AI Insight
This Lancet Commission commentary calls for a reexamination of the relationship between political activism and public health, framing the current global moment as one defined by extreme wealth inequality and widespread human rights violations. The authors reference the concentration of wealth among a small number of individuals as a structural determinant of health, arguing that such imbalances translate into political power that undermines citizens' rights. The piece positions activist engagement not as peripheral to health science, but as a necessary component of addressing systemic drivers of poor health outcomes.
Why it matters
If health institutions and researchers formally integrate activism into their frameworks, this could shift how public health interventions are designed and who is considered a legitimate actor in shaping health policy. The commission signals a broader effort within major medical publishing to acknowledge political economy as a core public health concern.
The political thinker Antonio Gramsci (1891–1937) is often inaccurately attributed with the phrase “The old is not yet dead, and the new is waiting to be born; now is the time of monsters.”1 Regardless of its origins, the phrase resonates with the current moment—when monsters abound. The wealth owned by the poorest half of the world is less than that of just a dozen individuals, granting them de facto political power to shape our economies at the expense of citizens’ rights and freedoms.2 Human rights and international law are routinely violated, with five countries in active stages of genocide during 2025.
Source: [Comment] Imagining otherwise for better health: a Lancet Commission on activism and health