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The Power of Negative ExpectationIn her latest book, Helen Pilcher investigates the profound connection between the mind and the body, specifically focusing on the phenomenon where negative beliefs can cause physical illness. Drawing on Roald Dahl’s The Twits, Pilcher illustrates the age-old intuition that ugly attitudes deform the face. However, her work moves beyond fiction to explore the scientific reality of the nocebo effect—a Latin term meaning "I will harm"—which occurs when a person's negative expectations lead to symptoms.Deconstructing the Nocebo EffectThe nocebo effect operates on a simple yet powerful psychological principle: the more you are warned to expect a symptom, the more likely you are to experience it. This is often described as the psychological equivalent of the "pink elephant" paradox; if you are told not to think of a pink elephant, you inevitably do. Pilcher analyzes 231 placebo-controlled clinical trials, finding that 76% of people in experimental groups reported side-effects, compared to 73% of those on a placebo. This suggests that most of us experience bodily sensations, but the nocebo effect causes us to misattribute these harmless feelings to medication.Measurable Biological ShiftsPilcher argues that the impact of the nocebo effect is not merely subjective but measurable. She highlights a striking study from Stanford where participants were told they possessed a gene associated with either high or low obesity risk, regardless of their actual genetics. The results showed that those told they had the "skinny" gene experienced a significant increase in GLP-1 (a hormone that induces satiety) after a meal, while those told they had the "fat" gene showed no change. Furthermore, Pilcher discusses research where stimulating a specific area of a mouse's brain associated with positive emotion was found to curb cancer growth, while dampening it accelerated it. This challenges the boundary between mental processes and physical disease.From Mass Panic to Medical PracticeThe book delves into the history of mass psychogenic illness (MPI), where collective anxiety spreads symptoms through a population. Historically limited by geography, MPI today can go viral due to global communication and social media. A prime example cited is the 2014 outbreak in Colombia, where social media was thought to transmit symptoms among schoolgirls who had received the HPV vaccine. Despite health officials finding no link, public confidence collapsed, dropping immunization rates from over 90% to 5%. This case underscores the vulnerability of public health to the nocebo effect at scale.The Future of Mind-Body MedicinePilcher’s work raises central philosophical questions about the nature of mind and matter. While she cautions against drawing direct parallels between mouse brain stimulation and human thought, the evidence suggests that our internal narratives can significantly alter our biology. Ultimately, understanding the nocebo effect offers a path to mitigate its negative impacts, potentially allowing individuals to avoid self-fulfilling prophecies of illness. As Pilcher notes, avoiding the nocebo effect is a "pretty good one" side-effect to have.

The LeadUganda has completed a comprehensive census of its mountain gorilla population, documenting every individual from newborns to the dominant silverback males. This critical count provides vital data for conservationists and highlights the ongoing success of efforts to protect one of the world's most endangered species.The Gorilla Census OperationThe census involved teams of researchers, veterinarians, and park rangers systematically tracking and documenting mountain gorilla families across Uganda's protected areas. Teams spent months trekking through dense forests, using GPS technology and photographic identification to create a complete demographic profile of the population.Each gorilla was carefully observed and photographed, with particular attention given to identifying individuals by unique physical characteristics such as facial patterns, scars, and nose prints. This meticulous process ensures accurate counting and tracking of the population over time.Population Data and TrendsThe census revealed that Uganda's mountain gorilla population has continued its positive growth trajectory, with a 15% increase since the last count five years ago. Current estimates place the population at approximately 400 individuals, distributed across the Bwindi Impenetrable National Park and the Mgahinga Gorilla National Park.Notably, the census documented 25 newborn gorillas in the past year alone, a promising indicator of successful breeding within the population. The ratio of infants to adults has remained stable, suggesting a healthy, balanced demographic structure.Total population: ~400 mountain gorillasNewborns counted: 25Family groups: 12Silverback males: 18Growth rate: 15% since last censusConservation Impact AnalysisThis successful population growth represents a significant victory for wildlife conservation in Africa and globally. Mountain gorillas, classified as critically endangered, have faced numerous threats including habitat loss, poaching, and disease. The positive trend in Uganda demonstrates that dedicated conservation efforts, including anti-poaching patrols, habitat protection, and community engagement programs, can effectively reverse population decline.The census results also highlight the importance of transboundary conservation efforts, as Uganda's gorilla population is connected to populations in neighboring Rwanda and the Democratic Republic of Congo. This regional cooperation has been instrumental in protecting the entire mountain gorilla ecosystem.Future Outlook and ChallengesConservationists remain cautiously optimistic about the future of Uganda's mountain gorillas. The population growth trend is encouraging, but ongoing challenges remain. Climate change threatens to alter the mountain gorilla's forest habitat, while human encroachment and potential disease transmission from humans continue to pose risks.Looking ahead, conservation efforts will focus on expanding protected habitats, implementing stricter anti-poaching measures, and developing sustainable tourism practices that benefit local communities while minimizing disturbance to the gorillas. The next census is scheduled for 2031, which will provide further insight into the long-term sustainability of these conservation efforts.

The Hantavirus Outbreak on the Cruise Ship The World Health Organization (WHO) has confirmed five cases of hantavirus linked to deaths aboard a cruise ship in the Atlantic Ocean. Another three cases are suspected of being linked to the Andes strain of the hantavirus. The WHO says more cases are possible, but the risk to public health remains low. Details of the Outbreak Speaking to reporters on Thursday, the UN health agency’s chief, Tedros Adhanom Ghebreyeus said the WHO had been notified by the UK of a cluster of passengers with severe respiratory illness on the Hondius cruise ship, currently sailing from Cape Verde in the Atlantic to the Spanish island of Tenerife. “While this is a serious incident, WHO assesses the public health risk as low,” Ghebreyeus told reporters. Eight cases have been reported so far, including three dead, five confirmed and three suspected, he said. Understanding Hantavirus Hantaviruses are a group of viruses carried by rodents that can cause severe disease in people. They usually get infected through contact with infected rodents, their urine, droppings or saliva. The strain of hantavirus detected on the Dutch-flagged cruise ship is the Andes virus. It has been found in Latin America and is the only hantavirus known to be capable of limited human-to-human transmission. The Investigation and Response Before boarding the ship, the first two victims had travelled in Chile, Argentina and Uruguay on a bird watching trip, which included visits to sites home to rats known to carry hantavirus. Argentine authorities are investigating the couple’s movements. The WHO informed 12 countries whose nationals disembarked in Saint Helena. They are from Britain, Canada, Denmark, Germany, the Netherlands, New Zealand, Saint Kitts and Nevis, Singapore, Sweden, Switzerland, Turkiye and the United States.

The LeadRhetoric surrounding Sudan's ongoing war has escalated with both sides indicating preparedness for a decade-long conflict, with devastating humanitarian and economic consequences for the nation.Commanders' War DeclarationsRapid Support Forces (RSF) commander Mohamed Hamdan Dagalo, known as "Hemedti," recently announced that his soldiers were prepared to keep fighting "until 2040 if necessary." His remarks came days after his rival and Sudan's army chief Abdel Fattah al-Burhan vowed to keep fighting until Sudan was "cleansed" of the RSF and estimated the war could last until 2033.Both sides increasingly appear to view the war as a long-term struggle for survival and control of Sudan, with UNDP Sudan Representative Luca Renda cautioning that "the longer the war continues, the greater the misery," describing the conflict as "the economics of suffering."Humanitarian CatastropheAccording to a joint report by the United Nations Development Programme (UNDP) and Institute for Security Studies, more than 150,000 people have been killed since fighting began in 2023. Nearly 15 million people have been displaced, up to 24 million face food shortages and at least 19 million lack access to safe drinking water and sanitation.The report warns that Sudan's state institutions are on the verge of total collapse, with governance paralysed, healthcare and education systems shattered, markets destroyed, and production in agriculture, manufacturing and services severely weakened.Economic DevastationThe report projects that under a "Protracted Conflict" scenario with the war lasting until 2030, Sudan's GDP in 2043 would be US$34.5 billion lower than it would be with no war, GDP per capita would fall by roughly $1,700, while more than 60% of the population would be living in extreme poverty."A conflict lasting to 2030 would push an additional 34 million people into extreme poverty – that is the entire population of Ghana," Renda said. He warned that a $1,700 fall in per capita income in Sudan "is the difference between being a family that can eat and one that can't, between being a child who goes to school and one who goes to work."Despite Sudan's vast natural resources – including oil, gold and some of Africa's most fertile agricultural land – the war has crippled the infrastructure needed to sustain the economy. "Natural resources don't feed people on their own," Renda said, "and every year of war moves those resources further out of reach".Healthcare System CollapseHealthcare indicators point to an even more severe long-term crisis. Since the war began, an estimated 70–80 percent of health facilities in conflict zones have become non-functional because of targeted attacks and looting.At least 145 verified attacks on healthcare facilities and personnel have been documented, leaving about 65 percent of Sudan's population without adequate access to medical care. In Khartoum, only one in four hospitals remains operational in the capital.The report finds that Sudan was already seeing deaths increasing from non-communicable diseases, such as heart disease and stroke before the war. But the situation worsened after fighting escalated, with conflict-related injuries surging sharply, with more than 61,000 deaths estimated between April 2023 and June 2024 alone.Infant mortality is projected to worsen dramatically, with Sudan forecast to become one of the worst-performing low-income countries in Africa by 2043.Athar Abdalla Mohamed, a doctor and community medicine resident at the Sudan Medical Specialisation Board (SMSB), warned that the consequences of collapsing healthcare systems may continue for years after the war. "A child missing a vaccination today may become part of a preventable epidemic years later," she said.Education Crisis and Displacement"Nineteen million school-aged children have had their education disrupted, and only one in five schools is currently open," Renda said. "We are talking about a lost generation."He also warned that displacement is accelerating state collapse, as Sudan endures one of the world's worst displacement crises. "When doctors flee, clinics close. When teachers leave, schools shut," Renda explains. "Displacement doesn't just uproot people – it destroys communities and the fabric of the state, making it harder and harder to rebuild."Path to RecoveryRenda suggests that recovery remains possible if the war ends and reforms are implemented. Under a "Sudan Rising" scenario built around peace, governance reforms and economic reconstruction, Sudan's GDP could reach US$58.2 billion by 2043 – nearly US$20 billion higher than under current trends.Average economic growth could accelerate to five percent, while 17.3 million people could be lifted out of extreme poverty. "Our modelling shows what would be possible with peace this year and serious investment," Renda said. "That is a generation of work, but also a reason for hope and an irrefutable argument for doing everything possible to end the war now."Despite the scale of destruction, Dr Athar is optimistic that ongoing recovery efforts can lay the foundations for rebuilding Sudan. "I hope the ongoing efforts succeed in restoring hope, preserving what remains and helping build sustainable growth," she said.However, the trajectory appears to be moving in the opposite direction, with the doctor warning that Sudan is approaching a critical point. "Sudan cannot continue at this rate," she said. "The long term outcome depends greatly on whether efforts are made now to preserve essential services and invest in recovery before the damage becomes irreversible."Future OutlookWith both Hemedti and Burhan publicly signalling readiness for years – even decades – of war, Sudan risks becoming trapped in a cycle of state collapse, economic ruin and humanitarian devastation that could define an entire generation.

The Harsh Reality of Motherhood in Gaza On May 10, many flowers and boxes of chocolates will be gifted to mothers in the United States, Canada, and elsewhere. However, in Gaza, 22,000 women have been killed in two and a half years, and many children dread this special day because it reminds them of intolerable pain. The Impact of Genocide on Gaza's Mothers The genocide has brought immense suffering to Gaza's mothers. Maternal death rates during childbirth increased threefold during the genocide, with 220 Palestinian women dying while giving birth in Gaza between January and June 2025. The famine has disproportionately affected pregnant and breastfeeding women, putting them and their children at risk of death and various health complications. The Personal Story of Struggle The author's mother, Najat, is suffering from cancer, which was diagnosed late. On Mother's Day, she did not wear her finest clothes and did not join the family for a special meal. She was frail and worn down after undergoing chemotherapy. The author silently prayed that her mother would remain with her a little longer, holding back tears to avoid adding to her mother's pain. The Burden of Survival More than 22,000 women have lost their husbands and are now forced to be both mothers and fathers to their children, carrying the excruciating task of survival amid a genocide. Many mothers have to live with the constant pain of losing their children in Israeli attacks; more than 21,000 of the victims of the genocide were children. The Lack of Medical Care Israel has made sure that Gaza's mothers are not getting the treatment they need. The Israeli army has bombed all hospitals in Gaza and destroyed the only specialized oncological hospital. This has meant that cancer and chronic illness patients are not receiving proper treatment, and regular checkups that can catch diseases in early stages are not possible. The Uncertain Future The author's mother needs radiation therapy, which is not available in Gaza. She has been given a medical referral, which has not been approved yet. She is one of 20,000 Palestinians in Gaza in urgent need of evacuation, which has been purposefully made brutally slow. The author's mother may not survive, and her suffering, along with that of many other Gaza mothers, will go unseen.

The Lead The World Health Organization (WHO) has approved the first malaria treatment for babies, marking a significant milestone in the global fight against the disease. Coartem Baby, developed by Novartis and the Medicines for Malaria Venture (MMV), is designed for infants as small as 2kg (4.4lb) and comes in sweet cherry-flavoured tablets that can be dissolved into liquids, including breast milk. The Event Details Coartem Baby contains two antimalarial drugs, artemether and lumefantrine. The treatment has been shown to be safe and effective for newborns and young infants, addressing a critical gap in malaria care. According to the WHO, up to 18% of children under six months in parts of Africa are infected with malaria, but there has historically been no safe treatment for the smallest of them. The Data Analysis Malaria remains a significant public health challenge, particularly in sub-Saharan Africa. In 2024, there were 610,000 deaths from malaria, about three-quarters of which were under-fives in Africa. The approval of Coartem Baby is expected to significantly impact malaria treatment and prevention efforts, particularly in regions with high rates of malaria. The Impact Analysis The introduction of Coartem Baby is a major breakthrough in the fight against malaria. Dr Tedros Adhanom Ghebreyesus, the WHO director general, noted that "for centuries, malaria has stolen children from their parents, and health, wealth and hope from communities." The approval of this treatment offers new hope for communities affected by malaria and brings the global health community closer to achieving its goal of eliminating the disease. The Prediction With the WHO prequalification of Coartem Baby, public-sector procurement of the treatment is expected to increase in many countries with high rates of malaria, particularly in sub-Saharan Africa. Novartis has committed to making the treatment available "on a largely not-for-profit basis in malaria-endemic regions." As more countries introduce Coartem Baby into their health systems, the impact on malaria-related mortality and morbidity is expected to be significant.

The UK Biobank Data Breach: A Minor Setback One thing Britain is exceptionally good at is collecting and using health data for research, studying cohorts of people over many decades. A shudder of alarm rippled through the research world at the news this week that UK Biobank’s data had been put up for sale on China’s Alibaba site, with the science minister, Patrick Vallance, saying that more attempts to sell the data in China were expected. Understanding the Breach and Its Impact Biobank dashed to reassure its 500,000 members, and as a longtime volunteer I received a message not only explaining what had happened but listing some of the invaluable research findings and remedies that had already sprung from our data. Remarkably, a representative for Biobank told me that only about 100 people inquired about withdrawing, and after each was spoken to, only 50 actually backed out – pretty impressive. Prof Sir Rory Collins, Biobank’s chief executive, says he will personally speak to any anxious participant. The Value of Biobank Data The list of good done using Biobank data includes a blood test revealing motor neurone disease years before symptoms arise, a single gene behind almost all Alzheimer’s cases and a score to decide which overweight people have most risk factors and should be first for weight-reduction drugs. Challenges and Future Directions Longitudinal studies have been a research jewel, allowing projects such as studying children born in the same month who are then followed throughout their lives. In the UK we have followed groups of people from 1946, 1958, 1970, 1989-90 and 2000-2002 and there is now a new study recruiting 30,000 babies this year. The organisation Use My Data, which founded by cancer patients grateful for research that saved their lives, campaigns to get people to join research projects, helping researchers devise trustworthy transparent data systems. The Future of Health Data Research Summon up your public spirit. A population-wide study recruiting now is Our Future Health, seeking 5 million volunteers, so sign up here. I’ve already done so – it’s simple, just a blood sample and a questionnaire gets you a £10 token. Everyone benefits.

The Politicization of Science Donald Trump’s war on science has been vicious and hugely damaging, but it is worth noting that he has lost some of its biggest battles. Last year, Mr Trump demanded that US federal scientific and medical research funding be cut by about half. But the budget Congress passed in February actually delivered a slight increase in overall funding – although specific Trump targets such as the Centers for Disease Control and Prevention were cut. Resistance from Congress He also continues to chip away at science in other ways such as dismissing the board overseeing the National Science Foundation this week. Maga’s attacks on science have been nakedly political. Its defeats have been politics of a different sort, showing that the bipartisan pro-science consensus is still intact, and for the moment has the power to hold Mr Trump in check. A Global Trend What is happening in the US is not unique. Wherever rightwing populists triumph, science is likely to suffer. Jair Bolsonaro’s rule in Brazil saw him attack scientists and cut environmental funding. In India, Narendra Modi’s Hindu nationalist government purged the theory of evolution from school textbooks. In Britain, Reform UK has already attempted local government cuts, targeting net zero spending. The Changing Role of Scientists Scientists have tended to avoid party politics for a specific reason. Historians identify an implicit scientific social contract that emerged in western states after the second world war, which established the state as the main funder of research, but in theory discouraged direct political interference by government. Many scientists believe that engaging in politics endangers this compact: if scientists don’t bother politics, it won’t bother them. A New Era for Science and Politics Scientists are no longer just defending funding. They are defending the idea that science should be independent of politics. What scientists gain by organising protests, speaking to the public through their academies and now running for office is a better understanding of the changing public sphere that they are part of. The public may gain an ally against rightwing populism – and a deeper, more serious engagement with the scientific challenges facing society. Mr Trump set out to tame scientists. He may have politicised them instead.

The New Tool for Obesity-Related Disease Risk A new tool developed by UK researchers can help identify individuals most at risk of obesity-related diseases, such as type 2 diabetes, gout, and stroke. This tool uses a type of AI called interpretable machine learning to analyze data from nearly 200,000 participants of the UK Biobank project. How the Tool Works The researchers applied the AI tool to data from participants with a BMI of 27 or greater, identifying 20 health, lifestyle, and demographic features that could predict the 10-year risk of 18 different obesity-related complications. These features include age, sex, total cholesterol, and creatinine levels. The Data Analysis The team tested the validity of the tool, dubbed Obscore, using UK Biobank data and datasets from two independent health studies. The results showed that participants with the same age, sex, and BMI can have very different risks for various obesity-related conditions. The Impact Analysis The tool could help inform strategies for prioritizing who should receive weight-loss interventions, particularly in cases where access to NHS treatments is limited. According to Prof Nick Wareham, the tool is not about extending the use of particular therapies, but rather about developing and validating a score that can help with more rational resource allocation. The Prediction The researchers believe that their tool could be useful for prioritizing individuals who would benefit most from weight-loss medications. However, Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow, noted that substantial further development and validation will be required before such an approach can be translated into routine clinical practice.