[World Report] Ambitious UK plans on levelling up lack detail and funding
The UK Government has finally published a long-awaited white paper, which aims to reduce inequalities. Jacqui Thornton reports.
[World Report] Burkina Faso crisis hits health care
A coup on Jan 24, 2022, further risks health and health-care provision. Munyaradzi Makoni reports.
[Comment] Offline: Complacency threatens progress against COVID-19
Hans Kluge, WHO’s Regional Director for Europe, has been reported as saying that European nations could soon be entering a “long period of tranquillity” as the pandemic abates. Pointing out that mortality from COVID-19 seemed to be plateauing, he suggested the continent was approaching a “plausible endgame” and an “enduring peace”. As WHO’s chief spokesperson for the 53 countries that make up his regional responsibility, Kluge was no doubt seeking to strike an optimistic and encouraging note. But it is disappointing that he took such a narrow geographical perspective about a global pandemic.
[Comment] Accelerating Indigenous health and wellbeing: the Lancet Commission on Arctic and Northern Health
Arctic Indigenous communities and adjacent Indigenous peoples considered Northern or Circumpolar in distribution recognised the threat posed by COVID-19 to their communities. Despite inhabiting many of the world’s most resourced countries, the health of Arctic Indigenous peoples lags behind their non-Indigenous counterparts across many indicators,1,2 and many communities remember the devastating consequences of the 1918–19 influenza pandemic on their communities.3 Swift action by Arctic Indigenous leaders limited COVID-19 cases in many communities, protecting their vulnerable groups from the worst outcomes seen in some other Indigenous communities globally.
[Comment] New NICE guideline on chronic fatigue syndrome: more ideology than science?
The National Institute for Health and Care Excellence (NICE) in the UK published a new chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) guideline in October, 2021.1 The previous NICE 2007 guideline recommended cognitive behavioural therapy (CBT) and graded exercise therapy (GET) for people with mild or moderate CFS/ME based on evidence from randomised trials.2 Since then, more randomised trials and systematic reviews have provided additional evidence supporting these recommendations.3–8 No new or more effective interventions have been identified.
[Comment] Another piece in the COVID-19 treatment puzzle
A new study1 from the RECOVERY Collaborative Group adds another piece to the puzzle of severe COVID-19 therapy. The RECOVERY trials have been pivotal in providing evidence on the efficacy of compounds within current treatment guidelines for COVID-19, such as dexamethasone, tocilizumab, and the casirivimab and imdevimab combination.1–3 In previous randomised trials, these monoclonal antibodies4 were effective in preventing infection and clinical progression when given in the early phase of infection.
[Editorial] Health and health care in Ukraine: in transition and at risk
The crisis in Ukraine continues to intensify. Russian troops are massing near the Ukrainian border and the US military is reinforcing its NATO allies in Europe. Meanwhile, diplomatic talks are loaded with accusations but little resolution, and Ukrainian forces are already fighting Russia-backed separatists in the east. With the world’s attention on the geopolitical situation in the region, there is a danger that the ordinary lives and health of Ukrainians are forgotten.
[Correspondence] The Global Drug Policy Index: its rationale and the role of civil society
One of our goals in creating the inaugural Global Drug Policy Index (GDPI) was to encourage debate about how to best measure and compare states’ drug policies, and we therefore welcome well informed critical commentary. Although such commentary did feature in the World Report1 (for example, Harry Sumnall offered lucid and insightful criticism), we felt that this was not true across the piece.
[Correspondence] The vaccinated proportion of people with COVID-19 needs context
We read the Correspondence by Günter Kampf1 with surprise, as it appears to argue that the base-rate fallacy2 is, in fact, not a fallacy. In the context of COVID-19 vaccines, the base-rate fallacy is often described as the illusion that vaccines are ineffective because, in highly vaccinated populations, the majority of COVID-19 cases occur among vaccinated people. For example, if a population is 99% vaccinated against a hypothetical virus and 51% of infected individuals have been vaccinated, the base-rate fallacy (falsely) implies that the vaccine is ineffective at preventing infection.
[Correspondence] Stigma, vaccination, and moral accountability
Günter Kampf1 argues that use of the term pandemic of the unvaccinated by officials in Germany is both overly simplistic and dangerous. The danger he says arises from “engender[ing] negative experiences by stigmatising parts of the population…I call on high-level officials and scientists to stop the inappropriate stigmatisation of unvaccinated people, who include our patients, colleagues, and other fellow citizens”.1 I leave it to epidemiologists to comment on whether the description that Kampf condemns is simplistic.