Greece will benefit from the generosity of the Stavros Niarchos Foundation (SNF) as a partnership and will inject capital for three new hospitals and other important health initiatives worth a total of 420 million euros. Expansion of fundamental access to healthcare drives the funding, which will open up more health options, and possibly if rules changed, new research as a care option. The Greek population is one of the healthiest in the world—with some of the longest life spans anywhere while its economy is a poor performer. With improvements to health care infrastructure, why not open up clinical research as well and, in the process, transform itself into a world epicenter for a new model of good health—and wealth.
Thanks to the SNF (billionaire shipping magnate) Newly funded hospitals will include Komotini General Hospital (2024), Sparta General Hospital (2025) and the Thessalonki Pediatric Hospital (2024), to be designed by famous architect Renzo Piano—each facility is budgeted at 90 million euros while the children’s hospital comes in at 150 million.
The funding will also secure four new PET/CT scanners at regional hospitals to increase availability and reduce patient wait times. The Evangelismos General Hospital, Athens, will be updated with technology and equipment for diagnostic advancement. More improvements, such as strengthened Intensive Care Unit and Emergency departments at Evangelismos Hospital, are made possible with additional funders, including Aliki Perroti and Thanassis Martinos. Public and private partnerships are emphasized as the Greek government seeks to improve health care infrastructure.
Other initiatives tie into education, such as bolstering of education at the Nursing Schools of the Evangelismos Hospital and the National and Kapodistrian University of Athens (NKUA), the training of medical and nursing students, EKAV first responders, doctors and the surgeons in the treatment of trauma, and the training of medical personnel in the prevention of in-hospital infections.
Clinical Research in Greece
Several years ago a comprehensive survey found that clinical trials in Greece were segmented by the following therapeutic areas: oncology (26.5%), endocrine disorders (16.4%), cardiovascular disease (13.9%), diseases of the blood (10.3%), respiratory diseases (6.3%), and musculoskeletal disorders (6.3%).
Greece is traditionally underrepresented in volume and amount of clinical research when compared to comparably sized countries in Europe. For example, at least some years ago, Belgium or the Netherlands have three times as much as in Greece; Austria and Switzerland more than twice as much activity while Hungary and the Czech Republic are 175% higher. The European Medicines Agency for pivotal trials generated comparable statistics.
Why is Greece Behind in Clinical Research?
With a population of nearly 11 million, a sufficient and diversified pool of patients, and significant existing health care infrastructure counting 136 public hospitals (23 tertiary), and according to one report at the time, it has the highest number of physicians per capita among OECD members.
With such infrastructure, clinical research should be more robust, dynamic, and voluminous. It would benefit the Greek economy, the Greek health care system, and Greek people. However, as might be suspected, Greek politics and bureaucracy—manifested in the regulatory framework and administrative procedures controlling the conduct of clinical trials could be streamlined. As reported, “bureaucracy and complexity” of approval process within the Greek NHS and lack of emphasis on the importance of not only clinical trials, but also clinical research as a care option merit a serious look.
The Dearth of R&D Investment in Medicines
In fact, by 2017, industry groups bemoaned new government measures spooking clinical sponsors. The European Federation of Pharmaceutical Industries and Associations (EFPIA) reported a few years ago that at least 75 billion euros (30 billion euros in Europe) is invested annually in biopharma research and that Greece’s share is tiny. They offered the comparison of Belgium, with a comparable population of 11.5 million, attracts some 2.5 billion euros. In contrast, Greece attracted less than 80 million euros of which 20% (16 million euros) goes to the State, 15% (12 million euros) to participating hospitals, 5% (4 million euros) to research fund management accounts (ELKEA/ELKE) covering only 4% of pharmaceutical needs.
Bureaucracy, Red Tape and Headache
Reported on by Spyros Filiotis, vice president of the Hellenic Association of Pharmaceutical Industries (SFEE) noted at an event back in 2017 by the Pharma Letter, “Clinical trials are a great opportunity that remains untapped. The country fulfills all the conditions for attracting investment in clinical research and for increasing the investment threefold within three years, to up to 250 million euros annually. The benefits are multiple, especially for participating patients who receive free medicines and early and intensive medical care. However, for this to happen, Greece needs to rationalize and optimize the institutional framework, deal with red-tape, establish a Special Secretariat for Clinical Trials at the Ministry of Health—so as to speed up the relevant processes, effectively reinforce the National Ethics Committee of EOF, and modernize the legal framework with a view to ensuring satisfactory compensation for the medical and nursing staff employed.”
Overall, the Greek society has struggled economically, and times for many are harder than they are easy—from a financial perspective. The Greek government has been taking small steps to move forward and modernize its pharmaceutical sector. But these actions are set in the context of an economy, hit hard during the Financial Crisis of 2008; one that has had fits and starts and about 40% of its GDP is associated with the public sector. Tourism represents nearly 20% of GDP, immigrants represent 20% of the workforce, and the ancient birthplace of Individualism and Democracy is a major beneficiary of EU aid—representing about 3.3% of its GPD. From an economic standpoint, Greece really struggles, ranking 50th of nations below countries such as Peru, Iraq, Romania, Vietnam, etc. Greece has struggled to stimulate economic engines, but clinical research could be such a trigger—given its strategic location on the Mediterranean—near Asian Minor and the Middle East, Northern Africa, and of course, Europe.
Well, with one of the healthiest and longest-living populations, what if the society could generate more wealth for more people by leveraging its health infrastructure to spur a dynamic and robust research culture—one that transforms this important, strategically situated country to an epicenter of where it should be—given where it has been.