Lancet

We thank Liang V Tang and colleagues, Perrine Truong and Francois-Xavier Ageron, and Wei Xiong for their interest in our CASTING study and their comments.

Veltkamp R, Korompoki E, Harvey KH, et al. Direct oral anticoagulants versus no anticoagulation for the prevention of stroke in survivors of intracerebral haemorrhage with atrial fibrillation (PRESTIGE-AF): a multicentre, open-label, randomised, phase 3 trial. Lancet 2025; 405: 927–36—In this Article, the final sentence of the Findings in the Summary was incorrect and has been deleted. This correction has been made to the online version as of March 13, 2025, and the printed version is correct.

Human African trypanosomiasis or sleeping sickness is caused by infection with Trypanosoma brucei gambiense or Trypanosoma brucei rhodesiense parasites, which are transmitted by tsetse flies in sub-Saharan Africa. Control of human African trypanosomiasis is based on case detection, treatment, and vector control. In the past decade, simple rapid diagnostic tests were introduced for gambiense human African trypanosomiasis, facilitating screening in primary health-care facilities. A new oral drug, fexinidazole, became the first-line treatment for gambiense human African trypanosomiasis without severe meningo-encephalitic disease, as well as for rhodesiense human African trypanosomiasis.

Adding a single sentence suggesting a deadline for FIT return in the invitation letter to FIT colorectal screening resulted in more timely FIT return and reduced the need to issue reminder letters. This is a highly cost-effective intervention that could be easily implemented in routine practice. A planning tool had no positive effect on FIT return.

Hirst JE, Witt A, Mullins E, Womersley K, Muchiri D, Norton R. Delivering the promise of improved health for women and girls in England. Lancet 2024; 404: 11–14—In this Comment, the second sentence and reference 1 to a Manual source have been removed because this reference was found not to be reliable. These changes have been made to the online version as of March 12, 2025.

Investments in programmes such as the US President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the President's Malaria Initiative have saved millions of lives, strengthened health systems, and shown the power of sustained international cooperation.1,2 These programmes have not only advanced humanitarian goals but have also bolstered US economic and national security interests, reinforcing geopolitical stability in key regions, while expanding markets for American industries.

Colorectal cancer is the second leading cause of cancer-related death globally, accounting for more than 900 000 deaths each year.1 A large share of this burden could be avoided by well-organised screening programmes. In recent years, an increasing number of countries have introduced organised screening programmes with faecal immunochemical tests (FITs) directly sent, along with easy to understand information and instructions for use, to the eligible target population. Such programmes can achieve high adherence rates, well above 60%,2 and their introduction has been shown to be followed (after an initial apparent transient rise in incidence due to early detection of prevalent colorectal cancer) by a major reduction of both colorectal cancer incidence (in particular incidence of late-stage cancer) and mortality.

Like political leaders throughout Europe, US President Donald Trump pledged if elected to detain and deport millions of migrants without legal documentation or with temporary protected status.1 Since Jan 20, 2025, he has moved swiftly to achieve these aims. His administration rescinded guidance that restricted immigration enforce­ment in health-care facilities, religious institutions, and schools.2–4 Military resources have been diverted for deportations, with wrenching images of shackled people directed into military planes, detained at Guantánamo Bay military base, and crowded into militarised camps in Panama.

In 2020, WHO published guidance on the use of multiple micronutrient supplements (MMS) for pregnant women, which usually provide up to 15 vitamins and minerals in tablet or capsule form.1 In the 2020 update to the 2016 guidance,2 WHO issued a context-specific recommendation: “Antenatal multiple micronutrient supplements that include iron and folic acid are recommended in the context of rigorous research.”2 The evidence that informed this recommendation indicated that, compared with standard of care (iron and folic acid [IFA] supplementation), MMS reduced the prevalence of low birthweight but had little to no impact on other maternal and neonatal outcomes.

When compared with a licensed, quadrivalent meningococcal conjugate vaccine, and given alongside other routine vaccines, a single dose of NmCV-5 was safe and elicited a non-inferior immune response in infants aged 9 months and young children aged 15 months.

Since the introduction of the MenA conjugate vaccine in the African meningitis belt through mass vaccination campaigns and its inclusion in the Essential Program on Immunization (EPI), cases of serogroup A meningococcal meningitis have disappeared. This success has provided hope of eliminating serogroup A meningococcal disease and certainly epidemics in the African meningitis belt. The novel MenACWYX conjugate vaccine (NmCV-5), which contains four additional polysaccharides, is now expected to do the same for the remaining epidemic-causing serogroups in the region.

Digital adherence technologies did not reduce poor treatment outcomes in the four countries investigated. The use of digital adherence technologies should be based on careful review of additional data on economic evaluation, patient and stakeholder preferences, and the effect on other important patient outcomes beyond programmatic treatment outcomes.

Poor treatment adherence remains a major obstacle in national tuberculosis programmes globally. Digital adherence technologies offer novel opportunities to monitor and address poor adherence. Research shows that adherence challenges are common under programmatic conditions, vary among patient subgroups, and worsen over the course of treatment.1,2 Patterns of poor adherence range from missed doses and irregular treatment to discontinuation of treatment.2 Although digital adherence technologies can improve adherence through patient reminders and better monitoring, assessing their impact is challenging due to the Hawthorne effect3 and difficulties in measuring adherence in control groups without digital adherence technologies.

Pre-exposure prophylaxis (PrEP) is the advent of antiretroviral treatment use for people at increased risk of acquiring HIV-1. With access to PrEP in key risk groups and consistent use, HIV-1 incidence can decrease substantially.1–3 Initially, only oral PrEP options were available with tenofovir disoproxil fumarate or tenofovir alafenamide plus emtricitabine. Long-acting PrEP with cabotegravir became available in the early 2020s in some settings, but is still not widely implemented.4 Long-acting PrEP alternatives, including a dapivirine vaginal ring, are available in some African countries, but are associated with lower efficacy.

Following administration of once-yearly intramuscular lenacapavir, median plasma concentrations exceeded those associated with efficacy in phase 3 studies of twice-yearly subcutaneous lenacapavir for PrEP for at least 56 weeks. Both formulations were safe and well tolerated. These data show the potential for biomedical HIV prevention with a once-yearly dosing interval.

Diagnosis and management of patients with suspected acute brain infections improved following introduction of a simple intervention package across a diverse range of hospitals on three continents. The intervention is now being implemented in other settings as part of the WHO Meningitis Roadmap and encephalitis control initiatives.

Referred to as “cause for national shame” by the Health Secretary, Wes Streeting, maternity services in the UK have been the focus of repeated national scandals, with shocking reports of gross negligence and avoidable deaths in units across the UK. The largest maternity review in National Health Service (NHS) history, involving more than 2000 families, is now underway at Nottingham University Hospitals Trust. The government has promised the biggest reimagining of the NHS since its inception with the 10-year Health Plan, due this spring—in doing so, the government must deliver on long overdue pledges to improve maternity services.

The treatment landscape for first-line oncogene driver-negative metastatic non-small-cell lung cancer (NSCLC) has remained largely unchanged in recent years. Since the 2016 approval of the anti-PD-1 immune checkpoint inhibitor (ICI) pembrolizumab for front-line treatment of patients with metastatic NSCLC with PD-L1 expression of 50% or greater,1 numerous ICI monotherapies and combination regimens have followed. With an abundance of treatment options already available in the first-line setting, the HARMONi-2 trial—the results of which are presented by Anwen Xiong and colleagues in The Lancet2—raises critical questions: does ivonescimab, a novel bispecific antibody targeting VEGF and PD-L1, offer meaningful clinical advantages over existing PD-1 or PD-L1 inhibitors? And is there a compelling need for another therapeutic option in this space?

Germany's likely new Chancellor inherits a series of plans for health reform and must deal with an ageing population and underinvestment in infrastructure. Ferry Biedermann reports.

More than 300 cases have been reported, which experts have linked to infection with Campylobacter jejuni. Samaan Lateef reports from Mumbai.