The UK Government's long-anticipated response to the childhood obesity crisis disappointed everyone. From doctors, health charities, and celebrities to the very industry it seeks to propitiate, the Childhood Obesity Plan, published with as little noise as possible in the summer recess, has met with resounding criticism. As a Comment in today's Lancet highlights, the strategy has been delayed for a year, and in that time it has been watered down to a vague Plan with no teeth.
What began as a peaceful protest for democratic reform in Syria in March, 2011, has morphed into a cataclysmic and enduring war against the civilian population. The latest violations against international law in the conflict include a suspected chlorine gas attack on the town of Saraqeb, Idlib province, on Aug 2 and the continued bombing of civilians in the city of Aleppo. Now a new report by Amnesty International released on Aug 18 details a further concern—torture, disease, and death in Syria's prisons.
Not so long ago, women in the USA faced overt institutional sex discrimination in access to health care. “Gender rating” meant some women could be charged up to 50% more for health-care insurance than men, while many services that women required—such as sexual, reproductive, and maternity services—were often excluded from insurance plans. One of the key aims of the Patient Protection and Affordable Care Act (ACA), introduced in 2010, was to address women's unequal access to affordable health care.
Over the past several decades, dozens of randomised controlled trials have compared various diets for the treatment of obesity. Ideally, such studies should have provided strong evidence for clear clinical recommendations and also put a stop to society's endless parade of fad diets. Unfortunately, the evidence base remains contested and the “diet wars” continue unabated.
Current nutrient guidelines recommend a wide acceptable range of total fat and carbohydrate intakes, emphasising quality and source rather than quantity of macronutrients, substantial restriction of free sugars, and usually restriction of saturated fat.1 Recent food-based dietary guidelines are based on similar recommendations.2 Wide dietary variation, including typical healthy dietary patterns, can be accommodated within such nutrient-based advice. And so criticisms of nutrition guidelines confuse both health professionals and the public, and provide justification for inaction by policy makers.
Obesity is a worsening and far-reaching public health problem. The future costs of rising diabetes prevalence, as obesity rises in older age, are well understood. Tackling childhood obesity is an urgent task, and it is essential to do it well.1
Clinton and Trump seem to agree on at least some ways to bring down the cost of prescription drugs, but Clinton offers more details. Susan Jaffe, The Lancet's Washington correspondent, reports.
Russia has drafted its first national HIV/AIDS policy in a decade, but it falls far short of what is needed to curb the country's growing epidemic, say experts. Fiona Clark reports from Moscow.
All the early medical microbiologists left relics of their breakthrough science. Given the importance of Louis Pasteur, Robert Koch, and Alexander Fleming it's not surprising that their veneration includes the conservation of laboratory artifacts. These are often simple pieces of glassware—slides, pipettes, flasks, petri dishes, test and culture tubes. Historic glassware containing the original preparation (the once living matter) is rarer, and plaster models of microbes occasionally suffice in museum displays.
Images of migrants arriving in Europe have caused much political debate in host countries about how to meet their needs. Recent estimates from the UN indicate that, in 2015, about 244 million people, representing the 3·3% of the world's population, lived outside their country of origin and increasing numbers are forced to migrate because of man-made causes, such as conflict, poverty, political persecution, or economic insecurity. Women, who represent just under half of migrants globally, are vulnerable to the dramatic changes imposed by forced migration.
Médecins Sans Frontières (MSF) has won high praise for alerting the world to Ebola and responding so fast, but, says Joanne Liu, its International President, for MSF Ebola was a failure: “It took us 6 months to convince the world that something was happening. So for us it was such a trauma.”
Last year I had the good fortune to travel to the tiny island of Pukapuka—there and back in one day. My lifelong desire to visit this remote atoll in the middle of the Pacific Ocean stems from the ethnographic fieldwork undertaken by my father, Ernest, and mother, Pearl, who spent 7 months on Pukapuka 80 years ago. This work is described in detail in their book of 1938 Ethnology of Pukapuka, and in Islands of Danger, my father's more personal story about their experiences written in 1935 but not published until 1944, and in my mother's unpublished manuscript Dictionary of Pukapukan and her 1989 book String Games.
Paediatrician and cancer geneticist. He was born in Los Angeles, CA, USA, on Aug 9, 1922, and died in Philadelphia, PA, USA, on July 10, 2016, aged 93 years.
Working against pathogenic microbes in a globalised world is a matter of self-interest at least as much as a responsibility to our neighbours. Antimicrobial resistance (AMR) is responsible for an estimated 700 000 deaths annually worldwide. The review1 on AMR, commissioned by the British Government and chaired by Jim O'Neill, estimates that, if current trends continue, annual fatalities from drug-resistant microbes could rise to more than 10 million by 2050, exceeding deaths caused by cancer.
Health is a human right, with research underpinning every advance in health care. Even if political Europe is under siege, health research must remain high on the agenda of all stakeholders. The Scientific Panel for Health,1 created under the Horizon 2020 Framework Programme for Research and Innovation of the EU, was born out of concerns of the European biomedical research community.2,3 Too often, high-quality research is not translated into innovation. European strengths and values are not embedded in or supported by research policies.
Open research data allows for verification, replication, scrutiny, and subsequent analyses of published studies, while reducing likelihood of research duplication. By contrast, failing to publish data, which is a key impediment in the fight against cancer and non-communicable disease epidemics, hinders timely and effective response to these challenges.1 Hence, data should be liberated and made widely available to researchers.1
Michael Temer, Brazil's new interim president from the centre-right Brazilian Democratic Movement Party (PMDB), has unveiled an agenda of austerity measures to stimulate economic growth. In the manifesto Uma Ponte Para Futuro (October, 2015), he announced plans to reduce public spending, including the education and health-care sector. The minimum budget guaranteed by the constitution (3·8% of gross domestic product at present) would be abolished. The new Health Minister, Ricardo Barros, has revealed plans to end the monitoring of private health-care quality by the National Supplementary Health Agency (Agência Nacional de Saúde Suplementar), while encouraging Brazilian citizens to seek private health care instead of relying on the Brazilian National Unified Health System (Sistema Único de Saúde [SUS]).
In December, 2015, the first imported case of Zika virus (ZIKV) infection was diagnosed in French Guiana in a group of 136 travellers returning from Suriname. No autochthonous cases had been detected in French Guiana at that time. To prevent secondary cases, we systematically screened co-travellers 1, 10, and 30 days after their return (clinical examination, urine samples, and blood samples). One case of ZIKV infection was confirmed when viral RNA was detected by real-time PCR (rtPCR) in blood or urine or when ZIKV IgM antibodies and neutralising antibodies were found in serum.
I enjoyed the comprehensive and thoughtful Lancet Seminar on bipolar disorder by Iria Grande and colleagues (April 9, p 1561).1 However, an historical correction concerning some statements on bipolar depression is necessary. The authors state that the symptomatic differences between unipolar and bipolar depression were first described in the 1950s by German psychiatrist Karl Leonhard and later validated in the 1960s by Jules Angst, Carlo Perris, and George Winokur. This statement is not correct.
In their Seminar, Iria Grande and colleagues wrote that the prevalence of psychiatric and medical comorbidities was high in patients with bipolar disorder.1 Among Diagnostic and Statistical Manual of Mental Disorders axis I diagnoses, bipolar disorder has one of the highest rates of comorbid substance use disorders. In the World Mental Health Survey Initiative,2 61 392 adults from 11 countries in the Americas, Europe, and Asia were assessed using the Composite International Diagnostic Interview—a fully structured psychiatric diagnostic interview.