Lancet

Philosopher and principal author of the Belmont Report on bioethics. Born on Dec 2, 1939, in Austin, TX, USA, he died from complications of a pulmonary embolism in Washington, DC, USA, on Feb 19, 2025, aged 85 years.

The US Agency for International Development (USAID) has faced significant funding cuts under the current administration. In March 2025, Secretary of State Marco Rubio announced that 83% of USAID programmes would be cancelled following a mandated review authorised by an executive order.1 These cuts have had devastating consequences for children in humanitarian crises. The USAID, a cornerstone of global humanitarian aid since 1961, supports disaster relief, poverty alleviation, and global health with an average annual budget of US$23 billion.

In 2024, the global population of refugees rose to 43·7 million—the highest in the UN's history.1 Resettlement in a safe country offers a durable, long-term solution for the world's most vulnerable refugees. Despite the urgent need for resettlement, in January, 2025, the US federal government abruptly suspended the US Refugee Admissions Program and cancelled over 10 000 approved flights for refugees awaiting resettlement.2 This decision left many groups vulnerable, including refugees with disabilities, women, unaccompanied children, and those at immediate risk of harm, undermining US commitments to humanitarian and international law.

There is an old fable about a frog being put into a pot of boiling water. If the frog is placed in gradually warming water, it will not perceive the danger in time and will boil to death. The frog adjusts to the uncomfortable surroundings and adapts, losing the strength to jump out in time. However, when the frog is dropped immediately into a pot of boiling water, it jumps—acts to save itself from immediate death. This is not a call to test the thermotolerance of frogs, but rather, an allegory for the current state of institutional and governmental support for science and research, particularly regarding minority and underserved populations.

The Lancet has published Institute for Health Metrics and Evaluation (IHME) findings since 1990.1,2 Throughout, the IHME has relied on a poorly substantiated theoretical minimum risk level of 24 h sodium consumption of more than 3 g per day or 1000–5000 mg.3 Scientific societies and well designed peer-reviewed research do not support either amount as safe. Meta-analyses of randomised controlled trials indicate that blood pressure increases when a person's sodium intake is over 800 mg per day. Likewise, high-quality observational studies indicate that cardiovascular disease risk rises at sodium intakes greater than 1900 mg per day.

We share the interests of Bill Jeffery and Norm RC Campbell in better understanding the impact of dietary sodium on global health and acknowledge its importance as a risk factor—in 2021, we estimated that 1·86 million deaths were attributable to high sodium consumption.1 This estimation makes sodium the second highest contributor to global disability-adjusted life-years in 2021 among the 15 dietary risk factors evaluated in the Global Burden of Disease study.1 Most of this burden (primarily cardiovascular disease) is mediated by the relationship between sodium and systolic blood pressure (SBP).

We read with keen interest the Article by Robert Bissonnette and colleagues,1 detailing the efficacy and safety of delgocitinib cream in the DELTA 1 and DELTA 2 trials for moderate to severe chronic hand eczema in adults. The rigorous methodology of the study is commendable, and the authors’ important contributions to the field are appreciated.

We read with great interest the Article by Robert Bissonnette and colleagues.1 Following 16 weeks of treatment, the authors showed a greater proportion of improvement in delgocitinib-treated patients compared with cream vehicle patients in both DELTA 1 and DELTA 2 trials.

In their Article, Robert Bissonnette and colleagues conducted a clinical trial of delgocitinib cream for chronic hand eczema and presented encouraging results.1 Previously, chronic hand eczema was considered difficult to treat, and the common therapeutic methods yielded unsatisfactory effects.2 The topical pan-JAK inhibitor used in this clinical trial provides an excellent and innovative therapeutic approach.

We thank Yuli Guo and Ruirui Hou, Seanna Yang and colleagues, and Xiaoyu Gu and colleagues for their interest in our Article on the efficacy and safety of delgocitinib in adults with moderate to severe chronic hand eczema.

Ferrante M, D’Haens G, Jairath V, et al. Efficacy and safety of mirikizumab in patients with moderately-to-severely active Crohn's disease: a phase 3, multicentre, randomised, double-blind, placebo-controlled and active-controlled, treat-through study. Lancet 2024; 404: 2423–36—In this Article, Massimo Claudio Fantini's full name should have been included in the VIVID Study Group; the first column of table 1 should have been “median C-reactive protein” and “median faecal calprotectin” as opposed to mean; and two people, Minhu Chen and Britta Siegmund, should have been mentioned in the VIVID-1 Steering Committee list in the appendix.

The African Critical Illness Outcomes Study (ACIOS) Investigators. The African Critical Illness Outcomes Study (ACIOS): a point prevalence study of critical illness in 22 nations in Africa. Lancet 2025; 405: 715–24—In the appendix of this Article, the names of the ACIOS Investigators have been updated. This correction has been made to the online version as of April 10, 2025.

Castells A, Quintero E, Bujanda L, et al. Effect of invitation to colonoscopy versus faecal immunochemical test screening on colorectal cancer mortality (COLONPREV): a pragmatic, randomised, controlled, non-inferiority trial. Lancet 2025; 405: 1231–39—In this Article, the affiliations for Cristina Hernández and Rodrigo Jover have been corrected and María Beso-Delgado should have been included in the COLONPREV study investigators. These corrections have been made to the online version as of April 10, 2025, and the printed version is correct.

Sidibe M, Makgoba TC, Bishop Paul, et al. Accelerating domestic investments to end AIDS in Africa. Lancet 2025; Published Online April 8, 2025 https://doi.org/10.1016/S0140-6736(25)00685-3—In this Correspondence, paragraph four has been updated to clarify that amfAR conducted the research using World Bank Development Indicators on health spending. This correction has been made to the online version as of April 11, 2025, and the printed version is correct.

The 2025 report of the Lancet Countdown to 2030 for women's, children's, and adolescents' health1 assesses global progress and challenges in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) and nutrition, with a focus on sub-Saharan Africa. Global mortality rates related to RMNCAH and nutrition have declined in the past two decades, but progress has slowed since 2015.1 This deceleration has particularly affected sub-Saharan Africa, a trend that is reflected in Senegal's RMNCAH situation.

In The Lancet, we present a concerning picture of progress in improving reproductive, maternal, newborn, child, and adolescent health (RMNCAH) and nutrition, characterised by a marked slowdown since the 2016 launch of the Sustainable Development Goals (SDGs).1 Our analysis in the 2025 report of the Lancet Countdown to 2030 for women's, children's, and adolescents' health1 identifies multiple internal and external threats to progress and highlights the widening gap between sub-Saharan Africa and other regions.

In line with previous progress reports by Countdown to 2030 for Women's, Children's, and Adolescents' Health, this report analyses global and regional trends and inequalities in health determinants, survival, nutritional status, intervention coverage, and quality of care in reproductive, maternal, newborn, child and adolescent health (RMNCAH) and nutrition, as well as country health systems, policies, financing, and prioritisation. The focus is on low-income and middle-income countries (LMICs) where 99% of maternal deaths and 98% of child and adolescent deaths (individuals aged 0–19 years) occur, with special attention to sub-Saharan Africa and South Asia.

We express our great appreciation to the American people and US Government for the incredible support through the President's Emergency Plan for AIDS Relief (PEPFAR), or any other new programme that will continue our strategic collaboration to end the threat of HIV and AIDS. Beyond this life-saving contribution for Africa, we recognise that PEPFAR's policy investments through the 2003 US Leadership Act Against AIDS, Tuberculosis, and Malaria have also strengthened the USA by safeguarding global health security, preserving geopolitical stability, and catalysing two-way trade.

The 2025 European tuberculosis surveillance report underscores the gravity of the situation in the WHO European region.1 Across 53 member states in Europe and Central Asia, more than 225 000 people had tuberculosis in 2023, with 16 000 deaths from the disease.1 Nearly 65 000 cases—or nearly 30%—are thought to be drug-resistant tuberculosis.1 Meanwhile, nine out of 53 WHO member states in the region rank among the world's top 30 high-burden drug-resistant tuberculosis countries.1 Alarmingly, more than half (53%) of Europe's cases of drug-resistant tuberculosis are among previously treated patients, contributing to a quarter of the global burden of drug-resistant tuberculosis.

Productivity in the UK's National Health Service (NHS) is declining, and many people are worried about this. It is the focus of meetings, white papers, articles, and webinars, and the topic arises in almost every NHS-related conversation.1–6 This worry prompts concern among policy makers, excitement among those in the health technology industry who see opportunity, and weariness among health-care workers. The debate around productivity is not new,7 but it has been reignited as an issue by the necessary efforts and thinking on how to get the NHS back on track after the COVID-19 pandemic.