Lancet

Nearly 300 000 women die every year due to pregnancy or childbirth. Substantial inroads in reducing maternal mortality were made during the early part of the 21st century, but progress has stalled over the past decade and the world is not on track to meet the Sustainable Development Goal to reduce maternal deaths by 2030. World Health Day 2025, on April 7, marks the start of a year-long campaign by WHO, entitled “Healthy beginnings, hopeful futures”, which aims to reinvigorate much-needed efforts to ensure access to high-quality care for women and babies globally.

Progress in reducing neonatal and under-5 mortality have stalled as experts call for greater investment in services. Udani Samarasekera reports.

The panel will seek to understand the causes of suicide among students and formulate recommendations for prevention. Dinesh C Sharma reports.

Belarusian political prisoners report worsening medical care, particularly since a crackdown on political dissent. Ed Holt reports.

Suzanne O’Sullivan, author and consultant in neurology and clinical neurophysiology at the National Hospital for Neurology and Neurosurgery in London, UK, is nothing if not observant. Within minutes of our meeting, she has figured out something about me. “You don't have an Irish accent, but you keep saying grand”, she says. “What's your Irish background?” I confirm that my family are indeed Irish; this is the cue for her to talk about her own upbringing in Dublin. She is, she tells me, from a “typical kind of Irish family”; her parents worked hard to put her and her four siblings through school, and hers was the first generation to go to university.

Nearly a century has passed since writer Virginia Woolf alerted us to the breakdown of language when confronted with pain. Woolf noted that words provide an endless resource for those who dream or fall in love, “but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry”. First-person accounts of illness have grown widely since Woolf's 1926 essay On Being Ill, but the breakdown she describes still rings true, although it may have more to do with what we expect language to do when confronting pain or distress—and the form we assume it to take—than its functional limits.

As historians we rarely predict the future since we are trained to look at the past, draw lessons from it, and identify turning points in history. The Industrial Revolution, beginning around 1800, was such a turning point with its enormous resource needs, as was the period after 1945 with the rush to exploit fossil fuels on an unparalleled scale. There is a growing realisation that changes to our ecosystems are already damaging the health of populations and the planet. Perspectives from the arts and humanities can help illuminate issues related to the human-induced climate and health crisis.

Nurse who pioneered the enhanced role of the nurse practitioner and introduced the unification model of nurse training. Born in New York City, NY, USA, on Dec 28, 1920, she died on Jan 22, 2025, at her home in Wildwood, FL, USA, aged 104 years.

Lower limb venous disease is a common reason patients see primary care physicians. Presentations vary from varicose veins, to swelling, to venous skin changes (eg, eczema), and to ulceration. The reported prevalence rates are estimated at 40%. Combined with the negative effect on quality of life, and international annual health-care costs in excess of £3 billion a year, venous disease clearly presents a major health-care burden to patients and society.1 International guidelines recommend clinical and cost-effective management strategies: compression therapy applied to the lower limbs and surgical intervention for incompetent or non-functioning veins.

China's persistent decline in fertility rates and the accompanying demographic shift towards an ageing population have brought challenges to the country's health-care system, particularly in the realm of maternal and child health.1 Recently, the Chinese Government implemented a series of policy changes—most notably the three-child policy—in an attempt to address these demographic shifts.2 However, as fertility rates continue to decrease, the evolving needs of pregnant women and children require urgent attention.

On World AIDS Day 2024, UNAIDS proposed use of a human rights-based approach to end the HIV pandemic by 2030.1 Their approach is centred on achieving equity in access to HIV prevention and treatment, and is referred to as Take the Rights Path to End AIDS. As discussed in an Editorial,2 the HIV-1 capsid inhibitor lenacapavir is an important new tool for HIV prevention and should be made accessible to all in need. Many HIV-afflicted resource-constrained countries with generalised epidemics have predominantly rural populations.

In a Correspondence, Jaime Garcia-Iglesias and colleagues1 argue that the term mpox is inconsistently used in Spanish-speaking, French-speaking, and Portuguese-speaking countries. These countries sometimes still use stigmatising names with racist connotations, such as viruela del mono, variole du singe, and variola dos macacos. The authors advocate adopting viruela M, variole M, and variola M instead. Although we understand the authors’ rationale, their proposed nomenclature could cause confusion between mpox and smallpox, which is also known as viruela, variole, and variola.

The recent study by Ndembi and colleagues on the epidemiology of mpox in Africa1 provided a thorough analysis of the disease's spread across the continent. However, we would like to highlight an important omission, in which Angola was not included in the epidemiological assessment, despite having reported confirmed cases of the disease.

Peter Borchmann and colleagues1 showed the efficacy and safety of the brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone (BrECADD) regimen compared with escalated doses of the bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP) regimen for advanced stage classical Hodgkin lymphoma in a phase 3 trial. Although the patient backgrounds were different, both the BrECADD and eBEACOPP regimens in this study showed better outcomes than the classic doxorubicin, bleomycin, vinblastine, and dacarbazine regimen or a regimen of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine.

We thank Yutaka Shimazu for his constructive comments on our HD21 trial.1 In the PET-2 positive cohort, 165 (69%) of 240 patients treated with brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, and dexamethasone (BrECADD) and 129 (59%) of 231 patients treated with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP) had complete remission after six cycles. The 4-year progression-free survival rates for patients who were PET-2 positive were 90·3% (95% CI 86·6–94·3) for BrECADD and 87·8% (83·4–92·4) for eBEACOPP, showing a poor positive predictive value of PET-2 and very little room for improvement in this subgroup.

Christopher Burton and colleagues1 conducted an unblinded trial of a consultative intervention for 354 people with persistent physical symptoms but no identifiable “organic” cause. Patient Health Questionnaire-15 (PHQ-15) score, which is a brief, subjective, self-administered screen of severity of somatic complaints, was the primary outcome. This kind of trial design can be expected to produce modest positive outcomes, via expectation bias alone.2 No real-life, objective assessment of functioning was conducted.

We thank Joan S Crawford and David Tuller for their interest in our Article.1 Persistent physical symptoms are heterogeneous and, by definition, do not tend to go away easily. In the absence of perfect knowledge about their pathophysiology, we believe that interventions to help people with multiple persistent physical symptoms should apply the knowledge that we currently have.2

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. Lancet 2024; 404: 2077–93—In this Article, Patricia Varona-Pérez should have been included in the collaborator group list in the end matter and appendix. This correction has been made to the online version as of April 3, 2025.

Wong K, Pitcher D, Braddon F, et al. Effects of rare kidney diseases on kidney failure: a longitudinal analysis of the UK National Registry of Rare Kidney Diseases (RaDaR) cohort. Lancet 2024; 403: 1279–89—For this Article, the RaDaR consortium list has been updated. This correction has been made to the online version as of April 3, 2025.

Pancreatic cancer is frequently a lethal disease with an aggressive tumour biology often presenting with non-specific symptoms. Median survival is approximately 4 months with a 5-year survival of 13%. Surveillance is recommended in individuals with familial pancreatic cancer, specific mutations, and high-risk intraductal papillary mucinous neoplasm, as they are at high risk of developing pancreatic cancer. Chemotherapy combined with surgical resection remains the cornerstone of treatment. However, only a small subset of patients are candidates for surgery.