Recent escalations in the ever simmering tension between India and Pakistan brought us closer to conflict - conflict between two nuclear powers.

For a long time doctors have campaigned for nuclear disarmament, and Chris Zielinski, president of the World Association of Medical Editors, makes the case for returning WHO's mandate to measure the potential impact of nuclear war.

Also the militarization of the region is detrimental to the health and wellbeing of the populations in both India and Pakistan. co-chairs of The BMJ's South Asia editorial board, Sanjay Nagral and Zulfiqar Butta, explain why a focus on the daily material and health needs of citizens is the way to change political rhetoric in the region.

Gordon Guyatt, distinguished professor at McMaster University, was one of the people responsible for starting GRADE - which is a structured system for assessing the quality of evidence in systematic reviews and clinical practice guideline. Gordon thinks that process has become too complicated - so he’s now championing “Core GRADE”. He joins us to explain why.

Reading list

Ending nuclear weapons, before they end us

Why Core GRADE is needed: introduction to a new series in The BMJ

China was declared malaria free in 2021 - and we'll hear how persistence was key to their success, and what new technologies are available to help the rest of the world become malaria free, from Regina Rabinovich, director of the Malaria Elimination Initiative at the Barcelona Institute for Global Health. 

Sonia Saxena, professor of primary care at Imperial College London, and Miguel O’Ryan, dean of the medical faculty of the University of Chile join Kamran to talk about what broke academic medicine, and why it's time for a revolution.

New research shows that data from retracted papers is still having an alarming effect on clinical practice. Chang Xu, Hui Liu, and Fuchen Liu from the Naval Medical University in Shanghai, and Suhail Doi from Qatar University, join us to talk about their study which has maped retracted papers impact on systematic reviews and clinical guidelines. 

Reading list

Malaria control lessons from China

Vision 2050: a revolution in academic medicine for better health for all

Investigating the impact of trial retractions on the healthcare evidence ecosystem (VITALITY Study I)

- An example of the BMJ's approach to updating metaanalysis after a study retraction 

The UK government is debating legislation to allow assisted dying in England and Wales, which puts doctors at the forefront of deciding if their patient will be eligible for a medically assisted death - the key criteria being a 6 month prognosis. But is making a 6 month prognosis actually clinically reliable?

To discuss we're joined by a panel of experts on end of life;

Reading list

Assisted dying and the difficulties of predicting end of life

Breaching the stalemate on assisted dying: it’s time to move beyond a medicalised approach

Also in this episode, we dim the lights and raise the curtains - there is a public fascination with doctors who kill and the stage show turned podcast, ‘An Appointment with Murder’, takes a deep dive into the crimes of GPs John Bodkin-Adams and Harold Shipman.

Kamran is joined by Harry Brunjes and Andrew Johns to talk medical murder.

An Appointment With Murder on Apple Podcasts

Kamran Abbasi interviews Professor Ashish Jha, Dean of Public Health at Brown University and former COVID-19 pandemic advisor to President Biden.

Watch this interview on our YouTube.

Trump’s second term has touched everything in the US political sphere - and health is no exception. With research funding for medicine and science weathering under Trump’s storm of cuts, how can Americans who care about public health and data navigate a course through the swells?

Professor Jha discusses how to resist an anti-vaccine resurgence, and comments on revisionist narratives that drive ill-conceived public health policies.

Reading list:

Professor Jha’s December 2024 editorial on the Trump admin’s plans for American healthcare coverage 

The UK’s chancellor has announced a £5bn cut to benefits, much of which will be borne by those on long-term disability allowance. Gerry McCartney, professor of wellbeing economy at Glasgow University explains about why these cuts will not only hurt the most vulnerable, but will be counterproductive to the government's wish to get people back to work.

Also, Suzanne O'Sullivan, consultant neurologist and author, joins us to talk about her new book "Age of Diagnosis". The book used clinical cases to explore the issues of medicalisation, and Suzanne explains why overdiagnosis doesn't mean that care isn't needed.

Reading list;

UK welfare reforms threaten health of the most vulnerable

Guardian edited extract from "The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far"

In the UK, the prime minister has announced the disbanding of NHS England, Nigel Crisp - former chief executive of the NHS, explains why he thinks that it’s important the health service is closer to the political decision makers, and why this could be the time to really acknowledge the healthcare emergency.

On the international stage, the Trump administration's withdrawal from the WHO is throwing global health into disarray - Illona Kickbusch, founder of the Global Health Centre at the Graduate Institute in Geneva, joins us to explain which new alliances are emerging, why the funding that has disappeared may never be replaced, and how tech will surpass pharma when it comes to industry influence.

Finally, there is a triple burden of malnutrition for adolescent girls in south Asia - which creates a cycle of ill health that is hard to break. However, Zulfiqar Bhutta, chair in global child health at the Hospital for Sick Children in Toronto, thinks the region can come together to change both government and society to champion young women’s health.

Abolishing NHS England: risks and opportunities

https://www.bmj.com/nhs-commission

https://www.bmj.com/collections/nourishing-south-asia

We've just published a new rapid review on the safety and efficacy of physician and anaesthetic associates in the UK, which was commissioned to support the ongoing Leng review of these new roles in the NHS. Trish Greenhalgh, professor of primary care at the University of Oxford, joins us to discuss the data she found.

Habib Naqvi is director of the NHS Race and Health Observatory, and is holding up a mirror to the NHS on it's support for ethnic minority patients and doctors - he joins us to talk about the work they've done, and why Reform UK's manifesto pledge to disband the Observatory is a matter of pride. 

Finally, our annual trip to the Nuffield Summit is not complete without a roundtable, this year we asked the question "What is stopping staff from speaking up?". Our panellists raised the usual issues of hierarchy and psychological safety, but also how the lack of positive change from senior leadership has habituated people into thinking "why bother".

Our panel;

Katie Bramall-Stainer, chair of the General Practice Committee of the BMA

Reading list

Physician associates and anaesthetic associates in UK: rapid systematic review of recent UK based research

Together we can challenge the racism that persists in healthcare

From pay restoration, to making sure there are enough training posts for resident doctors, the BMA has been busy.

In this podcast, Kamran Abbasi, the editor in chief of The BMJ, spoke to Phil Banfield, chair of the BMA’s council.

They talk about the ongoing pay discussions, how the BMA is working with the new government - touching on both speciality training places, and the role of physician assistants.

The conversation also covers the BMA's changing strategy, which aims to empower local members to take on the fights they care about, and how the organisation is linking both their trade union and professional activities.

Providing quality healthcare is demanding, often stressful, and requires sustained effort. When resources are stretched and pressure mounts, compassion can slip - but compassion is an essential tool for leaders, who need to support their teams to continue delivering the best possible care.

In this final episode of The BMJ’s podcast series on quality of care, Rachael Hinton, BMJ Editor, speaks to three healthcare leaders. They discuss how fostering kind and compassionate leadership and care can improve morale, combat burnout, and contribute to better patient outcomes.

01:48 Lydia Okutoyi talks compassionate leadership in Kenya

08:39 Pedro Delgado talks refocusing on the human factor and tools for kind leadership

15:02 Alexander Ansah Manu talks reaping quality of care benefits in Ghana

This podcast was produced as part of the BMJ Collection on Quality of Care, developed in partnership with the World Health Organisation and the World Bank. Visit bmj.com/qualityofcare to view the full Collection. The BMJ commissioned, edited, and published this podcast. This episode edited by Brian Kennedy.