THE LANCET :We grieve for Xulhaz Mannan, a gay rights activist and editor, and his friend Mahbub Rabbi Tonoy, who were viciously killed last week in Dhaka. Alarmingly, this brings to five the number of writers, activists, or intellectuals murdered in Bangladesh in April alone, and to ten in 2016. The common denominator is that of expression of views perceived to be anti-Islamic by extremists, although worryingly the targets seem to be widening to anyone with a progressive or liberal view. The brutality of the killings is matched in tragedy by the impunity with which the crimes are carried out. Not a single person has been held to account, says Amnesty International, and the Bangladesh authorities insist the security situation is normal. The impunity follows a pattern of shameful indifference. The governmental response following 2015’s rash of murders of secular writers was to advise bloggers to “use restraint in their exercise of free speech”. Last week, the Prime Minister again blamed the victims saying her government will not take responsibility for “untoward incidents” against people who express objectionable opinions, reported The Economist. In 2013, The Lancet’s Series on Bangladesh celebrated the country’s secularism and pluralism as drivers of its remarkable global health development. Now it is hard to deny that some views are being marginalised, threatened, and extinguished.But a country that cannot ensure free expression cannot fulfil its promise of progress. And freedom of expression-a basic human right-is inseparably linked to health. A lack of freedom of expression can literally kill you, as the Bangladesh situation shows. Whether religious, cultural, sexual, artistic, or journalistic, freedom of expression is fundamental to the ability to discuss and debate current predicaments and the future vision of societies-how people wish to live and prosper, of which health and wellbeing are central components. Anything that restricts the freedom of expression restricts health and development. That a country so distinguished for its development success seems to be dangerously sliding backward is distressing. We mourn the precious lives of those brutally killed for expressing their views, but also the wound this leaves on Bangladeshi society.