The medicine industry - which is not only the pharmaceutical industry, but also the diagnostic, medical device, dietetic and alternative medicine industries - seems to dictate guidelines and rules rather than being attentive to the true needs of the National Health Service, a precious asset that should not be weakened or even lost. Diseases are invented, the parameters of normality are lowered, everything is medicalized in order to often sell the most useless things. The path that should lead medicine to the field of evidence, or scientific proofs, seems to find obstacles. The speed with which knowledge increases requires, on the one hand, that we resist the temptation to believe that everything is now resolved, and on the other it requires new ways of communicating the information deriving from research to those who have to apply it. Hospital doctors and general practitioners must have more time for continuous training and to create continuity between the hospital and the community. Scientific societies must be independent in order to be able to give indications free from conflicts of interest. Academy, regulatory activities, local health authorities must tune into a common goal, that of a health service that is predominantly public, without intramoenia or supplementary insurances that create discrimination. Medicine must incorporate the expectations of patients who rightly claim the right to health, but who must not forget that alongside rights there are duties, starting with practicing those "good" lifestyle habits that allow you not to become a "parasite" of the community. Medicine based on prevention and evidence is essential to maintain the sustainability of the National Health Service which must always have the centrality of the patient as its point of reference. It is no coincidence that the discussion of these issues, on the occasion of a symposium with the most authoritative international experts, in Milan on 13 September, was chosen to celebrate the 50th anniversary of the foundation of the Mario Negri Institute for Pharmacological Research.
Silvio Garattini Director of the Mario Negri Institute of Pharmacological Research, Milan
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