Mind & body, in brief

Lenacapavir is an injection given twice a year that stops people catching HIV, and it replaces a pill that has to be swallowed every day. [1]

It is injected into the abdomen and releases slowly, so one jab protects for six months. [1]

It attacks the virus at several stages of its life cycle rather than one, which is why the US regulator also allowed it for people whose HIV has survived other drugs. [1]

Flavia Matovu Kiweewa, who led the Uganda trial, describes other prevention drugs as a guard on one door and this one as guards posted throughout the building. [1]

In the PURPOSE 1 trial, none of the nearly 4,200 women caught HIV in the year after everyone was offered the drug, and more than 96 per cent came back for their injection on time. [1]

An independent monitoring committee found it so effective that the randomised part of both trials was stopped early, and the people on dummy injections were offered the real drug. [1]

The US drug regulator approved it in June 2025 and the World Health Organization recommended it for HIV prevention the following month. [1][7]

Kenya gave the first injection in East Africa, Nigeria added it to its national programme, and South Africa launched at 360 clinics as the ninth African country. [2][3][4]

Zambia's medicines regulator approved it in 12 working days and Zimbabwe's in 18, by relying on reviews already done elsewhere under a WHO procedure. [6]

Uganda received nearly 20,000 doses in February 2026 and began giving them in April, a month late. [1]

Kasensero, a fishing town of about 15,000 people with one of Uganda's highest HIV rates, got enough for 60 people and has run out. [1]

Kalangala, a district chosen for the trial because so many people there catch HIV, was left out of the first round; the health ministry's plan adds more sites in November 2026 when new stock arrives. [1]

Why it matters. Watch whether the next batch reaches the districts that were skipped: Uganda's health ministry says more sites join in November 2026 when new stock lands, and Kalangala is not in the first round. [1]

Doctors Without Borders, the medical charity that works in war zones and emergencies, asked Gilead Sciences for a limited supply of lenacapavir and was turned down after months of talks. [10] Gilead will not sell the injection directly to humanitarian organisations. [10] The charity gets it instead through the Global Fund, the international fund that buys HIV, tuberculosis and malaria medicines for poorer countries, which agreed with Gilead in late 2024 to distribute the drug to two million people. [10] The charity called the refusal unconscionable. [10]

Why it matters. Humanitarian groups reach people no national programme reaches - refugees, people in camps, people in places with no clinic. Going through a third party means they get what is left after governments have ordered.

South Africa's government is negotiating with Gilead Sciences for a voluntary licence that would let the drug be produced inside the country. [11] The talks followed months of argument over access. [11] Before them, campaigners had urged South Africa's government to issue a compulsory licence instead, which would let local manufacturers copy the drug without the patent holder's agreement. [13] Yvette Raphael, co-founder of Advocacy for Prevention of HIV and AIDS, said no access plan can leave South Africa out. [13]

Why it matters. South Africa has about eight million people living with HIV, more than any other country, and roughly 160,000 new infections a year. [4] Who makes the drug decides how fast it arrives there.

Unitaid, an international body that pays to get medicines into poorer countries, is funding South Africa and Zambia to widen access to lenacapavir. [12] The plan works through health ministries and community groups to reach sex workers and pregnant and breastfeeding women. [12] Distribution is meant to run through unorthodox channels, including pharmacies and hair salons, rather than only through clinics. [12]

Why it matters. The drug only prevents anything in people who come and get it. Reaching people through places they already go is the part of prevention that a licence and a price cannot fix.

On 24 September 2025 two agreements were announced that set a price of $40 per patient a year for generic lenacapavir in 120 low- and middle-income countries from 2027. [8] Unitaid, the Clinton Health Access Initiative and the Wits Reproductive Health and HIV Institute in Johannesburg are backing Dr Reddy's Laboratories; the Gates Foundation is backing Hetero Labs. [8][9] Gilead had already signed royalty-free licences with six generic makers in October 2024. [8] The generic versions still need regulatory approval. [7]

Why it matters. Funders are paying a company's development costs so that a copy exists sooner. That is the step that turns a price announcement into a vial in a fridge.

The World Health Organization reported in July 2026 that 32 million people living with HIV were on treatment by the end of 2025. [14] New infections have fallen by 42 per cent since 2010 and AIDS-related deaths by 57 per cent. [14] Nine million people still have no treatment, and new infections are rising in several regions, particularly among men who have sex with men, sex workers, people who inject drugs, transgender people and people in prison. [14] Hepatitis B infections are down 32 per cent since 2015. [14]

Why it matters. This is the base the injection is being added to. A 42 per cent fall took fifteen years of daily pills, testing and clinics, and it is that machinery the new drug plugs into.

The European Centre for Disease Prevention and Control and the WHO's European office reported 105,922 HIV diagnoses across 53 countries in Europe and central Asia in 2024. [15] Fifty-four per cent were made late, meaning the immune system had already been damaged before treatment started. [15] In the 30 countries of the European Union and European Economic Area there were 24,164 diagnoses and 48 per cent were late. [15] Nearly one in three diagnoses was in a person born outside the country where it was made. [15]

Why it matters. A late diagnosis means years of untreated illness and years in which the virus can pass on. Europe has the drugs; what it is short of is people finding out in time.

The US Centers for Disease Control and Prevention published 2024 figures showing more than 38,000 people aged 13 and over diagnosed with HIV in the United States and seven territories. [16] Men were 80 per cent of diagnoses and sex between men accounted for 65 per cent. [16] Black Americans are 12 per cent of the population and 39 per cent of diagnoses. [16] The southern states account for 51 per cent of all diagnoses. [16]

Why it matters. The injection was approved in the United States before anywhere else, and these are the people it would have to reach there. Half of them live in the region with the thinnest public health funding.

About 6,000 researchers and campaigners met at the International AIDS Conference in Rio de Janeiro in July 2026. [17] Funding from the United States, the single largest funder of global HIV work, fell from $6.7bn to $4.6bn last year. [17] The UN secretary-general has proposed closing UNAIDS, the agency that leads the global effort, by the end of the year as part of shrinking the UN; after objections, no final decision has been made. [17] Winnie Byanyima, who runs UNAIDS, said that when prevention disappears, infections rise. [17]

Why it matters. The injection arrives at the same moment as the cuts. A drug that works twice a year still needs a clinic, a nurse and a supply chain that somebody pays for.

PEPFAR, the US programme that buys HIV medicines abroad, has been credited with saving 26 million lives since it began in 2003. [18] Congress appropriated close to $6bn for global HIV work in 2026, more than President Trump requested and about the same as the year before. [18] People inside and outside the US government say the US State Department is deliberately withholding some of it. [18] Programmes the Trump administration itself called lifesaving are close to shutting down. [18]

Why it matters. This is money that exists, was voted for, and is not moving. Caspian Chouraya, who works on HIV in Eswatini, now spends his time reading up on the law around layoffs. [18]

Community groups that provide HIV testing and prevention in the United States are pushing federal health officials to renew a funding programme that recently lapsed. [19] If it is not renewed, expanded access to preventive care would be at risk and some groups may have to close. [19] Jeremiah Johnson, who runs the advocacy group PrEP4All, said groups have already heard from staff they may not be able to keep. [19]

Why it matters. These are the organisations that would hand out the new injection in American cities. Some of them may have to close if the grant is not renewed. [19]

Zambia's health ministry launched the R21/Matrix-M malaria vaccine as part of its routine childhood immunisation programme, aiming to vaccinate more than 500,000 children aged six to eight months in the following months. [20] The rollout covers 83 districts first, 79 of them high-burden. [20] Malaria cases among Zambian under-fives reached 523 per 1,000 children in 2023. [20] The vaccine is given in four doses, at six, seven, eight and 18 to 23 months. [20]

Why it matters. Four doses spread over eighteen months means four separate journeys to a clinic. Kenya gave exactly that reason for girls missing a second HPV dose: distance, cost, or simply forgetting to come back. [37]

Ethiopia launched the same R21/Matrix-M vaccine on 21 October 2025, becoming the 23rd African country to put a malaria vaccine into its routine schedule. [21] It started in 58 districts across nine regions, chosen as the highest-burden areas, with more than 91,000 children in the first phase. [21] Doses are given at six, seven, nine and 15 months. [21] The vaccine is being added alongside bed nets, indoor spraying and treatment rather than replacing them. [21]

Why it matters. WHO helped Ethiopia with its Gavi application, the implementation guidelines and the training materials. [21] Each country that joins leaves those documents behind for the next one.

An independent evaluation followed more than two million children given the first malaria vaccine, RTS,S, in Ghana, Kenya and Malawi between 2019 and 2023. [23] Deaths from all causes among children old enough to be vaccinated fell by 13 per cent, and hospital admissions for severe malaria dropped substantially. [23] More than nine in ten children ended up covered by at least one malaria protection, either the vaccine or a treated bed net. [26] The WHO published further evidence in May 2026 confirming the effect. [25]

Why it matters. The fall is in deaths from all causes, not only deaths from malaria. [23] It is also the hardest kind of result to show anyone, because it is made of funerals that did not happen.

As of April 2026, 25 African countries were giving a malaria vaccine, including nine of the ten countries with the heaviest malaria burden. [22] In 2025 some 28.3 million doses were distributed, a 169 per cent increase on the year before. [22] Cameroon recorded 17 per cent fewer laboratory-confirmed malaria cases between 2024 and 2025. [22] Burkina Faso, which introduced the vaccine in February 2024, saw total cases fall from 10.8 million to 7.3 million, and 38 per cent fewer among under-fives. [22]

Why it matters. Burkina Faso's drop is a third of a national caseload in under two years. It is the clearest evidence yet that the vaccine changes what happens in a country and not just in a trial.

Global malaria cases rose from 238 million in 2018 to 282 million in 2024, and deaths from 575,000 to 610,000. [24] Malaria is still endemic in 80 countries. [24] The WHO African Region carries 94 per cent of cases and 95 per cent of deaths, and about 438,000 African children died of malaria in 2024. [26] In trials both vaccines cut malaria cases by more than half in the first year, and by about 75 per cent when given seasonally alongside preventive medicine. [26]

Why it matters. A vaccine that works can sit inside a rising case count. Bed nets, spraying, diagnosis and treatment all have to keep working at the same time, and resistance is now eroding all three. [22]

Partial resistance to artemisinin, the backbone of malaria treatment, has now been confirmed or is suspected in multiple African countries, according to the WHO's World Malaria Report 2025. [22] Jane Carlton, who directs the Johns Hopkins Malaria Research Institute, says mosquito resistance to the insecticide used on bed nets is also widespread, and that some rapid tests now miss mutant parasite strains. [22] That puts prevention, diagnosis and treatment under pressure at the same time. [22]

Why it matters. The vaccine is the newest tool and the other three are the old ones. If the old ones stop working, the vaccine is protecting children inside a system that is failing around it.

As of 17 September 2026 the CDC had confirmed 3,471 measles cases in the United States for the year, reported by 47 jurisdictions. [27] There have been 39 new outbreaks in 2026, and 95 per cent of confirmed cases were linked to an outbreak rather than isolated. [27] Some 1,376 of them came from outbreaks that began in 2025 and never stopped. [27] The whole of 2025 held 2,289 cases. [27] When the count passed 2,000 in June, experts said the true number was probably about three times higher. [34]

Why it matters. Measles was declared eliminated from the United States in 2000. [30] That status ends if the virus keeps spreading inside the country for twelve months, and outbreaks that started in 2025 are still producing cases this year. [30][27]

South Carolina reported 558 measles cases in January 2026, 124 of them in three days, with the count nearly doubling in a week. [28] The centre is Spartanburg County, where 90 per cent of schoolchildren are vaccinated against a threshold of 95 per cent. [28] Six linked cases appeared in North Carolina and three in Snohomish County, Washington. [28] Helmut Albrecht, an infectious disease doctor at Prisma Health, said the state had lost the ability to contain it with the immunity it has. [28]

Why it matters. Spartanburg sits five points under the level that stops measles spreading. [28] The outbreak there has already put linked cases in North Carolina and in Washington state. [28]

Coverage of the measles vaccine among US children starting school fell from 95.2 per cent in the 2019-20 school year to 92.5 per cent in 2024-25. [29] The target is 95 per cent, the level at which enough people are immune to stop the virus finding a chain of hosts. [29] KFF, a US health policy research group, reports that non-medical exemptions from school vaccine requirements have risen since the pandemic and are still rising. [31]

Why it matters. A 2.7 point fall sounds like nothing. Measles is one of the most contagious diseases there is, so below 95 per cent one infected child starts a chain instead of being the end of one. [28]

A country keeps elimination status as long as it has not had 12 months or more of uncontrolled domestic transmission. [30] The United States has held that status since 2000. [30] From January 2025 to the end of March 2026, states reported more than 3,800 cases. [30] KFF lists the causes as funding and staffing cuts at federal, state and local level, mixed messages from the health secretary, no Senate-confirmed CDC head for almost the whole period, and rising public doubt about the vaccine. [30]

Why it matters. Elimination is a statement about a country's surveillance and its clinics rather than its luck. The United States has held the status since 2000. [30]

Researchers writing in Nature Health used parents' own reports, gathered through an online surveillance platform, to estimate measles-mumps-rubella coverage county by county for children under five. [32] They found areas with coverage below 60 per cent. [32] The clusters of undervaccinated children overlapped closely with the places that had recent outbreaks, particularly in Texas and New Mexico, where the model put coverage well below the official figures. [32]

Why it matters. National averages hide the number that decides an outbreak, which is the coverage of the particular town the virus lands in. School-entry records and phone surveys systematically miss the most vulnerable families. [32]

Britain's vaccine advisory committee recommended giving the second measles-mumps-rubella dose earlier, from 2026, and researchers modelled what that would do in England. [33] Moving it to 24 months, from three years and four months, cut simulated cases by 11.9 per cent. [33] If the second dose reached as many children as the first, cases fell by 22.4 per cent. [33] Allowing for protection fading over time, the gain shrank to 5.3 per cent. [33]

Why it matters. The change costs nothing new: the same vaccine, the same child, an earlier appointment. What it buys is fourteen fewer months in which a toddler is only partly protected.

About 85 per cent of the world's infants, around 110 million children, received three doses of the diphtheria-tetanus-pertussis vaccine during 2025. [23] Nearly 21 million children missed their routine first measles dose, worse than the 19 million who missed it in 2019. [23] The WHO treats measles as an early warning system, because its contagiousness exposes gaps in immunity faster than any other disease. [23]

Why it matters. Twenty-one million is the pool that every future outbreak will be drawn from. They are mostly not in countries with a vaccine debate; they are in countries with no nurse within walking distance.

A US-funded trial in Costa Rica gave girls one dose of an HPV vaccine, then gave half of them a second dose and the other half a tetanus jab as a control. [35] The girls were tested for new infections every six months for five years. [35] One dose was no worse than two, and both were at least 97 per cent effective against lasting infection with the two virus types behind more than 77 per cent of cervical cancers. [35] The results were published on 3 December 2025. [35][36]

Why it matters. Cervical cancer kills about 250,000 women a year and fewer than 30 per cent of the world's adolescent girls have been vaccinated. [35] Halving the number of visits halves the main reason girls never finish.

Kenya moved from a two-dose to a one-dose HPV schedule in November 2025, following the WHO's expert immunisation group. [37] The country had vaccinated 10-year-old girls on two doses since 2019. [37] Cervical cancer is the second most common cancer among Kenyan women, with about 5,845 new cases and 3,600 deaths a year. [37] Beatrice Dbwoge, a nurse at Kilifi County Hospital, said girls were missing the second dose because of distance, cost, or simply forgetting to come back. [37]

Why it matters. One visit instead of two lets the same budget and the same nurses protect more girls. [37] The change is administrative, and what it alters is how many cervical cancers appear decades later.