Medical Journal News

The death toll continues to rise in central Myanmar after a 7.7 magnitude earthquake hit South East Asia on 28 March. Over 2700 people have died so far, with another 4521 injured and 441 reported missing.1The disaster prompted Myanmar’s ruling military junta, the State Administration Council (SAC), to make a rare call for humanitarian aid on 29 March, despite the ongoing civil war. On 1 April, however, aid agencies reported that the junta was preventing humanitarian assistance from reaching earthquake survivors.2 SAC resumed airstrikes in rebel areas barely three hours after the earthquake struck.3A UN assessment found that many health facilities in Myanmar have been damaged by the earthquake and warned that a “severe shortage” of medical supplies, including trauma kits, blood bags, anaesthetics, and assistive devices, was hampering response efforts. According to the World Health Organization4 three hospitals were severely damaged, with 22 sustaining partial damage.In a 30 March...

by Lin Geng, Lilith K. Whittles, Borame L. Dickens, Martin T. W. Chio, Yihao Chen, Rayner Kay Jin Tan, Azra Ghani, Jue Tao Lim

When hurricane Helene flooded a North Carolina plant that made 60% of the US’s intravenous fluids in October 20241 it was a grimly familiar situation. The damage worsened a shortage that had lingered since hurricane Maria hit the same company’s production in Puerto Rico in 2017.Medical procedures had to be altered to reduce the use of IV products. Fluids were rationed and surgeries postponed, and some patients had to get by with sports drinks.2 It took three months to bring the crisis under control.A broader, more intractable crisis has replaced it. Trump’s aggressive reconfiguration of US trade relations and a pledge to make all of the country’s essential drugs and their inputs at home is threatening the stability of medical supply chains that have only just recovered from covid.Additionally, tariffs targeting both traditional US allies and rivals are likely to hamper progress already made on relocating some medical sourcing from...

In this feature by Sally Howard (BMJ 2025;388:r305, doi:10.1136/bmj.r305, published 6 March 2025) we have removed a sentence stating that more than 1000 women a year die each year from unsafe abortion in Malawi—a statistic that has been disputed, including in the paper originally referenced in our article (Miller C. Maternal mortality from induced abortion in Malawi: what does the latest evidence suggest? Int J Environ Res Public Health 2021;18:10506. doi:10.3390/ijerph181910506. https://pmc.ncbi.nlm.nih.gov/articles/PMC8507663/).

The World Health Organization will slash its budget for 2026-27 by more than a fifth after the US withdrew, and other nations reduced, its funding.WHO plans to cut back the scale of its projects and its workforce to tackle a funding gap of nearly $600m (£464m; €555m) this year, Reuters reported after seeing an internal memo from 28 March. WHO proposes cutting its 2026-27 budget by 21%, from $5.3bn to $4.2bn. It had initially proposed a more modest cut, reducing spending to $4.9bn.“Despite our best efforts, we are now at the point where we have no choice but to reduce the scale of our work and workforce,” the memo reportedly said. Staff numbers will be cut by the end of April.In an earlier memo dated 10 March, WHO announced a one year limit on staff contracts and was working to alleviate the funding shortfall with more contributions from countries, private...

Singh and colleagues answer questions on managing HIV in primary care.1 Several other aspects are relevant to primary care clinicians caring for people with HIV.Many people with HIV, such as men who have sex with men, are at higher risk of mpox infection and are therefore recommended to receive mpox vaccination by the UK Health Security Agency.2Patients who have taken pre-exposure prophylaxis drugs and have suspected recent HIV acquisition might present atypically with, for example, HIV indeterminate serology and an undetectable or low RNA viral load. Discussion with a local expert or with a national clinical service for people with unusual HIV test results is recommended in this circumstance.3Although Singh and colleagues are right that HIV-2 infections are observed mainly in people with links to West Africa, HIV-1 is probably still more common than HIV-2 in many countries in that region, although data on HIV-2 prevalence are generally more limited.45Regarding...

We have a capacity problem in general practice. There are too few GPs, either as partners or employed, for the number of patients who need looking after. This is despite there being GPs unable to find work and practices that would like to employ them but lack the money or space.1Unsurprisingly, capacity and access are a priority for the government—perhaps because nothing says that the system is broken quite as effectively as an 8 am queue for appointments snaking around the block. Last year’s primary care network contract included extra payments related to this, with a number of boxes that needed to be ticked to earn them.2 Unfortunately, the focus was entirely on ease of access (how the patient makes contact with the surgery through new telephone systems and online triage) rather than on increasing capacity (the number of GP appointments available). This doesn’t help patients or doctors, and it...