Search Medical Journals & Research Articles

[Correspondence] Let Afghan women work: maternal health depends on it

Afghanistan today faces a maternal health crisis that is as much political as it is medical. When girls are banned from studying beyond grade 6, nursing and midwifery schools are shuttered, and female health workers are restricted in their ability to work, the results are tragically predictable: women give birth without skilled support, and preventable maternal deaths rise.

[Perspectives] Masking harm: dust, diseases, and industry

During the COVID-19 pandemic, we were all reminded of the long history of masks used as protection against disease, ranging from the iconic plague doctor's beaked mask to the cloth masks seen in historical paintings of past epidemics. Yet history holds its surprises. The beaked mask never existed as a real object: 17th-century engravings of plague doctors were satirical, portraying them as crows—omens of death that stole from the sick. As for the cloth masks, they were indeed worn, but as perfuming devices, not air filters.

[Perspectives] A quest for vaccine equity

For those working in global health, and especially on immunisation, it is difficult not to feel despair at the headwinds in 2025 that have been blowing forcefully against decades of collective efforts to improve the world's health through prevention of infectious diseases, especially for those in greatest need. Cuts to official development assistance in Europe and USAID in the USA, and reduced funding for WHO and Gavi, the Vaccine Alliance, among other organisations, threaten populations today, with the impacts expected to be felt for a generation.

[Perspectives] Fitsum Tadesse: shaping malaria research in sub-Saharan Africa

“Over the last one and a half decades we have seen malaria incidence, morbidity, and mortality decreasing. Ethiopia was performing phenomenally”, comments malaria researcher Fitsum G Tadesse, a Wellcome Trust Research Fellow at the UK's London School of Hygiene & Tropical Medicine (LSHTM), who heads a large research team at the Armauer Hansen Research Institute (AHRI) in Addis Ababa, the clinical and biomedical research arm of the Ministry of Health of Ethiopia. “But, since 2019, that trend has reversed, and unfortunately, it's now moving in the wrong direction.” Tadesse is referring to the 960 000 cases of malaria reported across Ethiopia in 2019, that by 2025 had increased to 9·7 million.

[Comment] Offline: The death of globalism (part 1)

Tempting as it is to write off the Trump phenomenon and its effects on medicine and global health as a temporary derangement of mass politics, one would be severely mistaken for doing so. The imitations and embodiments of Trumpism reach far across the world, from Latin America to Europe and Asia. The apparent random nature of the President's pronouncements and actions, his predictable unpredictability, suggests a chaotic and disorderly approach to government. But, again, such a conclusion would be a grave error.

[Comment] The changing spectrum of cardiovascular diseases

Advances in cardiovascular disease prevention are often hailed as one of the major public health accomplishments of the past 50 years. The progress achieved is rooted in efforts challenging the inevitability of vascular events, which led to the discovery of modifiable risk factors and systematic approaches to prevent population exposure. These prevention efforts have led to steep reductions in premature vascular mortality and morbidity in many parts of the world since the 1960s.1–3 However, this downward trend seems to have reached a plateau or even reversed in several high-income countries.

[Comment] A rights-based imperative for young women

For young women like me living with HIV in South Africa, health systems too often treat our care as a series of disconnected tasks. Sexual and reproductive health and HIV care should be integrated for convenience given the high unmet need in young people, including those living with HIV.1,2 This division forces adolescent girls and young women (aged 18–25 years) into fragmented care, with different providers and health-care service locations for antiretroviral therapy, contraception, and mental health services.

[Comment] Perioperative camrelizumab plus rivoceranib versus surgery in resectable hepatocellular carcinoma

Historically, hepatocellular carcinoma was deemed to be inherently drug resistant due to the presence of multidrug resistance genes that increased drug efflux and reduced drug uptake. For decades, multiple trials investigating systemic therapy for advanced hepatocellular carcinoma had failed to show clinical efficacy. In 2008, Llovet and colleagues1 reported that median survival and the time to radiological progression were nearly 3 months longer for patients treated with sorafenib versus placebo.

[Comment] Progress in outcomes for patients with metastatic squamous non-small-cell lung cancer

The use of immunotherapy in patients with various types of cancer has led to dramatic increases in survival. Increased median survival and even cure have been reported in a subgroup of patients receiving immunotherapy, especially following the use of checkpoint inhibitors targeting PD-1 or PD-L1 either as monotherapy or combined with targeted CTLA-4 therapy, chemotherapy, or both.1 Releasing the tumour-induced brake on the immune system by use of these inhibitors leads to broad improvements in patient outcomes, with long-term survival rates in those with historically untreatable disease types, such as metastatic melanoma and non-small-cell lung cancer (NSCLC).

[Editorial] Health in the US Government shutdown

The US Federal Government is gridlocked. When the 2025 fiscal year ended, the Senate and House of Representatives had not passed a budget for 2026, and so federal agencies are required to pause all non-essential services. Republicans have endorsed a short-term resolution to continue funding until a new budget can be approved, but Democrats in the Senate, who hold enough seats to block new appropriations, are leveraging the shutdown to demand reforms to health-care spending. This funding lapse has become the second longest in US history and, as The Lancet goes to press, political leaders have yet to begin negotiating a solution.

I-25: Public Law 119-21 and WiSeR

This program will evaluate how Medicaid and ACA reductions, as introduced by Public Law 119-21, will impact seniors' health insurance coverage, access to care, and long-term support services. Second, the program will review the ethical, clinical, and logistical considerations of implementing AI-driven prior authorization for Medicare outpatient services in the WISeR pilot.

Retinal Sensitivity in Areas of Retinal Nonperfusion

The study by Hamilton-Perais and colleagues leveraged both ultra-widefield fluorescein angiography and static automated perimetric threshold to study the association of retinal sensitivity deficits with retinal capillary nonperfusion in people with diabetic retinopathy. Developing and validating end points is a priority to design clinical trials on interventions for retinal capillary nonperfusion. The strength of this study is that the retinal sensitivity deficit was elicited across a much larger area of the retina (100°) compared with previous studies that have limited these correlation studies to the fovea or macula over 1 year.

Should Familial Hypercholesterolemia Be Included in Newborn Screening?

Newborn screening has revolutionized the early diagnosis of genetic conditions and enabled early therapeutic interventions, which have dramatically improved the outcomes for numerous disorders. The advent of tandem mass spectrometry in the 1990s opened the possibility of cost-effective multiplex screening for a multitude of disorders on the same sample. In the early 2000s, as it still is now, newborn screening was a state-based program, with some states screening for only 4 disorders while others screened for more than 30. This geographical variability prompted the US federal government to task the American College of Medical Genetics to develop national guidelines, including a uniform condition panel. The Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC) was created as a part of this mission and worked to review current evidence to create the Recommended Universal Screening Panel (RUSP). In the original report, 29 conditions were identified based on a scoring system as primary targets for screening (core panel) with an additional 25 conditions that could be identified while screening for the core panel conditions. Familial hypercholesterolemia (FH) was considered but not recommended as a part of the original core panel. Several other disorders that originally scored lower than FH, including mucopolysaccharidosis type I and Pompe disease, among others, have since been added to the RUSP as new treatments have become available, and there are currently 37 core conditions that are formally recommended on the RUSP.

[Position Paper] Research gaps for children who are HIV-exposed but uninfected: outcomes of a research prioritisation workshop

Globally, 16 million children are HIV-exposed but uninfected (HEU), with health disparities when compared with children who are HIV-unexposed. To identify current challenges, a research prioritisation exercise was conducted through an online survey and in-person workshop with diverse stakeholders, with the aim of identifying the top ten scientific priorities related to children who are HEU. Among 104 survey respondents (46% from Africa; 37% from Europe; 15% from the region of the Americas; and 2% from South-East Asia), 271 research questions were submitted.

[Review] Immunology of infants who are HIV-exposed uninfected in the parental combination antiretroviral therapy era

The introduction and programmatic scale-up of universal antiretroviral therapy in pregnancy (option B and option B+) and the subsequent universal test-and-treat approaches have dramatically reduced infant HIV-1 acquisitions globally, with a parallel increase in the number of infants who are HIV-exposed uninfected (HEU). Although infants who are HEU have historically had higher risk of morbidity and mortality than infants who are HIV unexposed, effective parental viral suppression has enabled people living with HIV to carry healthier pregnancies and realise the benefits of optimised feeding practices that support the transfer of key nutrients and immune factors through their parent's own milk.