Reflections on the future business model of European banks and the supervisory approach

Relevant forces are reshaping the banking sector and redefining banks’ business models. On the one hand, banks have been facing structural difficulties, such as a prolonged low interest rate environment and the costs of excess capacity. In addition, banks need to deal with more recently developing challenges, like the digital transformation, the entrance of new competitors in the banking sector and the climate change. A demanding regulatory environment and the impact of the COVID-19 pandemic further aggravate the situation. As a result, European banks are not being able to produce enough returns to cover their cost of capital, making it necessary to urgently face these challenges. To that purpose, banks may adopt different strategies, some of them complementary, among which the following can be highlighted: the reduction of overcapacity, consolidation, diversification or specialisation and the exploitation of the value of long-term relations with clients, as well as taking advantage of the opportunities stemming from digitalization and sustainable finance. Supervisors will need to stay abreast of the changes in the banking environment and closely monitor the adaptation processes. This article is intended to serve as a basis for discussion, given that several of the issues raised are controversial and uncertain under the current fast changing environment

Reflections on the future business model of European banks and the supervisory approach

Importantes factores están reconfigurando el sector bancario y redefiniendo los modelos de negocio de las entidades. Las entidades han venido afrontando dificultades estructurales, como un entorno de bajos tipos de interés prolongado o el exceso de capacidad instalada. A esto se añaden otros retos más recientes, como la transformación digital, los nuevos competidores en el mercado bancario y el cambio climático. Adicionalmente, un entorno regulatorio exigente y el impacto del COVID-19 suponen una presión añadida. Como resultado, los bancos europeos no están siendo capaces de producir resultados que cubran el coste del capital, lo que hace necesario afrontar con urgencia estos retos. Para ello, existen distintas estrategias posibles, algunas de ellas complementarias, entre las que se pueden destacar: la reducción de la capacidad instalada, la consolidación bancaria, la diversificación o especialización y la explotación del valor de la banca relacional, así como el aprovechamiento de las oportunidades derivadas de la digitalización y las finanzas sostenibles. El supervisor deberá estar al nivel de los cambios que se produzcan en el entorno bancario y seguir de cerca los procesos de adaptación. El propósito de este artículo es servir de base para el debate, dada la controversia existente y la incertidumbre que rodea a algunas de estas cuestiones en un entorno como el actual, que cambia con rapidez

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain

Background: Although only 8%-10% of persons infected with human T-cell leukemia virus type 1 (HTLV-1) may develop virus-associated diseases lifelong, misdiagnosis of asymptomatic infected carriers frequently leads to late diagnoses. Methods: A nationwide HTLV-1 register was created in Spain in 1989. A total of 351 infected persons had been reported by the end of 2017. We examined all new HTLV-1 diagnoses during the last decade and compared their clinical presentation. Results: A total of 247 individuals with HTLV-1 infection had been reported in Spain since year 2008. The incidence has remained stable with 20-25 new diagnoses yearly. Women represented 62%. Only 12% were native Spaniards, most of whom were foreigners from Latin America (72.5%). Up to 57 (23%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (n = 24; 42.1%), T-cell lymphoma (n = 19; 33.3%), or Strongyloides stercoralis infestation (n = 8; 14%). Human T-cell leukemia virus type 1 diagnosis had been made either at blood banks (n = 109; 44%) or at clinics (n = 138; 56%). It is interesting to note that Spaniards and especially Africans were overrepresented among patients presenting with HTLV-1-associated illnesses, suggesting that misdiagnosis and late presentation are more frequent in these populations compared to Latin Americans. Conclusions: Given that 23% of new HTLV-1 diagnoses in Spain are symptomatic, underdiagnosis must be common. Although screening in blood banks mostly identifies asymptomatic Latin American carriers, a disproportionately high number of Spaniards and Africans are unveiled too late, that is, they already suffer from classic HTLV-1 illnesses