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[Correspondence] Is open access a misnomer?

Sa, 26/03/2022 - 01:00
As a group of clinicians, we voice our concerns about recent changes to publication fees. Having coauthored an original article together, we were faced with the dilemma of having to pay £2000 in publication fees. This contrasts with a situation only 2 years ago when publication in most journals was free of charge or only incurred a small administration fee. The situation was further compounded by the fact that these costs are similar across the major journals in our specialty (appendix). Our institution has no dedicated funds to cover publication fees, and we were faced with either having to pay ourselves or retracting the manuscript.

[Department of Error] Department of Error

Sa, 26/03/2022 - 01:00
Webster P. Report finds no common cause for mystery brain disease. Lancet 2022; 399: 1035–36—In this World Report, Gerard Jansen's name was misspelled. This correction has been made to the online version as of March 24, 2022.

[Articles] Effectiveness and cost-effectiveness against malaria of three types of dual-active-ingredient long-lasting insecticidal nets (LLINs) compared with pyrethroid-only LLINs in Tanzania: a four-arm, cluster-randomised trial

Sa, 26/03/2022 - 01:00
After 2 years, chlorfenapyr LLINs provided significantly better protection than pyrethroid-only LLINs against malaria in an area with pyrethroid-resistant mosquitoes, and the additional cost of these nets would be considerably below plausible cost-effectiveness thresholds ($292–393 per DALY averted). Before scale-up of chlorfenapyr LLINs, resistance management strategies are needed to preserve their effectiveness. Poor textile and active ingredient durability in the piperonyl butoxide and pyriproxyfen LLINs might have contributed to their relative lack of effectiveness compared with standard LLINs.

[Clinical Picture] Extraskeletal Ewing sarcoma of the duodenum presenting as duodenojejunal intussusception

Sa, 26/03/2022 - 01:00
A 25-year-old woman presented to our hospital with a 2-week history of persistent vomiting, abdominal distension, and weight loss.

[Health Policy] NCD Countdown 2030: efficient pathways and strategic investments to accelerate progress towards the Sustainable Development Goal target 3.4 in low-income and middle-income countries

Sa, 26/03/2022 - 01:00
Most countries have made little progress in achieving the Sustainable Development Goal (SDG) target 3.4, which calls for a reduction in premature mortality from non-communicable diseases (NCDs) by a third from 2015 to 2030. In this Health Policy paper, we synthesise the evidence related to interventions that can reduce premature mortality from the major NCDs over the next decade and that are feasible to implement in countries at all levels of income. Our recommendations are intended as generic guidance to help 123 low-income and middle-income countries meet SDG target 3.4; country-level applications require additional analyses and consideration of the local implementation and utilisation context.

[Comment] Strengthening public mental health during and after the acute phase of the COVID-19 pandemic

Ve, 25/03/2022 - 01:30
The evolving nature of the COVID-19 pandemic with its incumbent stresses and the emergence of highly transmissible SARS-CoV-2 variants continue to challenge human resilience worldwide. In March, 2022, WHO reiterated the substantial impact of the pandemic on mental health and wellbeing globally; in the first year of the pandemic, there was a 25% increase in anxiety and depression globally and young people are at increased risk of suicide and self-harm injuries.1,2 There are also uncertainties about the long-term prognosis of people who recovered from COVID-19,3 its long-term effects on the general population,4 and the pressure of the pandemic on health-care systems in the future.

[Comment] A call for an immediate ceasefire and peaceful end to the Russian aggression against Ukraine

Ve, 25/03/2022 - 01:30
The Lancet–SIGHT Commission condemns the Russian Government's aggression against Ukraine and its attacks on civilians and civilian infrastructure, including health workers and hospitals. We support the March 2, 2022 UN General Assembly (UNGA) resolution ES-11/1 that “deplores in the strongest terms the aggression by the Russian Federation”.1 The indiscriminate use of weaponry violates international humanitarian law and has caused catastrophic health impacts, especially on children, older people, and disabled persons, and social and economic disruptions that will be long lasting.

[Correspondence] Poaching doctors from abroad is unethical

Ve, 25/03/2022 - 01:30
Recruiting an ever-increasing number of doctors from low-income countries to plug staff gaps in the UK National Health Service (NHS) is unethical. These doctors are needed to maintain essential services in their own countries. Based on WHO recommendations of doctor-to-patient ratios, India had a shortage of about 600 000 doctors in 2020,1 and Pakistan had a shortage of 200 000 doctors in 2019.2

[Comment] Financing the future of WHO

Gi, 24/03/2022 - 01:30
WHO has anchored the global health architecture since its founding in 1948, and it is impossible to imagine another institution filling the void if the international community were to let it atrophy. While also confronting and guiding the response to COVID-19, WHO is engaged in the most consequential reforms since its founding, including negotiating a global pandemic agreement and revising the International Health Regulations. Underpinning all these reforms is the need for robust and sustainable financing.

[Correspondence] Health-care workers and facilities in Ukraine must be protected

Gi, 24/03/2022 - 01:30
We, and the organisations we represent, are united in our concern for health-care workers, their patients, and health-care facilities in Ukraine as a result of ongoing hostilities due to the Russian invasion.

[Correspondence] Ritonavir and COVID-19: pragmatic guidance is important

Me, 23/03/2022 - 01:30
We thank Joseph Heskin and colleagues1 for highlighting the crucial issue of drug–drug interactions (DDIs) with ritonavir, the pharmacoenhancer or booster co-formulated with the novel SARS-CoV-2 protease inhibitor, PF-07321332 (Paxlovid, Pfizer [New York, NY, USA]).2 Since Paxlovid will be primarily administered to non-hospitalised individuals and prescribed by clinicians who might not routinely manage complex interactions or have access to their full medication list, an awareness of the DDI potential and clear pathways to support safe decision making are essential, ideally led by pharmacists who have speciality knowledge in this area.

[Comment] The value of alleviating suffering and dignifying death in war and humanitarian crises

Ma, 22/03/2022 - 01:30
Despite a vast literature on humanitarian crisis response,1–5 palliative care, pain relief, and care for the dying and bereaved need increased and urgent attention,5–11 particularly in the context of armed conflict. The Lancet Commission on the Value of Death12 challenged the medicalisation of dying and death and reaffirmed the moral injustice of the global palliative care and pain relief divide.13 The devastating humanitarian crisis in Ukraine raises the vital importance of these issues.12,13

[Correspondence] War in Ukraine and barriers to diabetes care

Ma, 22/03/2022 - 01:30
The conflict and violence that followed the military invasion of Ukraine in late February, 2022, has already left substantial scars on the population. The human cost of the combat becomes more evident each passing day. On March 15, 2022, the ongoing hostilities affected hundreds of thousands of inhabitants and substantially damaged crucial civilian infrastructure in eastern Ukraine, including homes, schools, hospitals, and water and gas pipelines. In some southeastern cities, such as Mariupol, people have been facing critical shortages of food, water, and life-saving medicines, which were aggravated by the blockade of humanitarian convoys trying to reach the region with supplies.

[Correspondence] An attack on a nuclear power plant during a war is indiscriminate terrorism

Ma, 22/03/2022 - 01:30
On March 4, 2022, Ukrainian officials reported that Europe's largest nuclear power station, the Zaporizhzhia plant, had been shelled by Russian troops, resulting in a fire breaking out. Thereafter, Russia took control of the plant.1

[Correspondence] War is a public health emergency

Ma, 22/03/2022 - 01:30
War has both immediate and long-term public health consequences: people can be killed or injured from violence itself, or can develop health problems stemming from the traumatic experience of war and the scarcity of access to adequate health care. War can affect people at any life stage—from infancy and early childhood to adulthood—for long periods of time, but children are probably most profoundly affected by war, given the utmost importance of the early years in a child's life.

[Correspondence] 36-fold higher estimate of deaths attributable to red meat intake in GBD 2019: is this reliable? – Author's reply

Lu, 21/03/2022 - 12:00
Alice Stanton and colleagues1 raise concerns about the large increase in estimated deaths due to red meat intake in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 20192 results compared with the GBD 20173 results. As they note, the reasons for the change were estimation of new risk functions, updated systematic reviews, and a change in the theoretical minimum risk exposure level (TMREL). Ioannidis has raised doubts about the credibility of much of the published literature on diet risk–outcome pairs that are based primarily on observational data.

[Comment] Sisonke: reaching several goals together

Sa, 19/03/2022 - 01:00
Research infrastructure and expertise from decades of HIV and tuberculosis research enabled several COVID-19 vaccine trials to be conducted in South Africa. The ChAdOx1 nCoV-19 vaccine procured by the South African Government did not protect against infection with the beta (B.1.351) variant of concern1 in a phase 1/2 trial and was therefore abandoned in early 2021.2 A single dose of the Ad26.COV2.S vaccine had been shown to be effective against the beta variant of SARS-CoV-2 by the ENSEMBLE trial,3 but as of early 2021 it was not yet authorised by the national regulator.

[Comment] Offline: Ukraine—where responsibility lies

Sa, 19/03/2022 - 01:00
“Ukraine will either be free, independent, and European, or it will not exist at all”, wrote the Ukrainian writer, Andrey Kurkov, this week. The health crisis facing 42 million Ukrainians has entered a desperate phase, one that is still not receiving the urgent attention it demands. First, the conflict has broken the country's already brittle health system, worsened by continued attacks by Russian armed forces on health workers and health facilities. Over 2 million people have been internally displaced.

[World Report] Califf takes the helm at the US FDA, again

Sa, 19/03/2022 - 01:00
Robert Califf will have to face several controversial health issues in his second tenure as commissioner. Susan Jaffe reports from Washington, DC.

[World Report] CEPI launches 100-day vaccine “moonshot”

Sa, 19/03/2022 - 01:00
CEPI has raised $1·5 billion for its work on tackling the next pandemic as civil society calls for a sharper focus on equitable access to new vaccines. Ann Danaiya Usher reports.