Academy’s advice and position paper

22 Oct The Innovative Power of Health Technologies Recommendations for the sustainable promotion of innovation in medical technology

National Academy of Science and Engineering (acatech)
2014

Health technology and modern medical technology play a key role in healthcare provision in Germany. They provide systems that help patients make a quicker and more complete recovery, help doctors prescribe more targeted treatments with fewer side-effects and allow people with disabilities to lead independent lives. Medical technology encompasses imaging techniques such as X-ray technology, diagnostic measurement techniques such as electrocardiography and both active and passive implants such as cardiac pacemakers and artificial joints. In recent years, computer-assisted surgery and hospital information systems have also increasingly come to the fore. New and improved medical products are thus not only of benefit to patients but also to doctors working in a wide range of different fields and indeed to business and society as a whole.

22 Oct Individualised Medicine Prerequisites and Consequences

National Academy of Science and Engineering (acatech)
2014

One of medicine’s central goals has been and is to heal, relieve or even prevent patients’ diseases. At the beginning of the 21st century, biomedical research and clinical medicine are undergoing a transformation, described by many as a paradigm shift. New approaches based on genome analyses and biomedical technologies are making it possible to analyse biological processes more precisely and more thoroughly than ever before. Associated with this is the goal of better understanding the causes of disease, providing accurate diagnoses, and last but not least, developing highly effective, precisely targeted therapies that have few side effects. For example, our understanding of why people who apparently have the same illness react differently to the same therapy is growing. ‘Individualised Medicine’ is an approach that adds another dimension to our understanding of illnesses. However, a number of ethical, legal and economic questions are associated with Individualised Medicine. This Statement depicts current developments, challenges and framework conditions of Individualised Medicine.

22 Oct Medical care for older people – what evidence do we need?

National Academy of Science and Engineering (acatech)
2017

In Germany today, reaching a very old age is no longer an exception. About 4.5 million people (5.4 percent of the population) are 80 years of age and older, and their numbers continue to grow. In recent decades, the over 85-year-olds have been the group with the fastest and greatest gain in life span and many positive developments for this growing population group have been recorded. The increasing life expectancy and the improved health of older people over a longer period are also attributable to therapeutic and preventive measures, in addition to other factors. Sick old people, however, may possibly have entirely different medical needs than younger people; this is not sufficiently reflected in the German healthcare system. The high standard in medicine, not only in relation to medical care, but also in research of diseases and the development of therapies, focuses typically on middle-aged patients with a single disease. Accordingly, knowledge gained from the treatment of middle-aged people is frequently also applied for older patients – although they differ both physically and mentally from younger people in terms of their medical care priorities and personal circumstances. This does not comply with good scientific practice, and often leads not only to inappropriate care, but may occasionally also actually endanger the concerned patients. Older people, who frequently suffer from multiple chronic disorders, take many medications at the same time, each of which focuses on one individual ailment. This polypharmaceutical treatment does not at times correspond to the health targets of older patients and may even pose a considerable health risk. There is a lack of external evidence on how to improve treatment for multimorbid older and very old people. There is also a lack of guidelines that indicate the current knowledge gaps and risks. At the same time, important medications are often not offered. Therefore, research to provide specific scientific evidence specifically for older people is absolutely essential. New treatment objectives come to the fore and determine the indication for pharmacotherapeutic, surgical and other interventions: In younger patients cure, restoration of working ability or long-term prognoses determine the course of action. In older patients, these priorities are often replaced by independence, quality of life despite complaints, and the relief of symptoms. The pressure for a quick and effective change to the healthcare situation of older people is growing continuously in line with the rapid demographic change. Physicians, therapists and carers alike must adjust to old and very old people in their daily work – particularly in hospital care. This also applies to basic, advanced and continuing staff training and the cooperation with other health care providers. At all points in the medical care chain, from the lack of scientific evidence to the implementation in practical care, the focus must be on older people and their specific needs.

22 Oct Academies call for consequences from the Ebola virus epidemic

National Academy of Science and Engineering (acatech)
2017

The Ebola virus is spreading rapidly and to an unexpected extent. The outbreak does not follow the patterns experienced in the past and the virus shows a new disease dynamic in regions, where it has never been recorded before. The German National Academy of Sciences Leopoldina, acatech – the German Academy of Science and Engineering, and the Union of the German Academies of Sciences and Humanities call for the following consequences to be taken: To combat the Ebola epidemic vaccines and antivirals are urgently needed. To meet this need, the further development of experimental vaccines and medicines for clinical application needs to be accelerated. Even if the pathogen should temporarily disappear again, research must continue as a precautionary measure because another outbreak is highly probable. Such precautionary measures must also include ensuring that sufficient quantities of available vaccines and antivirals are stockpiled in case of a new outbreak. Increasing medical and social science research in this area is also vitally important for future preparedness.