Josep Vergés Milano

Josep has built a pioneering, global, sustainable model in the health system for chronic conditions through a patient-centered approach, which is paving the way for a healthier, lifelong contributing society.

Josep, a prominent medical doctor, identified the urgent need to rethink health and care systems in response to global demographic changes, which present significant challenges in capacity, resources, and infrastructure. Chronic diseases such as neurodegenerative, rheumatic, and cardiovascular conditions, affecting millions, are often seen as inevitable consequences of aging. This perception has led to limited resources and attention for their prevention and treatment, which are crucial for healthier longevity.

Focusing on rheumatic diseases and joint health, Josep has established the world’s only dedicated foundation for osteoarthritis (OAFI). In Spain alone, 14% of the population, primarily women, suffer from these conditions. It is estimated that globally 15% of the population aged 30 and older experience osteoarthritis, demonstrating an alarming 132% increase from 1990.

Josep’s work with OAFI aims to reshape the narrative around rheumatic diseases and joint health, empowering patients to participate actively in their treatments and driving treatment agendas. His work means that health professionals and caregivers now prioritize healthy joint systems for active longevity, alleviating the burden on healthcare systems and fostering a culture of shared support and resilience.

To address these conditions holistically, Josep has introduced the ARTRO 360 model, piloted in Barcelona’s primary care centers and under implementation assessments in Madrid, Andalucia, and the Basque Country. This innovative multi-stakeholder prevention model involves primary care, bone specialists, pharmacists, nurses, families, and caregivers in establishing health policies, research, and osteoarthritis treatments.

Recognizing the global prevalence of rheumatic diseases, Josep created the Patient Task Force, an alliance of global patient associations with rheumatic problems to share knowledge and co-develop wide-ranging research. One of his pioneering efforts is highlighting osteoarthritis as a gendered affliction. Collaborating with partners, he has shown that women, due to their anatomy and loss of estrogen after menopause, experience higher disease prevalence and pain levels than men.

OAFI’s credibility and adaptable model have facilitated its implementation in France through the French League Against Rheumatism, as well as in Italy, Portugal, Latin America, and the USA through patient associations. Under Josep’s leadership, osteoarthritis is no longer a silent burden, but a condition addressed proactively through patient-led initiatives, shaping a healthier new longevity and more equitable world.

The demographic shift of the past decade predicts that by 2050, one-third of the population will be 65 or older. However, living longer doesn’t guarantee healthy aging. Traditional healthcare, economic, and social systems are outdated and require significant restructuring, especially in Western countries, where the healthcare system faces staffing and financial challenges.

Data from the Survey on Health, Ageing and Retirement in Europe (SHARE) shows that 36% of people aged 65 and over had at least two chronic diseases in 2020, with musculoskeletal and joint diseases as the main causes of pain in older adults, accounting for about 40% of chronic diseases and 20% of health expenditure. In Spain, chronic diseases account for 80% of primary care consultations, and patients are perceived as passive beneficiaries. There is a clear need for individuals to implement prevention practices autonomously and proactively and for the non-medical community to play a bigger role.

In Spain, 7 million individuals suffer from Osteoarthritis, a degenerative joint disease reducing patients’ autonomy and well-being. With the increase in life expectancy and the change in the attitude of society to lead a more active lifestyle in which the practice of sport has increased, the cases of osteoarthritis are beginning to be detected in other younger risk groups such as postmenopausal women, athletes, and even young people. Despite its prevalence, it remains an unknown disease to most of the population and is conventionally perceived as an inevitable reality in the later stages of life. Worldwide, 18% of women and 9.6% of men over 60 have rheumatic disorders. Women are particularly affected due to lower estrogen levels after menopause, necessitating gender-specific research and treatments along with a mindset change that these diseases are not inevitable.

The growing elderly population and rising chronic diseases highlight the need to reform healthcare and social systems. Proactive health measures and strong community support are crucial to ensuring that increased life expectancy is accompanied by a high quality of life.

To redesign health systems to face chronicity and a sustainable caregiving model for longer and healthier lives, Josep has designed a three-pronged strategy:

1. Community of expert patients for proactive health management
Josep has developed a strengths-based approach to chronic diseases, emphasizing affected individuals’ valuable experiences and resilience. He created a community focused on preventing joint deterioration and promoting self-care through partnerships with patient associations and medical centers. This community offers a range of resources, including individual training routines and synthesized information on chronic pain and rheumatic diseases, particularly targeting groups at higher risk due to genetic or lifestyle factors.

Through OAFI Woman, Josep addresses the specific needs of women, who often lack adequate resources and support for chronic pain and bone deterioration due to limited resources and investigation. Collaborating with national city councils in Catalonia, over 15,000 women now have access to in-person workshops and online tailored tools for understanding, treating, and preventing chronic pain, along with emotional support and health education.

OAFI also supports retired athletes in maintaining healthy joints and transitioning to active lifestyles post-career. The program provides resources for safe exercise practices and injury prevention, benefiting former professionals and the growing number of sports amateurs.

These initiatives have fostered a dynamic peer-to-peer community, connecting patients through educational programs, cultural activities, and online forums. This community provides peer support and intergenerational connections, reducing the isolation often associated with chronic illness. The Solidarity Clinic, launched by Josep, offers personalized diagnosis and treatment in Madrid and Barcelona, and online visits with patients in other locations, with monthly follow-ups by expert doctors. This comprehensive patient model has proven effective, with 80% of OAFI community members reporting improvements in pain, quality of life, and function.

2. Research and advocacy for a new patient-led model.
OAFI and the Patient Task Force, representing over 200 million patients globally, have conducted the first comprehensive review of osteoarthritis patients’ quality of life. This review highlights the disease’s impact and related factors. The Global OA Patient Perception Survey further explores patient perspectives across different cultures, enhancing research methods and giving patients a stronger voice.

Based on this research and his experience with the Solidarity Clinic, Josep developed the 360 ARTRO model validated by 20 medical associations in Spain. This model focuses on disease prevention, a multidisciplinary approach, and continuous patient support. It uses a Point of Care (POC) channel, a customizable technological platform integrated into healthcare systems, to manage health education through validated audiovisual content. In Spain, the model will be implemented in primary care centers, with healthcare professionals (doctors, nurses, psychologists, physiotherapists, nutritionists, and administrators) receiving training to ensure its ease of use. Pilot tests are being conducted with 100 patients per center in two primary care centers. In locations where disease diagnosis through the medical center is inaccessible, mobile units will provide diagnosis, reducing the usual 18-month wait time to minutes. Over 600 patients have already benefited from these telemedicine units.
 
Josep has also led an advocacy strategy in the Spanish Senate with the Spanish Society for Quality of Care, Sports Traumatology, Primary Care Physicians, Rheumatology, and the University of Barcelona, among others. This group highlights the economic burden of rheumatic diseases, costing around 5,831 million euros annually, which represents 0.5% of the national GDP, while around 55% of patients consider themselves dissatisfied. The ARTRO 360 model aims to reduce public spending significantly. More than 35,000 physicians and 5,000 pharmacists and nurses support this model and have joined a consortium to uphold the Model in Parliament. 

Through OAFI, Josep advocates for patients´ affordable access to treatment. In 2019, OAFI successfully opposed a government attempt to defund SYSADOAs, effective medications for osteoarthritis and cardiovascular issues. This advocacy ensured continued funding for these medicines, benefiting 3 million patients and potentially preventing 70% of strokes and heart attacks among osteoarthritis and cardiovascular patients.

3. Awareness and mindset shift to set chronic diseases in a broader audience and widespread agenda.
Josep is transforming the mindset around joint health from an issue concerning only the elderly to one relevant for everyone. He has established partnerships with diverse stakeholders to raise awareness across various health conditions and sectors.

Josep has dedicated significant resources to studying the coexistence of rheumatic diseases with other chronic illnesses. By demonstrating how chronic diseases like diabetes, cardiovascular conditions, and cancer can influence each other’s evolution, and if treated in isolation from the others, medication and treatment can enhance their aggravation. Josep’s ARTRO 360 model, adaptable to several conditions, reinforces the importance of this integrated approach. In 2023, OAFI released the first White Book on Aging and Osteoarthritis, endorsed by over 40 medical and scientific associations. This publication advocates for a longevity perspective in treating chronic illnesses, encouraging everyone to take an active role in their health and supporting patient-led innovations for active and fulfilling lives.

To disseminate information widely, Josep launched OAFI Radio, the only video podcast focused on joint health and sports. It covers unique topics like training according to the menstrual cycle, pain, and health economics. The podcast, along with Health and Sports Congresses held in partnership with the National Olympic Committee and Atlético de Madrid Football Club, informs the public about osteoarthritis risks, especially for sports practitioners and women. This initiative has created a community of 64,000 people, 60% of whom report implementing the recommendations in their daily routines.

Josep also organizes the Annual Osteoarthritis Patients World Congress, which celebrated its 7th edition in October. This event serves as a platform for stakeholders, including the health system, sports associations, the pharmaceutical sector, patients and companies, to exchange ideas and shape policy. The Congress has positioned Barcelona as the world capital of osteoarthritis, with over 4,000 participants throughout the years and 71% applying the knowledge acquired.

Additionally, Josep collaborates with unconventional partners through the OAFI Space program, which adapts environments to accommodate people rather than the other way around. This program assesses and certifies residences, wellness centers, and hotels as “osteo-friendly.” In its first year, it reviewed and certified nursing homes serving more than 500 residents and hotel chains accommodating approximately 70,000 guests annually.

Josep’s journey into the realm of medicine was shaped by profound childhood experiences and unwavering compassion. At the tender age of seven, faced with his grandmother’s illness, he made a solemn vow: to become a doctor and heal her. He had a very close friend who had a terrible limp and was made fun of. This was a horrible injustice for Josep, and he always stayed by her side, sticking up for her and helping her whenever he could. He did not know that joint health would be a key part of his life story but was already aware of the limitations that joint problems implied physically, socially, and mentally.

Another early memory that inspired Josep was a village cook, who used the virtues of bones and cartilage in her recipes and explained to Josep how these ingredients would make his bones healthy, this conundrum fascinated Josep. Little did he know that these childhood lessons would later inspire his pioneering work in pharmaceutical research to create solutions for rheumatic diseases using the same ingredients: bones and chicken combs, to prototype his medicines.

His professional relationship with osteoarthritis began in patient treatment in his clinical practice in Barcelona as a Family Physician and later as Head of Emergency at a nearby hospital. During his years of work in the clinic, he was impacted by the pain and the bad quality of life that OA patients suffered, especially women. The problems of mobility and fractures that they suffered were an eye-opening experience since most of the cases he saw could have been prevented. It was during this time as well that he saw how women were discriminated in the treatment and prevention of osteoarticular diseases. He then had the opportunity to study in North America, where he pursued a master’s degree in clinical pharmacology in Canada, emerging at the top of his class under the mentorship of Professor Patrick du Souich.

Returning to Spain, Josep embarked on a transformative journey with the pharmaceutical Bioibérica, where he spent nearly two decades developing from scratch the company’s osteoarthritis line, being a world reference in clinical pharmacology in osteoarthritis drugs such as chondroitin sulfate, glucosamine, and hyaluronic acid, - he likes to say that these drugs were like his children.

Given his extensive experience in therapies at Bioibérica, where he witnessed first-hand the unmet need for effective treatments for osteoarthritis, and at the same time, observing how this disease did not receive the attention and recognition it deserved, he felt the urgency to act. Convinced that patients deserved a more effective and compassionate response, he decided to drop everything and return to direct contact with the patient world, thus founding OAFI to provide innovative solutions and improve the quality of life of so many patients.