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      Gilead Agrees to Allow Generic Version of Groundbreaking H.I.V. Shot in Poor Countries

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      Many middle-income countries are left out of the deal, widening a gulf in access to critical medicines.The drugmaker Gilead Sciences on Wednesday announced a plan to allow six generic pharmaceutical companies in Asia and North Africa to make and sell at a lower price its groundbreaking drug lenacapavir, a twice-yearly injection that provides near-total protection from infection with H.I.V.Those companies will be permitted to sell the drug in 120 countries, including all the countries with the highest rates of H.I.V., which are in sub-Saharan Africa. Gilead will not charge the generic drugmakers for the licenses.Gilead says the deal, made just weeks after clinical trial results showed how well the drug works, will provide rapid and broad access to a medication that has the potential to end the decades-long H.I.V. pandemic.But the deal leaves out most middle- and high-income countries — including Brazil, Colombia, Mexico, China and Russia — that together account for about 20 percent of new H.I.V. infections. Gilead will sell its version of the drug in those countries at higher prices. The omission reflects a widening gulf in health care access that is increasingly isolating the people in the middle.Gilead charges $42,250 per patient per year for lenacapavir in the United States, where it is approved as a treatment for H.I.V. The company has said nothing about what lenacapavir will cost when used to prevent H.I.V. infections, a process called pre-exposure prophylaxis, or PrEP.The generics makers — four companies in India, one in Pakistan and one in Egypt — are expected to sell it for much less. Researchers at Liverpool University found the drug could profitably be produced for as little as $40 per patient per year, if it were being purchased in large volumes.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      W.H.O. Authorizes Mpox Vaccine, Clearing Way for Use in Africa

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      The decision is a crucial step in getting shots to the Democratic Republic of Congo, the center of the outbreak.The World Health Organization has given its authorization to a first vaccine to protect against mpox, a decision announced in such haste on Friday that it caught even the head of the company that makes the vaccine by surprise.The vaccine, made by the Danish company Bavarian Nordic, has been approved by the regulatory authorities in Europe as well as the United States and other high-income countries since a global mpox outbreak in 2022. But low- and middle-income countries rely on the W.H.O., through a process called prequalification, to determine which drugs, vaccines and health technologies are safe and efficient uses of limited health funding, and the organization had declined to act until now.The W.H.O. had come under increasing criticism for declaring a global public health emergency for mpox last month without giving a vaccine that prequalification stamp of approval, or a more provisional form of approval called emergency use authorization. Bavarian Nordic first submitted its safety and effectiveness data on the vaccine, called Jynneos, to the W.H.O. in 2023. The W.H.O. had defended its slow pace of review, saying that it needed to subject the vaccine to careful study because it, and two others that have been used to protect against mpox, were originally designed as smallpox immunizations, and because delivering it in low-resource settings such as Central Africa would involve factors different from those relating to its use in high-income countries.But on Friday morning, the W.H.O. suddenly said it was authorizing the shot.“This first prequalification of a vaccine against mpox is an important step in our fight against the disease, both in the context of the current outbreaks in Africa, and in future,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O. director general, said in a statement.Paul Chaplin, Bavarian Nordic’s chief executive, said he was among the many who had been caught off guard.“We’ve got there eventually — I don’t know quite how,” he said. “But it’s good news. It’s going to make the regulatory pathway much easier.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      China Woos Africa, Casting Itself as Global South’s Defender

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      More than 50 African leaders have gathered in Beijing for a summit aimed at projecting the influence of China’s leader, Xi Jinping, in the developing world.African flags have been flown over Tiananmen Square. Leaders of African nations have been greeted by dancers, honor guards and children waving flags. They have been escorted in extensive motorcades past banners celebrating “A Shared Future for China and Africa” and giant, elaborate flower arrangements.China has pulled out all the stops for a gathering of leaders and top officials from more than 50 African nations this week in Beijing, welcoming them with pomp and pageantry. “After nearly 70 years of hard work, China-Africa relations are at the best period in history,” China’s leader, Xi Jinping, told the gathering on Thursday. Mr. Xi has cast his country as a defender of the developing world, one that can push the West to listen to the voices of poorer countries. He hosted a banquet for the leaders at the start of the event on Wednesday, after three straight days of back-to-back bilateral talks with nearly two dozen leaders of nations ranging from impoverished Chad to the continental economic powerhouse of Nigeria. The three-day forum is meant to demonstrate Beijing’s global clout despite rising tensions with the West. Mr. Xi’s courtship of African countries is part of a great geopolitical competition with the United States that has intensified in recent years over Russia’s war in Ukraine and China’s aggressive posture toward Taiwan.China is “trying to take advantage of the space left by the U.S. and Europe, which are increasingly disengaged with Africa,” said Eric Olander, the editor in chief of the China-Global South Project website. “China sees an opportunity to really step up its engagement, and not necessarily just with money.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Gilead Shot Provides Total Protection From HIV in Trial of Young African Women

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      An injection given just twice a year could herald a breakthrough in protecting the population that has the highest infection rates.Researchers and activists in the trenches of the long fight against H.I.V. got a rare piece of exciting news this week: Results from a large clinical trial in Africa showed that a twice-yearly injection of a new antiviral drug gave young women total protection from the virus.“I got cold shivers,” said Dr. Linda-Gail Bekker, an investigator in the trial of the drug, lenacapavir, describing the startling sight of a line of zeros in the data column for new infections. “After all our years of sadness, particularly over vaccines, this truly is surreal.”Yvette Raphael, the leader of a group called Advocacy for Prevention of H.I.V. and AIDS in South Africa, said it was “the best news ever.”The randomized controlled trial, called Purpose 1, was conducted in Uganda and South Africa. It tested whether the every-six-months injection of lenacapavir, made by Gilead Sciences, would provide better protection against H.I.V. infection than two other drugs in wide use in high-income countries, both daily pills.The results were so convincing that the trial was halted early at the recommendation of the independent data review committee, which said all participants should be offered the injection because it clearly provided superior protection against the virus.None of the 2,134 women in the arm of the trial who received lenacapavir contracted H.I.V. By comparison, 16 of the 1,068 women (or 1.5 percent) who took Truvada, a daily pill that has been available for more than a decade, and 39 of 2,136 women (1.8 percent) who received a newer daily pill called Descovy were infected.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      $29 Trillion: That’s How Much Debt Emerging Nations Are Facing

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      A decades-long crisis is getting worse, and now dozens of nations are spending more on interest payments than on health care or education.The Vatican’s meeting on the global debt crisis last week was not quite as celebrity-studded as the one that Pope John Paul II presided over 25 years ago, when he donned sunglasses given to him by Bono, U2’s lead singer.But the message that the current pope, Francis, delivered this time — to a roomful of bankers and economists instead of rock stars — was the same: The world’s poorest countries are being crushed by unmanageable debt and richer nations need to do more to help.Emerging nations are contending with a staggering $29 trillion in public debt. Fifteen countries are spending more on interest payments than they do on education, according to a new report from the United Nations Conference on Trade and Development; 46 spend more on debt payments than they do on health care.Unmanageable debts have been a recurring feature of the modern global economy, but the current wave may well be the worst so far. Overall, government debt worldwide is four times higher than what it was in 2000.Government overspending or mismanagement is one cause, but global events out of most nations’ control have pushed their debt problems into overdrive. The Covid-19 pandemic slashed business profits and worker incomes at the same time health care and relief costs were increasing. Violent conflicts in Ukraine and elsewhere contributed to rising energy and food prices. Central banks raised interest rates to combat soaring inflation. Global growth slowed.Pope Francis earlier this week in Rome.Fabio Frustaci/EPA, via ShutterstockWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      The Disease Detectives Trying to Keep the World Safe From Bird Flu

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      As Dr. Sreyleak Luch drove to work the morning of Feb. 8, through busy sunbaked streets in Cambodia’s Mekong river delta, she played the overnight voice messages from her team. The condition of a 9-year-old boy she had been caring for had deteriorated sharply, and he had been intubated, one doctor reported. What, she wondered, could make the child so sick, so fast?“And then I just thought: H5N1,” she recalled. “It could be bird flu.”When she arrived at the airy yellow children’s ward at the provincial hospital in Kratie, she immediately asked the child’s father if the family had had contact with any sick or dead poultry. He admitted that their rooster had been found dead a few days before and that the family had eaten it.Dr. Luch told her colleagues her theory. Their responses ranged from dubious to incredulous: A human case of avian influenza had never been reported in their part of eastern Cambodia. They warned her that if she set off the bird flu warning system, many senior government officials might get involved. She risked looking foolish, or worse.Anxious but increasingly certain, Dr. Luch phoned the local public health department, located just across the street. Within minutes, a team arrived to collect a sample from the child, Virun Roeurn, for testing in a lab.By then, Virun’s distraught parents had lost faith in the hospital. They demanded that he be sent by ambulance to the capital, Phnom Penh. His flu swab sample traveled with him.Virun died on the journey. At 8 p.m., Cambodia’s National Public Health Laboratory confirmed Dr. Luch’s suspicion: He had died of highly pathogenic avian influenza.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Millions of Girls in Africa Will Miss HPV Shots After Merck Production Problem

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      The company has told countries that it can supply only 18.8 million of the 29.6 million doses it was contracted to deliver this year.Nearly 1.5 million teenage girls in some of the world’s poorest countries will miss the chance to be protected from cervical cancer because the drugmaker Merck has said it will not be able to deliver millions of promised doses of the HPV vaccine this year.Merck has notified Gavi, the international organization that helps low- and middle-income countries deliver lifesaving immunizations, and UNICEF, which procures the vaccines, that it will deliver only 18.8 million of the 29.6 million doses it was contracted to deliver in 2024, Gavi said.That means that more than 10 million girls will not receive their expected HPV shots this year — and 1.5 million of them most likely will never get them because they will be too old to qualify for the vaccine in subsequent years.Patrick Ryan, a spokesman for Merck, said the company “experienced a manufacturing disruption” that required it to hold and reinspect many doses by hand. He declined to give further details about the cause of the delay.“We are acting with urgency and rigor to deploy additional personnel and resources to resolve this matter as soon as possible,” he said.Mr. Ryan said that Merck would deliver the delayed doses in 2025. He also said the company would ship 30 million doses of the vaccine to Gavi-supported countries this year. However, about a third of these are doses that were supposed to have been sent in 2023, leaving Gavi with the 10.7 million dose shortfall.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Global Warming Is Particularly Bad for Women-Led Families, Study Says

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      New U.N. research shows that climate change disproportionately erodes income in households led by women in poorer countries. But there are ways to fix it.Extreme heat is making some of the world’s poorest women poorer.That is the stark conclusion of a report, released Tuesday, by the United Nations Food and Agriculture Organization, based on weather and income data in 24 low- and middle-income countries.The report adds to a body of work that shows how global warming, driven by the burning of fossil fuels, can magnify and worsen existing social disparities.What does the report find?The report concludes that while heat stress is costly for all rural households, it is significantly more costly for households headed by a woman: Female-headed households lose 8 percent more of their annual income compared to other households.That is to say, extreme heat widens the disparity between households headed by women and others. That’s because underlying disparities are at play.For instance, while women depend on agricultural income, they represent only 12.6 percent of landowners globally, according to estimates by the United Nations Development Program. That means women-headed households are likely to lack access to essential services, like loans, crop insurance, and agricultural extension services to help them adapt to climate change.The report is based on household survey data between 2010 and 2020, overlaid with temperature and rainfall data over 70 years.The long-term effect of global warming is also pronounced. Female-headed households lose 34 percent more income, compared to others, when the long-term average temperature rises by 1 degree Celsius.The average global temperature has already risen by roughly 1.2 degrees Celsius since the start of the industrial age.Flooding similarly suppress the incomes of female-headed households more than it does other kinds of households, according to the report, but to a lesser degree than heat.“As these events become more frequent, the impacts on peoples’ lives will deepen as well,” said Nicholas Sitko, an economist with the Food and Agriculture Organization and the lead author of the report.Why does it matter?There’s been growing attention in recent years to the disproportionate harms of extreme weather, sometimes aggravated by climate change, on low-income countries that produce far less greenhouse gas emissions, per person, than wealthier, more industrialized countries.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More