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[Correspondence] Inequalities in non-communicable diseases in Israel – Authors' reply

Sa, 10/02/2018 - 00:00
We thank John Yudkin for his comments on our Series paper1 discussing the inequalities in non-communicable diseases between the major population groups in Israel.

[Correspondence] Shared values cannot redress the occupier–occupied imbalance

Sa, 10/02/2018 - 00:00
In their Series paper, Karl Skorecki and Richard Horton (June 24, 2017, p 2551)1 seem to be suggesting that peace through health, or the so-called health as a bridge for peace approach, are “beacons that can illuminate a way forward”. They describe the direct interactions of Gazan and Israeli physicians as a telling example of “the values shared in the inherent fellowship of health practitioners, values that supersede political, religious, and ideological barriers” and state that these shared values are “the most powerful mediators human beings have to foster new but natural relationships between Israel and its neighbours”.

[Correspondence] Women's health in Israel

Sa, 10/02/2018 - 00:00
We congratulate The Lancet for its Health in Israel Series, which takes a broad and unprecedented look at Israeli health and health care, and applaud the effort to focus on women's health. We read with interest the Viewpoint by Leeat Granek and colleagues (June 24, 2017, p 2575),1 in which the authors state that the health of women in Israel is affected by the political situation in Israel. Although it might be true, this statement needs more support.

[Correspondence] Medical ethics in Israel

Sa, 10/02/2018 - 00:00
I am soon to become a medical resident and a bioethics scholar in Israel. I thus wish to respond to an Essay recently published in The Lancet by Alan B Jotkowitz and colleagues (June 24, p 2584)1 that seeks to “explore how a multicultural, modern society steeped in monotheistic tradition has navigated through most of these conflicts to create a mostly satisfactory and pragmatic consensus on contemporary bioethical dilemmas.” If the claims made by the authors do represent a consensus, then it is a painfully unsatisfactory one.

[Correspondence] Medical ethics in Israel – Author's reply

Sa, 10/02/2018 - 00:00
I thank Zohar Lederman for taking the time to read our Essay1 but am slightly confused by his comments. He mentions the importance of transparency and public scrutiny in bioethical debates but challenges us for alluding to the public debate in Israel on the force feeding of prisoners. Furthermore, in our paper, we did not praise or condemn the practice but simply noted that the ethics committee of the Israel Medical Association is opposed to force-feeding a hunger-striker because they regard it an affront to autonomy and human freedom.

[Correspondence] Deaths of children and women in Gaza hostilities

Sa, 10/02/2018 - 00:00
In their paper on maternal and child health in Israel, Lisa Rubin and colleagues (June 24, 2017, p 2514)1 observed that “Israeli children, from both Arab and Jewish backgrounds, and Palestinian children are unusually at-risk because of their exposure to violence from intermittent armed hostilities, including indiscriminate rocket fire and terror attacks”. However, they provided no data to illustrate these tragedies.

[Correspondence] Deaths of children and women in Gaza hostilities – Authors' reply

Sa, 10/02/2018 - 00:00
Iain Chalmers commented on the absence of specific numbers relating to Israeli and Palestinian casualties in our paper on maternal and child health in Israel.1 Given the clearly defined parameters of our work within the Series on Health in Israel, we find his comments perplexing.

[Comment] Making sense of the latest evidence on electronic cigarettes

Ma, 06/02/2018 - 10:00
In the UK, 2·85 million people (5·7% of adults) regularly use electronic cigarettes (ECs), almost all of whom are smokers or ex-smokers.1 Prevalence of EC use is similar in the USA2 but is lower in other European Union (EU) countries (average 2%).1 ECs produce an estimated 18 000 additional long-term ex-smokers in England each year;3 a recent update suggests that figure might be as high as 57 000.1

[Editorial] Changing culture to end FGM

Sa, 03/02/2018 - 00:00
When Ellen Johnson Sirleaf retired last month after 12 years in office in Liberia, she signed an executive order banning female genital mutilation (FGM) in the country for girls younger than 18 years. Her profile as Africa's first female president and a recipient of the Nobel Peace Prize for efforts to advance women's rights and peace ensured her executive order got international media attention, thus shining needed light on a devastating practice. Globally, a staggering 200 million women and girls have undergone FGM, and UNICEF estimates that more than one in three girls between 15 and 19 years of age are currently affected.

[Editorial] Yellow fever: a major threat to public health

Sa, 03/02/2018 - 00:00
The world's largest fractional-dose vaccination campaign for yellow fever started on Jan 25 in Brazil, with the support of WHO. The campaign attempts to avoid the urban transmission cycle, not seen in the country since 1942. 33 people have died due to yellow fever between Jan 14 and 23, while the number of confirmed cases in the country has reached more than 130.

[Editorial] Editing the human genome: balancing safety and regulation

Sa, 03/02/2018 - 00:00
The international race to bring human genome editing into widespread use in clinical medicine is moving fast. On Jan 23, the National Institutes of Health Common Fund launched its Somatic Cell Genome Editing programme, committing approximately US$190 million of funding over the next 6 years to propel development of genome editing into medical practice. A worthy effort, but the USA and Europe still trail behind China. As many as 86 patients in China have already had their genes altered as part of clinical trials to treat a range of diseases, including solid cancers.

[Comment] Should basic science matter to clinicians?

Sa, 03/02/2018 - 00:00
We have observed declining interest in discovery science by our medical colleagues. Across a range of top medical journals, the number of basic science articles decreased by 40–60% from 1994 to 2013,1 while a major North American university recorded a 60% decrease in clinician-investigator trainees pursuing basic science training between 1987 and 2016.2 The decline of basic science research in the medical literature and a disregard for it in continuing education programmes3 are allowing mastery of science to be lost by practising clinicians.

[Comment] The global fight against cancer: challenges and opportunities

Sa, 03/02/2018 - 00:00
By 2030, the number of cancer cases is projected to increase to 24·6 million and the number of cancer deaths to 13 million.1 Worldwide, health systems, especially in low-income and middle-income countries (LMICs), are ill prepared to manage the increasing cancer burden.2 Globally, there is a shortfall in coverage of cancer services for prevention, screening, treatment, and palliative care.3–5 If cost-effective interventions for cancer screening, prevention, and treatment were delivered through strengthened health systems, they could help largely avoid many premature deaths, unnecessary suffering, and unacceptable inequalities.

[Comment] Offline: Adolescent health—vulnerable and under threat

Sa, 03/02/2018 - 00:00
There is no other group in society more emblematic of the Anthropocene than the adolescent—defined as a person between the ages of 10 and 24 years. The irreversible harm we are inflicting on our planet today will hurt the lives of young people most of all. During the past decade, one of the most remarkable achievements in global health has been the emergence of a new movement for adolescent health. When Ban Ki-moon's signature Every Woman Every Child initiative was launched in 2010, the young person was absent.

[World Report] FGM in Sierra Leone

Sa, 03/02/2018 - 00:00
Three years after a 2014 ban against the practice of female genital mutilation in Sierra Leone, Sharmila Devi reports on the progress towards its eradication.

[World Report] Prospects for dementia research

Sa, 03/02/2018 - 00:00
After Pfizer's withdrawal from the market, some predicted a mass exodus of pharmaceutical companies' interests in Alzheimer's disease drug research. Geoff Watts reports.

[World Report] Developing countries in the digital revolution

Sa, 03/02/2018 - 00:00
A multidisciplinary commission was launched to question what role developing countries can and should have in the rapidly changing technological landscape. Talha Burki reports.

[World Report] A new paradigm for the MRC Units in The Gambia and Uganda

Sa, 03/02/2018 - 00:00
Two major medical research institutions in sub-Saharan Africa came under the purview of the London School of Hygiene & Tropical Medicine (LSHTM). The Medical Research Council (MRC) Unit The Gambia and the MRC/Uganda Virus Research Institute (UVRI) Uganda Research Unit transferred to LSHTM from their current positions under the MRC at the beginning of February.

[Perspectives] Virtual care for improved global health

Sa, 03/02/2018 - 00:00
Global access to health care is far from adequate, with health disparities widening; the rise of economic inequities and shortages in the health workforce are contributors. This is especially true for people who live in rural areas in low-income countries without access to essential health services. Yet digital infrastructure and technologies exist that could allow virtual and rapid provision of health care for many health conditions, for almost everyone, at any time, irrespective of their location.

[Perspectives] Superbugs and us

Sa, 03/02/2018 - 00:00
These days you would have to be peculiarly immune to public health messaging not to know that the world is on the brink of an antibiotic apocalypse. From the back of pill packets to the panels on the back of buses, prompts urging us to “keep antibiotics working” are almost as ubiquitous as the drug-resistant microbes themselves. Although medical experts have been warning about the indiscriminate use of antibiotics since the 1940s, their consumption continues to grow. This is not only a problem in countries like South Africa and India where antibiotics are widely available over the counter.