Lancet

“The COVID-19 crisis may have passed, but a harsh lesson remains: the world is woefully unprepared for the next pandemic”, said António Guterres, UN Secretary-General, on the International Day of Epidemic Preparedness, Dec 24, 2024. His remarks resonated with those of WHO Director-General Tedros Adhanom Ghebreyesus when asked whether the world is better prepared for the next pandemic. He noted that while some painful lessons have been learnt, many of the same weaknesses and vulnerabilities that allowed COVID-19 to gain a foothold 5 years ago still exist.

Chimeric antigen receptor (CAR) T-cell therapy has revolutionised immunotherapy;1 however, prolonged manufacturing times, high cost, and limited accessibility remain a challenge.2 Allogeneic products offer a readily available off-the-shelf therapeutic modality with healthy donor cells that can be dosed multiple times.3 However, allogeneic therapies have their own limitations, including donor-specific variability in composition and efficacy, limited persistence due to allogeneic rejection, and the risk of graft-versus-host disease (GVHD).

Dermatomyositis is a chronic autoimmune disease characterised by muscle weakness, skin lesions, and systemic complications. Its global prevalence ranges from one to ten cases per million people annually, with a higher incidence in women, who are affected approximately twice as often as men.1 This condition substantially diminishes quality of life due to its debilitating symptoms and systemic impacts.2

An urgent plea to all concerned with the defence of health and human rights: the Argentine government's decision to close the Haroldo Conti Cultural Centre at the Escuela de Mecánica de la Armada in Buenos Aires from Jan 2, 2025, is an act of violence against the families of 30 000 victims who were murdered by Argentina's 1976–83 military junta. It is a decision that must be reversed if Argentina is to retain credibility as a nation concerned with protecting and advancing the wellbeing of its citizens.

Founded more than 20 years ago, the Sexual Violence Research Initiative has grown into the largest network on research on violence against women and children. Sophie Cousins reports.

Researcher Ajit Lalvani is a pioneer in the understanding of immune responses to respiratory infections and in translating that knowledge to improve care. He is Chair of Infectious Diseases, Founding Director of the Tuberculosis Research Centre, and Director of the National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Respiratory Infections at Imperial College London, UK, and Honorary Consultant Physician at Imperial College Healthcare NHS Trust. Tuberculosis has been the major focus of his 30-year research career.

The illness memoir is now a well-established literary genre. This phenomenon gives the subliminal impression that as a society, we are anxious to do away with taboos around sickness, and to support the sick. The truth, to our discredit, is that many people are keener on reading books about the illness of strangers than helping friends with major illness. The stigma of psychiatric illness is well-recognised, but that associated with physical illness much less so. In high-income countries, sick people and their families are in many respects socially isolated; even worse, society does not generally recognise this issue.

I knew the way to go to see no one at all. From the pharmacy adjacent to the surgery where my parents worked as general practitioners for 30 years—in which my surname called at the counter could not but turn heads—I took the paper bag of mood stabilisers and antipsychotics, which were not helping, and trailed my slow feet beyond the pale of the village and into the trees.

HIV and LGBTQI+ rights advocate. Born on Sept 30, 1961, in Sodus, NY, USA, he died of hypertensive atherosclerotic cardiovascular disease on Nov 8, 2024, in Washington, DC, USA, aged 63 years.

The Editorial on the fertility industry rightly stated that insufficient public funding has driven the commercialisation and financing of assisted reproductive therapies.1 However, if it were not for the private sector, no effective fertility treatment would be possible in many countries. In Poland, for example, there was scarce access to in-vitro fertilisation (IVF) for many years due to a paucity of public financial support. According to the recent data, Poland had one of the worst rates of access to fertility treatment in Europe.

We were pleased to read the Editorial on cholera1 and its emphasis on water, sanitation, and hygiene practices to address the root cause of the cholera pandemic. However, what we missed was emphasis on strengthening local health systems to detect and respond to these outbreaks—axis 1 of the Global Task Force on Cholera Control roadmap.2 Strengthening local health systems has synergistic potential to improve health in relation to other pathogens and diseases, and has been advocated as best practice for interventions in low-resource settings.

Médecins Sans Frontières (MSF) set up its Access Campaign in 1999 to tackle the policy, legal, and political barriers that prevent people from accessing health tools in the communities where MSF work and beyond.1 In its Nobel Peace Prize speech, MSF demanded “change, not charity”, and has since challenged systemic inequities where pharmaceutical companies price lifesaving health tools out of reach and determine research priorities based on commercial prospects.2

In the World Report, Talha Burki1 reported on what we believe to be the misguided decision by a consortium of senior leaders in Médecins Sans Frontières (MSF) to dismantle its highly regarded Access Campaign.

We read with interest the results of the iCOMP collaboration from Anna Lene Seidler and colleagues.1,2 These individual participant data meta-analyses comparing immediate cord clamping, delayed cord clamping, and umbilical cord milking, including short, medium, and long deferral of delayed cord clamping, are commendable for their size and quality. In particular, we welcome the exclusion of 14 trials following integrity concerns.

We thank Jeremy Nielsen and Ben W Mol for their interest in our iCOMP Articles,1,2 and for commending our assessments of study integrity. They raise two key points: they suggest integrity assessments should be made available for each trial to increase transparency and they express concerns about the randomisation process of two included studies based on observed baseline characteristics.

FT596 was well tolerated as monotherapy or with rituximab and induced deep and durable responses in patients with indolent and aggressive lymphomas and the RP2D was preliminarily identified to be 1·8 × 109 cells for three doses per cycle. This study supports that cell therapy using iPSC-derived, gene-modified NK cells is a potent platform for cancer treatment and suggests that such a platform might address limitations of currently available immune cell therapies, including manufacturing time, heterogeneity, access, and cost.

Dazukibart resulted in a pronounced reduction in disease activity and was generally well tolerated, supporting IFNβ inhibition as a highly promising therapeutic strategy in adults with dermatomyositis.

A 62-year-old man with a parastomal hernia at the site of a urinary conduit and symptoms of urinary obstruction lasting several months presented to our hospital.

Axial spondyloarthritis manifests as a chronic inflammatory disease primarily affecting the sacroiliac joints and spine. Although chronic back pain and spinal stiffness are typical initial symptoms, peripheral (ie, enthesitis, arthritis, and dactylitis) and extra-musculoskeletal (ie, uveitis, inflammatory bowel disease, and psoriasis) manifestations are also common. Timely and accurate diagnosis is challenging and relies on identifying a clinical pattern with a combination of clinical, laboratory (HLA-B27 positivity), and imaging findings (eg, structural damage on pelvic radiographs and bone marrow oedema on MRI of the sacroiliac joints).

In 2011, the UN Political Declaration on Non-Communicable Disease (NCD) Prevention and Control announced a target date of 2025 to reduce rates of premature mortality from cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes by 25%—the so-called 25 × 25 goal. 10 years later, the global probability of prematurely dying from one of those targeted NCDs had improved by only 1·5%. NCDs are the leading causes of premature death and disability worldwide, estimated in 2021 to be responsible for the deaths of 17·3 million people and nearly 80% of all years lived with disability before the age of 70 years.