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[Health Policy] Lancet Countdown on health and climate change in Africa: an international collaboration for locally led research and action

Climate change inflicts substantial economic damage on developing African nations, threatening progress towards the UN Sustainable Development Goals. There are synergies between actions needed to tackle climate change and other ongoing development priorities for Africa, including infectious disease control, facilitating clean energy access, reducing air pollution, tackling malnutrition and food insecurity, and providing universal health coverage. Action to protect human health against climate change needs to be integrated into all systems that are responsible for delivering essential services and implementing policies across all sectors that underpin the attainment of key development priorities for Africa.

[Articles] Epcoritamab, lenalidomide, and rituximab versus lenalidomide and rituximab for relapsed or refractory follicular lymphoma (EPCORE FL-1): a global, open-label, randomised, phase 3 trial

Epcoritamab plus R2 resulted in significantly higher response rate and longer progression-free survival versus R2 among participants with follicular lymphoma who had received at least one line of therapy. Epcoritamab plus R2 had more grade 3 or higher adverse events versus R2. Adverse events were manageable and consistent with the established safety profiles of the individual components, with no new safety findings identified. These findings position epcoritamab plus R2 as a new standard of care for second-line or subsequent treatment of follicular lymphoma.

[Department of Error] Department of Error

Workowski KA. Zoliflodacin shows benefit as an oral treatment for uncomplicated gonorrhoea. Lancet 2026; 407: 108–109—In the last sentence of the first paragraph in this Comment, the name of the Global Antibiotic Research and Development Partnership has been corrected. In the second paragraph, the 11th sentence has been amended to read: “Microbiological cure rates at the urogenital site were 460 (90·9%, 95% CI 88·1–93·3) of 506 participants for the zoliflodacin group and 229 (96·2%, 92·9–98·3) of 238 participants for the comparator group, with the difference between groups meeting the prespecified non-inferiority margin.” Additionally, the last sentence in the second paragraph has been amended to read: “For the secondary endpoints of microbiological cure at the rectal and pharyngeal sites, 79% of participants in the microbiological intent to treat population and over 90% of participants in the evaluable population in both treatment groups were cured;however, the study was underpowered for extragenital endpoints.” These corrections have been made to the online version as of Jan 8, 2026, and the printed version is correct.

[Correspondence] DISTRICTS trial: enhancing carpal tunnel syndrome treatment – Authors' reply

We would like to thank Mustafa Turgut Yildizgören for his Correspondence, which gives us the opportunity to further clarify some of the rationale behind the design choices of the DISTRICTS study and its findings.1 The DISTRICTS trial compared the effectiveness of two treatment strategies for carpal tunnel syndrome: one starting with surgery and one starting with a corticosteroid injection, with the option to receive additional treatments in both strategies if needed.1 We deliberately chose not to impose a strict treatment protocol on participating centres.

[Correspondence] Rethinking CLDN18.2 expression in gastric cancer therapy – Authors' reply

We thank Peng Luo and colleagues for their interest in our work and insightful Correspondence regarding our Article on satricabtagene autoleucel (satri-cel).1 Their points on the dynamic nature of claudin-18 isoform 2 (CLDN18.2) expression and the effect of tumour biological heterogeneity are well received and resonated with broader challenges in the field of chimeric antigen receptor (CAR) T-cell therapy in solid tumours.

[Correspondence] Rethinking CLDN18.2 expression in gastric cancer therapy

The Article by Changsong Qi and colleagues,1 on satricabtagene autoleucel (satri-cel), a claudin-18 isoform 2 (CLDN18.2) targeted chimeric antigen receptor (CAR) T-cell therapy, is a crucial milestone in addressing therapeutic stagnation in gastric or gastro-oesophageal junction adenocarcinomas. However, the discussion surrounding biomarker-based patient selection, particularly CLDN18.2 expression, warrants deeper scrutiny.

[Correspondence] Revisiting platelet-rich plasma for knee osteoarthritis – Authors' reply

We thank Guilherme Corrêa de Araújo Moury Fernandes and colleagues for their response to our Seminar,1 and their discussion of the use of platelet-rich plasma for the management of knee osteoarthritis. We agree that not all platelet-rich plasma is equivalent. Platelet-rich plasma is an autologous blood product prepared from patients’ whole blood, comprising platelets, leukocytes, growth factors, and cytokines. Its composition depends on the concentration of the constituents in whole blood, and on the manufacturing procedure, which differs in centrifugation protocol, addition of activators, and other factors.

[Correspondence] Revisiting platelet-rich plasma for knee osteoarthritis

We read with interest the Seminar by Margreet Kloppenburg and colleagues,1 which provides a comprehensive overview of osteoarthritis. However, we were surprised by the assertion that there is an absence of evidence for the use of platelet-rich plasma for knee osteoarthritis. This conclusion, based primarily on the RESTORE trial,2 overlooks important and recent high-quality data.

[Correspondence] Lead poisoning in southeast Asia: an urgent call for action

Lead poisoning remains one of the world's most significant yet preventable environmental health threats. It accounts for 1·5% of annual global deaths1 and disproportionately affects those in southeast Asia, which has more than 20% of the world's children who are affected by lead.2 In this region, exposure to lead is concentrated in lower-income economies: 1·6% of children in Thailand have blood lead concentrations above the WHO threshold of 5 μg/dL,3 which is similar to high-income countries. By comparison, 79·4% of children in neighbouring Cambodia are estimated to exceed this threshold.

[Perspectives] Putting a price on care

A hospital invoice for a baby's birth in the USA occasionally makes the rounds on social media. For those of us lucky enough to live in the UK with universal health coverage through the National Health Service (NHS), the itemised costings for even a “normal” American delivery seem, frankly, grotesque: the hefty mark-up on a single sanitary pad; dollars for one dose of over-the-counter painkillers; billing for “skin to skin” between mother and baby.

[Perspectives] Rachel Clarke: writing life

“When I was really little”, says Rachel Clarke, looking back to her days at primary school, “we had to write a book called All About Me. Mine has a picture of me at a desk saying ‘When I grow up, I am going to be a writer of books.’” Clarke has more than fulfilled her childhood ambition and is the author of four books. The Story of a Heart, her account of a cardiac transplant from one child to another, won the UK's 2025 Women's Prize for Non-Fiction. Clarke divides her time equally between writing and work as a palliative care specialist in the UK.

[Comment] Offline: Watching the watchers (part 5)

Global Health Watch 7 (GHW7) is an important intervention in the theory and practice of global health, especially at a time of upheaval and uncertainty. (I am writing these words as I listen to the news that US forces have bombed Venezuela's capital, Caracas, and captured, arrested, and indicted the country's dictator-President Nicolás Maduro and his wife, Cilia Flores: the prospects for a rules-based world order have just swerved sharply towards danger.) The co-editors of GHW7, Ron Labonté and Chiara Bodini, have succeeded in offering alternative narratives to challenge prevailing beliefs and assumptions in global health—a discipline that rarely challenges the political and economic foundations of its work.

[Comment] Climate change, migration, displacement, and health: past, present, and future

The history of human health and migration, the human story, is deeply intertwined with the natural environment. As described by Anthony McMichael,1 pioneering scholar of health and environmental change, the climate is not merely a backdrop to human life, it is embedded in who we are and how we live. Modern human civilisation has been facilitated by the remarkably stable climatic conditions of the Holocene: the past 11 000 years during which century-to-century global average temperatures varied by no more than 1°C.

[Comment] Is proton therapy a new standard of care for oropharyngeal cancer?

The study by Steven J Frank and colleagues1 in The Lancet is the first randomised, phase 3 trial comparing intensity-modulated proton therapy (IMPT) with intensity-modulated radiotherapy (IMRT) in patients with oropharyngeal cancer. Support for the role of proton radiotherapy for head and neck cancer has previously come from dosimetric studies,2 as well as retrospective and case–control clinical reports.3–5 A study with early experience from the MD Anderson Cancer Center compared 50 patients treated with IMPT with 100 patients treated with IMRT, finding a significant reduction in acute gastrostomy tube use and severe weight loss with IMPT, but no difference in tumour control.

[Comment] A step forward in the treatment of relapsed or refractory follicular lymphoma

Follicular lymphoma remains an incurable malignancy characterised by successive relapses. Despite favourable initial responses to front-line therapy, most patients eventually relapse, and lymphoma or treatment-related complications remain the leading cause of death.1 Accumulating evidence shows that the duration of response shortens with each subsequent line of therapy, resulting in progressively reduced progression-free survival and overall survival after each line of treatment.2,3