NEJM This Week — December 4, 2025

This week, we look at new trials on glucocorticoids for pneumonia in Africa, shunting for normal-pressure hydrocephalus, and pegcetacoplan for two rare kidney diseases. We review updated vaccine evidence for Covid-19, RSV, and influenza, and present a case of respiratory decline and muscle weakness. Perspectives explore health care incentives, U.S. global health strategy, and bringing AI-enabled care to rural America.