FDA approves Bayer's Sunharbo, the first factor XIa blood thinner, to prevent a second stroke

The stories

20 on this beat today.

Every story told the same way: what happened, who is involved, why it matters, how it works, the truth and the good news.

1. 01

   FDA approves Bayer's Sunharbo, the first factor XIa blood thinner, to prevent a second stroke

   26%

   lower risk of a second stroke for people on Sunharbo

   in a trial of 12,327 adults who had just had a stroke [1]

   53

   people who must take it for a year to prevent one stroke

   8.4% on a dummy pill had another stroke, against 6.2% on Sunharbo [2]

   72 hours

   after a stroke, the latest anyone in the trial started the drug

   both groups also took the usual anti-clotting pills [1]

   What happened

   • The FDA, the US drug regulator, approved Sunharbo, a new blood thinner made by Bayer, on Monday. [1]
   • It is for adults who have just had a mild or moderate stroke caused by a clot. [1] Its job is to prevent a second stroke. [1]
   • In a trial of 12,327 adults, Sunharbo cut the risk of another stroke by 26%. [1]
   • The trial, called OCEANIC-STROKE, gave each person Sunharbo or a dummy pill within 72 hours of their stroke. [1]
   • Both groups also took the usual anti-clotting pills given after a stroke. [1] Half of them stayed on treatment for more than 14.2 months. [1]
   • In the trial, 8.4% of the dummy-pill group had another stroke, against 6.2% of those on Sunharbo. [2]
   • Put another way, 53 people must take it for a year to prevent one stroke. [2]
   • Many blood thinners are not given after this kind of stroke, because they raise the risk of bleeding. [2]
   • In the trial, serious bleeding was about as common on Sunharbo as on the dummy pill. [1]
   • But it was more common in people over 75, and in the first 90 days of treatment. [1]
   • Bleeding in the gut was more common on Sunharbo too. [1] Its most common side effect was diarrhoea. [1]
   • It is only for strokes from clots that did not start in the heart. [1]
   • The FDA does not recommend it for people with moderate or severe liver disease. [1]
   • The FDA gave it Priority Review, which puts a drug ahead in the queue for checking. [1]
   • Bloomberg says the approval helps Bayer's medicines business as some of its biggest drugs face cheaper copies. [3]

   Who is involved

   • The FDA the US drug regulator; it approved Sunharbo on Monday after giving it Priority Review
   • Bayer the German company that makes Sunharbo; the approval helps its medicines business as older drugs face cheaper copies
   • Hylton Joffe a senior FDA drug official; he said stroke survivors are at risk of another stroke

   Why it matters

   "Survivors are at risk of having another stroke," said Hylton Joffe, an FDA drug official. [1]

   Sunharbo is the first of a new kind of blood thinner that may prevent clots more safely. [2]

   How it works

   Haematologists, the doctors of the blood, call clotting a cascade: a chain of proteins, each switching on the next.

   Sunharbo blocks one link in that chain, a protein called factor XIa. [2] Blocking it is thought to stop bad clots without raising bleeding. [2]

   Seen it before

   A school can lock the back gate where trouble gets in and still keep the front gate open for pupils.

   The truth

   • What is really going on On Monday the FDA approved Bayer's Sunharbo on one trial of 12,327 stroke patients, in which 53 people had to take it for a year to spare one stroke. [1][2]
   • Why it works on people A cut of 26% sounds larger than 53 people taking a pill for a year so that one of them avoids a stroke, though both describe the same result.
   • The approval rests on one large trial against a dummy pill, OCEANIC-STROKE. [1]
   • Who gains Bayer — A newly approved drug adds sales to its medicines business while some of its biggest drugs face cheaper copies. [3]
   • Who pays Stroke patients over 75 on Sunharbo — In the trial, Sunharbo raised their risk of serious bleeding, though overall bleeding was no higher. [1]
   • Nobody knows yet

     How much extra bleeding Sunharbo causes in people over 75.

     The FDA notice says bleeding was higher in that group and in the first 90 days, but gives no figure for it. [1]

   Good news

   • A new kind of blood thinner cut second strokes by 26% without more serious bleeding overall. [1]

1. 02

   Eye warning for all GLP-1 drugs

   What happened

   • The FDA told the makers of every GLP-1 drug on Monday to add a warning about a rare eye condition. [4]
   • GLP-1 drugs include Ozempic, Wegovy, Mounjaro and Zepbound, used for type 2 diabetes and weight loss. [5]
   • The condition, NAION, happens when too little blood reaches the optic nerve, which carries sight from the eye. [6]
   • It can cause sudden, painless loss of sight in one eye, sometimes for good. [4]
   • In 126 trials, people on GLP-1 drugs had 6.4 cases a year per 100,000. [4] People on a dummy pill or other diabetes drugs had 3.8. [4]

   How it unfolded

   Last year the EU medicines agency called NAION a very rare semaglutide side effect, in up to 1 in 10,000. [5]

   Why it matters

   The warning covers a class of medicines that has become central to treating obesity and type 2 diabetes. [5]

   How it works

   Drug safety scientists call this pharmacovigilance: watching for harm after a medicine goes on sale.

   Each trial saw too few NAION cases to judge, so the FDA pooled 126 trials with 134,253 patients. [4]

   Seen it before

   One quiz cannot show who is best at maths, but a whole term of quizzes can.

   Why illnesses that share a cause can share a medicine

   Pathophysiology is the study of how illness works: when several illnesses grow from one cause, a drug that lowers that cause can ease them all.

   The twist

   Extra body fat helps cause sleep apnea, heart disease and fatty liver disease. So a drug that lowers body fat can ease all three, and each one still needs its own trial.

   The picture

   Foundayo43.8%

   Dummy pill6.3%

   Step by step

   1. 1 Extra body fat drives several illnesses at once
   2. 2 A drug lowers that one shared cause
   3. 3 Each illness that grows from it can ease
   4. 4 But each illness still needs its own trial
   5. 5 So one drug is tested again and again

   The same force, elsewhere today

   Where this chain is also running, in today's other stories.

   • A weight-loss pill eases sleep apnea

     Foundayo was made for obesity, and Lilly tested it next on sleep apnea, which extra weight helps cause.

   • Weight shot passes a heart safety test

     Boehringer is seeking approval of survodutide for weight loss and for fatty liver disease, two illnesses with one root.

   • Australia approves the Wegovy pill

     The same pill is approved for weight loss and to cut the risk of heart attack and stroke.

   • Eye warning for all GLP-1 drugs

     The shared causes run the other way too: diabetes and sleep apnea raise the eye risk, so the FDA struggled to tell the drug's harm from the illness.

   Where you've seen this

   Stopping smoking

   one change lowers the risk of lung cancer, heart disease and stroke together

   Blood pressure pills

   lowering one number cuts strokes, heart failure and kidney damage

   Fixing a leaking roof

   the damp, the mould and the peeling paint all stop at once

   The catch

   A shared cause is only part of each illness. Weight loss eased sleep apnea, but Foundayo still cut breathing stops by less than half.

   And the whole of it

   A person taking one of these drugs may have sleep apnea, high blood pressure and a fatty liver at once, each counted in a different trial. No one trial, and no one doctor, sees the whole person.

   The truth

   • What is really going on The same day it put an eye warning on every GLP-1 drug, because pooling 126 trials showed 6.4 cases a year per 100,000 users against 3.8. [4]
   • The FDA found no way, in animal studies, that the drugs could cause NAION. [4]
   • Many people on these drugs already have NAION's risk factors, such as diabetes, high blood pressure and sleep apnea. [4]
   • Nobody knows yet

     Whether GLP-1 drugs cause NAION, or the illnesses their users already have do.

     The FDA found no way in animal studies that the drugs could cause it, and its risk factors overlap with the illnesses the drugs treat. [4]

   • Nobody knows yet

     How large the eye risk is in real patients.

     In the FDA's study of US health records, GLP-1 drugs carried no clear extra risk against one class of diabetes drugs, but a higher risk against another. [4]

1. 03

   A weight-loss pill eases sleep apnea

   What happened

   • Eli Lilly said on Monday its weight-loss pill Foundayo eased sleep apnea in two year-long trials. [7]
   • In sleep apnea, the airway keeps collapsing during sleep, so breathing stops and oxygen falls. [7]
   • Without a breathing machine, Foundayo cut breathing stops by 43.8%, against 6.3% on a dummy pill. [7]
   • With a breathing machine as well, the cut was 27.5%. [7]
   • People on Foundayo lost about 28 pounds over the year. [8]
   • Without a machine, 12.2% stopped Foundayo over side effects, against 3.8% on the dummy pill. [7]

   Who is involved

   Foundayo is a GLP-1 drug, which copies a gut hormone that helps control appetite. [4] The FDA approved it for obesity in April. [8]

   How it unfolded

   1. April approved for obesity
   2. End of 2026 sleep apnea filing

   Why it matters

   Up to 936 million adults may have sleep apnea, and most have never been diagnosed. [8]

   Its drops in oxygen strain the heart and blood pressure over time, a study author said. [8]

   How it works

   Foundayo was made for obesity, and Lilly tested it next on sleep apnea, which extra weight helps cause.

   The idea, in story 02: Why illnesses that share a cause can share a medicine →

   The truth

   • Both experts quoted on the results by Scientific American have worked as consultants for Lilly. [8]
   • Who gains Eli Lilly — A sleep apnea approval would let doctors prescribe Foundayo for a second illness, and Lilly plans to apply by the end of 2026. [8]

   What comes next

   Lilly plans to ask the FDA to approve Foundayo for sleep apnea by the end of 2026. [8]

2. 04

   Weight shot passes a heart safety test

   What happened

   • Boehringer Ingelheim, a German drugmaker, said its weight-loss shot survodutide did not raise heart risks in a large trial. [9]
   • The trial, Synchronize-CVOT, followed 5,530 overweight adults with heart disease, kidney disease or risk factors for 72 weeks. [9]
   • Results were given on Monday at the American Heart Association's meeting in Chicago. [9]
   • People on survodutide lost up to 13.7% of their weight, against 2% on a dummy. [9]
   • On the 2 doses, 19.3% and 20.8% of people quit because of stomach side effects. [9] On the dummy, 1.9% did. [9]
   • Boehringer wants approval for weight loss and for MASH, a fatty liver disease. [9]

   How it unfolded

   1. Monday heart trial results
   2. 2027 approval filing planned

   Why it matters

   Survodutide would join a crowded market, where Lilly's Zepbound reported 15% weight loss over the same time. [9]

   How it works

   Doctors call this a heart safety trial: one built to show a drug adds no heart harm. [9]

   Boehringer agreed to run it for health regulators, before it knew the drug could also lower blood sugar. [9]

   Seen it before

   A new climbing frame is load-tested before the playground opens, even when nobody expects it to break.

   Boehringer is seeking approval of survodutide for weight loss and for fatty liver disease, two illnesses with one root.

   The idea, in story 02: Why illnesses that share a cause can share a medicine →

   The truth

   • Who pays People who need survodutide to lose weight — In the trial, far more of them quit the drug over stomach side effects than quit the dummy. [9]
   • Nobody knows yet

     Whether survodutide's stomach side effects can be brought down.

     Boehringer expects letting doctors adjust doses in later trials to help, but no trial has shown it yet. [9]

   What comes next

   Boehringer plans to ask regulators to approve it for weight loss in 2027. [9]

3. 05

   Immune therapy helps stiff person syndrome

   What happened

   • Doctors at the Mayo Clinic in the US reported big gains in stiff person syndrome patients given CAR-T therapy. [10]
   • Stiff person syndrome is a rare disease of the nervous system that causes rigid muscles and painful spasms. [10]
   • "I can go to work every single day," said Jonathan Walden, who needed family help to walk before. [10]
   • The results were published in the journal JAMA Neurology. [10]

   Who is involved

   It is an autoimmune disease, where the body's own defences attack it, and it has no cure. [10] The singer Celine Dion has it. [10]

   • Celine Dion the singer, who has it

   Why it matters

   CAR-T was built for blood cancers, and this adds evidence it can work beyond them, a blood cancer charity said. [10]

   How it works

   Doctors call CAR-T a kind of immunotherapy: a treatment that turns the body's own immune system on a disease. [10]

   In CAR-T, a patient's own immune cells are taken out and changed to wipe out the cells causing disease. [10]

   The truth

   • The report gives no patient count, and Anastasia Zekeridou, a Mayo neurologist, called the results early. [10] The key question is whether the gains last, she said. [10]
   • Nobody knows yet

     Whether the gains in stiff person syndrome last.

     The Mayo doctors called the results early, and the report gives no patient count. [10]

   Good news

   • Jonathan Walden needed his family's help to walk before CAR-T treatment for stiff person syndrome, and now goes to work every day.
4. 06

   Malawi cuts new HIV infections by 76%

   What happened

   • Malawi's National AIDS Commission said new HIV infections fell by 76% between 2010 and 2025. [11]
   • New infections fell from 60,000 a year to 14,000. [11]
   • The share of babies infected by their mothers fell from 40% to 6%. [11]
   • Officials put the fall down to years of prevention, testing and treatment. [11]

   Why it matters

   Malawi now aims to get new infections down to 6,000 a year by 2030. [11]

   Thousands of new infections a year still make the 2030 goal hard, officials say. [11]

   The truth

   • The figures come from Malawi's own AIDS commission, shown to journalists in Lilongwe, the capital. [11]

   Good news

   • AIDS deaths in Malawi fell from 36,000 to 13,000. [11]
5. 07

   Russia finds HIV spreading in 27 regions

   What happened

   • In 27 Russian regions, HIV has spread from high-risk groups into the general population, a state research institute said. [12]
   • Russia found 45,000 new HIV cases in 2025, 13.4% fewer than in 2024. [12]
   • But HIV and hepatitis infections caught inside clinics hit their highest level in 15 years. [12]
   • Experts blame staff reusing single-use tools, such as catheters, on several patients. [12]
   • At one health resort in Kabardino-Balkaria, 82 patients caught hepatitis C, 6 of them HIV as well. [12]

   Why it matters

   Only half of people with HIV in Russia had the virus under control by the end of 2025. [12]

   That leaves at least 600,000 people who can still pass the virus on, an expert said. [12]

   How it works

   Scientists call this a generalised epidemic. [12] In those regions, more than 1% of pregnant women test positive. [12]

   The truth

   • Two state bodies count differently: 1.23 million confirmed cases, against 846,500 people under medical care. [12]
   • Who pays Patients in Russian clinics — They catch HIV and hepatitis when staff reuse single-use tools on several patients. [12]
   • Nobody knows yet

     How many people in Russia have HIV.

     One state body counts 1.23 million confirmed cases, while Russia's health ministry has 846,500 people under care. [12]

6. 08

   Ebola contracts go to a spa firm's arm

   What happened

   • The Trump administration gave a small company nearly $40 million to screen for Ebola and other diseases, ProPublica reported. [13]
   • One contract screens travellers at US airports, and the other responds to outbreaks in Congo. [13]
   • The company, XpresTest, had never worked with Ebola or done this work abroad. [13]

   Who is involved

   Its parent firm, XWELL, made most of its money last year from airport spas and waxing salons. [13]

   A fund linked to Donald Trump Jr and Eric Trump invested in XWELL in February. [13]

   • Donald Trump Jr the president's son
   • Eric Trump the president's son

   How it unfolded

   Ebola has killed more than 5,000 people in Congo this year. [13]

   Why it matters

   The two contracts are worth 7 times all the US government work the company had won directly before. [13]

   The truth

   • "I'm not sure we can do it," said Ezra Ernst, chief executive of the parent firm. [13]
   • The sons' spokesperson said they are passive investors with no part in the contracts. [13] The State Department said the bidding was competitive. [13]
   • Who gains XWELL, owner of XpresTest — Its two new contracts are worth 7 times all the US government work it had won directly before. [13]
   • Who pays People in Congo's Ebola outbreak — US-funded outbreak work there went to a firm with no experience abroad. [13]
   • Nobody knows yet

     Whether XpresTest can do the Congo outbreak work.

     Its parent's chief executive said he is not sure it can, and the CDC did not answer ProPublica's questions. [13]

7. 09

   Shigella vaccine cuts infections in a trial

   What happened

   • Valneva, a French vaccine maker, said its Shigella vaccine cut infections in a mid-stage trial on Monday. [14]
   • Shigella bacteria cause shigellosis, the second biggest cause of deadly diarrhoea in the world. [14] There is no approved vaccine against it. [14]
   • In the US trial, 120 healthy adults got the vaccine or a dummy, then were given the bacteria on purpose. [14]
   • A second trial in Kenya tested it in 110 babies aged 9 months, and found no safety worries. [14]

   How it unfolded

   GSK handed the vaccine back in 2023, and Valneva bought the rights for 10 million euros in 2024. [14]

   1. 2023 GSK hands it back
   2. 2024 Valneva buys it

   Why it matters

   The full results will decide whether Valneva takes the first Shigella vaccine further, the company said. [14]

   The truth

   • Valneva has not yet published the numbers behind its claim. [14]
   • Nobody knows yet

     How well Valneva's Shigella vaccine works.

     The company says it met its main goal but has not published the numbers. [14]

8. 10

   WuXi AppTec off the US military list

   What happened

   • The US defence department took WuXi AppTec off its list of Chinese military companies. [15]
   • It did so to follow a court ruling from August, a public notice says. [15]

   Who is involved

   WuXi AppTec is a Chinese company that drugmakers pay to develop and make their medicines. [15]

   How it unfolded

   The US government put it on the list in June, over worries about its ties to China's military. [15]

   In August, a US judge blocked the listing after WuXi sued. [15]

   1. June put on the list
   2. August a judge blocks it

   Why it matters

   The listing reflected US worries that Chinese competitors threaten its lead in biotech. [15]

   How it works

   US lawyers call a decision made without a proper reason arbitrary and capricious, under the Administrative Procedure Act. [15]

   WuXi argued the US government had no proper reason for listing it, and a judge paused the listing. [15]

   Seen it before

   A referee's call can be overturned on video review if nobody can say why it was given.

   The truth

   • WuXi still risks being put back on the list, Endpoints News reported. [16]
   • Who gains WuXi AppTec — It no longer carries the US label of a Chinese military company, after a US judge blocked the listing. [15]
   • Nobody knows yet

     Whether WuXi AppTec stays off the US list.

     It was removed to follow a court ruling, and it still risks being listed again. [15][16]

9. 11

   Argenx buys a pill-design biotech

   What happened

   • Argenx, a Belgian-Dutch drug company, agreed to buy US biotech Unnatural Products for up to $1.15 billion. [19]
   • It pays $550 million in cash now, and up to $595 million more if the drugs pass set tests. [17]

   Who is involved

   Unnatural Products, in Santa Cruz, California, designs macrocyclic peptides: ring-shaped drugs built from protein parts. [18]

   Argenx is best known for Vyvgart, a drug for two immune diseases that weaken nerves and muscles. [18]

   • Vyvgart argenx's best-known drug

   How it unfolded

   Argenx already owned part of the company and had worked with it for more than 2 years. [17]

   Why it matters

   The same hope drove Gilead's recent $1.28 billion purchase of PepStar, which makes a peptide pill. [18]

   How it works

   Pharmacologists call a drug's ability to reach the blood when swallowed its oral bioavailability.

   These drugs can survive the gut and reach targets usually hit only by drips. [18] So they could be swallowed as pills. [17]

   The truth

   • Who gains Unnatural Products' owners — They get $550 million in cash now, with up to $595 million more if the drugs pass set tests. [17]

   What comes next

   The deal is expected to close by the end of the year. [17]

10. 12

    Liver doctors agree one definition

    What happened

    • Liver doctors from 5 societies around the world agreed one definition of acute-on-chronic liver failure. [20]
    • It strikes when a liver already damaged by long disease suddenly worsens, often after alcohol or a virus. [20]
    • Diagnosis now starts with two blood tests: bilirubin, a waste pigment, and INR, a measure of clotting. [20]

    How it unfolded

    Before, different parts of the world defined it differently, which delayed some patients' treatment. [20]

    The experts met in Barcelona in May, and published their paper in the journal Hepatology in October. [20]

    1. May experts meet in Barcelona
    2. October paper in Hepatology

    Why it matters

    In the US, acute liver failure moves a patient up the transplant list, but this condition does not, yet. [20]

    The FDA helped shape the parts that drug trials will use. [20]

    How it works

    Doctors call such a shared rule diagnostic criteria: the tests a patient must pass to count as having the illness.

    Without one definition there was no common way to test new treatments in trials, Bajaj said. [20]

    Seen it before

    A football league needs one rulebook, so a goal counts the same in every match.

    The truth

    • The cut-offs were checked against death within 30 days, not just agreed by vote, said Jasmohan Bajaj, a liver doctor. [20]
11. 13

    A test for the last traces of cancer

    What happened

    • Illumina, a maker of DNA-reading machines, opened early access to a test for traces of cancer DNA in blood. [21]
    • It aims at the small amount of cancer that can remain after treatment. [21]
    • In tests, it found tumour DNA at 2.5 parts per million. [21]
    • Kits are due to ship in early 2027, for research use only. [21]

    Who is involved

    NYU Langone Health, a New York hospital group, is among the first users. [21]

    How it unfolded

    1. Now early access opens
    2. Early 2027 kits ship

    Why it matters

    Faint traces are hardest to find in early cancers that shed little DNA, Illumina said. [21]

    How it works

    Geneticists call this duplex sequencing: reading each DNA letter on both strands of the molecule. [21]

    A change seen on both strands is more likely real than an error made in the lab. [21]

    Seen it before

    Two friends checking the same sum catch mistakes that one of them alone would miss.

12. 14

    A cancer gene takes a shortcut to divide

    What happened

    • Scientists at the University of California, Santa Cruz found a shortcut a cancer-linked gene uses to make cells divide. [22]
    • Most cells rest instead of dividing, and the body keeps sending signals to keep them resting. [22]
    • The gene, E2F1, switched on cell-division genes without unpacking the DNA much, or at all. [22]

    How it unfolded

    To divide, a cell usually unpacks its tightly wrapped DNA first. [22]

    Why it matters

    E2F1 goes wrong in many cancers, so the shortcut may help explain how tumours grow. [22]

    The truth

    • The work was done on cells in the lab, and published in The EMBO Journal. [22]
13. 15

    A supplement eases brain fog after cancer

    What happened

    • A small UCLA trial found a supplement, oxaloacetate, eased brain fog in breast cancer survivors. [23]
    • Of 18 women who joined, 16 finished 8 weeks of taking it twice a day. [23]
    • Their main brain-fog score rose from 29.1 to 55.5, into the normal range. [23]

    Who is involved

    Oxaloacetate is a molecule the body already makes, which cells use to produce energy. [23]

    Why it matters

    Between 15% and 25% of breast cancer survivors have lasting problems with memory or concentration. [23]

    The truth

    • Every woman took the supplement, so there was no dummy-pill group to compare with. [23] The researchers say larger studies are needed. [23]
14. 16

    Childhood cancers may spread without new mutations

    What happened

    • Scientists in England suggest some childhood cancers can spread without gaining new mutations, changes in their genes. [24]
    • Many childhood cancers come from young cells that can still move around and change type. [24]
    • The cells may switch into states that help them grow, resist treatment and spread. [24]

    Who is involved

    The authors are from the University of East Anglia and Liverpool John Moores University. [24]

    • University of East Anglia
    • Liverpool John Moores

    How it unfolded

    They looked at neuroblastoma, Ewing sarcoma, osteosarcoma and other childhood cancers. [24]

    Why it matters

    Future treatments might aim to stop cells entering those dangerous states, the authors say. [24]

    The truth

    • The idea comes from a review of earlier studies, not from a new experiment. [24]
15. 17

    Timed sound helps the brain wash itself

    What happened

    • Timed bursts of pink noise in deep sleep raised the flow of fluid that washes the brain, a study found. [25]
    • The fluid, cerebrospinal fluid, flushes out waste that builds up in the brain each day. [25]
    • The study was published in Science Translational Medicine. [25]

    Who is involved

    Pink noise is a hiss with louder low pitches and quieter high ones. [25]

    Why it matters

    Poor sleep and ageing can slow this washing, which may raise the risk of brain disease. [25]

    How it works

    Sleep scientists call this closed-loop stimulation: a sound timed to the brain's own waves.

    Sleepers wore electrode caps inside an MRI scanner while a computer timed the sound to their slow brain waves. [25]

    Seen it before

    Pushing a swing just as it reaches the top sends it higher than pushing at random.

    The truth

    • The study did not test whether the extra flow cleared any waste, a co-author said. [25]

    What comes next

    The team wants to test it next in older people and in people with sleep disorders. [25]

16. 18

    Australia approves the Wegovy pill

    What happened

    • Australia's medicines regulator, the TGA, approved Novo Nordisk's Wegovy weight-loss pill last week. [26]
    • It is the country's first GLP-1 weight-loss pill, a daily tablet instead of a weekly injection. [26]
    • It is also approved to lower the risk of heart attack or stroke. [26]
    • Patients must fast for 8 hours before taking it, then wait 30 minutes to eat or drink. [26]

    How it unfolded

    1. 8 hours no food before the pill
    2. 30 minutes then food again

    Why it matters

    Australia's government does not pay for the injection except for type 2 diabetes, so many pay thousands a year. [26]

    How it works

    The same pill is approved for weight loss and to cut the risk of heart attack and stroke.

    The idea, in story 02: Why illnesses that share a cause can share a medicine →

    The truth

    • Who pays Australians who pay for the injection — Australia's government pays only for people with type 2 diabetes, so others can pay thousands a year. [26]

    What comes next

    It is due on sale by Christmas. [26]

17. 19

    Diabetes scientists boycott their own charity

    What happened

    • Nearly 1,200 diabetes experts are boycotting the American Diabetes Association's journals and meetings, The New York Times reported. [27]
    • Its chief scientific officer, Rita Kalyani, had resigned by 6 November, and so had its head of publications. [27]
    • Editors at Diabetes Care stopped editing, and submissions to the journal slowed. [27]

    Who is involved

    The association is a US charity that put $27.5 million into research last year and runs the journal Diabetes Care. [27]

    • Rita Kalyani chief scientific officer, resigned
    • Head of publications resigned

    How it unfolded

    In June, guards removed 5 scientists from its main meeting for handing out an editorial against US research cuts. [27]

    On 22 October, the association's own review apologised to 3 of them. [27]

    1. June 5 scientists removed
    2. 22 October 3 get an apology

    Why it matters

    Junior scientists may lose the chance to present at next year's meeting, which can matter for promotion. [27]

    The truth

    • The association said the scientists broke its rules, but its review found it had misread its own code. [27]
    • The scientists want its bylaws made public, and the association has refused. [27]
18. 20

    Tanzania hunts for missing hospital medicines

    What happened

    • Tanzania's prime minister, Mwigulu Nchemba, ordered security services to check every month where public hospitals' medicines go. [28]
    • Official figures say 97% of medicines are in stock in district and regional hospitals. [28]
    • Yet patients keep being told to buy them from private pharmacies. [28]
    • Nchemba asked residents of Simiyu region on Sunday how private pharmacies were getting the medicines. [28]
    • He said anyone found diverting the medicines or misusing public money must face firm action. [28]

    Who is involved

    • Mwigulu Nchemba Tanzania's prime minister

    Why it matters

    Many low-income households already struggle to pay for treatment, tests and medicines, he said. [28]

    How it works

    Health systems call this drug diversion: medicines bought with public money that end up sold privately.

    The stock figures say the medicines were bought, so the gap lies between the hospital shelf and the patient. [28]

    Seen it before

    A school can order a lunch for every pupil and still run short if some leave by the back door.

    The truth

    • The prime minister gave no estimate of how much medicine has gone missing. [28]