Last week, the National Cancer Institute (NCI) of the US National Institutes of Health, in collaboration with WHO, released The Economics of Tobacco and Tobacco Control—the 21st volume in a series of monographs on tobacco control produced from the NCI. The almost 700-page report contains an impressive body of work from more than 60 authors worldwide. It provides a comprehensive summary of the latest evidence and research, and what needs to be done on two areas. First, the economics of tobacco control, including tobacco use and growing, manufacturing and trade, and tobacco control interventions and policies to reduce tobacco consumption and its effects on health and disease burden.
In today's Lancet, Séverine Vermeire and colleagues report the results of FITZROY, a phase 2 randomised controlled trial that compared the JAK1 inhibitor filgotinib with placebo for clinical remission in patients with moderate-to-severe Crohn's disease. Although modestly sized, short-term, and preliminary, the study offers promise for several reasons: the different approach to cytokine blockade, oral dosing, stratification by prior treatment with anti-TNF compounds, and the use of meaningful patient-reported outcomes.
2017 will be a crucial year for the future direction of health care in China, not only because of the upcoming reshuffle of the top Chinese leadership—the Politburo Standing Committee—but also because of the 13th 5-year plan on health care (2016–20), which was officially issued by China's State Council on Jan 10. The plan represents the political health manifesto of the Communist Party.
A pharmaceutical company representative described the Access to Medicine Index 2016 as “a force for good, and not yet another stick with which to beat industry”.1 The Access to Medicine Index 2016,1 which will be presented at a public meeting later this month at the time of the WHO Executive Board meeting in Geneva, ranks the top 20 research-based pharmaceutical companies on their efforts to improve access to medicine in low-income and middle-income countries (LMICs). And those companies with high ranking tout their success to their stockholders and the media.
The Lancet and the Chinese Academy of Medical Sciences (CAMS) have held two successful health summits in 2015 and 2016 in Beijing, China. We are thrilled to be involved in the exciting and rapid progress of medical research in China, and will continue to support China's health science research. We invite abstract submissions from China for The Lancet–CAMS Health Summit 2017, to be held on Oct 13–14 in Beijing. Submissions are invited from all aspects of health science including, but not limited to: translational medicine, clinical medicine, public health, global health, health policy, the environment and ecological systems and health, health professionalism, and medical education.
It is with exquisite sadness that anyone concerned with the future of health care in England now observes the present broken covenant of trust between government and medical profession. I cannot recall a time since 1980 (the year I became a medical student) when the confidence doctors and politicians have in one another has been so low, when the dialogue between them has been so bitter. Ever since the creation of the Royal College of Physicians in 1518, the profession has served at the pleasure of government.
Canada is rapidly scaling up supervised injection facilities to tackle a surge in heroin overdoses. The move is welcomed by experts but several are calling for further measures. Paul C Webster reports.
Innovative schemes in Bulgaria are enabling young Roma to study medicine while others are encouraging Roma people to become health mediators. Jacqui Thornton reports from Sofia.
Suicide prevention programmes for Indigenous Australians have been reported to be failing. An Indigenous-led national response to the crisis is needed, say experts. Sophie Cousins reports.
This year will see major changes in leadership at WHO and at the Global Fund to Fight AIDS, Tuberculosis and Malaria, and probably in some other health-related multilateral organisations as well. History has shown that an able leader at the helm can make a difference. However, governance, organisational culture and performance, and funding equally define a leader's effectiveness. In the case of multilateral institutions, these are complex matters given the conflicting interests of their multiple stakeholders.
“I remember seeing a car parked here and there in Hackney, London, with an intriguing contraption made of metal rods, an antenna or two, and maybe some ropes protruding from the roof. I imagined it was the work of a wonderfully batty investigator who had some idiosyncratic notions about extra-terrestrial life or a new form of communication”, says Ken Arnold, Creative Director at the Wellcome Trust and Copenhagen's Medical Museion, when I ask him when he first came across British sculptor and artist Conrad Shawcross.
Bespoke—the process of making something unique for one individual—involves recognising what needs to be done and having the skills to do it. Recognising depends on close noticing. A tailor, like a clinician, must observe minutely, registering those almost imperceptible asymmetries on which individuality depends. Doing requires a different kind of understanding, a connection with materiality. This is the knowledge of the maker and it comes not from books but from spending time with “stuff”, from working with it and studying its nature.
Pioneering heart surgeon. He was born in Madison, WI, USA, on April 3, 1930, and died following a stroke in Milwaukee, WI, USA, on Oct 24, 2016, aged 86 years.
More than 300 000 children seeking asylum were registered in the 28 European Union (EU) member states during 2015, including 88 700 unaccompanied minors. These children have considerable health-care needs primarily because of mental health problems, but also as a result of infectious disorders and lack of basic health care (such as immunisations).1
Communicating with patients at the end of life is regarded as a difficult task, and speaking openly about death is often avoided.1,2 Around 50% of patients are informed about their diagnosis and prognosis in many European countries. Silence conspiracies are fairly common3—defined as the agreement between health professionals and relatives or carers to hide from the patient information related to their clinical condition.
On Oct 3, 2016, a doctor was fatally attacked by the patient's family member in China. Resentment, helplessness, confusion, and fear again damaged the already fragile doctor–patient relationship. Many have attributed the deterioration in this relationship to media, policy, patients, or doctors, in an apparent attempt to look for someone to blame. But in this recent case, an innocent paediatrician was attacked by a new father whose baby died of congenital disease. In denial, depression, and anger, the new father vented his grief on the doctor, with tragic consequences.
The recent publication by Jessica Metcalf and others (Aug 13, p 728),1 calls for the establishment of a World Serum Bank; something we feel should be titled a World Serology Bank given its emphasis on monitoring changes in the immune response to infections. A possible rapid and cost-effective way of setting this up would be to use existing primary care sentinel networks such as the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC).2
Climate change is affecting public health.1 These effects occur directly because of changes in temperature and precipitation and natural disasters, through ecological disruptions (such as crop failure and changes in disease vector ranges), or social responses to climate change (such as population displacement with rising sea levels).
In response to our Viewpoint proposing a World Serum Bank,1 Coates delineates how this data might be used to probe a major contemporary public health question: how climate change will affect the burden of infection. De Lusignan and Correa propose a pragmatic resource for initiating such a bank—ie, deploying primary care sentinel networks—in conjunction with public health entities. Both raise excellent points. We agree in particular that the issue of consent is key; and that diverse sources of data should be leveraged.
A century after it was first described, Hugh Willison and colleagues (Aug 14, p 717) provide a fabulous clinical overview of advances in the pathophysiology, immunopathology, and management of Guillain-Barré syndrome.1 Unfortunately, despite listing poliomyelitis in their differential diagnosis, no mention was made of the global public health surveillance importance of Guillain-Barré syndrome.