Managing a ministry of health during a civil war: difficult, but possible

Sudan's minister of health writes from the frontlines about the challenges of protecting public health during a civil war.

April 21, 2024 Check out STAT+

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By Pat Skerrett First Opinion Editor

A few of this week's First Opinion essays got me thinking about clinicals trials (the rest got me thinking about other things). Some say clinical trials began with work by Dr. James Lind, a surgeon in Britain's Royal Navy, in 1747. He divided a group of sailors with scurvy into different groups and had each group follow a particular diet. Those who consumed oranges and lemons recovered far quicker than the others, leading to using citrus fruits as a way to keep sailors safe from scurvy. Some point to a series of experiments devised by Benjamin Franklin and Antoine Lavoisier in the late 1700s to debunk healing based on the theory of animal magnetism promoted by Anton Mesmer. But even if trials didn't really get off the ground until after the thalidomide disaster in the early 1960s focused greater attention on testing new drugs, the fact that experts are still calling for gender and racial equity in trials and clinical research is a shame. Dr. Wendy Chung, a pediatrician and autism researcher at Boston Children's Hospital, explains how children of color and their families often aren't include in research, making it difficult to see them as part of the "face of autism." ADHD specialists Michael Morse and Kathleen Nadeau say much the same thing about girls and women with ADHD. A forthcoming First Opinion looks at the damage caused by excluding pregnant people from clinical trials. Striking a positive note, health consultant Wendy Cheng writes about how artificial intelligence and machine language could help companies sponsoring and running clinical trials make them more diverse. Like the world, the United States is a diverse collection of people. Clinical trials and other types of research should reflect that. I'd also like to draw your attention to an essay by Heitham Mohammed Ibrahim Awadalla, Sudan's minister of health, about what it's like to work to protect public health during a civil war. Also in First Opinion this week: tracking vital hepatitis, kids and social media, why Medicaid should cover donor breast milk, raising the alarm on the effect of new weight-loss drugs on lean mass (like muscle), and more. You can read them all here.

ASHRAF SHAZLY/AFP via Getty Images Public health during Sudan's civil war: nurturing resilience amid conflict Since the bleak early days of the Sudan civil war, there has been steady progress, writes the director of the country's Ministry of Health. By Heitham Mohammed Ibrahim Awadalla Autism doesn't discriminate. Autism research shouldn't either New research on autism provides insights and answers to improving access to treatment in underserved communities. By Wendy K. Chung ADHD is often overlooked in girls and women. They need help, too It is harder for girls and women to access appropriate ADHD diagnosis and treatment, and shortages of medication further reduce access. By Michael Morse and Kathleen Nadeau Adobe STAT+ | How AI can help satisfy FDA's drug, device diversity requirements AI and machine learning can help life sciences companies increase diversity in clinical trials for drug and device development. By Wendy Cheng Moving the conversation about obesity beyond the scale The jury is out on whether the new GLP-1 obesity drugs should preserve lean mass, like muscle. Measuring that in trials can provide answers. By Jonathan Isaacsohn Practicing medicine at a predominantly Black institution gave me the gift I didn't realize I needed Practicing medicine at a predominantly Black institution led physician Vanessa Grubbs to find her full, authentic, un-code-switched self. By Vanessa Grubbs Adobe Former HHS secretaries: Congress should adopt site-neutral payments for health care Site-neutral payments (tying payment to a procedure or service rather than to where care is delivered) will reduce U.S. health care costs. By Alex Azar and Kathleen G. Sebelius Viral hepatitis is a silent killer. It can't be eliminated if it isn't tracked Many public health departments lack the capacity to collect data for measuring state and local burdens of viral hepatitis infections. By Heather Bradley Kids can't wait any longer for social media safety The Kids Online Safety Act could establish common-sense safeguards to protect kids from social media pushing harmful content to minors. By Molly O'Shea Gregory Bull/AP Medicaid should cover donor breast milk for vulnerable infants Human breast milk is the best way to prevent the leading cause of death in premature babies. Many need donor breast milk. By Sionika Thayagabalu and Dominick Lemas

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