Biotech & Longevity · Sunday, 20 September 2026
Fiji has declared HIV a national emergency. One adult in 60 now carries the virus, against one in 167 five years ago.
Fiji recorded 2,016 new HIV diagnoses in 2025, sixteen times its 2019 figure, and only 22% of the people who have the virus are getting the drugs that hold it down. The country is now writing a law so it can hand out clean needles for the first time.
1 in 60
Fijian adults now living with HIV
it was 1 in 167 five years ago
2,016
new HIV diagnoses in Fiji in 2025
sixteen times the number recorded in 2019
22% of 78%
Fijians with HIV who were on treatment, against the world average
only 39% of them even knew they had the virus
18
babies in Fiji who died before their first birthday with HIV
59 were born with the virus last year
The lead story — what happened
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Fiji has declared HIV a national emergency. About one adult in 60 now has the virus, against one in 167 five years ago.
[1] [2] -
The country recorded 2,016 new diagnoses in 2025, sixteen times the number recorded in 2019.
[1] [3] -
Of the 9,100 Fijians living with HIV last year, only 39% knew they had it and 22% were getting the drugs that hold the virus down.
[2] [3] -
Across the world, 78% of people with HIV are on that treatment.
[2] -
Fifty-nine babies were born with HIV in Fiji last year and 18 died before their first birthday.
[3] -
Health Minister Antonio Lalabalavu said an outbreak-level response is no longer sufficient.
[2] -
Fiji's government will set up a needle-and-syringe programme, which the country has never had, and change the law in parliament so it can run.
[2] [3] -
Among cases where the route is known, more than half were passed on through sex and over 42% through injecting drugs.
[3] -
Health workers describe bluetoothing, where people inject the blood of someone already high, so several share one hit and one syringe.
[2] -
Jason Mitchell, who leads Fiji's HIV taskforce, expects it to take more than five years to get on top of the epidemic.
[2] -
Fiji is a hub for business, tourism and transport in the South Pacific, and UNAIDS warns the rise could reach its neighbours.
[1]
Who is involved
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Antonio Lalabalavu
Fiji's health minister; he declared the emergency and said an outbreak-level response is no longer enough
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UNAIDS
the United Nations programme that tracks HIV across the world; it called Fiji's rise one of the sharpest anywhere
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Jason Mitchell
the man running Fiji's national HIV taskforce; he expects more than five years to bring the epidemic under control
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Winnie Byanyima
the head of UNAIDS; she said Fiji's epidemic is a reminder to the world that AIDS is not over
How it unfolded
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Five years ago about one Fijian adult in 167 is living with HIV
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2025 Fiji records 2,016 new diagnoses and 59 babies are born with the virus
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Tuesday Fiji's government declares HIV a national emergency
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Wednesday UNAIDS calls it one of the sharpest rises in new infections anywhere
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Next a needle-and-syringe programme, once parliament changes the law
Where this points
Watch whether Fiji's parliament passes the law that lets clean needles be handed out, and whether the share of infected Fijians who know they have the virus rises above 39%.
What is pushing on the whole day
The bar and the word are our reading of how hard each one is pushing today. The arrow is where it is heading. The evidence is in the stories below.
In Fiji only 39% of people with HIV knew they had it.
A San Francisco coroner wrote cychlorphine on a 16-year-old's autopsy, the only time it has appeared there.
Eli Lilly showed early data on brenipatide, a weight-loss-style drug it is now testing in alcohol use disorder and depression.
76% of Americans now call the measles shot safe for children, down from 84% in 2020.
The rest of the day
19 more stories on this beat.
Each with its own sources. None of these is a link to the story above.
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02
A rare Ebola relative keeps growing
Bundibugyo belongs to the same virus family as Ebola and causes the same severe bleeding illness.
[4] Before this year it had appeared in only two recognised outbreaks, in Uganda in 2007 and Congo in 2012.[4] By 11 June the current outbreak in Congo and Uganda had 695 confirmed cases and 138 confirmed deaths, the World Health Organization said.[4] A review published this week in the New England Journal of Medicine, by Nancy Sullivan of Boston University, says outbreak preparation must reach past the few diseases that get most attention.[4] Why it matters — Early symptoms look like malaria or typhoid, so confirming a case needs a laboratory, and laboratory access is thin across much of eastern Congo.
[4] This outbreak was formally recognised only after a nurse died.[4] -
03
A flesh-eating fly is back in Texas
The New World screwworm is a fly whose larvae feed on the living flesh of animals and, rarely, of people.
[5] A campaign in the 1950s and 1960s wiped it out of the United States and pushed its range south to Panama.[5] Before that it cost southwestern livestock producers an estimated 50 to 100 million dollars a year, and it has now reached Texas and New Mexico.[5] Researchers at the University of California San Diego and the county health department have built a dashboard estimating the risk for every US county.[5] Why it matters — Laboratory confirmation can take days or weeks, so the team fed news coverage into the dashboard to see the fly arrive before the official reporting system does.
[5] Only public health officials can use it for now.[5] -
04
Trust in the measles shot falls
A Reuters/Ipsos poll of Americans completed on Monday found 76% believe the combined measles, mumps and rubella vaccine is safe for children, down from 84% in a May 2020 poll by the same pair.
[10] The fall was sharpest among Republicans.[10] The United States has recorded more than 3,000 confirmed measles infections this year, its worst count in 35 years, with outbreaks in Pennsylvania, Utah and South Carolina.[10] Vaccination coverage among children starting school fell last year to 92.5%.[10] Say the measles shot is safe for children, May 202084%The same answer this week76%Share of Americans calling the measles, mumps and rubella vaccine safe for children, in two Reuters/Ipsos polls. Why it matters — Experts put the level needed to protect children who cannot be vaccinated at 95%, so coverage is now below it.
[10] Just 19% of Americans told the pollsters they approve of President Trump's handling of the outbreak.[10] -
05
The US health secretary addresses his old group
Robert F. Kennedy Jr., the United States health secretary, told a convention of Children's Health Defense on Thursday that they have a strong and steadfast friend in President Trump's White House.
[11] He founded the group, which campaigns against vaccines, and led it for years before taking the job.[11] He said he would die with his boots on pursuing answers about vaccine risks.[11] The speaker before him called the polio vaccine's success a fraud, and the speaker after him was Andrew Wakefield, whose retracted paper linked the measles vaccine to autism.[11] Why it matters — The speech came a day after Nicole Saphier, President Trump's nominee for surgeon general, defended the safety of vaccines at her Senate confirmation hearing.
[11] Two parts of the same administration are saying opposite things about the same shots.[11] -
06
Scotland's street drugs keep changing
Gareth Balmer of the charity With You told the BBC that the drugs now sold on Scottish streets are more dangerous than they have ever been, and that a grain of some of them is enough to kill.
[7] Police Scotland seized about 80 million pounds of street drugs in 2025 and has already seized 78 million pounds this year.[7] A laboratory at Dundee University, run by Professor Niamh Nic Daeid, has been expanded into a national drug testing centre.[7] Why it matters — Naloxone reverses an opioid overdose, and Balmer says getting hold of it matters more than ever.
[7] But nobody can give the right advice about a substance they have not yet identified, which is what the new centre is there to fix.[7] -
07
A drug no coroner had seen before
Dante Paul Lacourte was 16 when he died in his bedroom in San Francisco on 7 April.
[6] His mother, Christina Lacourte, forced the door open, found him and used the two doses of Narcan, the overdose antidote, that she kept in a kitchen drawer for exactly that moment.[6] They did not revive him.[6] She assumed fentanyl had killed him, but the autopsy named a drug she had never heard of, cychlorphine, and it is still the only time that word has appeared on a San Francisco coroner's report.[6] Why it matters — An antidote only works on the drug it was built for.
[6] A family that had stocked Narcan for a fentanyl overdose had nothing at all for what actually arrived.[6] -
08
A company aiming at drunkenness
Goa Therapeutics came out of stealth this week with GOA26, an engineered protein meant to clear alcohol out of the blood far faster than the body manages alone.
[13] Surgeons often cannot safely operate on badly injured patients who arrive drunk, and the company says up to half of severe trauma patients are intoxicated.[13] In anaesthetised pigs given the equivalent of a heavy binge, blood alcohol fell by an average of 61.3% within twenty minutes, against untreated animals.[13] Goa plans to apply to start human testing by the end of the year.[13] Why it matters — Everything so far is in rats and pigs, and most things that work in animals never work in people.
[13] Chief executive Andrew Altschuler's stated goal of a product sold in every bar sits several trials beyond a phase 1 study that has not started.[13] -
09
A weight-loss drug aimed at addiction
Eli Lilly presented phase 1 results at the Psych Congress meeting in New Orleans for brenipatide, a drug of the same family as its weight-loss injections Mounjaro and Zepbound.
[12] More than 200 healthy, overweight and obese volunteers were randomly given the drug or a dummy injection, at doses up to 4.5mg.[12] It stayed in the body far longer than those products, with a half-life of 9 to 12.5 days.[12] Lilly is already running late-stage trials of it in alcohol use disorder and in recurrent major depression.[12] Why it matters — A phase 1 trial only checks safety and how the body handles a drug.
[12] It cannot say whether brenipatide helps anyone drink less or feel less depressed, and the trials that could are still running.[12] -
10
Blood thinners and memory decline
Researchers at the Karolinska Institutet in Sweden studied 7,308 people who had both Alzheimer's disease and atrial fibrillation, an irregular heartbeat that raises the risk of stroke.
[14] They compared three matched groups: people on newer blood thinners called NOACs, people on the older drug warfarin, and people on no blood thinner at all.[14] Scores on a standard memory and thinking test fell more slowly in the NOAC group, by a little over 0.2 points a year.[14] The work is published in the European Heart Journal.[14] Why it matters — A fifth of a test point a year is small for any one patient, and the team say it could add up over many years.
[14] The study compared existing records rather than assigning treatment, so it can show the pattern but cannot prove the drug caused it.[14] -
11
Which germ you carry changes the risk
Streptococcus pneumoniae is a bacterium carried harmlessly in the nose and throat of about one adult in five worldwide, but it sometimes invades and causes meningitis, pneumonia or blood poisoning.
[8] Researchers examined roughly 59,000 invasive cases collected over 19 years by South Africa's national surveillance programme.[8] Three subtypes, numbered 14, 19A and 8, carried the highest risk after exposure to air pollution.[8] Risk generally peaked about two weeks after exposure, but where subtypes 4, 8, 23F and 19F were common it rose in the same week.[8] Why it matters — Sophie Belman, now at Yale School of Public Health, says the risk is not the same for every person or in every place, because the strain someone happens to be carrying changes the odds and the timing.
[8] Older adults and young children were most vulnerable when pollution was high.[8] -
12
Cells that survive their own death
Apoptosis is the body's controlled way of killing off cells that are old, damaged or no longer wanted, and it is carried out by enzymes called caspases.
[15] A team led by Tslil Braun in Eli Arama's laboratory at the Weizmann Institute of Science found cells that begin that process and then survive it.[15] Their descendants were far more resistant to later damage and helped rebuild tissue quickly.[15] The work, published in Nature Communications, repeats a 1970s experiment in which heavily irradiated fly larvae still grew fully working wings.[15] Why it matters — The same trick may be what lets some tumours come back after treatment in a more aggressive form.
[15] A mechanism that helps healthy tissue heal could be helping cancer cells survive the drugs meant to kill them.[15] -
13
Starving malaria inside the mosquito
Malaria parasites cannot make vitamin B5 and have to take it from whatever they are living in; inside a mosquito, that is the mosquito.
[16] Researchers tested two new compounds, PZ-3022 and PZ-3883, that cut how much of the vitamin is available in Anopheles stephensi, a mosquito that carries malaria in Asia and has recently spread in Africa.[16] Mosquitoes fed the compounds carried far fewer parasites in the gut and in the salivary glands, for two Plasmodium species.[16] Neither compound slowed the parasite growing in a dish.[16] Why it matters — Almost every malaria medicine treats the patient; a compound that works on the mosquito would stop the parasite being passed on instead.
[16] This is laboratory work in insects, and no person has taken either compound.[16] -
14
A scan beats the weight chart in sepsis
Body mass index cannot tell fat stored under the skin from fat packed around the organs.
[9] Researchers ran automatic analysis over abdominal CT scans from 1,107 adults treated for sepsis, the body's overwhelming reaction to an infection, at a single hospital.[9] Of those patients, 300 died within 28 days.[9] More fat under the skin went with a lower risk of dying, and a higher ratio of organ fat to skin fat went with a higher risk, after adjusting for other factors.[9] Why it matters — The two kinds of fat point in opposite directions, and a single BMI number averages them together.
[9] The authors say the finding needs checking at other hospitals before anyone relies on it.[9] -
15
The surgeon who counted the delays
Harold P. Freeman, a cancer surgeon who arrived at Harlem Hospital Center in New York in 1967, died on 11 August in Atlanta at 93.
[17] He found that his poor, often uninsured patients turned up only once their cancers were advanced, and built a programme that assigned someone to walk each patient through the hospital system.[17] That idea, called patient navigation, spread to hospitals around the world.[17] Since 2024 Medicare has paid for some navigation for cancer, heart failure and HIV.[17] Why it matters — Freeman wrote that he had imagined he could cut cancer out of Harlem, and learned the disease would not yield to a surgeon's knife.
[17] His patients were arriving late, not getting worse operations.[17] -
16
Most men have not heard of the dairy link
A survey of 1,102 men in the United States, run by Morning Consult for the Physicians Committee for Responsible Medicine, found that 20% knew of research linking milk and other dairy products to a higher risk of prostate cancer.
[18] The same share said a health professional had ever discussed nutrition and prostate cancer risk with them.[18] After being told about the link, 66% said they would be likely to avoid dairy.[18] Three in four supported warning labels on dairy products.[18] 2 of 10
men who knew of the dairy link
Two men in ten, out of 1,102 surveyed in the United States, knew that research has linked dairy to a higher risk of prostate cancer. Why it matters — The group that paid for the survey campaigns for plant-based diets, so it was asking about a link it already argues for.
[18] The studies behind that link record what men ate and what later happened, which cannot separate dairy from everything else in a diet.[18] -
17
Floods and power cuts together
Researchers matched hospital records in New York State from 2005 to 2021 against floods and power cuts.
[19] Each on its own went with more admissions for heart and blood-vessel illness, and the two together were worse than either alone, with a rate ratio reaching 1.09.[19] The risk rose once a flood lasted more than three days, or once a power cut covered more than 15.3% of an area.[19] Hospital stays were longer as well.[19] Why it matters — The effect was strongest for high blood pressure, stroke and reduced blood flow to the heart.
[19] It fell hardest on people over 65, rural residents, and those on Medicaid or with no insurance.[19] -
18
Bird flu tested against the body's alarm
Interferon is the alarm chemical a cell releases when a virus gets in, telling its neighbours to defend themselves.
[20] Researchers fitted three mathematical models to matched readings of virus levels and interferon in human nose and windpipe tissue infected with seasonal flu and with two versions of H5N1 bird flu, from 2005 and 2022.[20] The models disagreed about how interferon actually holds a virus back, and with only ten readings per condition the data could not pick between them.[20] The strains differed mainly in how fast interferon was cleared away.[20] Why it matters — H5N1 causes severe disease in people and is watched as a pandemic risk, so knowing which part of the body's first response slows it would matter.
[20] The authors say the measurements are too sparse to answer that yet.[20] -
19
A hedge fund builds its own drug firm
Two years ago Mohit Gupta, an analyst at the biotech hedge fund Adar1 Capital, walked into the Austin office of his boss Dan Schneeberger.
[21] He proposed building a company from scratch to make a longer-lasting antibody treatment for atopic dermatitis, the most common form of eczema.[21] Schneeberger's job is to invest in drug companies that already exist, not to start them.[21] The result, a company called North Immunology, was reported by STAT this week.[21] Why it matters — A fund that spends its days judging other people's drug programmes decided it could run one better itself.
[21] That is a different bet from the ones it usually makes, and it carries the development risk rather than trading around it.[21] -
20
An English hospital counts its own deaths
Rotherham NHS Foundation Trust in northern England told its board that deaths after emergency abdominal surgery at Rotherham Hospital were 168% above the national average in 2024/25.
[22] A national audit covered 104 of its patients between April 2024 and March 2025, and 14 of them died, about one in seven.[22] An emergency laparotomy means opening the abdomen to deal with something life-threatening, such as internal bleeding or a burst bowel.[22] The trust said it has changed how patients move through the hospital and added staff.[22] 1 of 7
died after emergency abdominal surgery
Of 104 Rotherham patients in the national audit, 14 died, which is about one in seven. Why it matters — Patients needing this operation are often already very ill and pass through several departments, and the trust said no single cause explained the figure.
[22] It said more recent numbers show the performance improving.[22]
Ready for the last outbreak, not this one
Fiji had clinics, tests and HIV drugs, but no clean-needle programme, because the virus had never spread that way there before.
The twist
Fiji already had HIV drugs that work. What it did not have was a supply of clean needles, and shared needles were carrying the virus from person to person.
The picture
How it works
- A disease spreads one way at first
- Clinics, tests and drugs get built for that way
- The disease starts spreading a second way
- Nobody has the tool the second way needs
- Cases climb while that tool is built
The same force, elsewhere today
Where this chain is also running, in today's other stories.
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The Ebola relative in Congo
Hospitals there test for malaria and typhoid, which is what Bundibugyo looks like, so the outbreak was recognised only after a nurse died
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The flesh-eating fly back in Texas
The United States wiped the parasite out in the 1950s and stopped watching for it, so officials had to build a new tracking dashboard this month to see where it goes next
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Scotland's new street drugs
Overdose services were built around heroin, and a university laboratory had to be turned into a testing centre because nobody knows what is in the new powders
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The San Francisco teenager
His mother kept two doses of Narcan in a kitchen drawer for a fentanyl overdose, and the drug that killed him was one the city's coroner had never named before
Where you've seen this
Flood defences
a river wall is built to the height of the worst flood on record, and the next flood sets a new record
Antivirus software
it blocks the harmful programs already catalogued, and a brand-new one walks straight through
Building rules
they are written after an earthquake, and only for the kind of shaking that one produced
The catch
Building for the last problem is not stupidity. It is the only thing anyone has evidence for, and preparing for every possible route would cost more than any health budget holds.
And the whole of it
Fiji's clinics, the doctors in Congo testing for malaria, and a mother with Narcan in her kitchen drawer had each got ready for the thing that happened before. Most of us do the same, and we usually find out what we were missing only after it arrives.
What is really going on
Fiji has HIV tests and HIV drugs, and one adult in 60 is now infected, because the country never had a legal way to hand out clean needles and is only creating one now.
Why it works on us — Calling something a national emergency sounds like the start of a response, and it is also the moment a government says its normal services were not enough, which is what Fiji's health minister said in plain words.
Who gains
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Fijians who inject drugs
— The declaration commits Fiji's government to a needle-and-syringe programme and to free, voluntary, confidential testing, neither of which existed at this scale before.
[2] [3] -
Eli Lilly
— Brenipatide stayed in volunteers for 9 to 12 days, which lets the company argue a weekly injection is enough for addiction and depression trials.
[12] -
Adar1 Capital
— The hedge fund now owns a piece of a drug company it built itself, instead of only holding shares in ones other people built.
[21] -
The Physicians Committee for Responsible Medicine
— It paid for a survey whose finding, that most men have not heard of the dairy link, is an argument for the plant-based campaign it already runs.
[18] -
Goa Therapeutics
— It released its pig data at a trauma surgery meeting on the same day it launched, which is the audience for its first intended use.
[13]
Who pays
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Babies born to mothers with HIV in Fiji
— Fifty-nine were born with the virus last year and 18 of them died before their first birthday.
[3] -
Fiji's hospitals
— Jason Mitchell, who runs the national taskforce, says people who could be well on treatment are instead filling beds and outpatient clinics.
[2] -
American children too young or too ill to be vaccinated
— Coverage among children starting school fell to 92.5%, below the 95% that protects those who cannot have the shot themselves.
[10] -
Health workers and families in eastern Congo
— Bundibugyo passes through contact with body fluids, so carers are exposed first, and this outbreak was formally recognised after a nurse died.
[4] -
People over 65 and rural residents in New York State
— Floods and power cuts together raised heart-related hospital admissions most in those groups, and among people on Medicaid or with no insurance.
[19] -
Livestock farmers in Texas and New Mexico
— The screwworm has reached both states, and before it was eradicated it cost southwestern US producers an estimated 50 to 100 million dollars a year.
[5]
What nobody knows yet
Open questions from across today’s stories — ours included.
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01
How many people in Fiji have HIV and do not know it.
UNAIDS estimates 9,100 people were living with the virus last year and that 39% knew their status, so the missing number is an estimate resting on an estimate.
[2] [3] -
02
How much of Fiji's rise is more infection and how much is better counting.
The authorities say expanded testing uncovered infections that already existed, which would make part of the jump a measuring change; nobody has separated the two.
[3] -
03
Whether Fiji's needle-and-syringe programme will actually run.
The health ministry says supplies are in the country, but parliament has to change the law first and no date has been set.
[2] -
04
How large the Bundibugyo outbreak is now.
The most recent confirmed count in this week's review is from 11 June: 695 cases and 138 deaths in Congo and Uganda.
[4] -
05
What cychlorphine is and how it reached San Francisco.
It has appeared on exactly one coroner's report in the city and nowhere else, so there is no pattern to read from yet.
[6] -
06
Whether newer blood thinners really slow Alzheimer's.
The Karolinska team compared existing patient records rather than assigning treatment, so something other than the drug could explain a gap of 0.2 test points a year.
[14] -
07
Why deaths after emergency abdominal surgery at Rotherham Hospital were 168% above the national average.
The trust told its board that several factors could affect the result and did not name one.
[22] -
08
Whether GOA26 does anything in a person.
The only results are in rats and in anaesthetised pigs, and the company has not yet applied for permission to test it in humans.
[13] -
09
How much of the fall in US vaccine confidence is about measles specifically.
The Reuters/Ipsos poll asked about the measles, mumps and rubella shot and about childhood vaccines generally, and reported the sharpest drop among Republicans without separating the two questions.
[10]
Harold Freeman arrived at Harlem Hospital Center in New York in 1967 and found his poor patients turning up only once their cancers had grown too far, so he built a programme that assigned someone to walk each patient through the hospital system. He died last month at 93, and Medicare now pays for that job for people with cancer, heart failure and HIV.
Also true today
- Fiji's health authorities said wider testing is what turned up many of last year's 2,016 diagnoses, which means those people can start treatment. Fiji's government is setting up free, voluntary and confidential testing across the country.
- Among 7,308 Swedish patients who had both Alzheimer's disease and an irregular heartbeat, those taking newer blood thinners had lower risks of death, stroke, blood clots and fractures than those taking none.
- Mosquitoes fed two new compounds carried far fewer malaria parasites in their guts and their salivary glands, for both parasite species tested.
- A laboratory at Dundee University has been expanded into a national drug testing and research centre for Scotland, so that what is actually in a street drug can be reported back in close to real time.
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