“The experience of Spain for freedom of scientific research and cure�?

by Bernat Soria, Minister of Health, Spain

Many thanks for this opportunity to be here with you. I am willing to tell you what a researcher, who dedicated his life to the research in a laboratory and his last years to stem cells and diabetes, thinks when he becomes Minister of Health in a democratic government.
A Friday I was called by the Prime Minister whom I knew for sure although I had always worked in a laboratory and never involved in politics, nonetheless he proposed to me to become a minister of his Cabinet and I accepted. The next Monday I set in the Cabinet myself. I had not thought of what it means to be a minister, but during the last year and an half, since I became active in the field of politics as a minister, I have been keeping my research group too and I have been thinking about the power of politics and the opportunity to solve problems I could not solve as a mere researcher.
First of all I want to speak of the value of scientific research and of its impact on society and on social values. Science is a value we have got and one that has an impact on other social values. Science represents a value because of this impact on society, law and technology, but much more when the scientific method and knowledge are accepted as a tool to build society. You may notice it from a economic, ethical, political viewpoint and much more. In the context of a democratic society scientific ethics represents a service for the humanity. In the context of a democratic society some decisions have an economic impact but research in certain fields, that I am going to comment, goes beyond the economic relevance; a health system using these results makes innovation available for patients. Moreover costs are cut down and cures are more viable.
How was Spain until 2004 and how did it change from 2004 to 2008, that is the first legislature of socialist government, where I took part in during its last time? In 2004 scientific research suffered a set of restrictions, be they legal – since we needed a framework to develop our research – religious, ethical or cultural, but also financial restrictions. In fact the pharmaceutical industry is not always interested in a certain pathway of research and I would like to comment not only the case of stem cells but of rare diseases and orphan drugs, since they are addressed to a limited group of patients, that is a niche market, not to be funded by the pharmaceutical industry. This is a situation we have tried to solve. Before 2007 scientific research was limited by a set of rules, but in some aspects we could make research. We needed a new law; this was issued during our last legislature, that is a law concerning biomedical research, together with another law on assisted reproduction, which authorized and ruled the use of embryonic material. Moreover it analysed the ethical, political, economic aspects concerning genetic tests. It authorized the nuclear transfer, it ruled the procedure and I would like to comment it. In fact you talk about ethics – and for the last 10 years hundreds of people have talked about it with me and any researcher working on embryonic stem cells – and other aspects of medical ethics, such as the genetic diagnosis or the knowledge of human genome, which are relevant in the field of biomedical research, although they are not considered with due attention. This law helped Spain adopting a legal framework comparable to the United Kingdom, Sweden, Singapore and other countries where research not only was authorized but also duly ruled. In fact research needs not only to be authorized but also ruled so that juridical consequences are clear for researchers or for whoever working on it. How did the situation change? Let’s show some figures: until 2004 there had been no project of research on embryonic stem cells, but only two projects concerning rare diseases and orphan drugs and in 2008 we had got 65 projects in Spain concerning embryonic stem cells along with 36 on orphan drugs and rare diseases. The government is financing 65 projects through 120 millions and a Health Minister has got means to finance projects and establish priorities since a politician is responsible for telling you what you should investigate and what we want to solve: this is the mandate we have been given by citizens. The sum of money we dedicated in Spain raised from 2.900,00 million euro to around 8.000,00 million euro in a short legislature. The political responsibility does not only consist in deciding what we can investigate, but how we fund that research.
As a researcher, when I was asked what I did need to make research, I replied: both a change in the regulation and a financial budget. Changing the law is not enough, you need to fund projects, too, otherwise you never get results. I would like to comment very rapidly since many fields are affected by these limitations, not only research with stem cells, but also orphan drugs and other fields.
In all these cases we have legal, cultural, religious or economical limitations which hamper the development of research in a lot of fields. Among my first provisions as a Minister I created a general direction for advanced therapies, which is needed to facilitate new therapies for those pathologies for which there is no solution yet.
The government should push for new therapies where there is none. Launching calls is not enough; you must say: “Let’s go this way�?, because citizens require that and I sit in that Cabinet because citizens put me there.
What I did was to create a general direction for advanced therapies and transplants. As you may know, Spain is number one in the world as for organ transplants; we have expertise in transplants of tissues and cells. But we are also willing to be pioneers, so we approved a law which is still in force: the law on assisted reproduction and biomedical research.
When you want to develop an area, you also need to improve training along with regulation. When we started to research stem cells, we noticed that a few researchers knew about them. There were good cell biologists, good molecular biologists, good developmental biologists and so on but they were to be trained. Moreover, we must train technicians to work according to GMP (Good Manufacture Practice), since we want that clinical trials follow to that research.
To that purpose we do not need regulations only: we need to train people, to launch our Spanish Medicines Agency which is part of the European Agency, to open a section to evaluate, register and authorize new therapies, to open a unit for the so-called independent research, that is generally the kind of research not funded by the pharmaceutical industry.
We are promoting the creation of a European forum for advanced therapies, we need to build clean rooms according to GMP and to develop infrastructures along with funds and these resources.
In conclusion I would like to reflect on a further point, that is the value of freedom of research during the economic crisis. The financial crisis worldwide touches every activity, including the political and cultural activity.
The governments meet, the Euro-group meets, they undertake actions, help the bank sector, small enterprises, there are severe financial problems. And I would like to reflect about the crisis which overwhelms us and freedom of research can help us finding a solution. This is the reflection of a researcher who now is a minister, hence it is not an economist’s reflection, nor the thought of an expert in crisis, since I am not, but I would like to share my viewpoint with you. In the last 200 years we had around five technological revolutions: the industrial revolution, the steel revolution, the railway revolution, the revolution of advanced engineering, the last revolution concerned oil and the mass production, the production of cars. Each revolution encountered a crisis in the middle. Therefore we cannot exclude that we are going through the crisis of the today’s technological crisis. The today’s technological revolution is the information revolution. Look at the curve representing the evolution of technological revolution: first of all there is a phase of bing bang, the explosion of anything, the knowledge of anything having a big impact; afterwards you have a franticness, a very rapid rhythm supported by huge investments. This franticness bursts into the crisis then we solve it and enter a synergy that is a golden phase consisting in an increased social wealth and even richness. Thus this technological revolution comes to its end, it reaches its top and its stability at last.
Each crisis goes through this curve: for instance the franticness of the Twenties, that is a moment of happiness, when everybody bought, was happy, the art and the culture developed, there was an extraordinary moment of explosion; then the crisis of ’29 and the Thirties wanted a strong regulation. A phase of stability followed to that. After the Second World War we entered a further stage of wealth.
Then the sensation is that we are going through the crisis of the information revolution, due to the new information and communication technologies. It also consisted in a starting phase, a phase of franticness around the Nineties – 2000, i.e. the crisis of the “dot com�?; we are in the middle of it.
In my opinion every technological revolution passes a phase of crisis in the middle, until it meets its place in the society. I believe that freedom of scientific research is very important to go out from this crisis, since it entails freedom to research options.
Nobody knows how we will get out of this crisis, but if we are not free to raise different solutions it will be difficult to find out the best one. Nobody knows the rule, moreover nobody predicted it rightly: neither the best economist nor the sociologists predicted what is passing now. In my opinion knowledge, innovation and, for granted, freedom, may help us getting well out of this crisis.
Secondly, knowledge may create wealth when there are social structures which allow the transfer of that knowledge. Take for instance the Spanish national health system. Spain is a young democracy, it is only 30 years old; in the last 20 years this young democracy generated a national health system which universal, public and for free. The first socialist government created that in 1986 and now the Spanish national health system is deemed to be one of the world’s best. In 2008 the international reports referred that we were the 4th best while in 2001 we were the 6th; a good national health system however. How can you measure whether we are the best in the field of organ donations and transplants? I mean whether our health indicators are good or not? Let’s take for instance a due reference: United States. United States are the first economic power in the world. They are the first in research as well, but they are not the first as far as it concerns health. This is a very important rule, because we researchers, we all state that our projects are aimed at a knowledge which will be good for health and will generate social well-being. All the good and great researchers we have in Italy and in Europe, like Elena Cattaneo and Giulio Cossu, write that as the first sentence in their projects proposals. We have an example here of the way the first power in the world, the first economic power in the world breaks over this statement. For this reason President Obama’s programme is focused on the reform of the health system. They lack a transfer system from knowledge to patients. There is a system to transfer the knowledge to the pharmaceutical industry and produce wealth, but in the United States they have not got a system to transfer it to patients.
On the contrary we efficiently manage our health system in Spain and this is my responsibility as a Minister now: we spend 1.300,00 euro a year per inhabitant, while in the United States they spend three times as much. In the field of health you may use several indicators: life expectancy at birth, child mortality and so on. As for child mortality Spain is the 3rd best in the world, while United States are the 19th. Therefore the first conclusion is that we need a system to transfer the knowledge to the patients and a good national health system, to be universal, i.e. including all patients, if we want research to generate social freedom. That is we do not only need to research in certain areas; we do not only need to fund and manage that structure. Spain has got a lower average rent, we have four years more life expectancy than United States, nonetheless, thanks to our structure to share health.
We want that society generates its values from a form of scientific thinking and no other forms of thinking; they are all legitimate but I defend that the scientific knowledge does not only generate knowledge but values in the society. Secondly, we must change the legislation, including not only stem cells but other fields which are subject to restrictions and which are important for patients, e.g. orphan drugs, rare diseases, non-commercial research. Take for instance what passes to authorized drugs which are already marketed but have adverse effects: who will monitor them? Who is interested in researching cheaper drugs? The government is, since the market does not profit of a cheaper drug though it is a good drug. I dedicated almost my entire life to diabetes and there you have good drugs with one defect: they are very cheap, hence industry does not research such. To this purpose the government must do that. Lastly, I must say that I am convinced that knowledge, innovation and freedom of research may help us getting out of this crisis and that in order to benefit from knowledge we need structures which transfer the knowledge to all – I repeat all – citizens, be they poor or rich, from the North or the South, the ones suffering from a very common disease or a rare one.
(Danny Reviers: “I am an ALS patient. Amyotrophic lateral sclerosis is a degenerative disease, a “motor neurone disease�? is what is called in English. People’s status degenerates very quickly. Sometimes they only have five, even three years after their diagnoses. It degenerates so that we cannot breathe, we can no longer speak! In addition to this there is no treatment for that disease, so of course people end up in a very desperate situation and they become so desperate that they end up seeking any therapy abroad. They sometimes get in touch with researchers in countries which have not the best intentions, perhaps in countries where there is less regulation in rending stem cell therapies, for example. People regularly travel to China where they end up spending 30.000,00 euro for a couple of hours treatment, then of course that therapy doesn’t work. The only aim of those scientists is to get money out of those people. This is a very serious situation, we have been combating it all heartedly. Therapies are now emerging all around Europe: in Germany, the Netherlands, Belgium. Treatments were banned in the past, nevertheless people are so wealthy that they end up purchasing treatments with stem cells. There are people treated and getting their embryos implanted a couple of weeks later somewhere else. Those people can’t be held liable. Stem cell research already exists to a large extent. We need to make more efforts. My own vision in this respect is that we need to support each other. When you talk about cycling, football, championships, we are like enemies. But with stem cell therapy and human lives, we have to move into the same direction. I am delighted to see there is so much progress in Spain. Would you like to take on a pioneering role in promoting it in Europe?�?)
B. S.: I am. I know this pathology very well: amyotrophic lateral sclerosis is a neurodegenerative disease. It progressively leads to the paralysis and to death. It is an example of neurodegenerative diseases for which there is no kind of treatment. Stem cells are one of the probabilities that we are r
searching. But I am informed that to date nobody can grant a treatment hence we cannot recommend it. We must persuade patients that some charlatans with little ethics advise on the internet by charging abusive prices so that families have to sell their properties in order to get a treatment with no effect. The desperation of the family and the patients is easy to understand but no serious scientist, no physician can recommend those treatments.

What we do need is to authorise, to finance and to regulate. Regulating is needed since any new therapeutic proposal must be analysed by an ethical committee in charge of clinical trials, that is an efficient system to test whether there are scientific basis for the proposals, by considering both the risk the new treatment may entail and the value of the scientific plan so that we can conclude whether this proposal is positive, neutral or negative for the patient’s health. First of all we authorised that kind of research in Spain; secondly, we funded it. I remember at least a group researching stem cells and amyotrophic lateral sclerosis, but maybe there are more. Finally, we regulated. It means that a new treatment or a new drug in Spain are authorised by the Spanish Medicines Agency which is part of the EMEA.

When the process works, we can help all Europe getting this treatment, through an European authorization and more probably a certification to facilitate the proceeding. What I have already done in Spain is to limit the proceeding to two tracks for the authorization: the normal track, which is very slow, for new molecules, except for innovating molecules for some types of cancer which degenerate very quickly. The other track of authorization and evaluation is targeted to advanced therapies, including amyotrophic lateral sclerosis. This track also requires patients’ safety and quality of the process but it is much more rapid since we know that we do not have much time.

Once I was struck by a sentence, I was speaking with some patients and one of them affected by ALS like you asked me: “When will stem cells help treating this disease?�? and I replied what I am replying to you: first of all, nobody can grant that there will be a treatment not even in the future; we could only reply that we were not allowed to research. First of all you need to research so that you can see whether you can find out a solution like that. But the patient went on and asked: “How long does it take to know whether this is the right pathway or not?�?. A scientist can hardly say and I replied: “Give me five years time�?, provided that scientific projects usually last five years, I did not mean that I was going to be able to answer. And the patient replied: “I do not have five years time�?.

To this purpose I have created a rapid authorization track for that kind of trials in Spain. This is the only way since we cannot go more rapidly. The only way is doing well, that is not purchasing miraculous treatment, since they do not exist. “Going on time there where we can go�?, I have not got a better answer. I would like, but I do not believe that I can give a better answer.

One of the things I experienced being minister of the government is that I lose freedom. As a scientist, I could make comments about everything, but as a minister, I cannot comment other countries’ politics. I cannot make comments on Italy. It is friend of Spain. We collaborate in many ways. I have made a sure reference to USA, because previously I gave lectures in Washington. We are collaborating with the new administration in this sense. So, I cannot break my commitment. I should not make comments about other countries’ politics.

Secondly, I consider it very difficult to reach a conclusion, which is practical or regulatory for all the countries. If you consider abortion by example, in Europe there are different laws for abortion. There are two countries in which there are strong limitations or it is forbidden. So, those aspects in which ethics is involved are extremely difficult if not impossible to regulate at an international level. So, I could make comments about what the UK has done, their decision to destroy the supernumerary embryos. That is something that each country will solve. We know there are many remaining embryos, but we do not need all of them, because these embryos were not created for this aim, but for other aims. But it is important – and I will end with this comment – to ask the couples: what do you want to do with your embryos? We did the survey before and later. We did the survey before we knew that the stem cells could have a therapeutic use: in that case 40-50% of the people said yes. But when the people knew that embryos could have a therapeutic use, more than 90% in Spain said yes. We will authorize the embryos to be used in research. We are producing new cell lines too, we have about 20 new cell lines. We are now producing cell lines with particular mutations, what is relevant to study a disease, in order to know how it appears. We did some progress, but all these lines have been produced through new supernumerary embryos thanks to the couple’s consent. What will happen to the rest of embryos? I really don’t know. At least thanks to the new law we issued in 2006 – a new law for human assisted reproduction – Span is very active. We gave several options for the embryos. Supernumerary embryos could be used for research, could be kept, could be destroyed. It depends on the couple. They decide.

*text not revised by the author

ITALIAN VERSION

“L’esperienza della Spagna per la libertà di ricerca scientifica e di cura�?

di Bernat Soria, Ministro della Salute, Spagna*

Vi ringrazio per l’opportunità che mi viene data di essere qui con voi oggi. Quello che vorrei raccontarvi e di cui vorrei parlarvi è cosa pensa un ricercatore, che ha dedicato la sua vita al laboratorio e, negli ultimi anni, alle cellule staminali e al diabete, quando diventa Ministro della Salute in un governo democratico.

Un venerdì ho ricevuto la chiamata del Presidente, che conoscevo ovviamente – per quanto sia sempre stato in un laboratorio, mai nella politica – e che mi propose di diventare ministro. Io gli dissi di sì. Il lunedì dopo sedevo già nel Consiglio dei Ministri. Non ebbi il tempo di pensare a cosa significasse essere ministro, però durante l’ultimo anno e mezzo – periodo durante il quale ho partecipato attivamente nella politica come ministro, pur mantenendo il mio gruppo di ricerca – ho avuto modo di riflettere sulla funzione della politica e su quello che un politico può fare per risolvere problemi che non potevo risolvere quando ero un ricercatore.
Il primo punto che voglio trattare è il valore della ricerca scientifica, il suo impatto sulla società e sui valori della società. La scienza è un valore che ci viene trasmesso ed è un valore che influenza altri valori della società. Il valore della scienza è dato dall’impatto che questa ha sulla società, sulle norme, sulle leggi, sulla tecnologia, però soprattutto il valore della scienza implica l’accettazione del metodo scientifico e della conoscenza come strumento per costruire una società. Ha una dimensione economica, etica, politica e così via. Nel contesto di una società democratica, etica scientifica significa rendere un servizio all’umanità. Nel contesto di una società democratica, determinate decisioni hanno valore economico, però lo studio in certi campi (che vi commenterò) possono avere un valore in più a parte quello economico; traslare le scoperte in un sistema sanitario permette che l’innovazione passi ai pazienti e, in più, abbatte i costi ed abbattendoli fa sì che detta innovazione possa essere più fattibile.
Com’era la Spagna fino al 2004? Come cambiò dal 2004 al 2008 ossia durante la prima legislatura del governo socialista di cui io sono entrato a far parte nell’ultimo periodo? Nel 2004 esistevano una serie di limiti alla ricerca scientifica: restrizioni di tipo legale, perché avevamo bisogno di un sistema per sviluppare i nostri studi; restrizioni religiose, etiche o culturali, ma anche di tipo economico. Non sempre l’industria farmaceutica ha interesse in una particolare linea di ricerca e vorrei commentare non solo il caso delle cellule staminali, ma anche quello delle malattie rare e dei farmaci orfani che – dal momento che sono destinati a un gruppo limitato di pazienti – riguardano una nicchia di mercato, non interessano a una gran parte del mercato e pertanto non ricevono fondi dall’industria farmaceutica. Ed è proprio questa problematica che abbiamo cercato di risolvere. Fino al 2007 esistevano una serie di norme che limitavano la ricerca, nonostante alcuni aspetti di quest’ultima avrebbero potuto svilupparsi. Quello di cui avevamo bisogno era una legge che fu creata già durante la precedente legislatura: una legge sulla ricerca biomedica e sulla riproduzione assistita, che autorizzava e regolava i procedimenti per l’utilizzo di materiale embrionale, il trasferimento nucleare e, al tempo stesso, analizzava gli aspetti etici, politici ed economici che ruotano intorno agli esperimenti genetici. Si autorizzavano i trasferimenti nucleari e si regolavano i procedimenti. Vorrei fare un commento a questo proposito: perchè quando si parla di etica delle staminali – e questa domanda a me negli ultimi 10 anni è stata fatta centinaia di volte e così a qualsiasi ricercatore che lavora con le cellule staminali embrionali – e di altri aspetti dell’etica medica, come la diagnosi genetica, la conoscenza del genoma umano e altri aspetti che sono molto rilevanti quando parliamo di ricerca biomedica, comunque non gli si riconosce tanta importanza. Con quella legge la Spagna si dotò di una normativa comparabile a quella di Regno Unito, Svezia, Singapore e altri paesi dove la ricerca non solo è autorizzata, ma correttamente regolata. Infatti è molto importante che queste ricerche non solo siano autorizzate, ma anche regolate, che egli scienziati o chi sta lavorando in quel momento non sia incerto rispetto alle conseguenze giuridiche.

Qual è stato il cambio? Se analizziamo i numeri vediamo che fino al 2004 non esisteva alcun progetto sullo studio delle cellule staminali embrionali e solamente due progetti sulle malattie rare o farmaci orfani; nel 2008 in Spagna abbiamo avuto 65 progetti sulle cellule staminali embrionali e 36 sui farmaci orfani o malattie rare. Solo per dare un’idea di quanto il governo stia finanziando questi progetti: 120 milioni per 65 progetti. Il Ministro della Salute è colui che ha gli strumenti necessari per decidere quali sono le ricerche più importanti da finanziare, poiché è obbligo del politico stabilire le priorità e dire in che campo bisogna studiare e dove vogliamo delle risposte: questo è il dovere che abbiamo nei confronti dei cittadini.

Durante una legislatura, in Spagna, la quantità di denaro investita è triplicata. Responsabilità del politico non è solamente decidere in che campo fare ricerca, ma trovare il modo di finanziare questa ricerca. Quando mi domandavano, come ricercatore, di che cosa avevo bisogno per i miei studi, rispondevo: c’è bisogno di cambiare la legge e c’è bisogno di un budget. Cambiare la legge da sola non basta, bisogna cambiarla e finanziare i progetti, altrimenti sarà impossibile avere dei risultati.

Vorrei fare un commento veloce sulle restrizioni di tipo legale, culturale, economico o religioso, che impediscono lo sviluppo non solamente della ricerca sulle cellule staminali, ma anche sui farmaci orfani e in molti altri campi di studio. Uno dei primi provvedimenti che ho preso come Ministro è stato quello di creare una Direzione Generale di Terapia Avanzata. Dobbiamo incentivare le nuove terapie per quelle patologie per le quali non abbiamo ancora una soluzione. Non abbiamo cure e deve essere il governo a spingere in questo senso ma non è sufficiente aprire il discorso, bisogna dire: “Dobbiamo andare in quella direzione, perché questo è quello che vogliono i cittadini ed io sono nel Ministero perché i cittadini lo hanno voluto�?. Tutto quello che abbiamo fatto è stato creare una Direzione Generale di Terapia Avanzata e Trapianti. Come saprete, la Spagna è il numero uno nel settore di trapianti degli organi, abbiamo quindi esperienza in questo campo: trapianti di tessuti e cellule che si devono incorporare in questo programma. Vogliamo anche essere dei pionieri. Però si deve parlare anche delle problematiche che non sono causate dalle norme: difatti se si vuole potenziare un programma di ricerca, si deve potenziare la formazione dei ricercatori. Quando abbiamo dato il via al programma di ricerca sulle cellule staminali, la prima cosa che abbiamo visto è che non esistevano tanti scienziati a conoscenza dell’argomento cellule staminali. Avevamo buoni biologi cellulari e biologi molecolari, però dovevamo allenarci, per far sì che queste conoscenze passassero alla fase di sperimentazione clinica; dovevamo formare tecnici al livello di GMP (Good Manufacture Practice). Questo significa che abbiamo bisogno di azioni non normative, dobbiamo fare formazione, dobbiamo creare la nostra Agenzia Spagnola della Medicina che sia parte dell’Agenzia europea. Dobbiamo aprire una sezione per la valutazione, registrazione ed autorizzazione di nuove terapie, un ufficio per la ricerca indipendente.

Che vuole dire ricerca indipendente? Essenzialmente significa ricerca non commerciale, ricerca che non riceve l’appoggio dal settore farmaceutico. Stiamo promuovendo la creazione di un foro europeo di terapia avanzata e dobbiamo creare camere sterili, GMP per lo sviluppo di infrastrutture.
Vorrei riflettere, e con questo termino, su un altro punto per cui la libertà di ricerca è così importante in un momento di crisi economica. La crisi economica e finanziaria mondiale sta avendo un grande impatto su tutte le attività, politiche e culturali. I Governi si riuniscono, l’Eurogruppo si riunisce, e si prendono provvedimenti aiutando il settore bancario, le piccole imprese; ci sono seri problemi di tipo finanziario. A questo proposito vorrei fare una riflessione sulla crisi nella quale ci troviamo in questo momento e la parte che potrebbe giocare la libertà della ricerca nel tentativo di risolvere questa crisi. Questo è il punto di vista di uno studioso che adesso è Ministro, quindi non la riflessione di un economista che non sono.

Negli ultimi 200 anni nel mondo abbiamo avuto cinque rivoluzioni tecnologiche: la rivoluzione industriale, la rivoluzione dell’acciao, della ferrovia, dell’ingegneria avanzata; le ultime sono quelle del petrolio, della produzione di massa, della produzione di automobili; ognuna di queste rivoluzioni ha avuto una crisi nel mezzo. Quindi è molto probabile che in questo momento ci troviamo nel mezzo della crisi della rivoluzione tecnologica. Se fate caso c’è un filo conduttore che mostra come si sviluppa una rivoluzione tecnologica: esiste, in primo luogo, una fase di big bang, l’esplosione di qualche cosa, una scoperta, qualche cosa che ha un impatto molto forte; si viene a creare quindi una situazione di frenesia, un ritmo velocissimo con un grande appoggio finanziario. La frenesia è talmente grande che entriamo in crisi, poi questa crisi si risolve e quindi entriamo in una fase di sinergia che crea il momento di splendore, dove esiste un aumento del benessere sociale e di ricchezza; finalmente questa rivoluzione tecnologica arriva alla sua fine e si destabilizza. Possiamo fare degli esempi per ognuna di queste crisi: la frenesia degli anni ’20 per esempio, fu un momento di allegria, tutto il mondo comprava, era felice, si svilupparono l’arte e la cultura, ci fu un momento straordinario e poi la crisi degli anni ’30 che necesssitò di un intervento potente. Quando si riuscì a regolarizzare questa crisi, si entrò in un’altra tappa, del dopoguerra della Seconda Guerra Mondiale: anche questo fu un momento che creò molta ricchezza. Adesso la sensazione è che siamo entrati nella crisi della rivoluzione informatica, con le nuove tecnologie di telecomuni