Leading influenza researchers have agreed to a voluntary 60-day pause on controversial research involving mutant H5N1 virus strains that are transmissible in mammals. In an announcement on Jan 20, the scientists said the hiatus will allow time for governments, organisations, and the scientific community to discuss potential safety concerns.

This week we publish surprising and, on the face of it, disturbing findings. According to Christopher Murray and colleagues at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, there were 1·24 million deaths (95% uncertainty interval 0·93–1·69 million) from malaria worldwide in 2010—around twice the figure of 655?000 estimated by WHO for the same year. How should the malaria community interpret this finding? Before we answer that question, we need to look beneath the surface of this striking overall mortality figure.

An independent advisory group has urged the UK Government to integrate genomic medicine into the National Health Service (NHS). The Human Genomics Strategy Group (HGSG), established in 2010 after a House of Lords inquiry into genomic medicine, set out their recommendations in a report published on Jan 25. First, the group proposed that the government outline a policy for expansion of genomic technology in the NHS; HGSG emphasised that commissioning of cost-effectiveness studies will be a necessary step.

In July, 2011, the UK's medical regulator, the General Medical Council (GMC), was told by the Commons Health Select Committee to send a “clear signal” to doctors that they were failing in their duties if they did not report concerns about patients' safety. That signal has now come in Raising and acting on concerns about patient safety—new GMC guidance published on Jan 26, which advises doctors about the best ways to alert employers and health-care regulators about poor quality care.

The National Health Service (NHS) in England has been a leading international model of tax-financed, universal health care. Legal analysis shows that the Health and Social Care Bill currently making its way through the UK Parliament would abolish that model and pave the way for the introduction of a US-style health system by eroding entitlement to equality of health-care provision. The Bill severs the duty of the Secretary of State for Health to secure comprehensive health care throughout England and introduces competitive markets and structures consistent with greater inequality of provision, mixed funding, and widespread provision by private health corporations.

In The Lancet, the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) report meta-analyses of outcomes in 100?000 women with early breast cancer in more than 100 trials of adjuvant chemotherapy, which include the first EBCTCG meta-analyses of adjuvant taxane treatment. This study comes 35 years after the first report of the benefit of adjuvant chemotherapy, and is the 16th publication in the group's 28-year history of bringing together individual patient data from all randomised trials worldwide.

The nature, scale, and interactions of behavioural disorders after neonatal and perinatal insults, including preterm birth and infectious diseases, are not well understood. In The Lancet, Michael Mwaniki and colleagues present a broad systematic review of the type and probability of development of a range of neurodevelopmental sequelae, in which they have included 153 research studies and 22?161 liveborn children. The authors report a very high overall prevalence of at least one deficit in any domain (median risk 39·4%, IQR 20·0–54·8%).

“The rapid advances in cardiology during the first half of the 20th century may be fairly ascribed to the introduction of new techniques.”Paul Wood, 1951

Antisocial behaviour in adolescence can be associated with ill health in the form of self-harm, drug abuse, and mental disorders, and may presage criminal activity later in life. This is a worldwide problem with far-reaching social and economic implications, for individuals as well as for society as a whole.

Seen on a plate somewhere in Italy. Brains. Quite a delicacy. Not a chance.

Scientific papers on chronic fatigue syndrome (CFS) often evoke much debate and emotional reaction, as exemplified by the recent discussions in The Lancet on the PACE trial. Also, the potential role of a retrovirus in CFS kindled a fierce controversy which has recently culminated. In 2009, in Science, Lombardi and colleagues described the occurrence of the xenotropic murine leukaemia virus (MLV)-related virus (XMRV), a gammaretrovirus, in white blood cells in 67% of patients with CFS and in 3·7% of healthy controls.

Harm-reduction programmes are remarkably successful in controlling HIV in injecting drug users worldwide, but more effort is needed to prevent even more HIV infections in this group. Recent reviews individual behavioural approaches, and medical treatment and care. Still, little is known about evidence-based educational intervention effects of harm-reduction programmes for injecting drug users.

Ethical violations in clinical trials in India have exposed gaping holes in the country's regulatory system, which has struggled to oversee the booming industry. Amy Yee reports from New Delhi.

New NICE guidelines on epilepsies have come under fire by several experts who say that they do not reflect clinical experience and focus too much on drug cost effectiveness. David Holmes reports.

Portugal's debt crisis is forcing hospital closures and hasty reform of the National Health Service, causing some observers to raise concerns about patient care. Gonçalo Figueiredo Augusto reports.

Arriving at Washington DC's Reagan National airport last year, I, like other visitors, was greeted with large signs featuring the Statue of Liberty and the words: “Welcome to America, home to 5% of the world's people and 25% of the world's prisoners.” The posters were produced by the National Association for the Advancement of Colored People (NAACP) to help publicise their “Misplaced Priority: Over Incarcerate, Under Educate” campaign.

The place that for many years served London's Middlesex Hospital as its Outpatient Department is not a beautiful building. Yet it's the oldest element of that great London hospital still standing on Cleveland Street, diagonally across from the vast field the institution used to fill, now sadly strewn with dust and broken bricks. This building has recently been the subject of a very public tussle: the owner intent on its replacement by a huge apartment block; locals and others (myself among them) equally determined to preserve it.