Gavin, Richard, and Jessamy enter the studio once more for a Lancet Voice chat. A new book on Alzheimer's disease causes controversy across the Lancet team, we discuss the new Countdown on Plastics & Health, and a quick look at the problems facing the upcoming UN High Level Meeting on NCDs.

You can read the Lancet Countdown on health and plastics here:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01447-3/fulltext?dgcid=buzzsprout_tlv_podcast_August_25_lancet

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Where did the 10,000 steps recommendation come from? Why has it proven so stubborn? What's the science behind the new recommendations? How strong is the evidence?

Professor Melody Ding joins Gavin to talk about her new systematic review published in The Lancet Public Health, examining the relationship between step counts and health outcomes. We also explore the challenges of measuring physical activity, the importance of inclusive research, and the role of environmental and policy interventions in promoting population health.

Read the article from The Lancet Public Health here:

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00164-1/fulltext?dgcid=buzzsprout_tlv_podcast_August_25_lanpub

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It’s no exaggeration to say that the past decade has revolutionized how we think about and treat obesity. Drugs like semaglutide (Wegovy) and tirzepatide (Zepbound) have dominated headlines, enabling significant weight loss at speeds once considered unthinkable. The market for innovative weight loss medications is booming, with pharmaceutical companies investing heavily in hopes of developing the next blockbuster drug.

However, amid this race for market dominance, many experts are questioning whether the amount of weight loss alone is the best measure of these drugs’ usefulness. How can the next generation of obesity treatments meaningfully improve upon the powerful options already available?

Joining The Lancet editors Callam Davidson and Miriam Sabin to discuss this question is Professor Steven Heymsfield from the Pennington Biomedical Research Center. This wide-ranging conversation covers exciting pharmaceutical advances and limitations of these treatments, including the significant disparities in access, and why these breakthroughs may have broader societal implications.

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The sustainability of our existence relies on the health of every human, every animal, and the environment we all share. Published today, "The Lancet One Health Commission: harnessing our interconnectedness for equitable, sustainable, and healthy socioecological systems" highlights challenges like climate change, food security, and antimicrobial resistance to lay out the One Health approach to informing and implementing solutions.

Senior Executive Editor at The Lancet Pam Das is joined by lead Commissioners, Andrea Winkler and John Amuasi, to explain the past, present, and future of the One Health concept.

You can read the Commission here:

https://www.thelancet.com/commissions-do/one-health?dgcid=buzzsprout_tlv_podcast_lancetonehealth25_lancet

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Professor Adam Kucharski joins Gavin & Jessamy to discuss the intersection of mathematics, epidemiology, and truth, off the back of his new book, Proof. How do we generate scientific knowledge? How can we communicate uncertainty? What is the impact of social media and artificial intelligence on public trust in science?

Adam also tells us about the importance of public engagement, the nuances of misinformation, the importance of transparency in policy, the future of scientific communications, the need for adaptable definitions of proof, and the value of pragmatic, transparent approaches to decision-making in health and science.

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How safe is it to use period tracking and digital contraception apps? Who is your data being shared with? What regulation actually exists in this area to protect app users?

Femtech offers women digital tools for tracking reproductive health. Gavin and Jessamy are joined by Dr. Catriona McMillan, Senior Research Fellow in Medical Law and Ethics at the University of Edinburgh, to talk about how accurate these apps actually are, significant concerns about data privacy, and what regulatory oversight exists and can be applied.

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Richard, Jessamy, and Gavin reflect on developments at the 78th World Health Assembly, including the passage of the pandemic agreement and shifting dynamics in global health leadership. What's next for WHO without US engagement? How has WHA changed over the years?

We also address the importance of recommitting to adolescent health following our new Commission, and discuss a controversial recent study about the pace of scientific innovation.

You can read the second Lancet Commission on Adolescent Health & Wellbeing here:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00503-3/fulltext?dgcid=buzzsprout_icw_podcast_lancetadolescenthealth25_lancet

This is the paper on the pace of scientific innovation discussed on the podcast:

https://www.nature.com/articles/d41586-025-01548-4

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Gavin, Richard, and Jessamy return to the studio to discuss some publications that caught their eye this month, and in doing so set themselves the lofty goal of examining how meaning, purpose, optimism, and social context shape our understanding of health beyond traditional clinical measures. We also ponder the future of research and higher education in the face of funding challenges in both the US and the UK.

Articles mentioned in this episode:

The Global Flourishing Study: https://www.nature.com/articles/s44220-025-00423-5

The second Lancet Commission on adolescent health and wellbeing: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00503-3/fulltext?dgcid=buzzsprout_tlv_podcast_May_25_lancet

Standing up for gender justice: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00679-8/fulltext?dgcid=buzzsprout_tlv_podcast_May_25_lancet

How the United States became a science superpower: https://www.nature.com/articles/d41586-025-01146-4

Universities grip financial crisis – but at what cost to the nation?: https://www.universitiesuk.ac.uk/what-we-do/creating-voice-our-members/media-releases/universities-grip-financial-crisis-what

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Gavin and Jessamy welcome Dr. Hugh Alderwick from the Health Foundation to The Lancet Voice as we explore the impact of the Labour government's health policies since coming to power in the UK. What might the anticipated 10-year plan for the NHS look like? What are the implications of dismantling NHS England? Will any government get a handle on social care?

Hugh also provides expert analysis on the balance between funding and reform, the role of AI in health care, and the pressing issue of improving access to primary care.

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Gavin and Jessamy welcome back Oksana Pyzik of UCL to talk about the significant impacts of Trump's actions on health infrastructure in Ukraine and broader Europe.

Oksana provides a comprehensive update on the current health situation in Ukraine, the challenges faced by healthcare systems amidst ongoing conflict, and the repercussions of halted aid on crucial programs like HIV and TB. 

We also explore the response of international institutions responsible for coordinated efforts to address pressing health issues and discuss what a tariff schedule might mean for the pharmaceutical industry.

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Gavin, Richard, and Jessamy reunite for another bonus episode, covering the first three months or so of health in the US under Trump. What do the appointments tell us about the administration's agenda? How can institutions stand up to cuts and intimidation? 

We also look at gender justice in global health as laid out by the excellent new Commission in The Lancet, and highlight that the world's impressive gains on maternal and newborn mortality are slowing - what more needs to be done?

You can read "Achieving gender justice for global health equity: the Lancet Commission on gender and global health" here:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00488-X/fulltext?dgcid=buzzsprout_tlv_podcast_lancetgenderhealth25_lancet

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Following the discovery of H5N1 influenza of avian origin in a sheep in the UK this week, Gavin is joined by Dr. Abraar Karan of Stanford University to discuss the current state of bird flu in the US, its impact on public health, and the potential for human-to-human transmission. Dr. Karan analyses the ongoing outbreaks and infections in the US, the challenges in detecting and controlling the virus, and the lessons learned from COVID-19.

We chat about the complexities of viral evolution, the importance of robust testing and surveillance, the critical need for coordinated efforts to prevent a potential epidemic, and how bird flu might end.

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Content warning: discussions of sexual assault, violence, and rape

How does society handle sexual assault? What are the health implications for victims and for populations? Did the Pelicot case change attitudes and what can we do to address stigma? 

Gavin is joined by Professor Betsy Stanko OBE and Professor Katrin Hohl OBE, who together worked on the London Metropolitan Police's Operation Soteria to change how the police deal with sexual assault cases. 

In this episode, we explore the global burden of sexual violence, its profound impact on women's health, the systemic challenges in addressing the hidden dimensions of sexual violence, the difficulties in measuring its prevalence, and the critical need for a trauma-informed and holistic approach in both healthcare and criminal justice systems.

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Gavin is joined by Heather Wardle, Professor of Gambling Research and Policy at the University of Glasgow, and the lead commissioner on The Lancet Public Health’s Commission on Gambling, to discuss the rapid expansion of the global gambling industry and its profound public health implications. We chat online gambling, technological advancements, and increasing accessibility, and how they are transforming the gambling landscape, leading to widespread health harms.

You can read the Commission here:

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00167-1/fulltext?dgcid=buzzsprout_tlv_podcast_lanpubgambling24

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Donald Trump has taken office in the US and immediately turned his attention to dismantling the US position as a world leader in global health. How will actions taken so far affect the health of people around the world? Gavin is joined by co-host Miriam Sabin, North American Executive Editor at The Lancet, and they speak to Dr. Gavin Yamey, lead author of The Lancet's recent Commission on Investing in Health, and Director of the Center for Policy Impact in Global Health at the Duke Global Health Institute.

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Richard, Gavin, and Jessamy return to the studio for another freeform discussion kicking off with the responsibilities of science and scientific publishing in a time where fact checking and moderation are going out of fashion. We also cover climate change in the US with the recent wildfires, and the importance of retaining institutional memory following traumatic experiences after Richard was particularly struck by a recent trip to Argentina.

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Where does power lie in global health? What are the historical and systemic barriers that perpetuate inequities, and what is the impact of political shifts towards nationalism? 

Catherine Kyobutungi and Madhukar Pai join Gavin to talk about their recent Comment published in The Lancet, "Shifting power in global health will require leadership by the Global South and allyship by the Global North". Join us to learn about the challenges and opportunities for Global South leadership and the importance of redefining knowledge, success, and problem identification in global health.

You can read Catherine and Madhu's Comment piece here:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02323-7/fulltext?dgcid=buzzsprout_tlv_podcast_generic_lancet

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The last Lancet Voice of the year delves into the latest findings from the Institute for Health Metrics and Evaluation (IHME) from our recently released US Special Issue. Ali Mokdad and Emmanuela Gakidou join Miriam Sabin and Gavin Cleaver to explore the comprehensive analysis of the Global Burden of Disease, the alarming trends in obesity and life expectancy, and the critical need for policy changes to improve public health in the United States.

Read the US special issue here:
https://www.thelancet.com/journals/lancet/issue/vol404no10469/PIIS0140-6736(24)X0050-1?dgcid=buzzsprout_tlv_podcast_generic_lancet

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In September 2023, Wales passed legislation making the maximum speed limit 20mph in built-up areas. How are speed limits linked to public health? How can researchers engage with governments to enact public health research? And how do you deal with the situation when there is a huge online backlash to your work? Dr. Sarah Jones from Public Health Wales joins Gavin to discuss how her research was implemented, how it's gone so far, and what's next.

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What is the impact of systemic racism on public health in New York City? How can we leverage government to meet ambitious goals for improving life expectancy?

Prof. Michelle Morse, the interim Health Commissioner of the Department of Health of New York City, joins Miriam Sabin and Matt Gilbert of The Lancet to discuss bridging public health and clinical care to reduce health inequities.

Together, they explore the challenges and solutions in addressing health across a diverse city, tackling maternal mortality, and the importance of community engagement in public health.

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Gavin, Richard, and Jessamy get into the studio for another bonus episode looking at the launch of the Global Health 2050 report at the World Health Summit in Berlin, a report which shows a path to cutting premature mortality by 50% by 2050. Also up for discussion are the limits of human longevity and what well-designed cities mean for health.

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The US is the richest country in the world, but has some of the most entrenched poverty and associated poor health outcomes. Miriam Sabin (North American Senior Executive Editor at The Lancet) joins Jessamy to chat with Luke Shaefer (Professor of Public Policy at the University of Michigan and Director of Poverty Solutions) and Mona Hanna (Professor of Public Health at Michigan State University and paediatrician at Hurley Medical Centre) about why this is, their innovative Rx Kids cash grant program for families in Michigan, and what the upcoming US election means.

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Gavin is joined by Paul Moran (Professor of Psychiatry, University of Bristol and Honorary Consultant Psychiatrist, Bristol Royal Infirmary, UK) and Helen Christensen (Scientia Professor of Mental Health at the University of New South Wales, Sydney, Australia) to discuss The Lancet's new commission on self-harm, exploring its prevalence, cultural factors, and the crucial need for better data and compassionate care. We also talk about stigma and improving mental health services globally.

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https://www.thelancet.com/commissions/self-harm?dgcid=buzzsprout_tlv_podcast_lancetselfharm24_lancet

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Jessamy, Gavin, and Richard come together for another bonus episode of The Lancet Voice. A freeform chat covers xenotransplantation, the use of AI in scientific research, the Darzi report into the UK's National Health Service, and falling population levels over the next few decades.

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Ramanan Laxminarayan is the founder and president of the One Health Trust, Director of the WHO Collaborating Center on Antimicrobial Resistance in New Delhi, India, and an Affiliate Professor at the University of Washington, Seattle, WA. He is the lead author of The Lancet’s May 2024 series on Sustainable Access to Antibiotics. He joins Gavin and Jessamy to discuss how big of a problem AMR currently is and will be, what is being done, and what needs to be done.

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https://www.thelancet.com/series/antibiotic-resistance?dgcid=buzzsprout_tlv_podcast_generic_lancet

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