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The Lancet

The Lancet

Newspaper | United Kingdom | Centre

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Discussions from The Lancet

Healthcare

How might the discovery of plasma biomarkers for Alzheimer's in middle-aged people affect health policies and community support programs?

Alzheimer's disease has a long preclinical phase in which neuropathological changes, such as amyloid β (Aβ) and tau pathology, accumulate over many years.1 This preclinical phase provides an opportunity for earlier disease detection and interventions to prevent or delay dementia. Emerging blood-based biomarkers provide a minimally invasive approach to assess Alzheimer's disease-related pathology and show promising diagnostic and prognostic value in symptomatic individuals.2 However, performance of these biomarkers in cognitively unimpaired, middle-aged populations remains unclear

Global
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Society

How can we improve our humanitarian system to better address inequalities and support mutual aid efforts?

The humanitarian system presents itself as a beacon of hope amid humanitarian crises, a vision that drew many of us into the field of humanitarian work. Yet once inside, the ideal unravels. Rooted in colonial histories and perpetuated by enduring global power asymmetries and the neoliberal logic of the aid sector, the humanitarian system frequently reinforces the very inequities it purports to resolve.1 These inequities manifest through policies and frameworks, as well as via interpersonal and cultural practices that, implicitly or explicitly, marginalise the most vulnerable

Global
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Healthcare

How should we change our approach to global health to make it better for everyone?

The Offline piece1 by Richard Horton is right that global health is on the brink: funding is collapsing, political volatility persists unabated, and powerful actors are renegotiating international engagement. But the answer is not simply a new narrative organised around climate, pandemics, conflict, migration, demography, or digital transformation. What global health requires is structural reorientation

Global
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Healthcare

How can we improve treatment options for patients with squamous NSCLC based on recent research findings?

We read with interest the results of the HARMONi-6 trial by Zhiwei Chen and colleagues,1 which showed that ivonescimab plus chemotherapy improved progression-free survival versus tislelizumab plus chemotherapy in advanced squamous non-small-cell lung cancer (NSCLC). However, PD-L1-based subgroup results reveal a critical stratification signal. In patients with PD-L1 tumour proportion score (TPS) of under 50%, dual blockade achieved marked benefit (hazard ratio [HR] 0·63; 95% CI 0·41–0·98), whereas in patients with PD-L1 TPS of 50% or over, the improvement was numerical but not significant (HR 0·71; 0·37–1·33)

Global
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Healthcare

How can India create a health system that works for all citizens?

The Lancet Commission on a Citizen-Centred Health System for India presents a timely and comprehensive assessment of India's health system.1 Although noting India's progress in reducing infant and maternal mortality and increasing life expectancy, the report also highlights persistent gaps in health-care delivery, and identifies that the main challenges are fragmented governance, poorly coordinated delivery, and a system organised around facilities rather than patients. The Commission's equal emphasis on equity and efficiency is also crucial

India
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Healthcare

How can India create a health system that works for everyone?

The Lancet Commission on a Citizen-Centred Health System for India presents a timely and comprehensive assessment of India's health system.1 Although noting India's progress in reducing infant and maternal mortality and increasing life expectancy, the report also highlights persistent gaps in health-care delivery, and identifies that the main challenges are fragmented governance, poorly coordinated delivery, and a system organised around facilities rather than patients. The Commission's equal emphasis on equity and efficiency is also crucial

India
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Healthcare

How can we improve universal health coverage while addressing financial challenges?

Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. A matter of human rights and equity, UHC also underpins inclusive and sustainable economic growth by supporting a healthy and productive workforce, and contributes to better education, poverty eradication, stronger social protection, and equality for all—critical foundations for human development. Japan's achievement of UHC in 1961, which contributed to social stability and rapid economic growth, shows the importance of promoting UHC at an early stage of economic development

Global
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