2023-09-06 17:41:47
Updated Wednesday, September 6, 2023 – 17:41
The president of the Spanish Epidemiology Society (SEE), Óscar Zurriaga, recalls the 9.5 million European funds provided for a State Public Health Agency that has not been created
Óscar Zurriaga, president of the Spanish Epidemiology Society (SEE).KIKE TABERNER
Better look to the future. The recent past of Epidemiology in Spain is full of duties to fulfill or, in other words, unfulfilled promises. About the present? “This is not the time to discuss these issues until it is clear how the Government is formed,” says the president of the Spanish Epidemiology Society (SEE), Oscar Zurriaga.
Prior to starting the XLI Annual Meeting of the Spanish Society of Epidemiology (SEE), Zurriaga analyzes with this medium the situation in Spain. Spanish epidemiologists they are not happy. The legislature, which concluded with the call for elections on July 23, has left “sleeping the sleep of the just” royal decrees that were going to change epidemiological surveillance in Spain to make it a fundamental instrument in decision-making in the health and beyond. But it is that, in addition, it has returned to the “starting box” the law creating the State Agency for Public Health.
“The Government has breached its commitment to Europe to create the State Public Health Agency and a new epidemiological surveillance network,” Zurriaga affirms, referring to what appears in the Recovery, Transformation and Resilience Plan, where the Government explains in detail the destination that it was going to give to the European funds planned to repair the damage caused by the covid.
In the sea of pages of the aforementioned document, dated 2021, there is the section that corresponds to Component 18 and there almost 81 million euros are allocated for this “increase in the capacity to respond to health crises.” Of these European funds, 9.5 million were earmarked for the technological equipment of the future State Public Health Agency and 27.4 to provide a new information system for the Public Health surveillance network. Investments that, according to the president of the SEE, have been left up in the air.
In addition to investment in technology, you have been warning of a lack of professionals.We need both human and technical resources. In Spain there is a whole generation that is retiring. Many have already retired and in the following two, three or four years those who belong to the generation that began in the Transition are going to retire, in the structure that was created at that time. There has been a very important break in the call for oppositions, with which the relief is little established in its labor categories. To this we must add the strong blow that the pandemic has represented, which has caused many people to rethink their way of working and their way of living, almost, in epidemiology. Saying: I can’t take it anymore, put me somewhere else!… and that kind of thing.So, epidemiological surveillance in Spain is suffering from that, from a determined impulse to be able to cover vacancies. And, to fill places, what you have to do is very simple: pay them like the others and, then, people will want to go. What others?Like the rest of the health personnel, because they often forget that we are also health personnel. Occurs on too many occasions that the epidemiologist is an official of the general regime, such as those of Agriculture or the Treasury. So, the guards are not contemplated, for example. And in the pandemic it was shown that this entire system was unfeasible. How many epidemiologists have studied medicine?Many, in the Spanish Society of Epidemiology (SEE) represent half of the associates. But having a good epidemiological surveillance network improves the entire health system. We are asking that surveillance systems be modernized. For example, it seems a lie, but we know very little about diabetes.What is it referring to?Well, there is no organized surveillance system for diabetes in Spain that integrates, on the one hand, the pharmacy information on what is being prescribed, the insulins that are being prescribed or the new antidiabetics that are having so much success for other things.
But we don’t know either how many times does a diabetic go to primary care or hospital consultations, how many times he enters… This type of information must be put together and given a surveillance vision and not a purely care vision. Those are the things of the most immediate future and for that technical resources are required, which cost money, and human resources that are capable of working with those technical resources. That is, professionals who are adequately trained. It’s not worth everyone. And for all this, the will of the decision-makers is necessary. with a regulation that makes it possibleand an adequate financial endowment. Now, the epidemiological surveillance budget occupies less than 1% of the health budget.How many epidemiologists do you think Spain needs in an ambitious surveillance system?This is a discussion that we have had for a long time and must be raised first, at the national level, and then in each of the autonomous communities. Because, many times, it is calculated by assigning a certain number of professionals per 100,000 inhabitants, but it is not only that. There are places in Spain where relatively few people live, but zoonoses are very important, because it has a large cattle herd and you have to be very attentive to the surveillance of zoonoses. So the calculation only by population/human cannot be. We must establish risks that we face.
There are also environmental risks in uninhabited places. Until not long ago we had thermal power plants in relatively uninhabited places, but they were producing not only acid rain, but problems of asthma and associated mortality in relatively remote places, because the winds transported what those thermal power plants threw away. So these types of issues must also be dimensioned when calculating the number of epidemiologists that are needed in those sites.
But for that, first, we have to see what epidemiologists do, because now surveillance is very focused on communicable diseases. The rest of the risks are not contemplated: environmental, diabetes, cancer…, therefore, nobody measures them.
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