[Correspondence] Underestimation of the global burden of schistosomiasis
The Global Burden of Disease (GBD) Study aims to determine the cumulative global disability that is attributable to diverse diseases, the knowledge of which is essential in targeting public health responses, prioritising funding, and guiding research. The 2016 GBD study (Sept 16, 2017, p 1211)1 suggested that, of all 328 diseases considered, schistosomiasis showed the most pronounced reduction in age-standardised years lived with disability (YLD) between 2006 and 2016. Schistosomiasis was ranked in the top ten for YLDs in six sub-Saharan countries but was now reported to account for only 1 ·496 million YLD worldwide...
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Charles H King, Alison P Galvani Tags: Correspondence Source Type: research

[Correspondence] Great expectations – Authors’ reply
Non-ST-segment elevation myocardial infarction (NSTEMI) is associated with relevant mid-term mortality and might be associated with poorer long-term prognosis compared with ST-segment elevation myocardial infarction.1 All-cause mortality is the most objective and clinically meaningful endpoint regarding data quality of randomised controlled trials and patient prognosis. However, as pointed out by Gilles Lemesle and colleagues, all-cause mortality is unlikely to be an appropriate endpoint to power a randomised controlled trial funded by a government agency and investigating the optimal timing of invasive coronary angiograph...
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Alexander Jobs, Steffen Desch, Holger Thiele Tags: Correspondence Source Type: research

[Correspondence] Great expectations
We congratulate Alexander Jobs and colleagues1 (Aug 19, 2017, p 737) for their meta-analysis of trials addressing the optimal timing of an invasive strategy in acute coronary syndromes (ACS), using individual or standardised tabulated data. Their analysis did not support a mortality benefit of an early strategy compared with a delayed strategy. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Gilles Lemesle, Marc Laine, Mathieu Pankert, Etienne Puymirat, Laurent Bonello Tags: Correspondence Source Type: research

[Correspondence] Atezolizumab and bladder cancer: facing a complex disease
Cytotoxic chemotherapy has been the first choice treatment for advanced or metastatic bladder cancer for many years, without substantial insights despite the advent of targeted therapies. Following the enthusiasm for cancer immunotherapy, several trials have investigated checkpoint inhibitors for the treatment of bladder cancer. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Carlo Cattrini, Francesco Boccardo Tags: Correspondence Source Type: research

[Correspondence] The updated Physician's Pledge and Chinese junior physicians
On Oct 14, 2017, a newly revised version of the Physician's Pledge1 was approved by the World Medical Association, including several important amendments that are in accordance with the needs of the modern medical profession. Among the Chinese medical community, additional focus and consideration need to be directed towards the revised Physician's Pledge given that the current occupational environment is not ideal, particularly for junior physicians. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Liming Lu, Menghan Gao, Tian Yang, Xiao Gong Tags: Correspondence Source Type: research

[Obituary] Gian Franco Bottazzo
Researcher on diabetes and autoimmunity. Born in Venice, Italy, on Aug 1, 1946, he died there of bacterial endocarditis on Sept 15, 2017, aged 71 years. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Geoff Watts Tags: Obituary Source Type: research

[Perspectives] Successful ageing
Increased longevity in many high-income countries has transformed old age. Life expectancy in the UK continues to increase by 2 years per decade, although recent data reveal this is not the case in more socio-economically deprived areas nationally. Between 1991 and 2011, life expectancy for men in the UK increased from 77 ·9 years to 82·6 years and for women, from 81·5 years to 85·6 years. Unfortunately, these extra years do not seem to be spent in better health, with morbidity and dependency increasing over the past 20 years. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Louise Robinson Tags: Perspectives Source Type: research

[World Report] Senior WHO appointments are praised but raise questions
WHO Director-General Tedros Adhanom is making progress towards his pledge to transform the global body, but some say that this comes at the cost of transparency. John Zarocostas reports. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: John Zarocostas Tags: World Report Source Type: research

[World Report] Mega-crisis in DR Congo
The UN fears the humanitarian crisis in DR Congo will further deteriorate in 2018, putting in jeopardy the lives of over 13 million people. John Zarocostas reports. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: John Zarocostas Tags: World Report Source Type: research

[Comment] Offline: Why we must learn to love economists
George Bernard Shaw once remarked that, “If all economists were laid end to end, they'd never reach a conclusion.” Since the global financial crisis of 2007–08, economists have suffered a sharp loss of intellectual confidence. Some critics have rejoiced. Yet the fact remains that economics is the discipline that orders our world. It s locus of influence is the national Treasury. It is finance ministers who have the most decisive say about a country's priorities. For health advocates, we have two choices. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Editorial] Institutional and coercive mental health treatment in Europe
Images of people incarcerated, unkempt and kept in chains, mocked, and uncared for dominate the history of psychiatry, particularly from the middle ages to the early 20th century. Locked up for years, and forcibly sedated or sterilised, those with mental ill health were subject to inhumane conditions and removed from society, often under the supervision of doctors. What of now? How have things improved for those with mental illnesses? (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Facial injuries
Patients, surgeons, and other health-care professionals met to discuss life after facial injuries at an event on Jan 22 organised by the Royal Society of Medicine and Saving Faces, the facial surgery research foundation. A large proportion of facial injuries result from interpersonal violence, in which the maxillofacial region is frequently targeted. In domestic violence, damage can be very severe due to extreme violence and protracted uninterrupted attacks. In trauma cases, facial injuries are often a sign of extensive injuries and many patients experience associated head injury. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] The health of a president: an unnecessary distraction
The respected New York Times physician-journalist, Lawrence K Altman, often wrote about the personal health of US presidential candidates and other elected leaders in high office. He argued that the medical records of each president should be made publicly available and that the public have a right to know that their president is fit to fulfil the role. Last week, the health of President Donald Trump became the subject of sometimes wild political speculation after the release of his first physical examination results since he took office. (Source: LANCET)
Source: LANCET - January 26, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial
Add-on cannabidiol is efficacious for the treatment of patients with drop seizures associated with Lennox-Gastaut syndrome and is generally well tolerated. The long-term efficacy and safety of cannabidiol is currently being assessed in the open-label extension of this trial. (Source: LANCET)
Source: LANCET - January 24, 2018 Category: General Medicine Authors: Elizabeth A Thiele, Eric D Marsh, Jacqueline A French, Maria Mazurkiewicz-Beldzinska, Selim R Benbadis, Charuta Joshi, Paul D Lyons, Adam Taylor, Claire Roberts, Kenneth Sommerville, GWPCARE4 Study Group Tags: Articles Source Type: research

[Comment] Cannabidiol for drop seizures in Lennox-Gastaut syndrome
Lennox-Gastaut syndrome is a rare epilepsy with childhood onset and is characterised by multiple seizure types, typically tonic, atonic, and atypical absences in which non-convulsive status epilepticus (atypical absence, tonic, myoclonic, or mixed) is common. Generally, the electroencephalogram shows generalised slow spike-and-wave discharges in wakefulness and sleep and paroxysmal fast rhythms in sleep. Learning and behavioural difficulties are common. Causes include structural or acquired brain lesions, metabolic disease, and genetic abnormalities. (Source: LANCET)
Source: LANCET - January 24, 2018 Category: General Medicine Authors: Sophia Varadkar Tags: Comment Source Type: research

[Comment] Amid US funding cuts, UNRWA appeals for health and dignity of Palestinian refugees
The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) faces a major challenge in upholding its mandate and preserving key services such as education and health care for Palestinian refugees. On Jan 16, 2018, the US Government announced a contribution of US$60 million for 2018 so far,1,2 in support of UNRWA's efforts to keep our schools open, health clinics running, and emergency food and cash distribution systems functioning. Although important, this funding is dramatically below past levels. (Source: LANCET)
Source: LANCET - January 22, 2018 Category: General Medicine Authors: Akihiro Seita, Amelia Goldsmith, Majed Hababeh, Yousef Shahin Tags: Comment Source Type: research

[Correspondence] The definition of acute kidney injury – Authors' reply
We thank John A Kellum and Norbert Lameire for their letter in response to our Comment.1 An acute increase in serum creatinine (sCr) is caused by direct injury to kidney cells (ie, pathophysiological processes resulting from ischaemia, sepsis, medications, metals, or enzymes) or a compromise in cardiovascular homoeostasis (ie, substantial volume depletion,2 congestive heart failure,3 or portal hypertension4). Hence, we appreciate that an acute rise in sCr can indicate several pathophysiological processes with worsened patient population outcomes. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Jonathan Barasch, Richard Zager, Joseph V Bonventre Tags: Correspondence Source Type: research

[Correspondence] The definition of acute kidney injury
We read with interest the Comment in The Lancet by Jon Barasch and colleagues (Feb 25, 2017, p 779)1 with its controversial title “Acute kidney injury: a problem of definition”. We appreciate the opportunity to clarify what is written in the Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline on acute kidney injury (AKI),2 in the hope that clinicians will read beyond the headlines. The guideline cl early states that AKI is a clinical diagnosis and stresses the importance of clinical judgment: “While the definitions and classification system discussed in Chapter 2.1 provide a frame...
Source: LANCET - January 19, 2018 Category: General Medicine Authors: John A Kellum, Norbert Lameire Tags: Correspondence Source Type: research

[Correspondence] A public health approach to opioid addiction in North America – Author's reply
I agree with Mohammad Karamouzian and Thomas Kerr that “restricting access to prescription opioids for opioid-naive populations should be included in the primary strategies” in response to the epidemic of opioid overdose and addiction, as discussed in my Comment.1 Karamouzian and Kerr are also correct to note that people currently taking opioids wil l require different clinical and policy strategies. For example, some people with chronic pain conditions will need to remain on their medication indefinitely because the net costs and benefits of doing so are favourable. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Keith Humphreys Tags: Correspondence Source Type: research

[Correspondence] A public health approach to opioid addiction in North America
Keith Humphreys' Comment in The Lancet (July 29, 2017, p 437)1 describes the main drivers of the opioid crisis in the USA and advocates for global restriction of prescription opioids as an effective public health response to addressing the overdose epidemic. We argue that although the dominant narrative about the opioid crisis circulating around careless prescribing and unscrupulous pharmaceutical companies has some merit, it does not tell the whole story of the epidemic of opioid addiction in North America because it occurs among medical and non-medical opioid users. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Mohammad Karamouzian, Thomas Kerr Tags: Correspondence Source Type: research

[Correspondence] A new era for medical education in Colombia
During Nov 1 –3, 2017, most of the Deans of Medicine who belong to the Colombian Association of Faculties of Medicine (ASCOFAME)—a nationwide network of higher education institutions or universities with medical faculties—met in Monteria, Colombia. Their objective was to develop a consensus on medical educ ation.1 (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Alfonso J Rodr íguez-Morales, Carlos J González-Colonia, Julio C Gutiérrez-Segura, Eduardo Ramírez-Vallejo, Guillermo J Lagos-Grisales Tags: Correspondence Source Type: research

[Perspectives] Peter Robert Mason
Clinical microbiologist with a commitment to Zimbabwe. Born in Aldridge, UK, on July 9, 1948, he died of prostate cancer in Amsterdam, the Netherlands, on Sept 28, 2017, aged 69 years. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Geoff Watts Tags: Perspectives Source Type: research

[Perspectives] Health care as a cultural borderland
As a clinician, how do you best care for patients from a wide variety of backgrounds? Cultural diversity is not merely a matter of pluralism or multiculturalism; it is often accompanied by unequal or inadequate health care. Very often, cultural diversity and health disparity go hand in hand. As a response to such inequities, various forms of cultural competence training are now viewed as an essential curriculum component in medical education programmes and a key element of effective practice. However, these educational innovations have also come under fire. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Cheryl Mattingly Tags: Perspectives Source Type: research

[Perspectives] Encounters with Indian medicine
In 1911, an Indian-born medical doctor called Paira Mall was recruited by Henry Wellcome's Historical Medical Museum in London, UK. Overseen by its curator, C J S Thompson, Mall was sent to collect objects from the south Asian subcontinent; artifacts that would capture the art and science of healing throughout the ages, as well as medicinal plants for Wellcome's chemical research labs in the UK. Mall was well travelled, having served as an army surgeon in the Russo –Japanese War. A linguist and an expert in Asian cultures, he was by then fluent in German, French, Italian, Sanskrit, Persian, Hindi, Punjabi, and Arabic...
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Aarathi Prasad Tags: Perspectives Source Type: research

[Perspectives] Type 1 diabetes
Writing in 1649, the English herbalist Nicholas Culpeper despaired of his patients with diabetes: their “continual pissinge” was resistant to all treatment, and their deaths were rapid and certain. No longer: type 1 diabetes is a striking example of the transformation of the meaning of a diagnosis by application of clinical research. Its history reflects the trajectory of medicine away from heroic interventions and towards long-term treatment, from cure to care. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Richard Barnett Tags: Perspectives Source Type: research

[World Report] Universal health coverage law approved in Egypt
A universal health coverage law expanding access to health care in Egypt was approved by parliament, ahead of presidential elections. Sharmila Devi reports. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Sharmila Devi Tags: World Report Source Type: research

[World Report] Bolivia backtracks on malpractice law
In the midst of a health-care reform, a malpractice law put forward by the government has triggered strikes from the medical community. Amy Booth reports from Cochabamba. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Amy Booth Tags: World Report Source Type: research

[World Report] Changes in the US tax system will also affect health care
The tax overhaul pushed by Republicans could jeopardise the ACA's health insurance marketplaces. Susan Jaffe, The Lancet's Washington correspondent, reports. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Susan Jaffe Tags: World Report Source Type: research

[Comment] Offline: The misuse of universal health coverage
Health workers are taught to see their purpose as imbued with special human importance. Possessed with the values of knowledge, judgment, respect, responsibility, integrity, compassion, altruism, excellence, continuous improvement, and partnership, medicine is often said to be endowed with particularly moral attributes. This vocational foundation gives ethical momentum to the case for universal health coverage, the big idea of the Sustainable Development Goals. The creation of national health services, we doctors may suggest, are critical humanitarian milestones in the histories of nations. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] A time to remember and thank The Lancet's reviewers of 2017
Charles Dickens's A Christmas Carol provides an excellent opportunity to recalibrate what is important in life. An edgy adaptation by David Edgar is being performed by the Royal Shakespeare Company at Stratford-upon-Avon, UK, until February, 2018. The production emphasises that the social inequalities Dickens and his contemporary, Thomas Wakley —founder of The Lancet—railed at, remain uncomfortably present today. By contrast to the exploitative commercial and criminal relationships portrayed in this story, is the timeless theme of relationships that sustain, nurture, and redeem. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: The Editors of The Lancet Tags: Comment Source Type: research

[Comment] The Lancet –CAMS Health Summit 2018: a call for abstracts
The Lancet and the Chinese Academy of Medical Sciences (CAMS) have held three successful health summits in 2015 –17 in Beijing, China. We continue to support China's health science research communities and invite abstract submissions from China for the 2018 The Lancet–CAMS Health Summit, to be held on Oct 27–28 in Beijing. Submissions are invited from all aspects of health science, including, but not li mited to: translational medicine; clinical medicine; public health; global health; health policy; the environment and ecological systems; primary care; maternal, newborn, child, and adolescent health, heal...
Source: LANCET - January 19, 2018 Category: General Medicine Authors: Xuetao Cao, Helena Hui Wang, Limin Li, William Summerskill, Richard Horton Tags: Comment Source Type: research

[Editorial] The peril and promise of traffic
Just after the new year, a bus in Peru plunged off a winding cliffside road following a collision, leading to over 50 deaths. The road lacked guardrails or other safety equipment. The incident dramatically underscores the conclusions from a World Bank Group report published last week, The High Toll of Traffic Injuries. Addressing the burden of road traffic injuries (RTIs) will not only save lives but can greatly increase the social welfare of people in low and middle income countries (LMICs). (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Preparing for seasonal influenza
During the current northern hemisphere's winter, seasonal influenza activity has become worrisome. According to the US Centers for Disease Control and Prevention (CDC), influenza activity is affecting the entire continental USA for the first time in 13 years and this year's season might well be severe. In the UK, in the first week of 2018, GP consultation rates for influenza rose 78%, and influenza-confirmed hospitalisations increased by 50% from the previous week, according to Public Health England. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] A shared future for all: let's talk about homelessness
The World Economic Forum meeting in Davos is almost upon us again. From Jan 23 to 26, more than 2500 participants from over 100 countries will contemplate the state of the world in over 400 sessions (and many more side events and corridor conversations). This year's theme, Creating a Shared Future in a Fractured World, is certainly an apt motto in today's geopolitical context. The 48th annual meeting “aims to rededicate leaders from all walks of life to developing a shared narrative to improve the state of the world”—lofty goals in a lofty location. (Source: LANCET)
Source: LANCET - January 19, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Department of Error] Department of Error
Iuliano AD, Roguski KM, Chang HH, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet 2017; 391: 1285 –300—In the Research in Context panel of this Article (published Online First on Dec 13, 2017), the first sentence of the Evidence before this study section should read “Previous estimates commonly attributed to WHO indicate that 250 000–500 000 deaths occur annually worldwide due to sea sonal influenza viruses.” The last sentence of the second paragraph in the Methods section should read “Of the 15 remaining countries contacted, ...
Source: LANCET - January 19, 2018 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Pitfalls of the healthy vaccinee effect – Authors' reply
In our Article,1 we presented findings from a case-control study that showed a protective effect of a meningococcal vaccine against gonorrhoea infection. In their Correspondence, Salaheddin Mahmud and Christiaan Righolt argue that the correct method to determine vaccine efficacy is a randomised controlled trial (RCT) and that our use of chlamydia as a control is problematic. We would like to clarify the points raised in their letter. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Helen Petousis-Harris, Janine Paynter, Jane Morgan, Peter Saxton, Felicity Goodyear-Smith, Steven Black Tags: Correspondence Source Type: research

[Correspondence] Pitfalls of the healthy vaccinee effect
We read with interest the Article by Helen Petousis-Harris and colleagues (Sept 30, 2017, p 1603),1 which showed that the vaccine against outer membrane vesicle meningococcal B was 31% effective in reducing gonorrhoea among attendees of 11 clinics in New Zealand for patients with sexually transmitted infections. We disagree, however, with the authors' claims that their “findings provide experimental evidence that these vaccines could offer moderate cross-protection against [gonorrhoea]”. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Salaheddin M Mahmud, Christiaan H Righolt Tags: Correspondence Source Type: research

[Correspondence] GRECCAR2 trial: details worthy of more attention – Authors' reply
We thank Ji Zhu and colleagues, who made very appropriate and constructive comments on the French GRECCAR 2 trial.1 (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Eric Rullier, V éronique Vendrely, Quentin Denost, Julien Asselineau, Adélaïde Doussau Tags: Correspondence Source Type: research

[Correspondence] GRECCAR2 trial: details worthy of more attention
We read with great interest the GRECCAR 2 trial by Eric Rullier and colleagues (July 29, 2017, p 469),1 which reported that local excision showed no superiority over total mesorectal excision in rectal cancer patients with a good response after chemoradiotherapy. However, some aspects of the study warrant closer attention. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Huixun Jia, Yun Guan, Ji Zhu Tags: Correspondence Source Type: research

[Correspondence] Translation of the link between cancer and obesity to patients
The report summarised in The Lancet (Oct 14, 2017, p 1716)1 reinforces findings from previous studies that have noted an association between increased body-mass index and some malignancies.2,3 Obesity is a major public health concern and the way in which the link is communicated to patients is paramount to solving this problem. Patients should be made aware that only an association has been observed —ie, increased body-mass index raises the likelihood of the development of some cancers. Several theories have been proposed to explain this link, implying that adipose tissue directly affects malignancy growth. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Dalia Abdulhussein, Elham Amin Tags: Correspondence Source Type: research

[Correspondence] Questions regarding the CONCERN trial – Authors' reply
We thank Ricky Turgeon for his Correspondence regarding our CONCERN trial1 on the gastrointestinal safety of celecoxib plus esomeprazole versus naproxen and esomeprazole in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Francis K L Chan, Jessica Y L Ching, Yee Kit Tse, Moe H Kyaw Tags: Correspondence Source Type: research

[Correspondence] Questions regarding the CONCERN trial
Findings from Francis Chan and colleagues' study (June 17, 2017, p 2375)1 showed a 6 ·7% absolute risk reduction in recurrent upper gastrointestinal bleeding with celecoxib plus esomeprazole compared with naproxen and esomeprazole in patients who were on non-steroidal anti-inflammatory drugs and receiving concomitant aspirin following an upper gastrointestinal bleed. Additionally, the authors reported no significant difference between groups in serious cardiovascular events (4·4% [95% CI 2·4–7·7] for patients given celecoxib plus esomeprazole vs 5·5% [3·3–9·2] fo...
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Ricky D Turgeon Tags: Correspondence Source Type: research

[Correspondence] Singapore should play a strong leadership role in global health
The regions of the Association of Southeast Asian Nations continue to face several health threats associated with infectious and chronic diseases, ageing populations, and inadequate clean water and sanitation. Collective action is needed among the Asian countries to deal with these threats, and Singapore has much to offer in terms of knowledge and innovations.1 In 2017, Singapore was ranked in the top position in progress towards the health-related UN Sustainable Development Goals2 and in the Global Innovation Index 2017 (a metric among Asian countries). (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Tikki Pang Tags: Correspondence Source Type: research

[Correspondence] Treaty to prohibit nuclear weapons and Germany's global health responsibility
The adoption of the Treaty on the Prohibition of Nuclear Weapons by the UN1 and the immediate support by 50 nations is, as Andy Haines and Helfand2 note, “a victory for the public health perspective over the misguided national power and security considerations that have dominated nuclear policy” for decades. Strong support for the treaty by countries with a commitment to global health is needed to safeguard humanity. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Kayvan Bozorgmehr, Eva-Maria Schwienhorst-Stich Tags: Correspondence Source Type: research

[Correspondence] Saving the Joint Comprehensive Plan of Action: full of hope or just hopeless?
On July 14, 2015, Iran, the P5+1 countries (China, France, Russia, UK, USA, and Germany), and the European Union signed a landmark nuclear agreement that officially went into effect on Jan 16, 2016.1 Under the Joint Comprehensive Plan of Action (JCPOA; also known as the Iran nuclear deal), Iran was to put severe limitations on its nuclear programme in exchange for the removal of international sanctions. After signing this agreement, Iranian scientists considered it an historic opportunity for the scientific community, and they became hopeful that lifting the sanctions could gradually help their scientific advancements in m...
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Masoud Mozafari Tags: Correspondence Source Type: research

[Obituary] Shila Kaur
Malaysian public health expert and advocate for access to medicines. Born in George Town, Malaysia, on March 13, 1962, she died of breast cancer in Los Angeles, CA, USA, on Nov 21, 2017, aged 55 years. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Andrew Green Tags: Obituary Source Type: research

[Perspectives] Changing minds about changing behaviour
Most of us value our health highly yet act in ways that undermine it. If we ate and drank less, didn't smoke, and were physically more active, 40% of cancers and 75% of diabetes and cardiovascular disease would be avoided. Because these behaviours tend to cluster by deprivation, achieving these changes for everyone could also halve the gaps in life expectancy and years lived in good health between the rich and the poor. In the UK, around 16% of the population smokes, the lowest figure for many decades, although among those who are poorest this rate is doubled. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Theresa M Marteau Tags: Perspectives Source Type: research

[Perspectives] Natalia Kanem: lifelong advocate for women's health and rights
”My big disappointment is that women's rights are still not at the centre”, says Natalia Kanem, echoing her lifelong “passion and hope” for women's health and rights. Her interest in these issues started in 1975 when, as an undergraduate at Harvard University, she attended the first UN World Conference on Women. Appointed as the Executive Director of the United Nations Population Fund (UNFPA) in October, 2017, Kanem hopes she “can really affect the fate of some of the poorest and most vulnerable women and girls in the world”. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: John Zarocostas Tags: Perspectives Source Type: research

[Perspectives] Man-made disaster
In its last years, the Soviet Union was not meeting the needs of its citizens. One simple measure, life expectancy at age 15 years, showed the USSR to fall progressively further behind western Europe, all through the 1970s and 1980s. It was meeting material needs of its population —infant mortality was fairly low, and people had enough to eat—but not spiritual needs, to use the words of Mikhail Gorbachev, last General Secretary of the Communist Party of the Soviet Union. Deaths from heart disease were high, as were violent and other alcohol-related deaths. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Michael Marmot Tags: Perspectives Source Type: research

[Perspectives] Truth and information
“I'm mad as hell and I'm not going to take it anymore”. This iconic rallying cry was originally made by actor Peter Finch, as news anchorman Howard Beale, in Paddy Chayefsky's 1976 film Network. The same cry is now echoing in the Lyttelton Theatre, at the UK's National Theatre in London, in a st age adaptation of the movie by Lee Hall. Under the direction of Belgian director Ivo van Hove, American actor Bryan Cranston makes his debut on the British stage in a pitch-perfect performance as Howard Beale. (Source: LANCET)
Source: LANCET - January 12, 2018 Category: General Medicine Authors: Marco De Ambrogi Tags: Perspectives Source Type: research