The following will be published in the March 13 issue of The Lancet:

Testing times The UK’s General Medi­cal Council has launched a public consultation on the long-discussed proposal for a new licensing procedure for doctors. The process, known as revalidation, would involve a yearly appraisal of a doctor’s fitness to practise, supported by feedback from colleagues and patients. The consultation closes on June 4.

Doctors come home Authorities in Wasit Province, central Iraq, are offer­ing financial incentives, a car, and housing allowances to specialists such as anaesthetists, cardiologists, and gynaecologists to try to get them to return to local health facilities. Many doctors have fled to the more peaceful northern parts of Iraq or abroad because of violent conflict and crime.

Nutrition claim slap Ahead of plans to tighten up the labelling of foods, the US Food and Drug Administration has made public dozens of stiff warning letters that it issued recently to several foodmakers with respect to “unauthorized nutrient content claims” on product labels and websites. Some claims about health benefits were so extreme as to count some products as drugs.

Ecuadorian achievement Ecuador has become the second nation in the Americas to stop the transmission of onchocerciasis, according to the country’s Ministry of Health and the Onchocerciasis Elimination Program in the Americas (OEPA). Colombia interrupted transmission in 2008, and now only four nations in the region—Brazil, Guatemala, Mexico, and Venezuela—remain endemic. The OEPA seeks to stop transmission in these countries by 2012.

Mongolia winter crisis As heavy snow and temperatures of –50°C con­tinue to affect Mongolia, aid efforts have been redoubled. UNICEF and the government have airlifted emergency and edu­cational supplies to schoolchildren, while mobile medi­cal teams supported by WHO and UN agencies have been delivering support to pregnant women and newborn babies in remote areas.

Migrant health How to improve access to health care for hundreds of millions of international and inter­nal migrants was addressed last week at a meeting in Madrid, Spain. Convened by WHO, the International Organization for Migration, and the Spanish Govern­ment, the meeting called for more partnerships across sectors and be­tween countries affected by migration.

Child marriage UNICEF is supporting a new movement against child mar­riage, launched by children in West Bengal, India. Amar Shaishab Amar Adhikar (My Childhood, My Right), has released a manifesto, which for the first time collected children’s views on child marriage and suggested points of action for parents, teachers, and communities.

Prostate cancer screening In the wake of controversy about the benefit of screening strategies in reducing the burden of prostate cancer, the American Cancer Society’s new guide­lines, released on March 3, emphasise the importance of involving men in the decision to be tested. The guidelines suggest starting the screening discussion at different ages, dependent on the man’s risk.

Mudslide deaths Mudslides in eastern Uganda have left 80 people dead; hundreds more are missing after several days of torrential rains. The UN Office for the Coordination of Humanitarian Affairs, which has dispatched two teams to assess the situation, stated that immediate health needs include first aid and support in accessing medical facilities.

Environmental health European government ministers met in Parma, Italy, this week to discuss emerging environmental health challenges, with a focus on children. Four general areas—water and sanitation, physical activity, air quality, and protection from chemicals—were discussed in the broader context of socioeconomic and gender inequalities, extreme weather events, and the financial downturn.

Kenya health insurance Social health insurance in Kenya could be reality this year after the National Economic and Social Council accepted a proposal to transform the National Hospital Insurance Fund into a National Social Health Insurance Scheme for outpatient treatment. This reform could help millions of Kenyans who are currently only covered for in-patient treatment costs.

Pill power Could a glowing pill-bottle lid be a solution to the problem of  non-compliance? One such product is about to be tested in a small trial. When it is time to take a tablet, the top of the bottle glows orange. Pro­crastinate, and it will beep with in­creasing urgency. Ignore, and a wireless transmitter could inform your doctor.

The following will appear in the March 6 issue of The Lancet:

Earthquake hits Chile One of the biggest earthquakes in a century, measuring 8·8 on the Richter scale, hit Chile last week, killing at least 708 people, destroying buildings, and triggering a tsunami that threatened Pacific coastlines. President Michelle Bachelet estimated that the economic damage could be up to US$30 billion, equivalent to about 15% of Chile’s gross domestic product.

Road safety On March 2, the UN General Assembly met to discuss a new resolution on road safety. A proposed plan of action called on member states to tackle rising trends in road traffic deaths and injuries worldwide by increasing resources for road safety, targeting the most common causes of road traffic crashes, and setting targets for reduction of fatalities.

Prescription placebos The formal licensing and government fund­ing of homoeopathic treatments has been denounced by the UK’s Science and Technology Committee. Lack of evidence of the efficacy of homoeopathic treatments means that they should not be labelled as medicines, the Committee declared. Such actions “lend a spurious medical legitimacy to homeopathic products”.

India’s health budget In its 2010–11 budget, the Indian Government has earmarked US$4·82 billion for health (an increase of 8·3% from 2009). An annual health survey will be done to map the district health profile of the rural population. AIDS control, mental health programmes, prevention of diabetes and heart disease, and the shortage of health-care workers were all allocated increased funds.

Science lessons A report by the UK’s Science and Learning Expert Group has called for school science lessons to be made more exciting by adding more experiments to the classrooms. The report, commissioned by ministers, also advises the government to increase the salaries of science and mathematics teachers to attract more specialists into teaching.

Child poverty The number of Egypt­ian children living in poverty is increasing, according to UNICEF and the Egyptian Govern­ment. The country’s economic growth is failing to keep up with the rapidly rising population, leaving 23% of children younger than 15 years with less than US$1 per day. The report calls on Egypt to invest in education and to introduce special laws for the protection of children.

Misuse control Misuse of prescription drugs is on the increase, according to the International Narcotics Con­trol Board. Public ignorance about the risks associated with misuse of pain medication, and the distribution of drugs via illegal internet pharmacies, were highlighted. However, the danger that patients could be denied legitimate pain relief by overly rigorous policies was also recognised.

Drug R&D in Africa African policy makers were urged to improve drug research, production, and access to essential medicines at the African Expert Meeting on Pharmaceutical Innovation in Africa, which took place in South Africa on Feb 18–20. Although around 120 proposals for research and development are in place, initiatives are uncoordinated and long-term plans are scarce.

Going too far? A series of sexually suggestive anti­smoking posters by pressure group Les Droits des Non-fumeurs has sparked controversy in France. The posters, which have been circulated to the press, depict teen­agers in sub­missive sexual positions, and bear the slogan “Smoking is to be a slave to tobacco”. Smoking in 13–15-year-olds increased by 66% in France during 2004–08.

Dengue alert At least 20 years after its last registered case of dengue fever, Queensland, Australia, has announced its first locally acquired case. In an effort to contain the disease within one town, a team of mosquito controllers has been called and the population has been advised to thoroughly clean in and around their homes to reduce mosquito breeding sites.

Lobbying rules The Danish pharma­ceutical industry association, Lif, has issued a new code of conduct for its members to follow when lobbying decision makers such as health technology appraisal bodies. Stakeholders will be encouraged to learn that Lif members must not provide incorrect or misleading infor­mation nor use personal issues to exert pressure.

Round hole, square peg? The Ameri­can Academy of Pediatrics has recom­mended a redesign of the humble hot dog. The fast food results in the choking-related treatment of 15 000 youngsters in the USA every year. Experts say square-shaped hot dogs could save lives. But other foods, such as grapes, also pose a risk, according to the Academy. Sadly, their redesign might prove more difficult.

The following will be published in the February 27 issue of The Lancet:

More broken promises Last week the Organisation for Economic Co-operation and Development released a review of aid performance of its member countries for 2010. Although overall aid will reach a record high of US$107·4 billion, it is $21 billion short of the amount originally pledged in 2004. Countries not reaching their projected goals include France, Germany, Austria, Italy, Greece, and Portugal.

Organ awareness In an attempt to overcome the shortage of compatible donors in the UK, a campaign to raise awareness about organ donation in black and south Asian communities has been launched by NHS Blood and Transplant. Currently, black and south Asian patients wait nearly twice as long as does a white person for a compatible organ.

Niger famine 5 years ago, an extreme famine in Niger was largely ignored by the international community (despite pleas from aid agencies) until the media got involved. Worryingly, 7·8 million people—two-thirds of Niger’s population—are now facing extreme food insecurity. This time, pleas for international help should not be ignored.

Syrian seizure Syria has shut down a group of counterfeit drug manu­facturers and traders operating in the country and exporting fake drugs to Iraq, Turkey, Lebanon, Iran, and Egypt. Syrian officials also seized fake medicines and equipment used to produce the counterfeits. 65 people, including smugglers and pharmacists, have been arrested in connection with the case and await trial.

Waste disposal The UN Industrial Development Organization (UNIDO) and the Government of India have teamed up to help to improve disposal of hazardous medical waste in India. The 5-year, US$40-million project will use environmentally friendly methods such as microwave and autoclave to reduce persistent organic pollutants. UNIDO’s Director-General also appealed to the private sector to reduce the burden on hospitals.

Info or ad? An opinion from an Advocate General of the European Court of Justice might mean that the Information to Patients strand of the EC’s Pharmaceutical Package (which some have regarded as direct-to-consumer drug advertising by another name) might now become law. But the ruling is vague, relying on the “deliberate and direct intention” of drug companies to give information versus advertising.

Extreme poverty A joint report by the UN Economic and Social Commission for Asia and the Pacific and the UN Development Programme states that the global economic downturn could push 21 million people in the Asia-Pacific region into extreme poverty.  Asia has weaker social protection programmes in place than do other regions such as Latin America and eastern Europe.

Patent care The US Patent and Trademark office has upheld a previous decision that an element of Pfizer’s Viagra (sildenafil) is not a new invention and so cannot be patented. Seemingly sildenafil works in a similar way to the Chinese herb yin yang huo, otherwise known as horny goat weed, which is sold via the internet.

Pay for performance The World Bank has released the results of a study on the use of pay-for-performance (P4P) medicine in low-income countries. The study examined the effect of P4P on maternal and child health services such as facility-based childbirth and scheduled vaccination in Rwanda, and concluded that financial performance incentives are capable of improving both the quantity and quality of health services.

Nurse prescribing Finnish nurses could soon be able to prescribe drugs for the specific medical conditions in which they have been trained, with authorisation from a supervising doctor. The bill, currently being con­sidered by the Finnish Parliament, is expected to improve the efficiency of services in health centres and to slow down the increasing demand for physicians.

New drug registration A report by the Drugs for Neglected Diseases Initiative outlines recommendations to improve registration of new drugs in Africa. These include closer collaboration between high-income and low-income countries, further involvement of WHO, and the establishment of regional centres of excellence to assess the safety, efficacy, and quality of new drugs for the specific populations most affected by neglected diseases.

Medical drama Canadian researchers have revealed the shocking fact that medical dramas on television are not the best source of information about first aid, especially when it comes to seizures. The researchers spent many a gruelling hour watching episodes of House MD, ER, Grey’s Anatomy, and Private Practice, and found that 46% of depictions of seizure care involved inappropriate actions such as putting something into the patient’s mouth.

The following will appear in the February 20 issue of The Lancet:

Radiation protection The US Food and Drug Administration has an­nounced an initiative to reduce high radiation exposure from CT, nuclear medicine studies, and fluoroscopy. It will hold a meeting next month to solicit input about the requirements for manufacturers to incorporate safeguards in the development of technologies and provision of appropriate training for practitioners.

Dubious drugs A third of anti­malarial drugs available in three African nations are substandard, according to the USAID-funded Promoting Quality of Medicines pro­­gramme. Researchers sampled 491 antimalarials (artemisinin-based com­bination therapy and sulfadoxine-pyrimethamine) in Madagascar, Sene­gal, and Uganda. The results are part of a larger ten-country project.

Technology for health Pharmaceutical companies are turning to non-traditional partners, such as telecoms and information technology, to meet the needs of their customers. Ernst & Young’s report—Progressions, Pharma 3.0—discusses the need for innovative approaches, such as iPhone applications for glucose monitoring, to improve clinical outcomes.

Yemen law Yemen could introduce a complete ban on female genital muti­lation within 4 years if new evidence shows that the practice is continuing unabated 9 years after a ban on health workers doing the practice came into force. Women’s rights groups say that although the practice may have stopped in hospitals, it is now done at home where the tools are less clean.

Stem cells for stroke? The first clinical trial of stem cell therapy for strokes has been granted approval. If successful, the 2-year trial of 12 patients with ischaemic stroke could provide a promising treatment option for stroke survivors, with the potential to provide some recovery of function to people left disabled. Extensive animal tests lend support to the use of neural stem cells for brain tissue repair.

Haiti aid Only 6% of post-earthquake assistance funds have been allocated to nutritional aid for women and children in Haiti. UNICEF has warned that high levels of acute malnutrition will result if insufficient provision for these vul­nerable groups continues. The target beneficiaries are 2·4 million women of childbearing age, 240 000 pregnant women, and 600 000 children younger than 5 years.

Pharmacovigilance Experts gathered in Brussels, Belgium, late last month to discuss the European Commission’s proposals for strengthening pharma­covigilance in the European Union. Delegates welcomed direct reporting of adverse drug reactions by patients to health authorities, but were wary of a shift in responsibilities to the pharmaceutical industry. The draft legislation will be voted on in the European Parliament later this year.

Cholera outbreak Papua New Guinea is struggling to contain its cholera outbreak, which has spread to 2000 people. The waterborne disease has killed at least 40 people since July, 2009, and is spreading to new areas, owing to poor sanitation in the country. WHO officials have urged the government to ensure people’s access to clean water.

Don’t forget Pakistan The UN has urged donors not to neglect Pakistan as Haiti’s plight dominates headlines. The organisation has appealed for US$538 million to assist the estimated 1 million Pakistani nationals who remain displaced by fighting between the army and the Taliban. Many are living with host families, but tens of thousands are in camps where food is desperately needed.

Cigarette tax hike A report by the US Campaign for Tobacco-Free Kids, the American Heart Association, and others projects that adding a tax of US$1 per pack to cigarettes in the USA would raise more than $9 billion in new revenue per year, and save $52·8 bil­lion in immediate and long-term health-care costs; it also would prompt 1·2 million adult smokers to quit.

Deadly heatwave An unprecedented heatwave that began last month is continuing to cause deaths in Latin America. Those affected are mostly older people and those with existing medical disorders. With temperatures as high as 40°C in Paraguay and 43·9°C in Brazil, medical staff have launched campaigns to inform people of the dangers of dehydration, and the need to drink regularly.

Lost in space Global positioning systems (GPS), used in emergency services and disaster relief, might soon have their usual accuracy of 3 m decreased to 10 m as the sun wakes up from low activity. The speed of GPS signals entering the ionosphere is affected by the sun’s radiation. The Newton-Raphson equation for position might well need another dimension.

The following will appear in the February 13 issue of The Lancet:

Under-5 health The UK’s National Audit Commission suggests that the health of young children from deprived backgrounds and ethnic minorities has not improved over the past decade in important outcomes such as obesity and dental health, despite government efforts. The Commission has appealed to local authorities to tailor and monitor services more carefully, engaging parents early on in children’s development.

PET for Pakistan Last weekend saw the opening of Pakistan’s first PET and CT scanning centre at Shaukat Khanum Memorial Cancer Hospital in Lahore. In inaugurating the new unit, leader of the Movement for Justice party Imran Khan said that, until now, patients with cancer in Pakistan have had to travel thousands of miles to Singapore to obtain a diagnosis.

HIV plans On Jan 25, the US Centre for Strategic and International Studies published its report on priorities for HIV prevention over the next 5 years of the President’s Emergency Plan for AIDS Relief. It highlights deficiencies in research into prevalence and ef­fective interventions, and prioritises accessible testing, specifically for high-risk, high-stigma groups.

Information action Participants at the Global Health Information Forum in Bangkok, Thailand, on Jan 27–30, have released a call to action on improving national health-information systems. The general principles of the call are: transparency, good governance, investment and capacity building, harmonisation and integration, and planning for the future.

An end to smoking? The UK Depart­ment of Health has identified distinct social patterns in smoking, with low-income areas lagging behind in the quitting race. The government paper A smokefree future pledges renewed support for deprived communities, and targets tobacco advertising, vending machines, and cheap imports. One of the goals is a tobacco-free London for the 2012 Olympics.

Stricter rules Doctors in India could lose their licences if they receive gifts or sponsorship from pharmaceutical companies, according to new rules issued by the Medical Council of India (MCI)—the regulatory body for medical professionals in the country. The MCI has amended its professional code of conduct in a bid to reduce practices such as prescription of branded drugs instead of cheaper generic drugs.

Merck ban The AIDS Healthcare Foundation has banned Merck’s sales staff from its US health-care centres, urging the company to reconsider the price of raltegravir. The drug is still priced as a salvage therapy even though, after Food and Drug Administration approval for wider use, it is now used as a first-line treatment. Ralte­gravir is one of the most expensive antiretroviral drugs on the market.

Health-worker homes Civil society organis­ations have urged the Govern­ment of Uganda to address the scarcity of accommodation for health-care workers, especially in rural areas. According to a review by the Ministry of Health, only 20% of health workers are provided with accommodation at their place of work. Transport and cost issues for the remaining majority are leading to high workforce attrition.

Scottish H1N1 deaths Surprisingly high death rates from influenza A H1N1 have raised concern about general health in Scotland, with some interpreting the finding as indicative of a lower standard of health overall. However, the Scottish Government says that the unexpected ranking as the country with the third highest death rate can be explained by poor cross-national statistical uniformity.

Dengue rise Latin America has seen dengue cases increase almost five-fold in the past 30 years, according to the Pan American Health Organization. 4·8 million cases were reported during 2000–07, compared with 2·7 million in the 1990s and 1 million in the 1980s. Cases of dengue haemorrhagic fever are also increasing, and transmission is now occurring in almost all countries in the region.

Lipid woes A report from the US Centers for Disease Control and Prevention has shown that 20% of US teenagers have abnormal lipid concentrations. The large proportion of study participants who fulfilled the American Academy of Pediatrics criteria for lipid screening affirmed the importance of clinical vigilance, in view of the association with cardiovascular disease in adulthood.

Qatar course Qatar will be the first Middle Eastern country to run training programmes for disaster relief. A memorandum of under­standing has been signed by the International Committee of the Red Cross and the University of Calgary–Qatar to run the courses, which aim to train aid workers in responding to medical and other needs after a disaster.