The Lancet

Suicide and self-harm are major health and societal issues worldwide, but the greatest burden of both behaviours occurs in low-income and middle-income countries. Although rates of suicide are higher in male than in female individuals, self-harm is more common in female individuals. Rather than having a single cause, suicide and self-harm are the result of a complex interplay of several factors that occur throughout the life course, and vary by gender, age, ethnicity, and geography. Several clinical and public health interventions show promise, although our understanding of their effectiveness has largely originated from high-income countries.

Despite 2 years having passed since the start of the COVID-19 pandemic, there is still intense debate about the best therapeutic strategy for patients with COVID-19. Multiple randomised studies have evaluated the efficacy of different antiviral,1,2 anti-inflammatory, and antithrombotic treatments. However, results have been disparate and difficult to interpret at times due to conflicting results; some trials have reported that treatments reduce mortality and other trials, reporting on the same treatment, have shown mortality to be unaffected.

Remdesivir has no significant effect on patients with COVID-19 who are already being ventilated. Among other hospitalised patients, it has a small effect against death or progression to ventilation (or both).

High blood pressure is the leading attributable risk factor for preventable deaths globally.1 About 1·4 billion people have hypertension worldwide, one-quarter of whom live in China where blood pressure control rates are poor, especially in rural areas (<10% among those with hypertension).2–4

Compared with enhanced usual care, village doctor-led intervention resulted in statistically significant improvements in blood pressure control among rural residents in China. This feasible, effective, and sustainable implementation strategy could be scaled up in rural China and other low-income and middle-income countries for hypertension control.

Despite widespread condemnation of the UK's asylum partnership arrangement with Rwanda, the Home Office appears to be going ahead with its plans to relocate to east Africa people who it deems to have arrived illegally and who are therefore not eligible for asylum in the UK. The policy, formed in response to increasing arrivals of migrants in small boats (28 500 arrived to the UK in 2021), has been hailed by Prime Minister Boris Johnson as the “morally right thing to do”, and is designed to deter refugees from entering the country through “illegal, dangerous or unnecessary methods”.

Hundreds of clinical trials have been halted because of the war in Ukraine, disrupting treatment for patients and impeding research. Ed Holt reports.

An economic crisis has prompted a halt on imports, jeopardising supplies of drugs and medical equipment. Sharmila Devi reports.

A lack of demand could jeopardise manufacturing of the Johnson & Johnson vaccine in South Africa. Paul Adepoju reports.

When Karim Manji trained in child health three decades ago, there were only 11 paediatricians in his native Tanzania. Today there are about 220, evidence of the progress in child health that characterises his career. As Professor in Paediatrics and Child Health at the Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania, Manji is as focused on clinical care as he is in overseeing the multicentre international research programmes that are contributing to the transformation of newborn and child health in low-income and middle-income countries (LMICs).

Dutch primatologist Frans de Waal was once asked in an interview: “How's Catherine doing?” He was not used to journalists asking about his wife. Only after some awkwardness did it transpire that the interviewer thought she was a primate he had been studying. The dedication in his latest book had read: “For Catherine, my favourite primate.” That humans are just another primate lies at the heart of de Waal's new book, Different: Gender Through the Eyes of a Primatologist, which ambitiously attempts to reconcile what we know about sex differences in behaviour among other primate species with the sex and gender differences we can see in our own.

When I first returned to clinic a couple of months after the COVID-19 pandemic began, the first thing I noticed was that the bowl of candy at the front desk was gone. It had always been kept full, and I reflexively looked for my favourite lemon and orange mints. But that day, the bowl was replaced by hand sanitiser bottles neatly lined up in a row. The waiting area for patients was closed too. Only one staff member in full personal protective equipment sat at the front, screening patients individually and escorting them into examination rooms.

Pioneer of health technology assessment. He was born in Electra, TX, USA, on March 3, 1938 and died of lung cancer in Amsterdam, Netherlands, on March 10, 2022 aged 84 years.

Consistent with previous studies, the Article by the GBD 2019 Police Violence US Subnational Collaborators1 finds that the National Vital Statistics System (NVSS) data under-report approximately half of all violent deaths of civilians that occur following encounters with law enforcement.2–5 The decision not to assess the National Violent Death Reporting System (NVDRS) is unfortunate for two reasons. First, the NVDRS is the most promising surveillance database for tracking homicides by police in the USA; second, the NVDRS is excluded on the basis of the misconception that it does not capture homicides by police involving methods other than firearms.

We thank Andrew Conner and colleagues for their careful and thoughtful review of our Article.1 We greatly appreciate the feedback.

In their Viewpoint, Victor J Dzau and colleagues1 recommend ways academic health sciences systems (AHSS) can attend to important health-care needs. One recommendation in particular caught our attention: “AHSS across the world must come together to address global societal issues and advance the greater good.”1

Victor J Dzau and colleagues’1 Viewpoint provides an important perspective about the future of academic health sciences. Their summary of “bench to bedside to population to society”1 deserves widespread analysis but is incomplete. Both population and society are impersonal constructs, whereas health care exists for individual patients. Any overarching model should be modified to include the personal element of health care. In the future, patients (ie, as people with fears and feelings) will continue to interact with doctors and health professionals at the front line of health systems when receiving advice and care.

Improving the failure-to-rescue rate (ie, the mortality rate of patients who have major postoperative complications), is an important priority for surgical quality improvement.1,2 Pancreatic resections are complex operations with a high risk of postoperative complications. One of the most common complications after pancreatic surgery is postoperative pancreatic fistula (POPF). The incidence of POPF ranges from 3% to 45% at high-volume institutions. POPF can lead to further devastating complications, such as bleeding requiring intervention, multiple organ failure, and mortality.

The algorithm for the early recognition and minimally invasive management of complications after pancreatic resection considerably improved clinical outcomes compared with usual care. This difference included an approximate 50% reduction in mortality at 90 days.

Our Series on optimising child and adolescent health and development follows on almost two decades after the original Lancet Series on child survival and its corresponding call for action.1 With less than 10 years left to meet the 2030 Sustainable Development Goals (SDGs), we are concerned that, once again, the world is failing its children. The evidence is strong and calls for change abound; however, effective actions are few and far between.