Many Chileans think that their country has lost its way. Massive protests highlight the need for a political reform to prioritise universal health care. The uncritical worship of the most extreme version of the free market by the Pinochet dictatorship led to the dismantling of the social contract and privatisation of the social security system. A system of personal retirement accounts was mandatory for new workers whereas the current workforce could opt out from the existing government-managed schemes.
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Infective endocarditis is a life-threatening condition with a 50% requirement for early cardiac surgery and 30% mortality at 1 year.1 We have used publicly available annual admission data for hospitals in England2 to examine the incidence of infective endocarditis admissions (primary ICD-10 diagnostic code I33) between 1998 and 2019. These data show stable incidence between 1998–99 (26·6 cases per million) and 2009–10 (26·9 cases per million), but an 86% increase to 50·0 cases per million in 2018–19...
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Malnutrition is indeed a global emergency, and courageous and timely actions are needed from governments, media outlets, non-governmental organisations, and civil society.1 Nevertheless, I believe that a reduction in malnutrition is only possible if there is political will, economic stability, and a prioritisation of malnutrition as public policy and a developmental issue by governments, especially in developing countries. In Pakistan, public health is a conundrum as the country is facing challenges...
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Obstetrician and gynaecologist who transformed treatment of obstetric fistula in Ethiopia. Born on Jan 24, 1924, in Sydney, NSW, Australia, she died on March 18, 2020, in Addis Ababa, Ethiopia, aged 96 years.
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April 14, 2020: President Trump, speaking at The White House—“Today, I am instructing my administration to halt funding of the World Health Organization while a review is conducted to assess the World Health Organization's role in severely mismanaging and covering up the spread of the coronavirus…The WHO's reliance on China's disclosures likely caused a 20-fold increase in cases worldwide, and it may be much more than that. The WHO has not addressed a single one of these concerns nor provided a serious...
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I've been self-isolating with my family because we developed fevers. Whether this is any illness or coronavirus disease 2019 (COVID-19) is hard to say given the UK Government's position on community testing. How this infection started, how many people I might have infected, and how adhering to public health guidance to remain at home alters patterns of disease transmission is crucial information. For this knowledge, policy makers need epidemiologists and mathematical models of how diseases spread...
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Many countries are limiting travel to stem the pandemic, but these measures are restricting the movement of vital equipment and personnel. Sharmila Devi reports.
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The evolution of many professions has been driven by technological innovation and the need to overcome real-world challenges. The combination of advanced computing power with large datasets in areas as diverse as baseball, political polling, and economic forecasting has driven both the science of prediction and its practical application. There is much that can be learned from this technology for health care in the coming years, and the field of weather forecasting could be singularly instructive.
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My daughter's art project, a small ceramic bowl, tipped over the edge of the table and broke into pieces. To assuage her tears, I used what I had on hand, a thin wood glue, to patch it together. It was a rushed effort, but I deemed it good enough for the moment. The bowl hung precariously together until she decided, one day, to fill it with water to bathe a toy. Under that small challenge, the fragile bonds between the pieces gave way. The water dribbled out, and the bowl cracked open.
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In 1949, an international congress on malaria coincided with the publication of Mark F Boyd's massive two-volume work on the science of malariology. Placing the tomes on the rostrum, Paul F Russell announced to the delegates, “I present you these volumes as tombstones on the grave of malaria.” More than 70 years later, however, it is apparent that Russell's optimism was misplaced: malaria and the mosquitoes that carry this deadly parasitic disease still refuse to be buried. Nevertheless, malaria...
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In times of growing political tensions around migration, health-care providers can help to protect migrant populations from exclusion.1,2 The UCL–Lancet Commission on Migration and Health called for a strengthening, through regulatory and training bodies, of health professionals' and organisations' awareness of discrimination.2 We add that organisations engaged in health science and biomedical education can fulfil their moral and deontological duty to protect populations that are susceptible to discrimination...
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We do not agree with the conclusion of the Lancet Commission, that global malaria eradication is achievable by 2050.1 Although shrinking the malaria map from the periphery through country by country elimination appears to be feasible as shown by Sri Lanka, Argentina, Algeria, and even by the emerging malaria-free certification of China, elimination appears to be rather unrealistic with the available tools and the degree of poverty and weak governance in the majority of countries with high malaria...
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Inequities in access to the latest advances in health care and effective drugs constitute public health problems today,1 but was this also the case in ancient societies when practitioners used traditional medicines with limited means? The excavation of frozen graves in Yakutia (present day eastern Siberia, Russia) dating from 1700 CE2 led to the identification of a woman, buried almost naked, covered with a magnificent robe and with half a horse bit in her mouth (figure). The other half of the horse...
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The largest COVID-19 national lockdown in the world has been extended to May 3. As of April 22, India has reported 18 985 confirmed cases and 603 deaths from COVID-19 in 31 states and union territories since its first case on Jan 30. India was quick to close its international borders and enforce an immediate lockdown, which WHO praised as “tough and timely”. The lockdown has also given the government time to prepare for a possible surge in cases when the pandemic is forecasted to peak in the coming...
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We thank our colleagues for their thoughtful letters in response to the report of the Lancet Commission on Malaria Eradication.1,2
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In a low malaria-endemic setting, rfMDA and RAVC, implemented alone and in combination, reduced malaria transmission and should be considered as alternatives to RACD for elimination of malaria.
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In patients aged 70 years or older presenting with NSTE-ACS, clopidogrel is a favourable alternative to ticagrelor, because it leads to fewer bleeding events without an increase in the combined endpoint of all-cause death, myocardial infarction, stroke, and bleeding. Clopidogrel could be an alternative P2Y12 inhibitor especially for elderly patients with a higher bleeding risk.
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A 48-year-old man came to our eye clinic because his vision had been deteriorating over the previous 3 weeks; he had no pain and no other eye symptoms.
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We share the aspirations of the Lancet Commission on Malaria Eradication for attaining eradication worldwide within a generation.1 Nevertheless, we would like to stress the risks arising from setbacks and the importance of regional actions and long-term plans for achieving malaria elimination, as experienced in the Amazon basin.
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The report of the Lancet Commission on Malaria Eradication1 outlines the case for eradication of the disease within a generation without providing specific timelines for this aspirational goal. The public health definition of eradication by WHO and the International Task Force for Disease Eradication is specific: “the permanent reduction to zero of the worldwide incidence of infection caused by a specific pathogen as a result of deliberate efforts with no risk of reintroduction.”2
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We welcome the Lancet Commission on Malaria Eradication's bold call to action in their report advocating for the global eradication of malaria by 2050.1 We are encouraged by the message and agree with the necessity for eradication. Artemisinin-based combination therapies (ACTs) remain the frontline treatment for uncomplicated malaria. Faced with the rise of artemisinin resistance,2,3 do ACTs remain an effective tool in our arsenal? The short and clear answer based on prevailing evidence is yes, as...
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One could argue that, considering the proliferation of the Lancet Commissions, a commission about malaria eradication was inevitable. Still, it qualifies as classic bypassing that the Lancet Commission on Malaria Eradication1 worked in parallel to the pre-existing WHO Strategic Advisory Group on Malaria Eradication (SAGme).2 This duplication of efforts and findings has tilted the discussions around the Commission's report and manifesto1 towards two narrow issues. First, there was predominantly a...
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The Lancet Commission on Malaria Eradication1 is funded by the Bill & Melinda Gates Foundation. Unsurprisingly, therefore, the Commission's report reflects the Foundation's approach to global health,2 presenting the three main challenges to eradication as operational, biological, and financial.1 However, deep-rooted political and economic factors are the key to understanding the global distribution of malaria: Nigeria (53·7 million cases, 25%) and DR Congo (25·0 million, 11%) account for over...
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Fei Zhou and colleagues1 estimated mean duration of viral shedding by assessing the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA in patient samples. Assessing potential infectivity is a labour-intensive process, but the presence of nucleic acid alone cannot be used to define viral shedding or infection potential, as the authors state is possible within their methods.
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In 2007, my colleagues and I outlined a biological rationale1 for universal coverage with insecticide-treated nets (ITNs) that was rapidly adopted as global policy.2 Specifically, we developed behaviourally explicit mathematical models of malaria transmission and control to illustrate why the personal protection provided by ITNs is insufficient, and challenged the global strategy of selectively targeting these nets to vulnerable young children and pregnant women.1,3–6 Instead, we outlined why even...
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We thank Barry Atkinson and Eskild Petersen for their comments on our Article describing the clinical course and risk factors for mortality of adult inpatients with coronavirus disease 2019 (COVID-19) in Wuhan, China.1 We agree that the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA in a respiratory specimen cannot be directly interpreted as a potential for disease transmission and infection.
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The outbreak of coronavirus disease 2019 (COVID-19), which began in Wuhan, China, in late 2019, has spread to 203 countries as of March 30, 2020, and has been officially declared a global pandemic.1 With unprecedented public health interventions, local transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appears now to have been contained in China. Multiple countries are now experiencing the first wave of the COVID-19 epidemic; thus, gaining an understanding of how these interventions...
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With 10·93 deaths per million people from coronavirus disease 2019 (COVID-19), as of April 6, 2020, Ecuador has one of the highest rates of COVID-19 mortality in Latin America (figure; appendix).1 With only 7·46 PCR tests per 10 000 people,1 the government is in critical need of a systematic mechanism to bolster self-reporting, contact tracing, and effective isolation of suspected cases. The Ministry of Health has focused on closing gaps in medical resources by increasing availability of personal...
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The first wave of COVID-19 outside of Hubei has abated because of aggressive non-pharmaceutical interventions. However, given the substantial risk of viral reintroduction, particularly from overseas importation, close monitoring of Rt and cCFR is needed to inform strategies against a potential second wave to achieve an optimal balance between health and economic protection.
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There is no available vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and no drug with proven clinical efficacy, although there are several candidates that might be effective in prevention or treatment. Encouragingly, the response from the research community to the pandemic of coronavirus disease 2019 (COVID-19) has been vigorous. A review of clinical trial registries, as of March 24, 2020, identified 536 relevant registered clinical trials.1 Of the 332 COVID-19...
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van der Pluijm RW, Tripura R, Hoglund RM, et al. Triple artemisinin-based combination therapies versus artemisinin-based combination therapies for uncomplicated Plasmodium falciparum malaria: a multicentre, open-label, randomised clinical trial. Lancet 2020; 395: 1345–60—In this Article, R W van der Pluijm was incorrectly affiliated with The Open University, Milton Keynes, UK, and should have been affiliated with Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases,...
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Abstract For the first time, Rhizophora spp. (Rh. spp.) particleboard phantoms were developed using defatted soy flour (DSF) and soy protein isolate (SPI) modified by sodium hydroxide and itaconic acid polyamidoamine-epichlorohydrin (IA-PAE) adhesive. The microstructural characterization and X-ray diffraction patterns of the material revealed that the modified DSF and SPI adhesives became more compact and homogeneous when NaOH/IA-PAE was added, which prevented damage by moisture....
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Abstract Chemotherapy-Induced Peripheral Neurotoxicity (CIPN) is a severe and long-lasting side effect of anticancer therapy, which can severely impair patients’ quality of life. It is a sensory and length-dependent neuropathy, which predominantly affects large myelinated fibers. Easy and reliable monitoring of CIPN in patients is still an unmet clinical need. Since increasing clinical evidence supports the potential use of neurofilament light chain (NfL) as a biomarker of axonal...
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