Advancing health, improving lives

For more than 200 years, The Lancet has been at the forefront of medical publishing. But its mission extends beyond sharing research.

David Collingridge, Editor-in-Chief of The Lancet Oncology and Vice President of Editorial Strategy and Innovation at The Lancet Group, reflects on the evolving role of medical journals in shaping global health.

How do the Lancet journals advocate for health, and how do you define advocacy?

For us, our advocacy work is focused on the best science and its potential for improving lives. We use many approaches, including our Series (a collection of commissioned articles on a single theme), Lancet sessions at major conferences or world health events, and editorial collaborations with academic leaders and policymakers. Our flagship platform for advocating for change is publication of large white papers, called Commissions, in which we bring together an eminent group of experts to investigate and devise solutions for major unmet needs in health and medicine. The Lancet journals have phenomenal convening power, combined with the highest standards of academic rigour, peer review and publishing expertise - we aim to produce practice changing reports, and work with authors to elevate recommendations to policy makers.

Can you point to examples where the Lancet journals’ advocacy has led to measurable policy or health outcomes?

There are a lot of examples, but one project I’m particularly proud of is The Lancet Oncology’s Commission on cancer control in sub-Saharan Africa. This report was the first comprehensive undertaking to map out the inequities, inequalities and deficits in cancer care across the African continent and, importantly, provide actionable solutions. The report was also undertaken by African experts providing African solutions, which is the only way real change is possible. To date, the Commission has helped drive the issue of cancer care firmly up political agendas in many African nations. For instance, we have already seen a new comprehensive cancer hospital being built in Ghana; 800,000 girls in Tanzania have been vaccinated against HPV; and in collaboration with Bloomberg, key academics, and the former White House Moonshot team, a new financing platform has been devised to inject funding into cancer care systems in Africa, starting with Uganda.

Which areas of global health most urgently need stronger advocacy right now?

There are two areas of particular concern. First, research integrity and trust in science. The increasing prevalence of AI tools and amplified voices over social media is creating a perfect storm of misinformation, disinformation and fraudulent data - making the job of scrutinising research within editorial teams ever more important. And second, in these times of geopolitical instability, funding from the public purse for international development aid and research has decreased considerably, resulting in large reductions in access to medicines in many low-to-middle incomes, and the cancellation or truncation of ongoing research in many countries worldwide. Protecting hard-earned progress in global health - for example in under 5 mortality, or HIV treatment and prevention - will be essential but challenging in this new landscape.

Who gets to set the advocacy agenda in global health, and whose voices are still missing?

There are a lot of actors in this space: inter-governmental organisations, non-governmental organisations, charities, governments, academics and the commercial sector who will all have their own agendas as it relates to health and can sometimes result in a tension between conflicting, and sometimes opposing, views and the realities on the ground. Ultimately, there is a need to reframe many global health initiatives with louder voices in the region, with patients’ lived experiences, and with middle tier health organisations and hospitals to deliver tangible improvements in health.