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‫יריד הכנה להתמחות ‪2013‬‬
‫פרופ' ערן לייטרסדורף‬
PREDICTION FOR 1999:
DR. LOWRY H. MCDANIEL, CHAIRMAN
AT THE AMA CONVENTION IN ATLANTIC CITY IN 1955
PREDICTION FOR 1999:
DR. LOWRY H. MCDANIEL, CHAIRMAN
AT THE AMA CONVENTION IN ATLANTIC CITY IN 1955
•
•
•
Longevity: A man 90 years old will be considered young,
135 more mature and there will be a minimum of senility
because the heavy cholesterol which determines the age
of our arteries will be absent
Nutrition: Synthetic foodstuff will bring an end forever to
famine and starvation
Communicable diseases: All human infectious disease,
including rheumatic heart disease and venereal disease,
will be eradicated. The common cold and the more serious
respiratory virus infections will be only a memory
PREDICTION FOR 1999:
DR. LOWRY H. MCDANIEL, CHAIRMAN
AT THE AMA CONVENTION IN ATLANTIC CITY IN 1955
•
•
•
•
Menopause: Women, thanks to proper hormone
medication, would stay young, beautiful and shapely
indefinitely
Cancer: Cancer will be successfully treated by a virus
vaccine or radioactive compounds
Diabetes: Insulin will be given in tablet form for the control
of diabetes
Degenerative diseases: Medical science will discover an
effective treatment against the blood, heart and
degenerative diseases of old age
U.N. WORLD
POPULATION
ESTIMATES
1800 TO 2100
http://www.un.org/esa/population/publications/longrange2/WorldPop2300final.pdf
LIFE EXPECTANCY AT BIRTH 2009
Israel
http://www.health.gov.il/English/News_and_Events/Spokespersons_Messages/Pages/23112011_2e.aspx
NCDs account
for 87% of
total death
ESTIMATED NUMBERS OF NEW CASES OF
CANCER (MILLIONS) IN THE WORLD 1975–2050
Bray and Møller Nat Rev Cancer. 7: 1–12 ;2006
CANCER GENOME ANALYSIS IS EXPECTED TO
HAVE FAR-REACHING IMPACT
Stratton MR Science 331:1553-8;2011
MAB-BASED PHARMACOLOGICAL EFFECTS:
14 DRUGS APPROVED BY THE FDA
Modjtahedi H et al. Br Med Bull 2012;bmb.lds032
© The Author 2012. Published by Oxford University Press. All rights reserved.For permissions,
please e-mail: [email protected].
DRUG DISCOVERY AND DEVELOPMENT:
COST OF $1.778 BILLION PER NME LAUNCH
Paul et al. Nature Reviews Drug Discovery 9, 203-214; 2010
‫עלות טכנולוגיות לפי תחומים‬
‫טכנולוגיות‬
‫הוגשו‬
‫אושרו‬
‫אונקולוגיה‬
‫סוכרת‬
‫גנטיקה‬
‫חיסונים‬
‫נוירולוגיה‬
‫המטואונקולוגיה‬
‫גינקולוגיה‬
‫התמכרויות‬
‫גסטרואנטרולוגיה‬
‫ראומטולוגיה‬
‫רפואת ריאות‬
‫לב וכלי דם‬
‫בריאות השן‬
‫תזונה‬
‫עלות‪ -‬מיליוני ‪2013 ₪‬‬
‫למעלה מ‪ 680-‬טכנולוגיות בלמעלה מ‪ 2-‬מיליארד ‪₪‬‬
‫כ‪ 90-‬טכנולוגיות ב‪ 300-‬מיליוני ‪₪‬‬
‫‪99.89‬‬
‫‪28.09‬‬
‫‪26.58‬‬
‫‪21.47‬‬
‫‪20.52‬‬
‫‪19.86‬‬
‫‪18.77‬‬
‫‪14.56‬‬
‫‪11.78‬‬
‫‪8.16‬‬
‫‪7.66‬‬
‫‪6.96‬‬
‫‪6.56‬‬
‫‪2.66‬‬
OBESITY RATES AMONG THE ADULT
POPULATION IN OECD COUNTRIES:
1990, 2000 AND 2009
Israel 13-14%
http://www.health.gov.il/English/News_and_Events/Spokespersons_Messages/Pages/23112011_2e.aspx
US AND UK POPULATION PROJECTIONS BY OBESITY STATUS
ASSUMING HISTORIC TREND
2010
USA
UK
Claire et al. The Lancet 378: 815 – 825; 2011
2030
PREVALENCE OF DIABETES 2010
Israel – 6.5%
http://www.oecd.org/health/healthpoliciesanddata/49105858.pdf
DIABETES IN THE UNITED STATES 1980 - 2050
• Aging population
• Increasing size of
higher-risk minorities
• Declining mortality
among diabetics
Upper bound 95% CI
Lower bound 95% CI
Boyle et al. Population Health Metrics 8:29;2010
THE PROJECTED HEALTH CARE BURDEN OF TYPE 2 DIABETES IN THE UK FROM 2000 TO 2060
Caseload peaks in 2036 and decline towards 2060
Diabetic Medicine 19: 1-5; 2002
Impact Factor 2.902
THERAPEUTIC TARGETS
TO REDUCE CV RISK IN DIABETES
Desouza and Fonseca. Nature Reviews in Drug Discovery. 8:361-367;2009
Cyrus DeSouza & Vivian Fonseca
doi:10.1038/nrd2872
Nature Reviews Drug Discovery
,
8
361-367
(2009)
PREVALENCE OF DEMENTIA IN AGE >60 (2009)
Israel – 5.5%
http://www.oecd.org/health/healthpoliciesanddata/49105858.pdf
ALZHEIMER’S DISEASE CLINICAL TRIALS
Mangialasche et al. Lancet Neurology 9:702-16;2010
J&J AND PFIZER'S BAPINEUZUMAB AND ELI LILLY'S
SOLANEZUMAB DISCONTINUED
http://www.fiercebiotech.com/story/pharma-counts-just-3-alzheimers-drug-wins-13-years-101-losses/2012-09-14
A TALE OF CORONARY ARTERY DISEASE AND
MYOCARDIAL INFARCTION
Nabel and Braunwald N Engl J Med 2012; 366:54-63
IHD MORTALITY 1980-2009
Residual risk
http://www.oecd.org/health/healthpoliciesanddata/49105858.pdf
TRANSPORT ACCIDENTS MORTALITY 2009
Israel – 5.9
http://www.oecd.org/health/healthpoliciesanddata/49105858.pdf
CASUALTIES IN ROAD ACCIDENTS IN ISRAEL
1977- 2009
RATES PER 100,000
http://www.cbs.gov.il/www/publications10/1418/pdf/gr01_h.pdf
ROAD USER DEATHS PER 100,000 DRIVERS
BY TARGET DRIVER AGE
30 - 70
Tefft BC Journal of Safety Research 39:577–582; 2008
Cities are becoming important hubs for
the transmission of infectious diseases
Persons per sq.m
POPULATION DENSITY IN ISRAEL 2009 - 2059
http://www.cbs.gov.il/www/publications/tec27.pdf
Low
Medium
High
INTERNATIONAL TOURIST ARRIVALS 1950 - 2020
http://pub.unwto.org/WebRoot/Store/Shops/Infoshop/Products/1184/1184-1.pdf
DESTINATION CITIES AND PASSENGERS ARRIVING FROM
MEXICO DURING MARCH AND APRIL 2008
(INFLUENZA A H1N1 EPIDEMIC)
Ben Gurion Airport
3066 passengers
Khan et al. N Engl J Med 2009; 361:212-214
GLOBAL WARMING LEAD TO NEW PANDEMICS?
http://www.globalwarmingart.com/wiki/File:Global_Warming_Predictions_png
HEALTHCARE GROWTH EXCEEDS GDP
Copyright © 2010 by McKinsey & Company, Inc., and GSMA
EXPENDITURE ON HEALTH AS PERCENT OF GDP
ISRAEL AND OECD 1995 - 2010
http://www.cbs.gov.il/reader/newhodaot/hodaa_template.html?hodaa=201208211
‫הצרכים‬
‫המשתנים‬
‫התפתחות‬
‫המדע‬
‫הביו‪-‬רפואי‬
‫החוסן‬
‫הכלכלי וסדרי‬
‫העדיפויות‬
‫הלאומיים‬
‫הרפואה לאן?‬
‫יריד הכנה להתמחות ‪2013‬‬
‫פרופ' ערן לייטרסדורף‬