Lancet

Anne Hidalgo, the Mayor of Paris, is known for her pioneering environmental work, but her impact on public health is now being recognised more widely. Jacqui Thornton reports.

Rape is being used as a weapon of war in Sudan, where there is a shortage of health services. Sharmila Devi reports.

The modern explosion in medical memoirs is often attributed to Henry Marsh, the neurosurgeon whose instant classic, Do No Harm, was published in 2014. Yet 5 years earlier, another British surgeon, Gabriel Weston, beat him to it, producing an autobiography of startling panache and originality. Direct Red: A Surgeon's Story reeked, deliciously, of the wards, the surgical theatre, and the human form in all its bloody, splayed, intraoperative glory. The book depicted Weston's metamorphosis from a romantic English undergraduate with a love of the poet John Keats to a hard-boiled medical student whose most passionate relationship was with the corpse she meticulously dismembered.

How does a fragile body exist in a sick society? French author Michel Houellebecq has long displayed a fascination with medicine, the body, and death. Regarded by many as literature's enfant terrible in the 1990s and 2000s, Houellebecq's prose was electrified by anger and irony. He perceived Europe's deepest anxieties, magnified them, and wrote them large across brutal depictions of a society he saw as cynical and sick. His novel Atomised (1998) saw a molecular biologist perfect human cloning and Serotonin (2019) tells the story of a man taking a new form of antidepressant.

“It's done. You’ve had it.” My partner is grinning widely. I open my eyes but have no clue where I am. He tells me I had a double lung transplant and I am in the intensive care unit. At first, I am confused. Then in pain. Then frightened. I doze and wake, not sure if it is a new day, or whether it is daytime at all. I do not understand what is going on around me.

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.

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.