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Day Lila

Sunday, 20 September 2026

20 Sept · Biotech · In brief

Biotech · Sunday, 20 September 2026

Biotech, in brief

20 stories · 22 sources

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What is moving · 1 of 4

Tests that arrive too late

High ↑

In Fiji only 39% of people with HIV knew they had it. [3] In Congo, Bundibugyo fever looks like malaria or typhoid, and the outbreak was recognised only after a nurse died. [4] San Diego officials built a screwworm dashboard because laboratory confirmation can take weeks. [5]

What is moving · 2 of 4

Drugs nobody can name yet

Building ↑

A San Francisco coroner wrote cychlorphine on a 16-year-old's autopsy, the only time it has appeared there. [6] In Scotland, a Dundee University laboratory has been turned into a national drug testing centre because street drugs keep changing. [7]

What is moving · 3 of 4

Money moving into addiction

Building ↑

Eli Lilly showed early data on brenipatide, a weight-loss-style drug it is now testing in alcohol use disorder and depression. [12] Goa Therapeutics launched with an engineered protein meant to clear alcohol from the blood. [13]

What is moving · 4 of 4

Trust in childhood vaccines falling

High ↑

76% of Americans now call the measles shot safe for children, down from 84% in 2020. [10] Robert F. Kennedy Jr., the US health secretary, told the anti-vaccine group he founded that they have a friend in President Trump's White House. [11] The country has counted more than 3,000 measles infections this year, its worst in 35 years. [10]

Part of the day's signal

One pressure seen across the day runs through Biotech too.

Fiji has declared HIV a national emergency. One adult in 60 now carries the virus, against one in 167 five years ago.

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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]

Who is involved

Who is involved

Why it matters

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's 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. [2][3]

Why it works on people

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. [2]

Who gains

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]

Who pays

Fifty-nine were born with the virus last year and 18 of them died before their first birthday. [3]

Who pays

Jason Mitchell, who runs the national taskforce, says people who could be well on treatment are instead filling beds and outpatient clinics. [2]

Nobody knows yet

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]

Nobody knows yet

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]

Nobody knows yet

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]

Good news

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.

The short version

That's the story in short.

The whole story has 12 more parts.

or swipe up for the next storyor scroll on for the next story ↓

The whole story, in 12 parts ↓

Part 1 of 12 · Who else is involved

Part 1 of 12 · Who else is involved

Part 2 of 12 · How it unfolded

Part 3 of 12

The country recorded 2,016 new diagnoses in 2025, sixteen times the number recorded in 2019. [1][3]

Part 4 of 12

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]

Part 5 of 12

Across the world, 78% of people with HIV are on that treatment. [2]

Part 6 of 12

Fifty-nine babies were born with HIV in Fiji last year and 18 died before their first birthday. [3]

Part 7 of 12

Health Minister Antonio Lalabalavu said an outbreak-level response is no longer sufficient. [2]

Part 8 of 12

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]

Part 9 of 12

Among cases where the route is known, more than half were passed on through sex and over 42% through injecting drugs. [3]

Part 10 of 12

Health workers describe bluetoothing, where people inject the blood of someone already high, so several share one hit and one syringe. [2]

Part 11 of 12

Jason Mitchell, who leads Fiji's HIV taskforce, expects it to take more than five years to get on top of the epidemic. [2]

Part 12 of 12

Fiji is a hub for business, tourism and transport in the South Pacific, and UNAIDS warns the rise could reach its neighbours. [1]

A rare Ebola relative keeps growing

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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]

Why it matters

This outbreak was formally recognised only after a nurse died. [4]

How it works

Ready for the last outbreak, not this one

How it works

Fiji had clinics, tests and HIV drugs, but no clean-needle programme, because the virus had never spread that way there before.

How it works · step 1 of 5

A disease spreads one way at first

How it works · step 2 of 5

Clinics, tests and drugs get built for that way

How it works · step 3 of 5

The disease starts spreading a second way

How it works · step 4 of 5

Nobody has the tool the second way needs

How it works · step 5 of 5

Cases climb while that tool is built

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

Of the 9,100 people living with HIV in Fiji last year, 39 in 100 knew and 22 in 100 were on treatment. The world average is 78 in 100.

Seen the same day

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

Seen the same day

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

Seen the same day

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

Seen the same day

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

The catch

Building for the last problem is not stupidity.

The catch

It is the only thing anyone has evidence for, and preparing for every possible route would cost more than any health budget holds.

The whole

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.

The whole

Most of us do the same, and we usually find out what we were missing only after it arrives.

What's really going on

The same gap turns up elsewhere in the day: the Bundibugyo outbreak in Congo was recognised only after a nurse died, because the illness looks like malaria or typhoid [4], and a mother in San Francisco had the antidote for the drug she expected rather than the one that killed her son. [6]

Who pays

Bundibugyo passes through contact with body fluids, so carers are exposed first, and this outbreak was formally recognised after a nurse died. [4]

Nobody knows yet

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]

Part of a signal

Finding the illness too late

Also seen in Mind & body.

The whole signal →

A flesh-eating fly is back in Texas

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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]

Why it matters

Only public health officials can use it for now. [5]

How it works

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

The idea, in story 2: Ready for the last outbreak, not this one →

Who pays

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]

Trust in the measles shot falls

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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]

Share of Americans calling the measles, mumps and rubella vaccine safe for children, in two Reuters/Ipsos polls.

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]

Why it matters

Experts put the level needed to protect children who cannot be vaccinated at 95%, so coverage is now below it. [10]

Why it matters

Just 19% of Americans told the pollsters they approve of President Trump's handling of the outbreak. [10]

Who pays

Coverage among children starting school fell to 92.5%, below the 95% that protects those who cannot have the shot themselves. [10]

Nobody knows yet

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]

The US health secretary addresses his old group

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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]

Why it matters

Two parts of the same administration are saying opposite things about the same shots. [11]

Scotland's street drugs keep changing

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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]

Why it matters

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]

How it works

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

The idea, in story 2: Ready for the last outbreak, not this one →

Good news

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.

A drug no coroner had seen before

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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]

How it works

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

The idea, in story 2: Ready for the last outbreak, not this one →

Nobody knows yet

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]

A company aiming at drunkenness

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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]

Why it matters

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]

Who gains

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]

Nobody knows yet

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]

A weight-loss drug aimed at addiction

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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]

Why it matters

It cannot say whether brenipatide helps anyone drink less or feel less depressed, and the trials that could are still running. [12]

Who gains

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]

Blood thinners and memory decline

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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]

Why it matters

The study compared existing records rather than assigning treatment, so it can show the pattern but cannot prove the drug caused it. [14]

Nobody knows yet

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]

Good news

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.

Which germ you carry changes the risk

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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]

Why it matters

Older adults and young children were most vulnerable when pollution was high. [8]

Cells that survive their own death

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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]

Why it matters

A mechanism that helps healthy tissue heal could be helping cancer cells survive the drugs meant to kill them. [15]

Starving malaria inside the mosquito

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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]

Why it matters

This is laboratory work in insects, and no person has taken either compound. [16]

Good news

Mosquitoes fed two new compounds carried far fewer malaria parasites in their guts and their salivary glands, for both parasite species tested.

A scan beats the weight chart in sepsis

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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]

Why it matters

The authors say the finding needs checking at other hospitals before anyone relies on it. [9]

The surgeon who counted the delays

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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]

Why it matters

His patients were arriving late, not getting worse operations. [17]

Good news

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.

Most men have not heard of the dairy link

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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]

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.

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]

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]

Why it matters

The studies behind that link record what men ate and what later happened, which cannot separate dairy from everything else in a diet. [18]

Who gains

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]

Floods and power cuts together

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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]

Why it matters

It fell hardest on people over 65, rural residents, and those on Medicaid or with no insurance. [19]

Who pays

Floods and power cuts together raised heart-related hospital admissions most in those groups, and among people on Medicaid or with no insurance. [19]

Bird flu tested against the body's alarm

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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]

Why it matters

The authors say the measurements are too sparse to answer that yet. [20]

A hedge fund builds its own drug firm

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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]

Why it matters

That is a different bet from the ones it usually makes, and it carries the development risk rather than trading around it. [21]

Who gains

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]

An English hospital counts its own deaths

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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]

1 of 7

died after emergency abdominal surgery

Of 104 Rotherham patients in the national audit, 14 died, which is about one in seven.

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]

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]

Why it matters

It said more recent numbers show the performance improving. [22]

Nobody knows yet

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]

That's the whole Biotech day.

20 stories, 22 sources.