“Better to die from Ebola than the attacker who would come and cut my head off.” That was what Yap Boum II’s driver told him as he arrived this week in Beni, North Kivu, a province of the Democratic Republic of the Congo (DRC).Boum is head of the emergency preparedness and response division for the Africa Centres for Disease Control and Prevention (Africa CDC). He is also regional incident manager for the Ebola response. In early June he visited an Ebola treatment centre in Beni. A week before his trip more than 30 people were killed in attacks on nearby villages. Multiple victims were beheaded.1“When you listen to that, you change your perspective on what your role is in the response,” Boum told The BMJ. “The most important thing we have is the trust of the community—which is not a given.”Since the current Ebola outbreak emerged in mid-May2 there have...

The UK’s drug regulator has approved a daily pill version of the obesity drug semaglutide (Wegovy) for weight loss.The tablet form of Wegovy, manufactured by Novo Nordisk, is the first glucagon-like peptide-1 (GLP-1) receptor agonist pill to be approved by the Medicines and Healthcare Products Regulatory Agency (MHRA) for weight loss and weight management in the UK.The drug has until now been approved only in injectable form. However, oral semaglutide is already approved in the UK for treating type 2 diabetes under the brand name Rybelsus.1The MHRA’s approval of the drug for weight loss opens the door to more UK patients taking the oral version, but it will first have to be evaluated by the National Institute for Health and Care Excellence (NICE) before it can be used in the NHS.The treatment—which is cheaper than the traditional injectable version and has a more easily disturbed mechanism of action—was approved in...

Thousands of young people across England, Wales, and Scotland will be offered the meningitis B (MenB) vaccine for the first time this summer.123Eligible students—those finishing year 13 this summer (aged 17 and 18), together with people under 25 starting university or other residential further education—will be offered two doses of the vaccine, at least four weeks apart, before they start further education this autumn.The programme is being launched after the major outbreak seen in Kent in March, which led to two deaths.4The Department of Health and Social Care described the outbreak as the “fastest growing and largest ever seen in the UK” but said there had also been “more clusters than normal this year, some of which have been bigger than expected.”Young people eligible for the vaccine will be contacted directly through the NHS app, text, email, or letter, depending on records held by the health service.Announcing the expanded vaccination...

The NHS must be less risk averse in adopting digitalisation, technology, and artificial intelligence, the new health and social care secretary James Murray has said.In his first major speech since replacing Wes Streeting last month.12 Murray also said ministers “cannot go further” in boosting the pay of resident doctors, who are due to go on strike again from Monday 15 June.Speaking at the NHS ConfedExpo conference in Manchester on 11 June, Murray said the NHS “too often” let concern over potential risks overshadow thinking about benefits of new technology.Instead, the NHS needed to “innovate and take the right risks,” he told the conference. “Too often the question is, ’What if it goes wrong?’—and of course that is an entirely legitimate question to ask, especially in health and social care where we are talking about profound consequences,” he said.“We also need to balance that question by giving equal weight to another...

Hospitals in England cared for around 90 000 patients last month—nearly 3000 a day—in corridors or other inappropriate treatment areas, new figures show.NHS England data on corridor care, published for the first time on 11 June, show how far ministers are from eradicating an “unacceptable” practice that doctors’ leaders and health analysts say has become “normalised.”“It should be a source of national shame this has been allowed to happen to our health service in the 21st century,” said Den Langhor, emergency medicine lead for the BMA’s Consultants Committee. “Treating patients in corridors isn’t just inappropriate: it’s undignified and often unsafe.”NHS England describes corridor care as a “significant patient safety and experience issue”1—defined as when patients in emergency departments and inpatient wards spend more than 45 minutes in a clinically inappropriate place where they cannot be assured of essential equipment or dignity.This includes patients in emergency departments receiving treatment, those waiting...

The president elect of the American Diabetes Association (ADA) has resigned following uproar at the association’s annual meeting, when five doctors were forcibly ejected after handing out copies of an editorial criticising the administration of the US president, Donald Trump.1Jennifer Green, professor of medicine at the Duke Clinical Research Institute, was due to lead the ADA from January 2027. But multiple sources cited by the MedPage Today news site,2 which broke the story, said that Green had resigned after the incident.Mark Atkinson, chair of the ADA’s Scientific Sessions Planning Committee, has also reportedly resigned over the incident.Dozens of experts had walked out of the presidential address session at the annual meeting on 7 June, holding a sign reading, “We stand with science.”The ADA has formally apologised to the five doctors expelled. In a video uploaded on 10 June3 Charles Henderson, ADA chief executive, said, “I recognise the impact that experience...

Thousands of men in England with prostate cancer are to be offered high powered “precision” radiotherapy that will cut their number of treatment sessions from 20 to five.The pioneering multibeam radiotherapy, known as stereotactic ablative radiotherapy (SABR), will treat the condition far more quickly and with fewer side effects, said NHS England (NHSE).Standard external beam radiotherapy delivers several beams of radiation to the treatment area and is typically given as a number of daily doses over a period of weeks. But SABR uses many smaller, focused beams of radiation directed from different angles that meet at the tumour, thus giving it a high dose of radiation while the surrounding healthy tissues get a much lower dose, lowering the risk of damage to normal cells.SABR is already offered to some patients with lung, liver, pancreatic, or brain cancer. The announcement on 10 June means that it will now also be available...

Ongoing resident doctors' strikes indicate overt workforce tensions in the UK.1 By contrast, Japan faces a less visible but equally concerning “silent strike.” Despite universal health coverage, increasing numbers of young doctors are opting out of core specialties such as internal medicine, general surgery, and paediatrics.2Government data show that, between 2006 and 2024, the number of trainees under 30 declined by 48% in internal medicine, 36% in general surgery, and 17% in paediatrics.3 Meanwhile, entry into cosmetic medicine has risen 16-fold. This shift reflects structural disincentives. Cosmetic practice, outside the national insurance system, allows flexible pricing, whereas insured care is tightly regulated. Financial pressures have intensified, the proportion of clinics making a loss increasing from 24.6% in 2023 to 39.2% in 2024.4Career structures further limit choices. The specialist training system introduced in 2018 restricts mobility by tying early career doctors to financially vulnerable institutions. In addition, the 2024 work-style reform,...

AbstractAutism is a neurodevelopmental condition with varied trajectories through the lifespan, leading to individualized patterns of strengths and challenges. Longitudinal autism cohort studies show the importance of developmental and adaptive skills starting in the early years, followed by emerging co-occurring conditions, and opportunities for autonomy and community participation when approaching adulthood. Studies of interventions to support developmental outcomes in autistic children have shown benefits; however, adverse events from therapies and outcomes prioritized by autistic people must be incorporated. Programs for autistic children and youth are making some progress by including members of diverse communities, developing and adapting interventions to meet their needs. Most importantly, autistic people have highlighted the many contributors to a ‘good life’, prominent among which are acceptance and meaningful inclusion. This review summarizes the latest evidence about developmental trajectories and outcomes among autistic children and youth, and how this translates into clinical practice and policy.

Retatrutide, a triple action treatment for type 2 diabetes, could significantly reduce blood glucose concentrations and body weight in patients with the condition, a phase 3 trial has reported.The results, published in the Lancet,1 show that patients who received injections of retatrutide for 40 weeks lost more than four times as much weight as those in the placebo group. After 40 weeks the average reduction in HbA1c with the new treatment was more than twice that in the placebo group, showed the trial, which was funded by the drug's manufacturer, Eli Lilly.Retatrutide is a triple hormone receptor agonist that targets receptors for glucagon-like peptide-1 (GLP-1) to suppress appetite, glucose dependent insulinotropic polypeptide (GIP) to control blood glucose concentrations, and glucagon to increase energy expenditure. This is in contrast to semaglutide (Ozempic), which targets just GLP-1 receptors, or tirzepatide (Mounjaro), which works on both GLP-1 and GIP, so is termed a...

Resident doctors and consultants in Northern Ireland have voted to go ahead with two 24 hour strikes later this month in a dispute over pay.A pay uplift of 3.5% for 2026-27 was recommended by the Doctors' and Dentists' Pay Review Body earlier this year.But the offer was rejected by the BMA in Northern Ireland, which then balloted its members on strike action.1 The organisation claims that Northern Irish doctors' real terms pay is significantly lower than 18 years ago.With the strikes now imminent, the BMA said that it was up to the minister of health in Northern Ireland to come forward with a “credible” pay offer.David Farren, chair of the BMA's Northern Ireland Consultants Committee, said, “This result sends a very clear message that concerns about pay erosion, workload, and the future of the profession are widely shared across the workforce, across all grades of hospital doctor.”Of the doctors who...

The retired GP and climate activist Sarah Benn has had her suspension from the medical register extended again after a tribunal.Benn was initially suspended for five months in April 2024 for breaching court orders and for contempt of court while taking part in climate change protests at an oil terminal in 2022.1In 2023 she pleaded guilty to criminal damage after chalk spraying the gates and a wall at a company involved in animal testing. She was referred for a second hearing at the Medical Practitioners Tribunal Service (MPTS), which then suspended her for 12 months in June of last year.2 Last week (5 June) she was suspended for a further 12 months after a fresh MPTS hearing.Benn qualified in 1990 and spent 32 years in clinical practice, working as a GP for most of her career before retiring in 2022. In 2022 she attended climate protests on three occasions at...

Doctors could be told to stop wearing political badges at work and not to attend political protests in work uniforms, after a national review.Strengthened official guidance on uniform and workwear for NHS staff is expected after a government commissioned review on tackling antisemitism and other forms of racism across the NHS.1However, doctors' leaders labelled some of the proposals as “deeply concerning.”They said having a “blanket ban” on all symbols being worn as a step too far and there are questions over who decides what is “political.”The review, carried out by the Labour peer and UK government adviser on antisemitism John Mann, was commissioned after an attack at Heaton Park Synagogue in Manchester in October 2025 and reports of doctors being struck off the medical register because of antisemitic comments.2Mann heard from Jewish people who said they experienced “routine ostracism” in the NHS.Jewish staff were also the only religious group in...

McNally correctly identifies that many of the challenges affecting parents who are doctors are compounded for trainees with frequent rotations and often long commutes.1 Being a dual doctor couple, which has become increasingly common, further compounds the problem. The degree of influence that trainees have over their rotations varies considerably across grade, region, and training programme. We started a family during higher specialty training, but there are many parents in foundation or early specialty training who are even more vulnerable to these problems, with shorter rotations and even less agency. Most trusts lack an on-site nursery, which is of limited use when both parents are working in different places. Our friends and colleagues who rely on family might seem to have a better deal, but these arrangements often strain personal relationships and can be vulnerable to changes of health or circumstance.2Less than full time (LTFT) working has allowed my wife...

bmj;393/jun05_11/e491185/VS1F1vs1Eric was born in Liverpool in 1925, was educated at Liverpool College, and went on to Liverpool University to study medicine.He qualified as a urologist and started his career at Sefton General, where he met his wife, Rosemary, who was working there as a physiotherapist. Most of his career was spent at the Manchester Royal Infirmary, where he became head of urology surgery.Eric was very involved in kidney research, and he spent his early career in the US at the Mayo Clinic, studying the artificial kidney. On his return to the UK, he developed and performed the first cadaver transplant. He was a leading force in Kidney Research Northwest and much involved in raising funds through the rugby sevens team. This was recognised by the Queen, and he attended one of her garden parties in the late 1970s.Eric became chair of the British Association of Urological Surgeons and was also...

A new drug to treat resistant ovarian cancer, and the first to be approved in over two decades, has been approved for patients in the NHS in England.What is the new drug?Mirvetuximab soravtansine (marketed as Elahere), developed by AbbVie, is an advanced, targeted treatment that combines a “homing” antibody with a cancer destroying drug.Often described by scientists as a “biological missile” or “trojan horse” therapy, the drug is already available in the US and Europe.It costs £4950 per 100 mg vial at list prices, excluding VAT.1 However, for the health service it is being made available subject to a confidential commercial arrangement between AbbVie and NHS England.How does it work?In contrast to chemotherapy, it uses a targeted therapy that seeks out a specific protein found on the surface of cancer cells called folate receptor alpha (FR?) and delivers a molecule that destroys the cancer cell from within.The drug is given...

While the growth rate of the world's population has declined to 0.86% per year, the rate of mortality has also slowed down. Part of the decline in mortality can be attributed to considerable efforts on young infant and child survival, which have been successful. But the message from a linked series of papers on neonatal, child, and adolescent mortality published in The BMJ (doi:10.1136/bmj-2025-088684; doi:10.1136/bmj-2025-088685; doi:10.1136/bmj-2025-088686; doi:10.1136/bmj-2025-088687) is clear: since 2015, the rate of decline in mortality rates in newborn babies, children under 5 years old, older children, and adolescents has slowed substantially.1234 Although the number of deaths among children under 5 has decreased over the past two decades, 4.9 million children in this age group died in 2024, with almost half of the deaths occurring in newborn babies. While the mortality rate among children under 5 declined by 3.9% in 2000-15, the rate of decline was only 1.5% in...

AbstractObjectiveTo estimate cause specific mortality among neonates and children under 5 for 195 countries from 2000 to 2024.DesignSecondary data analysis using a Bayesian multinomial logistic regression model to estimate cause specific mortality fractions.Data sourcesPubMed, Embase, Web of Science, SCOPUS, Cochrane, Global Health Index Medicus, PAHO, Global Health OVID, Africa-Wide Information, IndMed, WHO Mortality Database, Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS), and Health and Demographic and Surveillance Systems (HDSS).Inclusion criteriaStudies in the general population reporting empirical cause specific mortality for at least two causes in the age groups of interest, with a specified method for cause ascertainment. For studies identifying causes of mortality with verbal autopsy, ?25 deaths reported with ?25% of these deaths with unknown cause. For vital registration, ?80% population completeness and ?10% deaths assigned to ill defined causes determined by the international classification of diseases, 10th revision.ResultsCause specific mortality for countries with adequate quality vital registration was estimated with their own data with minor adjustments. For countries with low mortality without adequate quality vital registration, cause specific mortality was modeled by age group and based on vital registration. For high mortality areas, cause specific mortality was modeled primarily on the basis of verbal autopsy data identified in a systematic review. Estimated cause distributions were applied to all cause mortality rates and death counts estimated by the United Nations Inter-agency Group for Child Mortality Estimation. Among 4.9 million estimated global deaths in under 5s in 2024, the most important cause of death was preterm birth complications, with 0.82 (90% uncertainty interval 0.76 to 0.88) million deaths and 6.17 (5.93 to 6.42) deaths for every 1000 live births. This was followed closely by lower respiratory infections at 0.66 (0.60 to 0.71) million deaths, intrapartum related events (0.48 (0.43 to 0.52) million), and malaria (0.45 (0.39 to 0.51) million). Analysis for trends over time showed that the decline in most causes has slowed since 2016.ConclusionWith the recent slowed pace of decline in under 5 mortality for most primary causes of death, many high mortality countries are at risk of missing the sustainable development goal targets of ?12 neonatal deaths and ?25 under 5 deaths per 1000 live births without acceleration. Estimates presented here can help countries to determine the most appropriate course of action to reduce under 5 mortality and achieve these targets.

bmj;393/may28_11/s953/FAF1faThe zenith of Joseph Ana’s passion to improve healthcare in Africa, particularly in his native Nigeria, came in 2004, when he was appointed health commissioner of Cross River State in the south east of the country. Donald Duke, the state governor, was impressed when Ana, a GP in the UK at the time, made clear that “medicine was not about buildings and equipment but love and care.” Duke had “gone through two health commissioners already without the satisfaction of making progress.”When Ana took up his post, the state had to serve more than three million people with only 72 doctors, no psychiatrist, radiologist, or pathologist, and just over 1000 nurses and midwives, with most practitioners concentrated in the cities. Maternal mortality was over 1% and child mortality over 20%. Only a fifth of the population were immunised, and—although hardly acknowledged because of the stigma—12% of the population were HIV positive.Ana...

Resident doctors in England will return to the picket lines next month in their 16th walkout over pay and conditions, the doctors' union has announced.The strike will run from 7 am on Monday 15 June to 6 59 am on Friday 19 June, and the BMA has threatened “more strike dates in July” if no further progress is made.The announcement comes after talks broke down between the new health and social care secretary, James Murray, and the BMA's Resident Doctors Committee (RDC). BMA officials said Murray had made it clear that he would not put any more money on the table beyond what his predecessor, Wes Streeting, had previously offered. Murray expressed disappointment that the BMA had “rushed once again to unnecessary and unreasonable strike action.”On 27 May the RDC chair, Jack Fletcher, said he had hoped that a change in health secretary “would lead to a change in approach.”“Sadly,...