Richard Horton (editor)

A few days after the worldwide mobilisation promoted by the activist movement Extinction Rebellion, Horton asserted in a video that health professionals should involve themselves directly.[15]

On 28 February 1998 Horton published a controversial paper by Andrew Wakefield and 12 co-authors with the title "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" suggesting that vaccines could cause autism. The publication of the paper set off a sharp decline in vaccinations in Europe and America and in subsequent years globally.[16] In the United Kingdom, the Health Protection Agency attributed a large measles outbreak in 2008 and 2009 to a concurrent drop in the number of children receiving the MMR vaccine. Pockets of measles – which can be fatal —have also cropped up in Canada and the United States as a result of parents' refusal to vaccinate.[17]

Horton was heavily criticised for refusing to take action for so long. He was finally forced to retract the paper in February 2010 after the General Medical Council (GMC), which oversees doctors in Britain, said that "there was a biased selection of patients in The Lancet paper" and that Wakefield's "conduct in this regard was dishonest and irresponsible".[18] According to reporter Brian Deer, who exposed Wakefield's paper as fraudulent, Horton opposed the GMC's investigation that led to the retraction, arguing:

My own view is that the GMC is no place to continue this debate. But the process has started and it will be impossible to stop.[19]

Horton defended his position by saying "I do not regret publishing the original Wakefield paper. Progress in medicine depends on the free expression of new ideas. I worked at the Royal Free from 1988 to 1990 and met him on many occasions. He is a committed, engaging, and charismatic clinician and scientist. He asks big questions about diseases - what are their ultimate causes? - and his ambition often brings quick and impressive results."[20] However, there are groups criticising Horton for contributing to the ongoing dramatic drop of vaccination of children in Europe and America that causes several epidemics and deaths by delaying the retraction of the paper for 12 years.[21] The process for retractions could take several years at the time.[22][23][24]

In the 11 May 2005 The Lancet, Horton criticized the British scientific group, the Royal Society, under Lord Rees for its neglect of medicine.[25]

Horton published an article in 2005 supporting Professor Sir Roy Meadow who had been charged with serious professional misconduct by the GMC for giving erroneous and seriously misleading evidence in the Sally Clark trial. This was especially controversial as the article appeared whilst the GMC proceedings were still under away and was published on the first day of Meadow's defence. The article "incensed" Clark, a solicitor who had been the victim of a serious miscarriage of justice. With the support of erroneous statistical (and other) evidence from Meadow the prosecution wrongly convicted her of murder and she spent over three years in prison before her successful second appeal.[26][27]

Her husband wrote a rebuttal letter to The Lancet in order to correct Horton's 'many inaccuracies and one-sided opinions' and to prevent them prejudicing independent observers. James Le Fanu, medical practitioner and writer, also wrote to The Lancet in the same issue and described Horton's words as 'mischief'.[28] The Clark family issued a statement addressing and countering with established fact each of the points making up Horton's biased support of Meadow.[29]

At the Time to Go Demo of 23 September 2006, Horton accused American president George W. Bush and British prime minister Tony Blair of lies and killing children in Iraq. On 11 October, The Lancet published new estimates of the death toll of Iraqi citizens after the US-led invasion in 2003, putting it at a total of 655,000. Some supporters of the invasion of Iraq dismissed it for what they claimed was flawed methodology.[30][31][32] Some opponents of the invasion questioned its reliability due to its extreme divergence from other data on the conflict.[33] Some journals and statistical experts were supportive. Other experts in the field were not convinced, saying the estimates were "high, and probably way too high",[34] and that the authors had published a "misinterpretation of their own figures".[35] Others were incredulous that the survey could have been performed as reported under such dangerous conditions.[36][37]

Iraq's health minister estimated during a press conference in November 2006 that between 100,000 and 150,000 people had died since the invasion in 2003, based on an estimate of around 100 deaths per day brought to morgues and hospitals during 2006,[38] while saying that the Lancet estimates were an "exaggerated number".[39]

In August 2014 The Lancet published an open letter for the people of Gaza, criticising Israel in the wake of the 2014 Gaza conflict.[40]

Horton responded to criticism of the letter by saying that it was "a smear campaign" and that he didn't "honestly see what all this has to do with the Gaza letter. I have no plans to retract the letter, and I would not retract the letter even if it was found to be substantiated".[41] However, Horton subsequently came to Israel's Rambam Hospital for a visit and said that he "deeply, deeply regret[ted] the completely unnecessary polarization that publication of the letter by Paola Manduca caused".[41][42][43]

Professor Sir Mark Pepys wrote: "The failure of the Manduca et al authors to disclose their extraordinary conflicts of interest… are the most serious, unprofessional and unethical errors. The transparent effort to conceal this vicious and substantially mendacious partisan political diatribe as an innocent humanitarian appeal has no place in any serious publication, let alone a professional medical journal, and would disgrace even the lowest of the gutter press." In addition, Pepys accused Horton personally saying that "Horton’s behavior in this case is consistent with his longstanding and wholly inappropriate use of The Lancet as a vehicle for his own extreme political views. It has greatly detracted from the former high standing of the journal." In response, Horton said: "How can you separate politics and health? The two go hand-in-hand."[44]

Horton's initial response to the outbreak of Coronavirus was cautious, telling his Twitter followers on 23 January 2020 that COVID-19 probably "has moderate transmissibility and relatively low pathogenicity." But, as evidence came in from China, on 29 January, he said: "It must now surely be time to declare a Public Health Emergency of International Concern." And, on 31 January, he tweeted about "draconian measures that limit population mobility."[45][46]

By 7 March, Horton's was calling on the UK Government to "act more decisively. They must abandon their fears of the negative short-term public and economic consequences that may follow from restricting public freedoms." And, on 10 March, he called for the "urgent implementation of social distancing and closure policies."[47]

On 18 March, Horton strongly criticised the Government's initial plans "to allow a controlled epidemic", saying: "Any numerate school student could make the calculation. With a mortality of 1% among 60% of a population of some 66 million people, the UK could expect almost 400,000 deaths."[48]

Then on 26 March, he said: "We knew in the last week of January that this was coming. The message from China was absolutely clear that a new virus with pandemic potential was hitting cities. ... We knew that eleven weeks ago and then we wasted February when we could have acted." And, on 28 March, Horton's Lancet editorial stated that, having seen January's reports from China, the authorities "had a duty to immediately put the NHS and British public on high alert."[49]

On 29 March, the NHS Coronavirus director, Keith Willett, responded to Horton saying that the NHS had "declared a Level Four - the highest - National Emergency on 30 January". (This declaration, however, was not publicised until 3 March so it is unclear if Willett intended this as a response to Horton's Lancet editorial.)[50]

On 1 May, Horton was interviewed for the Chinese news program Xinwen Lianbo and praised the 'innovation' of the Chinese response (as compared to the past).[51]

By 16 May, an editorial explained that the U.S. Centers for Disease Control and Prevention had been weakened since the 1980s and needs rebuilding. It included a call for a U.S. president in 2021 who values public health over partisan politics.[52]

• Health Wars: On the Global Front Lines of Modern Medicine. A New York Review Collection.
• The COVID-19 Catastrophe: What's Gone Wrong and How To Stop It Happening Again. June 2020. ISBN 9781509549108.

• Horton, Richard (1996). "Surgical research or comic opera: Questions, but few answers". The Lancet. 347 (9007): 984–985. doi:10.1016/S0140-6736(96)90137-3. PMID 8606606. S2CID 34370179. (Joint author)
• Begg, C. (1996). "Improving the quality of reporting of randomized controlled trials. The CONSORT statement". Journal of the American Medical Association. 276 (8): 637–639. doi:10.1001/jama.276.8.637. PMID 8773637. (Joint author)
• Beaglehole, Robert; Bonita, Ruth; Horton, Richard; Adams, Cary; Alleyne, George; Asaria, Perviz; Baugh, Vanessa; Bekedam, Henk; Billo, Nils; Casswell, Sally; Cecchini, Michele; Colagiuri, Ruth; Colagiuri, Stephen; Collins, Tea; Ebrahim, Shah; Engelgau, Michael; Galea, Gauden; Gaziano, Thomas; Geneau, Robert; Haines, Andy; Hospedales, James; Jha, Prabhat; Keeling, Ann; Leeder, Stephen; Lincoln, Paul; McKee, Martin; MacKay, Judith; Magnusson, Roger; Moodie, Rob; et al. (2011). "Priority actions for the non-communicable disease crisis". The Lancet. 377 (9775): 1438–47. doi:10.1016/S0140-6736(11)60393-0. PMID 21474174. S2CID 390617. (Joint author)
• Davidoff, Frank (2001). "Sponsorship, Authorship, and Accountability". Journal of the American Medical Association. 286 (10): 1232–4. doi:10.1001/jama.286.10.1232. PMID 11559271. (Joint author)
• De Angelis, Catherine; Drazen, Jeffrey M.; Frizelle, Frank A.; Haug, Charlotte; Hoey, John; Horton, Richard; Kotzin, Sheldon; Laine, Christine; Marusic, Ana; Overbeke, A. John P.M.; Schroeder, Torben V.; Sox, Hal C.; Weyden, Martin B. Van Der (2004). "Clinical Trial Registration: A Statement from the International Committee of Medical Journal Editors". New England Journal of Medicine. 351 (12): 1250–1. doi:10.1056/NEJMe048225. PMID 15356289. (Joint author)
• Horton, Richard (2014). "Offline: The moribund body of medical history". The Lancet. 384 (9940): 292. doi:10.1016/S0140-6736(14)61050-3. S2CID 54248096.
• Manduca, Paola; Chalmers, Iain; Summerfield, Derek; Gilbert, Mads; Ang, Swee (2014). "An open letter for the people in Gaza". The Lancet. 384 (9941): 397–398. doi:10.1016/S0140-6736(14)61044-8. PMID 25064592. S2CID 4672171. (Joint author)

• "Doctors in society: medical professionalism in a changing world". Royal College of Physicians. Report of a Working Party of the Royal College of Physicians of London. London: RCP, 2005.
• "Innovating for health: patients, physicians, the pharmaceutical industry and the NHS". Royal College of Physicians. Report of a Working Party of the Royal College of Physicians of London. London: RCP, 2009.