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The World Health Organization (WHO) recommends one allergist for every 50,000 inhabitants. Spain, with more than 46 million inhabitants, would need at least 920 specialists to guarantee proper care. However, there are currently less than 800 allergists. Although there are several Autonomous Communities that have fewer than the recommended number of allergists, the most obvious case is that of the Balearic Islands, which currently does not offer an allergology service in its public health system, the President of the Society explains to ABC Salud Spanish Allergology and Clinical Immunology (SEAIC), the Dr. Antonio Luis Valero.
How many professionals would be needed to meet the needs of the Spanish population?
The number of allergists established by the WHO since 1980 is 1 for every 50,000 inhabitants.
The prevalence of allergic diseases is between 20 and 25% of the population; that is, at some point in life, 1 in 4 people will have an allergic problem of any kind, respiratory, drugs, food, stings, etc. But it is expected that in 2050 this figure will increase and that 50% of the population will be affected throughout their lives by an allergy problem. However, there are currently 800 allergists in public health and it would be necessary to reach 1,000.
Couldn’t the ratio established by the WHO be outdated?
It is a reference that supports us in our demands because the WHO says so. But it is that, despite the fact that it may not be the correct one due to the increase in the number of people with allergies, in Spain we do not even reach that. We have the problem that there are many patients who need specialized care from an allergist and there is a high demand for care. And, furthermore, because each CCAA establishes its resources, there are different ratios that generate a problem of inequity at the national level.
What is the ranking of the Autonomous Communities with fewer allergists than those recommended?
The list is headed by the Balearic Islands, which has only 1 allergist for 1.1 million inhabitants. But the situation is not what it should be in others, such as the Valencian Autonomous Community, 1.1 per 100,000 inhabitants, Cantabria with 1.2, Catalonia with 1.3, Galicia with 1.4, the Basque Country with 1.5, Canarias and Castilla y León with 1.6: while in other Autonomous Communities the ratio is met: Madrid has 2.5; Castile-La Mancha, 2.3; La Rioja, 2.2; Extremadura, 2.1; Navarra, 2.0, and Murcia with 1.9. There is a problem of equity, and not only because in the Balearic Islands there is only one allergist for all the islands, but for example because in other Autonomous Communities in Catalonia, where there are enough professionals in Barcelona, in others, such as Gerona, there are only 4 for 750,000 inhabitants, while in Tarragona with the same population there are 12.
Not only are there few, but they are poorly distributed, which means that, in general, needs are not covered. There is a clear lack of fairness.
Who is responsible for this situation?
It is somewhat shared by the Administration and by the allergists themselves, that we must be active so that our role in health care is recognized. But it is fundamentally a problem of the Administration because, for example, in Madrid there is no question of opening a hospital without an allergology service, while in other Autonomous Communities, small hospitals do not have one.
It is not a problem of professionals. Every year MIR positions are announced, but many of them, 40%, work in private health.
What is SEIAC doing to alleviate or solve this serious problem?
We are trying to get the Health Commission to urge the Balearic Islands Parliament to make a Non-Legal Proposal instructing the Balearic Islands Health Department to start up an allergology service so that there are professionals not only in Mallorca, but also in Ibiza and Minorca. We must not forget that we have been dealing with this problem for 10 years.
What do allergic patients do in the Balearic Islands?
Allergy consultations in the Balearic Islands are among the best in Spain and those who can afford them go. If you are born with some type of allergy in the Balearic Islands, it is better to have money to pay for a private consultation. And we return to the lack of equity because the law says that everyone must have access to the same portfolio of services and specialists necessary to serve you in the best possible way, regardless of where you live. The case of the Balearic Islands is a flagrant breach of the law.
What is the waiting time for a patient with allergies in the Balearic Islands?
It depends a lot on where you live, even in the same CCAA. Thus, while in Madrid it is weeks, in other places it can be months and even years.
But when we talk about allergies, we tend to think of respiratory or food allergies, but it is a specialty that does not target a single organ. For example, treating drug allergies is very important as it can determine the quality and quantity of life of a cancer patient. We have developed desensitization programs for cancer drugs so that patients can follow their therapy.
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