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[Health Policy] International law reform for One Health notifications

Ve, 08/07/2022 - 00:30
Epidemic risk assessment and response relies on rapid information sharing. Using examples from the past decade, we discuss the limitations of the present system for outbreak notifications, which suffers from ambiguous obligations, fragile incentives, and an overly narrow focus on human outbreaks. We examine existing international legal frameworks, and provide clarity on what a successful One Health approach to proposed international law reforms—including a pandemic treaty and amendments to the International Health Regulations—would require.

[Comment] The Health and Care Act 2022: challenges and priorities for embedding research in the NHS

Gi, 07/07/2022 - 00:30
The Health and Care Bill received Royal Assent and became an Act of the UK Parliament on April 28, 2022.1 Aimed at rebuilding the National Health Service (NHS) in the context of the continuing impacts of the COVID-19 pandemic, the Health and Care Act 2022 incorporates a valuable lesson learnt from the pandemic: the extraordinary value a research-active NHS can deliver. Embedding research in the NHS to improve outcomes for patients is now on a statutory footing. Yet whether the Act will address other challenges for the UK's health system is uncertain.

[Correspondence] Breakthrough SARS-CoV-2 infections during periods of delta and omicron predominance, South Africa

Gi, 07/07/2022 - 00:30
The omicron variant of SARS-CoV-2 (B.1.1.529) was first detected in South Africa in November, 2021.1–3 Declared a variant of concern on Nov 26, 2021,4 omicron spread exponentially, replacing the delta variant (B.1.617.2) and driving rapid increases in COVID-19 cases.5,6 In-vitro experiments show that the omicron variant escapes antibody neutralisation in people who have previously been infected with or vaccinated against SARS-CoV-2.7,8 Epidemiological data suggest that vaccine effectiveness is reduced,9 and reinfection rates are higher for omicron than for the beta (B.1.351) and delta variants.

[Comment] Use the remaining carbon budget wisely for health equity and climate justice

Me, 06/07/2022 - 00:30
According to the Intergovernmental Panel on Climate Change (IPCC), the estimated remaining carbon budget from 2020 onwards to limit the global average temperature increase to 1·5°C above pre-industrial levels with a probability of 67% is about 400 Gt carbon dioxide or 1150 Gt carbon dioxide for limiting this global heating to 2°C.1 The IPCC estimates depend on various factors, including the rate at which other greenhouse gases, including methane, decline. If carbon dioxide emissions remain at a constant level, the carbon budget would be used up in about 7 years and 25 years, respectively.

[Seminar] Bronchiolitis

Sa, 02/07/2022 - 00:30
Viral bronchiolitis is the most common cause of admission to hospital for infants in high-income countries. Respiratory syncytial virus accounts for 60–80% of bronchiolitis presentations. Bronchiolitis is diagnosed clinically without the need for viral testing. Management recommendations, based predominantly on high-quality evidence, advise clinicians to support hydration and oxygenation only. Evidence suggests no benefit with use of glucocorticoids or bronchodilators, with further evidence required to support use of hypertonic saline in bronchiolitis.

[Editorial] Ending child marriage: ensuring healthy futures for girls

Sa, 02/07/2022 - 00:00
One in five women are married before the age of 18 years. This fact has serious ramifications for health and wellbeing. Child marriage is associated with pregnancy at a young age, dangerous complications during pregnancy and childbirth, HIV acquisition, and intimate partner violence. Demographic changes mean that the number of adolescents is increasing and therefore more people will be at risk of child marriage. Disruption to education and a rise in poverty caused by the COVID-19 pandemic is estimated to put another 10 million girls at risk of child marriage over the next decade, in addition to the 100 million who were already projected to become child brides.

[Comment] Torus fractures of the distal radius: time to focus on symptomatic management

Sa, 02/07/2022 - 00:00
The torus (buckle) fracture of the distal radius is one of the most common fractures in children. This fracture is inherently stable and carries an excellent prognosis,1 and several studies have supported the use of a removable splint primarily for symptom relief and discretionary follow-up.2–5 In The Lancet, Daniel Perry and colleagues6 report the results of a pragmatic randomised trial that was designed to challenge the need for any immobilisation. At 23 emergency departments across the UK, 965 children (379 [39%] female and 586 [61%] male) from age 4 years to 15 years with a torus fracture of the distal radius, were randomly assigned to either an offer of a bandage and no scheduled follow-up (n=489) or rigid immobilisation (cast or splint; n=476) with follow-up as per the standard practice of the treating centre.

[Comment] WASH services and health: syntheses and contexts

Sa, 02/07/2022 - 00:00
An understanding of the associations between adequate water, sanitation, and hygiene (WASH) services and health has long been established, but gaps persist in the policy and research agenda.1 Effective policies require an intersectoral approach that encompasses health, WASH, and other areas, such as urban and rural development, and the environment. For research, it is relevant to address other dimensions of the relationship between WASH and health, including behavioural change, the role of socioeconomic factors, and technology.

[Comment] A compassion narrative for the sustainable development goals: conscious and connected action

Sa, 02/07/2022 - 00:00
At the midpoint of the 15-year timeline for achieving the UN Sustainable Development Goals (SDGs),1 the world is unprepared. The global community arguably has the scientific, technical, and political tools needed to achieve most, if not all, of the 169 SDG targets, yet we are far from the finish line. In 2019, UN Secretary General António Guterres warned that global efforts were insufficient and called for radical change.2 Such change never materialised. The COVID-19 pandemic shocked many of the systems needed to achieve the SDGs, revealing deep inequities and the inadequacy of siloed approaches to health and false divides between the education, health, environment, energy, and economic sectors.

[Comment] Offline: Changing the argument for health

Sa, 02/07/2022 - 00:00
One institution that has thrived, despite the UK's reputational implosion (see last week's Offline), is Chatham House. Also known as the Royal Institute of International Affairs, Chatham House is a globally respected independent policy centre that conducts research, promotes dialogue, and generates ideas to advance decision making for some of the most intractable issues in foreign affairs. Rob Yates leads Chatham House's Centre for Universal Health. His predecessor, David Heymann, established Chatham House as an important voice in global health.

[World Report] Federal abortion rights end, but not legal challenges

Sa, 02/07/2022 - 00:00
The US Supreme Court's decision to overturn Roe v Wade is due to spark further court cases. Susan Jaffe reports from Washington, DC.

[World Report] New declaration on neglected tropical diseases endorsed

Sa, 02/07/2022 - 00:00
Signatories reaffirmed their commitment to tackling neglected tropical diseases at a summit in Kigali, pledging US$4 billion. Talha Burki reports.

[World Report] New Zealand launches new Māori health authority

Sa, 02/07/2022 - 00:00
The new body aims to tackle health inequities, but is proving politically divisive. Chris McCall reports.

[Perspectives] Digitising heart transplant rejection

Sa, 02/07/2022 - 00:00
For more than four decades, the monitoring of cardiac allograft rejection (CAR) has been achieved by surveillance endomyocardial biopsies (EMBs) and manual assessment by cardiac pathology experts. The first criteria for histological assessment of EMBs were devised during the 1970s, and the International Society for Heart and Lung Transplantation (ISHLT) developed standardised guidelines in the 1990s that have been frequently updated. Besides rejection, these guidelines also pertain to the subtype of rejection (cellular or antibody) and CAR severity.

[Perspectives] The journey to greater equality

Sa, 02/07/2022 - 00:00
Economic inequalities have increased substantially across the world in the past three decades and have deepened during the COVID-19 pandemic. Thomas Piketty and his colleagues at the World Inequality Lab at the Paris School of Economics (PSE), France, have been at the forefront of tracking these changes, providing extremely useful analyses based on careful aggregation of national data on income and wealth inequality from a multitude of sources. They have shown that globally, inequality is now as entrenched as it was during the first part of the 20th century.

[Obituary] Morton Maimon Mower

Sa, 02/07/2022 - 00:00
Cardiologist and co-inventor of the automatic implantable cardioverter defibrillator. Born on Jan 31, 1933 in Baltimore, MD, USA, he died of cancer on April 25, 2022 in Denver, CO, USA, aged 89 years.

[Correspondence] Monkeypox genomic surveillance will challenge lessons learned from SARS-CoV-2

Sa, 02/07/2022 - 00:00
The emergence of a series of epidemiologically connected monkeypox virus infections around the world, with ongoing human-to-human transmission (as of June 15, 2022, 2103 confirmed cases, one probable case, and one death have been reported to WHO from 42 countries), raises concerns of a long-apprehended comeback of a human-adapted orthopoxvirus related to variola virus, the aetiological agent of smallpox. Since variola virus had no natural reservoir other than humans, the eradication of the virus by use of highly effective vaccines against orthopoxviruses was irreversible.

[Correspondence] The monkeypox outbreak is amplifying hidden voices in the global discourse

Sa, 02/07/2022 - 00:00
Tulio d Oliveira's Comment1 on the global inattention to infectious disease science done in Africa is timely, as the largest outbreak of monkeypox outside of Africa continues.2 As of June 15, 2022, 2103 laboratory-confirmed cases of monkeypox have been reported to WHO from 42 countries. The unexpected, unprecedented, and unusual nature of this outbreak in Europe and the Americas has spurred scientific, political, and media attention. Importantly, monkeypox has been known to cause human disease for over 50 years and is endemic in at least ten countries in west and central Africa with over a thousand incidences reported in the Democratic Republic of the Congo in the first 3 months of 2022 alone.

[Correspondence] Shifting gender barriers in immunisation in the COVID-19 pandemic response and beyond

Sa, 02/07/2022 - 00:00
2 years into the COVID-19 pandemic, gender remains marginalised in the global vaccine response. As a stark example, of the 157 countries that reported on COVID-19 vaccine coverage to WHO in April, 2022, only 21 (13%) provided sex-disaggregated data.

[Department of Error] Department of Error

Sa, 02/07/2022 - 00:00
Li G, Cappuccini F, Marchevsky N G, et al. Safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine in children aged 6–17 years: a preliminary report of COV006, a phase 2 single-blind, randomised, controlled trial. Lancet 2022; 399: 2212–25—In this Article, in figure 2, “LI” has been added to the x-axis labels reporting results of first and second vaccination doses in children aged 6–11 years, to indicate that these participants were assigned to the long interval schedule. Additionally, the eighth sentence of the second paragraph of the Statistical analysis section should have read “…who had an increase in anti-nucleocapsid IgG (by the multiplexed electrochemiluminescence immunoassay at PPD laboratories) of at least two times, or self-reported COVID-19…”.