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[Personal View] Making US public health a good idea again

The stress test the COVID-19 pandemic imposed on the US public health system illuminated predictable yet surprisingly unplanned for fault lines. A perceived lack of choice associated with nonpharmaceutical and pharmaceutical interventions led many Americans to question both measures and processes for mitigating disease consequences, such as masking and mass vaccination. A cultural-historical examination shows that a central impediment for US efforts to control the pandemic was the limited sense of common good.

[Viewpoint] A HEARTS-based integrated model for noncommunicable disease control in primary health care in Peru

Peru has developed and initiated the scale-up of a HEARTS-based, integrated, person-centered primary health care system to support people living with hypertension, type 2 diabetes mellitus, and chronic kidney disease. The model combines standardized clinical pathways with validated drivers, as well as maturity and performance indexes to promote evidence-based practice and continuous quality improvement across diverse primary care settings. National implementation started in 2024 through a structured capacity-building strategy and the deployment of regional facilitators to support supervision, data quality, and clinical mentoring.

[Health Policy] Precision diagnosis and therapy for pediatric central nervous system tumors: consensus from the Brazilian Society of Pediatric Oncology (SOBOPE)

Precision medicine has reshaped the classification and management of pediatric central nervous system tumors, enabling more accurate diagnoses and targeted therapies. However, access to molecular diagnostics and precision treatments remains uneven in many low- and middle-income countries, including Brazil. To address this gap, the Brazilian Society of Pediatric Oncology (SOBOPE) convened a national expert panel to develop consensus recommendations adapted to the Brazilian healthcare context. Using a structured literature overview and a modified Delphi process involving pediatric oncologists, neuropathologists, and laboratory medicine specialists, the panel proposed a tiered molecular testing strategy prioritizing essential and actionable biomarkers.

[Articles] Enterovirus D68 in United States wastewater: a longitudinal surveillance study integrating climatic, demographic, and clinical data

Wastewater surveillance can generate epidemiological metrics for EV-D68 without clinical surveillance data, identify where and when activity increases, and reveal the environmental and demographic factors driving these patterns. Wastewater surveillance offers high-resolution data for pathogens with diagnostic testing constraints and provides information that can strengthen epidemiological modeling and support preparedness for future disease waves.

[Articles] A hospital-based retrospective study of hospitalizations with hyalohyphomycosis and phaeohyphomycosis in the United States

Hyalohyphomycosis and phaeohyphomycosis were associated with substantial mortality. Culture-based diagnosis often takes weeks for growth and identification of the causative organism, often leading to inappropriate antifungal treatment while awaiting specific results. Innovation in non-culture-based diagnostics could help improve patient outcomes.

[Correspondence] Introducing dual practice may threaten equitable surgical access in Canada

Alberta's proposal to permit surgeons to perform both publicly funded and privately paid procedures represents a departure from Canada's commitment to universal, publicly financed health care.1 Although presented as a strategy to expand surgical capacity and reduce wait times, this shift introduces structural incentives that could undermine equitable access to medically necessary procedures, particularly for low-income, rural, and Indigenous populations who already face barriers to timely care.2

[Correspondence] Nationwide implementation of AI-assisted telemedicine in El Salvador

In November 2025, the government of El Salvador launched a comprehensive national telemedicine initiative aimed at improving access, provider competency, and health outcomes. To that end, the government entered a strategic alliance with Google LLC to integrate a suite of Gemini LLMs to assist in the diagnosis and treatment of non-emergency conditions in primary care. While similar initiatives are becoming increasingly common worldwide, they are still rare in low- and middle-income countries, hindered by infrastructure barriers, linguistic and cultural divides, and data governance issues.

[Comment] Measles re-emergence in Mexico: essential public health functions under strain

Measles has re-emerged in Mexico and the country risks losing its WHO measles-free status.1,2 The resurgence is more than an epidemiological event: it is a stress test of health-system performance in essential public health functions—routine immunisation, surveillance, and front-line response.3 In unequal settings, measles outbreaks are rarely surprises; they are delayed confirmations of routine operational failure.

[Comment] The implementation gap: how Cuba's tuberculosis setback exposes a universal challenge for low-burden countries

The pursuit of tuberculosis (TB) elimination is often depicted as a final sprint. In 2024, 62 countries reported a low TB incidence (<10 cases per 100,000 population).1 This commentary addresses a crucial challenge: the inherent fragility of progress in these settings, where hard-won gains can prove unexpectedly vulnerable to reversal.

[Comment] Political interference in vaccination policy and transnational implications for Latin America and the Caribbean

The United States (US) exerts strong normative and symbolic influence in global health, with its public health recommendations often echoed in Latin America and the Caribbean (LAC). Recent changes in childhood and maternal vaccination guidance by the US Department of Health and Human Services (DHHS) carry potential transnational implications. Once grounded in a solid scientific framework and consensus, US immunisation policy has become increasingly politicised after the COVID-19 pandemic, a shift associated with lower vaccine acceptance, reduced coverage, and higher morbidity and mortality from vaccine-preventable diseases—trends that heighten concern about their ripple effects beyond US borders.

[Comment] Public health research and health equity threatened by new US policies: impact and opportunities for Latin America

For decades, Latin American public health research has depended on US federal funds. Research shifts in US research priorities—including reduced emphasis on health equity, gender, and diversity—show what should have been obvious: depending on external funding means ceding control over regional research agendas. This is not a crisis to lament but a wake-up call to act. Latin America needs national and regional policies that invest sustainably in research as a development pillar, prioritizing local relevance and regional needs.

[Comment] Language matters: advancing linguistic equity in health research in the Americas

Embracing linguistic diversity in the Americas is core to advancing equity in health research. Yet English continues to dominate scientific research communication,1,2 even though it is the primary language for less than one-third of the region's population.3 By contrast, Spanish (∼400 million) and Portuguese (∼204 million) together represent a much larger share.3 Despite calls to decolonise language in global health research,1,2,4–7 persistent inequities overlook the Americas' unique diversity and shared social fabric.

Perioperative Enfortumab Vedotin and Pembrolizumab in Bladder Cancer

In cisplatin-ineligible patients with muscle-invasive bladder cancer, enfortumab vedotin–pembrolizumab plus surgery led to better event-free survival (74.7%, vs. 39.4%) and overall survival (79.7%, vs. 63.1%) than surgery alone at 2 years.

Heads or the Tail?

Survival in patients with cancer, affected by myriad factors, is notoriously difficult to predict. But while oncologists find it hard to communicate the uncertainty, patients are the ones who must live it.

Case 6-2026: A 91-Year-Old Man with Shortness of Breath, Weight Loss, and Eosinophilia

A 91-year-old man was admitted to the hospital with weight loss, dyspnea, and eosinophilia. An anteroposterior chest radiograph obtained 2 months earlier showed bibasilar patchy opacities. A diagnosis was made.