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In recent weeks, the UK has seen masked students queueing for emergency meningitis jabs and the publication of the module 3 of the UK covid-19 inquiry,1 which criticised the government’s reliance on flawed advice that the virus did not spread through the air.2One aspect of our lack of readiness for the next pandemic is the current policy on protecting healthcare workers from airborne respiratory pathogens. Specifically, whether respirators should be used instead of ordinary medical masks. Current policy in the UK and many other countries,3456 based on non-inferiority randomised controlled trials,78 is that respirators are needed only for aerosol-generating medical procedures such as intubation. But such trials are inherently predisposed to produce null results and mislead policymakers and potentially cause harm.Randomisation reduces some forms of bias, but it does not abolish bias altogether. Post-randomisation biases can arise once a trial is underway, for example in how interventions are delivered, how...

On the eve of the Easter bank holiday weekend, the UK government finally published the full text of its deal with the US government on the prices the NHS will pay for new branded drugs.1The central plank of the deal is to waive tariffs on UK pharmaceutical exports to the US in return for the NHS paying 25% more for new branded drugs. The initial mechanism for the latter is an equivalent increase in the National Institute for Health and Care Excellence’s (NICE) standard cost threshold from 1 April 2026, although further price increases may well be needed to meet the scale of extra drug spending the government has signed up to.2 This revised threshold means that a drug will be considered sufficiently cost effective if for every £35 000 extra it costs above the current standard NHS treatment for the condition, it improves health by at least one quality...

The Pakistan Medical Association (PMA) has raised alarm over 329 children who have tested positive for HIV in the southeastern province of Sindh in the first quarter of 2026, calling it a sign of major failures in infection control and regulation.A separate BBC investigation reported 331 HIV positive children in Punjab province in 2024 and 2025 in an outbreak linked to unsafe injection practices.Sindh health department data, reported by local media, showed 329 children among 894 HIV cases recorded from January to March 2026.1 The PMA blames the rise on contamination resulting from lax health practices such as reuse of needles in unauthorised clinics, and it warned in a 14 April statement that the reported figure was “merely the tip of the iceberg.”It estimated that the actual number of infected children could be fourfold higher than currently documented, because of the critical unavailability of mass screening facilities across the province.The...

In The BMJ’s themed issue on the climate emergency, Abbasi says: “The global rhetoric, led by the world’s biggest financial and military power, is rushing us towards planetary destruction. The dilemma that every leader and every one of us faces at such a moment is whether to fall in line with raw power—advocates of ‘might is right’—or to stand for the values and strategies that lead us to a better world.”1 So, we were surprised that there was no discussion of non-violent civil disobedience, a tactic used by many health workers in response to the climate emergency.In the same issue, Kim Stanley Robinson explains that his novel was inspired by the realisation that humanity simply could not adapt to a wet bulb temperature of 35°C.2 In July 2022, as temperatures hit over 40°C, the Met Office put out an unprecedented level 4 warning. Six colleagues from Health for XR (a...

Is technology already ruling us? A recent television series, The Capture, features artificial intelligence as its central character. The AI even has a name: Simon. In a fictional British security service humans no longer make decisions, however high ranking. Simon decides on everything, and what Simon says is an order to execute. Does the same apply to the UK government and Palantir, a controversial technology company?The debate on health data is highly charged. What are the principles of data stewardship? How should data be safely managed? We must make the best technical use of the data while ensuring privacy and security. It’s also important to operate the data environment in an ethically sound way, meeting the expectations of patients and health professionals.An alarming data breach at the UK Biobank recently highlighted concerns about our handling of population data (doi:10.1136/bmj.s660).1 Jess Morley and colleagues examine the implications and how best to...

Update and outcome to the journal’s expression of concern, March 2026: The journal has concluded its investigation into the concerns raised in the expression of concern below. The article by Attar and colleagues (BMJ 2025;391:e083382, doi:10.1136/bmj-2024-083382, published 29 October 2025) has been corrected1 to remove two individuals from the author list as they did not meet the authorship criteria. The article has also been retracted2 due to concerns about the reliability of the trial and the integrity of the reported data, which have been referred to the Iran Food and Drug Administration for independent review.Original expression of concern (12 November 2025)What happened after publicationIn this paper by Attar and colleagues (BMJ 2025;391:e083382, doi:10.1136/bmj-2024-083382, published 29 October 2025), The BMJ was alerted to post-publication discussion raising concerns about a variety of issues; some issues were apparent from the data that support the paper, and are linked to from the article. Examples...