias,” Klimanova said. Investors are largely men and prefer to invest in people that resemble themselves, she said.  
Data challenge: And due to gender bias in clinical trials, it’s vital to carefully identify reliable gender-based datasets to create AI health tech algorithms that work for women.
Over to you, EMA: “There should be guidelines on how to disaggregate data in clinical trials, because they don’t exist at the moment,” said Peggy Maguire, director general of the European Institute of Women’s Health. The European Medicines Agency should develop this, in conjunction with scientists and organizations, she said.
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CAN COP29 DELIVER ON HEALTH? It’s climate week in New York and, for the first time, health is one of the themes. And not before time — 2 billion people, or 25 percent of the world’s population, have experienced 30 days of heat that put their health at risk, the Global Climate and Health Alliance warned on Tuesday.
Developing countries are the most vulnerable but richer countries aren’t safe either. Major floods have already caused havoc across Europe this month. “The human impacts from climate change, caused by the extraction and combustion of fossil fuels, are major and growing,” said Jeni Miller, executive director of the alliance. 
Is COP the answer? At COP28 in Dubai last year, governments finally called for a phase-out of fossil fuels, the direct cause of the climate crisis. Now, Miller said, governments need to go further and commit to no new fossil fuel infrastructure at COP29, which will be held in Azerbaijan in November.
Low expectations: Bill McGuire, a climate scientist and professor emeritus at University College London, told Rory over email he was doubtful that COP29 would give climate and health advocates much to celebrate.
“The impact of climate breakdown on global health is already massive, and is only going to get much worse as the heat builds, crop yields fall, water supplies are compromized, and disease vectors expand their range,” he said.
“Indeed, three decades of climate COPs have done nothing to stop, or even slow, the remorseless rise in emissions that are causing global heating and the health issues it brings.”
SPAIN WILL CHASE THE ‘IMPOSSIBLE’ ON ADVANCED THERAPIES: Spain wants to expand access to advanced therapies with a new version of a plan that has seen 1,406 patients treated with CAR-T therapies over the last six years, Health Minister Mónica García said on Tuesday. A committee will develop a new version of the advanced therapies plan, before the end of the year, which will expand access and include new therapies “that will undoubtedly change the lives of many more patients,” García said. “There is still much to achieve and we are going to make the impossible possible.”
Small print: Spain’s EU-leading, hospital-made advanced therapies might however be under threat — if right-leaning negotiators get their way in the pharma legislation. The European People’s Party rapporteur wanted to significantly restrict this so-called hospital exemption to make cell and gene therapies, while the Commission wanted to standardize the process.
A data-led plan of action is needed to tackle the antibiotic emergency, argues Sally Hughes in The Guardian.
How tackling TB could help win the war on superbugs, in the FT.
‘What happened when my mother became the first 2024 West Nile patient in Manhattan’, from STAT.
**A message from MedTech Europe: Present every step of the way with the most health valuable information. This is what in vitro diagnostics (or IVDs) are: from prognosis, screening, and diagnosis to monitoring the progression of disease and predicting treatment responses, this is the #PowerOfMedtech. Discover more about IVDs and the #PowerOfMedtech.**