Atrium Health raised executive pay by 21% on average in 2025 while seeking a WakeMed deal. What the price gap could mean for patients.

Medicaid payment caps in the 2025 budget law could cut 10% to 25% of total Medicaid spending in 17 states. Who is most exposed, and when?

Health care in Chocó, the epicentre of the earthquake, was already under severe strain. Daniela Díaz Rangel and Amy Booth report.

The idea that science might promote cooperation could sound naive in a world beset by war, sanctions, strategic rivalry, and institutional breakdown. Science cannot stop armies or resolve diplomatic failures. When formal political institutions weaken, science can preserve communication channels, common standards of evidence, and trust across borders. Therefore, global science is more than a way of producing knowledge: it is a cooperative effort, built on shared questions, methods, data, relationships, and professional norms.

We read with interest the Commission by Paul Speigel and colleagues1 and commend its timely and ambitious effort to advance health equity and address the structural drivers of poor health outcomes worldwide. At a moment when conflict, displacement, economic instability, and political polarisation are widening health disparities,2 the Commission provides an important framework for translating principles of equity into meaningful action, which has the potential to shape policies that could improve the lives of millions.

The Johns Hopkins Center for Humanitarian Health–Lancet Commission by Paul Spiegel and colleagues offers a compelling account of humanitarian system failure and its consequences for people affected by conflict and forced displacement.1 The Commission calls for systems to uphold dignity, continuity, equity, accountability, and health for all. Perhaps most striking is that palliative care remains entirely unnamed in the Commission. A reform agenda that speaks of death, suffering, and abandonment would be strengthened by making explicit how people with serious illness are cared for when conflict obstructs access to physical, psychosocial, and spiritual support.

The Johns Hopkins Center for Humanitarian Health–Lancet Commission by Paul Spiegel and colleagues1 argues that the current humanitarian system is no longer fit for purpose. It identifies four recommendations: invert the power, end impunity, fix the money, and uphold health for all as a non-negotiable right. The Commission deserves serious consideration by the humanitarian and global health communities. Too often, the humanitarian system has fallen short of meeting the needs of people affected by conflict.

Thalassaemias are the most common monogenic inherited diseases and are characterised by reduced production of globin chains of haemoglobin. The two most common forms are α-thalassaemia and β-thalassaemia, which affect the production of α-globin and β-globin genes, respectively.1,2 Individuals with severe forms of thalassaemia receive lifelong chronic red blood cell transfusions, resulting in iron overload that leads to severe complications such as endocrinopathy, cardiomyopathy, diabetes, auditory abnormalities, osteoporosis, and growth failure, which can substantially affect their quality of life.

Paul Spiegel and colleagues should be congratulated on their Commission related to health, conflict, and displacement in a world of crises and impunity.1

In Jorge Luis Borges's fantastical short story, Tlön, Uqbar, Orbis Tertius, written in 1940, he imagines the invention of a new world, Tlön, by a secret society of, among others, astronomers, biologists, and engineers. Over several centuries, they developed “a rigorous and systematic plan” for this planet based not on materialism, but on idealism—the philosophy that nothing is real unless consciously perceived. There are no nouns in Tlön, only verbs and adjectives. There is no science. Nobody reasons.