Sam Ali

Violent demonstrations gripped eastern Yemen's Hadhramaut governorate after thousands of angry residents demonstrated against the local government's total service collapse. Long power outages, water supply interruptions and overpriced fuel have pushed communities to the brink in a country already struggling from a decade of war. The dire situation has long plagued Yemen, as foreign interests in Riyadh and Abu Dhabi conspire with local factions to advance their interests—not local ones.

Studies must be adapted to fill the evidence gapsPregnant and breastfeeding women have long been systematically excluded from clinical trials. Physiological changes associated with pregnancy and breastfeeding modify pharmacokinetics, pharmacodynamics, and exposure pathways; trial exclusion therefore creates an evidence gap for safe and effective care. Guidelines recently adopted by the European Medicine Agency and the US Food and Drug Administration12 aim to provide a framework to support inclusion.Women are often willing to participate in clinical trials when properly informed. However, pregnant women were included in roughly 1.1% of trials submitted for regulatory approval between 2019 and 2023, and breastfeeding women in just 0.6%, with the rationale for exclusion often undocumented.3Pregnant women are excluded because of perceived risks to the fetus; ethical complexities (weighing benefits to mother against unknown risks to fetus); liability concerns; social expectations that may deny women autonomy to participate; and resource limitations that discourage investment and participation.456 Many trials impose blanket requirements that women of childbearing age use contraception, further discouraging participation. For instance, some trials mandate double barrier contraception methods in phase 1 trials—even for drugs with minimal systemic absorption—or require contraception use months beyond the …