Americans should eat more beans, peas and lentils and cut back on red and processed meats and starchy vegetables, all while continuing to limit added sugars, sodium and saturated fat.

That’s the advice released Tuesday by a panel of nutrition experts charged with counseling the U.S. government about the 2025 edition of the dietary guidelines that will form the cornerstone of federal food programs and policy.

But the 20-member panel didn’t weigh in on the growing role of ultraprocessed foods that have been linked to health problems, saying there’s not enough evidence to tell people to avoid them. And the group steered clear of updating controversial guidance on alcohol consumption, leaving that analysis to two outside reports expected to be released soon.

Overall, the recommendations for the 2025-30 Dietary Guidelines for Americans sound familiar, said Marion Nestle, a food policy expert.

“This looks like every other set of dietary guidelines since 1980: eat your veggies and reduce consumption of foods high in salt, sugar and saturated fat,” Nestle said in an email. “This particular statement says nothing about balancing calories, when overconsumption of calories, especially from ultra-processed foods, is the biggest challenge to the health of Americans.”

What the scientific panel said about healthy diets

The nutrition panel concluded that a healthy diet for people aged 2 years and older is higher in vegetables, fruits, legumes, nuts, whole grains, fish and vegetable oils that are higher in unsaturated fat.

It is lower in red and processed meats, sugar-sweetened foods and beverages, refined grains and saturated fat. It may also include fat-free or low-fat dairy and foods lower in sodium and may include plant-based foods.

The panel, which met for nearly two years, was the first to focus on the dietary needs of Americans through what they called a “health equity lens,” said Dr. Fatima Cody Stanford, a Massachusetts General Hospital obesity expert who was part of the group. That meant considering factors such as household income, race, ethnicity and culture when recommending healthy diets. It will help ensure that the guidance “reflects and includes various population groups,” she said in an email.

The panel didn’t come to conclusions on ultraprocessed foods or alcohol

Ultraprocessed foods include the snacks, sugary cereals and frozen meals that make up about 60% of the American diet.

The panel considered more than 40 studies, including several that showed links between ultraprocessed foods and becoming overweight or developing obesity. But the nutrition experts had concerns with the quality of the research, leaving them to conclude that the evidence was too limited to make recommendations.

That decision is likely to bump up against the views of Robert F. Kennedy Jr., the nominee to lead the U.S. Health and Human Services Department, who has questioned potential conflicts of interest among members of the dietary guidelines panel and vowed to crack down on ultraprocessed foods that contribute to chronic disease.

The panel also didn’t revise recommendations that suggest limiting alcohol intake to two drinks or less a day for men and one drink or less a day for women.

In 2020, the last time the guidance was updated, the government rejected the advice of scientific advisers to recommend less alcohol consumption.

Two groups — the National Academies of Science, Engineering and Medicine and a committee of the government agency that oversees substance abuse — are expected to release reports in the coming months on the effects of moderate alcohol use to inform the guidelines.

Do Americans follow dietary guidelines?

The advisory panel acknowledged that the diets of most Americans don’t meet the current guidelines. More than half of all U.S. adults have one or more diet-related chronic health conditions and 18 million U.S. households have insecure sources of food, according to the report.

“Nutrition-related chronic health conditions and their precursors continue to threaten health through the lifespan,” the report concludes. “Which does not bode well for the future of health in the United States.”

What happens next?

The scientific report informs the dietary guidelines, which are updated every five years. Tuesday’s recommendations now go to HHS and the Agriculture Department, where officials will draft the final guidance set for release next year.

Starting Wednesday, the public will have 60 days to comment on the guidance. HHS and USDA officials will hold a public meeting January 16 to discuss the recommendations.

The new guidance, which will be finalized by the incoming Trump administration, is consistent with decades of federal efforts to reduce diet-related disease in the U.S., said Dr. Peter Lurie, president of the advocacy group Center for Science in the Public Interest.

“Broadly, I think these are well-formulated recommendations that the incoming administration would do well to adopt,” Lurie said. 
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Texas Attorney General Ken Paxton on Friday sued a New York doctor for allegedly providing a Texas woman with abortion pills by telemedicine.

The lawsuit by the Republican attorney general, which appeared to be the first of its kind, could offer a test of conservative states’ power to stop abortion pills from reaching their residents.

New York is among the Democratic-led states that have passed so-called shield laws aiming to protect doctors who provide abortion pills to patients in other states. The law says New York will not cooperate with another state’s effort to prosecute, sue or otherwise penalize a doctor for providing the pills, as long as the doctor complies with New York law.

“As other states move to attack those who provide or obtain abortion care, New York is proud to be a safe haven for abortion access,” New York Attorney General Letitia James said in a statement. “We will always protect our providers from unjust attempts to punish them for doing their job and we will never cower in the face of intimidation or threats.”

In the lawsuit, filed in the District Court of Collin County, Paxton said that New Paltz, New York, Dr. Margaret Carpenter prescribed and provided mifepristone and misoprostol, the two drugs used in medication abortion, to a Texas woman via telemedicine.

Medication abortion accounts for more than half of U.S. abortions. It has drawn increasing attention since the U.S. Supreme Court’s 2022 decision allowing states to ban abortion, which more than 20 have done.

The woman went to the hospital after experiencing bleeding as a complication of taking the drugs, which were subsequently discovered by her partner, according to the lawsuit.

Paxton claimed that Carpenter violated Texas’s abortion law and its occupational licensing law by practicing medicine in the state despite not being licensed there. He is seeking an injunction barring her from further violations of Texas’s abortion ban and at least $100,000 in civil penalties for each past violation.

Carpenter is a member of the Abortion Coalition for Telemedicine, which supports nationwide access to abortion through telemedicine, and helped start Hey Jane, an online telehealth clinic offering abortion pills, according to the coalition’s website. She could not immediately be reached for comment. 
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ABUJA, NIGERIA — The World Health Organization (WHO) and public health experts are calling for increased political commitment and funding to fight malaria, especially in endemic regions like Africa. This week’s release of the 2024 World Malaria Report by the WHO said there were 11 million more malaria cases compared to the previous year and that Ethiopia and Nigeria recorded their highest death tolls from the disease since 2015.

According to Wednesday’s report, there were 263 million cases of the mosquito-borne disease and nearly 600,000 deaths worldwide last year.

The report indicates global malaria cases grew by about 11 million compared to the year prior while fatalities remained nearly the same.

The WHO report said Africa accounted for 95% of global malaria deaths. Most of the victims were children under 5 years of age.

Dr. Kehinde Ajayi, an expert on malaria epidemiology and control, said one issue is that since 2020, most developing nations have had a shortage of resources to combat the disease.

“Some of the resources like insecticide-treated nets and also funding towards the malaria control programs have been hampered because of … COVID-19 and the economic imbalance in developing countries,” Ajayi said.

Ajayi said climate change and declining effectiveness of anti-malaria drugs are threatening progress.

Nigeria bears the world’s highest burden of malaria with more than 27% of global malaria cases and 31% of deaths.

But the WHO report also showed some progress — estimating that about 2.2 billion cases of malaria and 12.7 million deaths were averted globally since 2000.

Ajayi said increased government funding for malaria interventions could change things.

“Mosquitoes thrive very well under temperatures that are more than 19 degrees Celsius, and the climate change has made [that] possible,” Ajayi said. “Also, the plasmodium parasite has gained a lot of resistance against malaria drugs. Also, the government needs to invest more in our health sector. Government also needs to fund research that will help us in discovering indigenous drugs.”

The WHO report said only about half of the $8.7 billion target for malaria intervention last year was achieved.

In Nigeria, spending on health care is about 4% of the national budget, much lower than the 15% agreed upon by the African Union in 2001 — in the so-called Abuja Declaration.

Authorities have pledged to improve spending on health. On Thursday, Nigeria signed a deal to promote local production of test kits for HIV and malaria.

Last week, Nigeria launched its malaria vaccination campaign — becoming the latest African country to provide malaria vaccines to young children.

There are now 17 countries giving new malaria vaccines.
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A landmark hearing into nation-states’ legal obligations over climate change wrapped up at the United Nations’ top court in The Hague on Friday. The outcome could have implications for the fight against global warming — and for the big polluters blamed for emitting most greenhouse gases. Henry Ridgwell has more.
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At least 2,400 children have been killed or injured since Russia invaded Ukraine in February 2022, according to the latest UNICEF reports. The U.N. agency says the war is creating a mental health crisis among Ukrainian children. VOA Russian has the story, narrated by Anna Rice.
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MARONDERA, ZIMBABWE — Zimbabwean health officials said Tuesday they aim to eliminate HIV/AIDS as a public health threat by 2030, crediting the United States with making such progress possible through aid and support.

U.S. Ambassador to Zimbabwe Pamela Tremont and officials from PEPFAR and the U.S. Centers for Disease Control and Prevention toured the HIV services area at Marondera Hospital, located some 70 kilometers east of Harare, the Zimbabwe capital, where HIV/AIDS once sickened thousands.

Speaking to journalists afterward, Dr. Delight Madoro, a district medical officer in Mashonaland East province, said PEPFAR — or the U.S. Presidential Emergency Plan for AIDS Relief — enabled Zimbabwe to combat the epidemic with strategies such as blood-based self-testing and PrEP, which stands for pre-exposure prophylaxis.

“And after maybe you test positive, there are staff and support … at the facilities to help link you to other HIV services,” Madoro said.

“There is a lot that is happening on the ground in terms of [the] fight against HIV through the support that we are getting from PEPFAR,” he continued. “And in terms of human resources, we’re getting more staff. This means our clients are going to have more time with clinicians, so that we become thorough, and we get thorough with our treatment.

“So, in a nutshell, I can say the support that we have been getting from PEPFAR is of paramount importance,” he said.

Tremont said the U.S. was committed to help fight the HIV epidemic in Zimbabwe.

“We’ve made huge progress since 2006,” she said. “The number of deaths from HIV has fallen 80%, and that is something I think we should all be very proud of.”

Tremont mentioned that the U.S. provided antiretroviral treatments and many health care workers at clinics and hospitals around Zimbabwe.

“It’s great to see all that in action today and to see the dedication and stubbornness of the health care workers reaching down to those HIV patients who are scared and reluctant to undertake treatment,” she said. “Thank you to the health care workers. You are our heroes in all this.”

Haddi Cham, the Centers for Disease Control’s Zimbabwe HIV services branch chief, said the PEPFAR program made the HIV facility at Marondera Hospital possible.

“We have been supporting this facility for many, many years now, and we are really grateful for the collaboration with all the key stakeholders. Through that strong collaboration, we are able to realize these results,” Cham said.

Zimbabwe is one of the countries hit hardest by HIV/AIDS, especially before 1999, when authorities introduced an AIDS levy — a 3% tax on income and business profits that is used by the National AIDS Council for programs to combat the spread of the pandemic.

Data indicate the prevalence of HIV among adults ages 15 to 49 in Zimbabwe declined from 12.7% in 2019 to 10.5% in 2023.
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washington — The United States is moving to grant federal protections to the monarch butterfly — a once-common species recognizable by its striking black and orange patterns that has faced a dramatic population decline in recent decades.

The Fish and Wildlife Service (FWS) said Tuesday it has initiated a public comment period to consider listing the insect under the Endangered Species Act.

But the looming presidency of Donald Trump, who rolled back numerous wildlife protections during his first term, casts uncertainty over the decision.

“The iconic monarch butterfly is cherished across North America, captivating children and adults throughout its fascinating lifecycle,” said FWS Director Martha Williams in a statement. “Despite its fragility, it is remarkably resilient, like many things in nature when we just give them a chance.”

The proposed listing comes at a critical time for the species, which has been designated as endangered by the International Union for Conservation of Nature since 2022.

Monarchs are divided into two migratory populations in North America. The larger eastern group has declined by approximately 80% since the 1980s, while the western population has plummeted by 95%.

According to the FWS, the species faces a host of threats, including the loss and degradation of its breeding, migratory and overwintering habitats; exposure to insecticides; and the growing impacts of climate change.

As part of its conservation efforts, the FWS is also recommending the designation of critical habitat at specific overwintering sites along California’s coast. These habitats serve as vital winter refuges, providing monarchs the resources needed to rest and prepare for spring breeding.

“The fact that a butterfly as widespread and beloved as the monarch is now the face of the extinction crisis is a tri-national distress signal warning us to take better care of the environment that we all share,” said Tierra Curry, a senior scientist at the Center for Biological Diversity.

“For 30 years, we’ve watched the population of monarch butterflies collapse. It is clear that monarchs cannot thrive — and might not survive — without federal protections,” added Dan Ritzman, director of conservation at Sierra Club.

The Endangered Species Act of 1973 is widely credited with saving iconic American species such as the gray wolf, bald eagle and grizzly bear.

During Trump’s first administration, however, key provisions of the law were weakened. These changes, later reversed by President Joe Biden, included measures that allowed industrial projects such as roads, pipelines and mines in areas designated as critical habitat for vulnerable species.

Trump’s administration also removed endangered species protections for gray wolves across most of the United States and slashed critical habitat designated for northern spotted owls.
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NEW YORK — The most expensive dinosaur fossil ever discovered will be on view in New York starting this weekend, American Museum of Natural History officials announced Wednesday.

The giant stegosaurus fossil, dubbed “Apex,” is 3.3 meters tall and 8.2 meters nose to tail. The display will start in a giant atrium at the museum’s entrance before being moved to the museum’s existing fossil halls next year.

The museum also confirmed the identity of the philanthropist who purchased Apex. Billionaire hedge fund manager and longtime museum donor Ken Griffin bought it at an auction in July for $45 million, the most ever paid for dinosaur remains. Sean Decatur, president of the American Museum of Natural History, said that Griffin approved a long-term loan of Apex, as well as allowing scientists to take samples from the fossil for analysis.

“This partnership allows Apex to have pride of place at a museum world-renowned for its dinosaur collection and for its longstanding leadership in paleontology and, even more exciting, enables us to pursue specialized stegosaurus research centered around this extraordinary and scientifically important specimen,” Decatur said in a statement Wednesday.

Of the more than 80 stegosauri made available to scientific institutions, very few are substantially complete, the statement said. Apex is the most complete specimen ever found, Decatur said. With about 80% of its 320 bones preserved, it is miraculous for creature that has been dead for 150 million years. The specimen is also prized by scientists because it is estimated to have died at a relatively old age, and it could reveal insights into stegosaurus metabolism and bone growth.

Scientists will make CT scans of the internal structures of the dinosaur’s skull and analyze a small sample extracted from one of its giant thigh bones, the statement said.

“As exciting as is it is to have this dinosaur on display, it is even more exciting to have the opportunity to study it and make important scientific data available for research,” said Roger Benson, who curates the American Museum of Natural History’s fossil amphibians, reptiles, birds and plants.

The museum’s paleontologists have a long record of breaking ground in dinosaur research, including identifying the first dinosaur eggs and early evidence of dinosaur feathers, the statement said.

Commercial paleontologist Jason Cooper discovered in Apex on his land near Dinosaur, Colorado, on the Utah border near Dinosaur National Monument.

Griffin’s successful $44.6 million bid for Apex over the summer set a record for dinosaur remains, beating out the $31.8 million paid for “Stan,” the remains of a Tyrannosaurus rex sold in 2020. Like Apex, the Stan fossils were purchased by a private individual with plans to make it available to the public. The T. rex has been slated to be on display in Abu Dhabi, in United Arab Emirates, at a museum that opens in late 2025.
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SKOPJE, North Macedonia — A political party in North Macedonia on Saturday demanded authorities ban social networks whose content incites violence and self-destructive behavior after several young people were seriously injured in connection with the popular “Superman challenge” on TikTok. 

Health authorities said at least 17 students, ages 10 to 17, were brought to hospitals in the capital Skopje and other towns over the past week with broken bones, contusions and bruises. The children were injured after being thrown into the air by their friends to fly like superheroes and get applause on the internet. 

The Liberal-Democratic Party, which was part of the left-led coalition that ruled the country from 2016 to earlier in 2024, issued a press statement Saturday strongly condemning “the irresponsible spread of dangerous content on social media, such as the latest TikTok ‘challenge’ known as ‘Superman,’ which has injured six children across (the country) in the past 24 hours.” 

“The lack of adequate control over the content of social media allows such ‘games’ to reach the most vulnerable users,” the party statement said. It demanded the “immediate introduction of measures to ban content that incites violence and self-destructive behavior, increase surveillance, and sanction platforms that enable dangerous trends.” 

North Macedonia’s education minister Vesna Janevska said students should focus on education, not TikTok challenges. 

“The ban on mobile phones in schools will not have an effect. Phones will be available to children in their homes, neighborhoods and other environments,” she said. 

Psychologists have warned that the desire to be “in” with the trends on social networks, combined with excessive use of mobile phones, is the main reason for the rise in risky behaviors among children. They urged parents and schools to talk with students. 
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SYDNEY — Australian authorities are being criticized for ruling out drug decriminalization at an international summit in Sydney this week, ignoring a call by many experts and health groups for a health care response to drug use and addiction rather than criminal penalties.

Several hundred politicians, policy experts, police officers and health professionals gathered this week for a summit on drug reform in Sydney.

The New South Wales government is examining ways to redraft the state’s drug laws and policies.

Calls for the decriminalization of drug use and possession were the focus of the meeting.

Campaigners say not treating drug use as a crime would encourage people to seek help without fear of legal consequences.

New South Wales Health Minister Ryan Park told local media Friday, though, there is not enough local support for such reform.

“The summit is not just about decriminalization, and for a government to move to decriminalize in the drugs … would be a seismic shift to the way in which we handle drugs in New South Wales,” Park said. “In relation to decriminalization, we think that is too significant to put on the table now without a clear mandate.”

The Sydney summit heard from the mayor of Portland, in the U.S. state of Oregon, Ted Wheeler. He told delegates that earlier this year, state lawmakers repealed laws that decriminalized the possession of small amounts of illicit drugs in the state. He said that the health system has been overwhelmed, and that drug-related crime has risen sharply because of the legislation.

International debate is passionate and divided.

A report by the Global Commission on Drug Policy, formed in 2011 to campaign for drug reform, called for a total reexamination of the approach to illicit substances.

Louise Arbour, a former U.N. high commissioner for human rights, was involved in the report and told the Australian Broadcasting Corporation that a new approach is needed.

“Globally, it is very clear that this so-called war on drugs has created a gigantic international illegal drug trade,” Arbour said. “The worst aspect of that war is that it has essentially been a war on people — been a war on people who use drugs and not a war on people who actually prey on them.”

The annual number of drug overdose deaths in Australia has almost doubled over the past 20 years, according to the Penington Institute, a nonprofit organization in Victoria state.

Some 100,000 people are estimated to die each year from drug overdoses in the United States, but the number of fatalities has decreased, according to research from the Centers for Disease Control and Prevention.
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Efforts to reduce the nation’s persistently high maternal mortality rates involve state panels of experts that investigate and learn from each mother’s death.

The panels — called maternal mortality review committees — usually do their work quietly and out of the public eye. But that’s not been the case recently in three states with strict abortion laws.

Georgia dismissed all members of its committee in November after information about deaths being reviewed leaked to the news organization ProPublica. Days later, The Washington Post reported that Texas’ committee won’t review cases from 2022 and 2023, the first two years after the state banned nearly all abortions. In Idaho, the state let its panel disband in 2023 only to reinstate it earlier this year.

“They’ve become more of a lightning rod than they were before,” said epidemiologist Michael Kramer, director of the Center for Rural Health and Health Disparities at Mercer University in Georgia.

Here’s what maternal mortality review committees across the nation do and what might happen next:

What are they?

“Maternal mortality review committees are important because they are the most comprehensive source of information about maternal mortality that we have,” said David Goodman, who leads the maternal mortality prevention team at the U.S. Centers for Disease Control and Prevention.

The panels review deaths that occur during pregnancy or within a year after it ends, whether directly related to the pregnancy or not. Causes of death can range from hemorrhage during childbirth to drug overdoses to traffic accidents.

The goal, Kramer said, is to examine maternal deaths and help “decide what we can do about them.”

All states, a few cities and Puerto Rico have these committees. Their membership varies and may include OB-GYNs, maternal-fetal medicine doctors, nurses, midwives, mental and public health experts and members of patient advocacy groups. Most have representatives from several areas of expertise, which the CDC recommends.

How members are selected also varies; people may apply, submit letters of interest or be invited to serve.

The selection shouldn’t be politically motivated, Kramer said, because “if there’s a systematic exclusion of certain data or certain perspectives” it’s difficult to truly understand what’s happening.

How do they look at deaths?

First, the panels work with state vital statistics offices and epidemiologists to identify deaths associated with pregnancy by examining death certificates and looking for a pregnancy checkbox or a related cause of death. They may also search for links to birth and fetal death records, or delve into hospital discharge data, media reports and obituaries.

Once they identify cases, they collect as much information as possible, such as prenatal care records, hospital and social service records, autopsy reports and interviews with family members. Professional “abstractors” distill all this into case narratives, which committee members pore over. Most use a standardized review process developed by the CDC — and all panels can get help and guidance from the agency.

They consider questions such as: Was the death pregnancy-related? What was the underlying cause? Was it preventable? What factors contributed?

States generally have privacy rules that protect committee members and people who provide information on the deaths.

The groups then issue public reports that don’t name moms or hospitals but include overall findings, trends and recommendations. Some come out a couple of years or more after the deaths.

Across the nation in 2023, Goodman said, 151 recommendations from those reports were implemented by communities, hospitals, medical professionals and policymakers.

What about Georgia, Texas and Idaho?

Georgia will rebuild its committee through a new application process, the state public health commissioner said.

Texas’ committee has been reviewing 2021 deaths and will start on 2024 cases at its next meeting, Texas Department of State Health Services spokesperson Lara Anton said in an email to The Associated Press.

“Reviewing cases is a lengthy process and legislators have asked for more recent data. Starting the next review cycle with 2024 cases will allow us to provide that in the next report,” Anton said, adding that maternal and child health epidemiologists will continue to analyze and publish data for 2022 and 2023.

In Idaho, the reconstituted review committee now falls under the state board of medicine, which licenses doctors, instead of the state’s health and welfare department. It will operate like it always has, said Bob McLaughlin, spokesperson for the medical board. Members met for the first time in November and plan to issue a report by Jan. 31. Because the legislature wanted the most up-to-date information, McLaughlin said the first report will cover only 2023 cases, and the group will review 2022 deaths next.

Goodman said he’s encouraged that every state has a review committee now — only 20 had them in 2015.
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A surprising study of temperature-related deaths in Mexico upends conventional thinking about what age group is hit hardest by heat. Researchers found at higher temperatures and humidity, the heat kills far more young people under 35 than those older than 50.

For decades, health and weather experts have warned that the elderly and the youngest children were most vulnerable in heat waves. But this study looking at all deaths in Mexico from 1998 to 2019 shows that when the combination of humidity and temperature reach uncomfortable levels, around 30 degrees Celsius and 50% relative humidity, there were nearly 32 temperature-related deaths of people 35 years old for every temperature-related death of someone 50 and older.

The study in Friday’s journal Science Advances shows an especially surprising spike of heat-related deaths in an age group thought to be young and robust: people between 18 and 35. That age group alone had nine times as many temperature-related deaths as those older than 50.

Study authors and outside experts are scrambling to figure out why. Demographics alone don’t explain why more young adult Mexicans are dying in high heat than their elders. Two theories: Outdoor workers who can’t escape the heat, and young people who don’t know their limits.

The trend is likely to widen as the world warms from human-caused climate change, according to computer simulations run by the study team.

“We found that younger people are especially vulnerable to humid heat,” study co-author Jeffrey Shrader, a climate economist at Columbia University, said. “As the climate warms, we’re really going to be shifting the burden of temperature-related mortality towards younger individuals and away from older individuals who tend to be more vulnerable to cold temperatures.”

Data from cold weather shows more than 300 deaths of Mexican residents 50 and older for every young person dying from cold temperatures, according to the study.

“People of all ages are increasingly at risk from the rising temperatures, and this study shows that those that we might have considered relatively safe from heat-related adverse health outcomes might not be so much so,” said Marina Romanello, executive director of the Lancet Countdown that monitors health effects of climate change. She was not part of the study team.

“Heat is a much more dangerous silent killer than most people acknowledge it to be, and that heat is increasingly putting our health and survival at risk,” Romanello said in an email.

Study authors decided to examine weather-related deaths in Mexico because that country not only has detailed mortality data, but it has a variety of different climates making it an ideal place to study in depth, Shrader said.

Researchers also want to figure out whether this is just a situation in Mexico or other warmer sections of the globe have similar spikes in young adult deaths in high heat and humidity.

Initially the team just wanted to look at deaths and what scientists call wet-bulb globe temperatures, but when they looked at age differences, they were surprised and looked in more detail, Shrader said. Wet-bulb temperature, which is intended to mirror how the body cools itself, is derived using a complicated measurement system that factors in humidity and solar radiation. A wet-bulb globe temperature of 35 degrees Celsius is thought to be the limit for human survivability. Most places don’t reach that level.

Researchers determined temperature-related mortality by complex statistical analysis that compares numerous factors in the number of deaths and removes everything they can except temperature fluctuations, said study co-author Andrew Wilson, a Columbia climate economics researcher.

Researchers also calculated the ideal temperature for when there are the fewest excess deaths at each age group. Younger adults’ sweet temperature spot is about 5 degrees Celsius cooler than it is for older people, Shrader and Wilson said.

Some outside health and climate experts were initially puzzled at the higher youth mortality seen in the study. Co-author Patrick Kinney, a professor of urban health and sustainability at Boston University, said it was likely the study included a higher proportion of outdoor workers exposed to heat than prior studies did.

Study co-author Tereza Cavazos, a climate scientist at the Ensenada Center for Scientific Research and Higher Education in Mexico, said she remembers her father’s generations taking siestas in the high heat of the day and that was healthy. That doesn’t happen so much now, she said.

“There is a lot of population that is vulnerable in the future. Not even in the future, right now,” Cavazos said. She mentioned three Mexican heat waves this year that hit in the middle of the country and kept the deadly heat going overnight so people had little relief. Usually cool nights allow a body to recover.

Younger people often have a sense of invulnerability to weather extremes and do things that increase their risk, such as play sports in high heat, Cavazos said.

“High humidity makes it a lot harder for the body to cool itself through sweating – which is how our body primarily stays cool,” said Dr. Renee Salas, an emergency medicine physician and climate change expert at Massachusetts General Hospital and Harvard Medical School. She was not part of the study team. “So someone young and healthy working outside in heat and high humidity can reach a point where the body can no longer cool itself safely – causing a deadly form of heat injury called heat stroke.” 
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The U.S. space agency, NASA, is leading an effort to return astronauts to the surface of the moon and establish a routine presence on the lunar surface. As VOA’s Kane Farabaugh reports, NASA says it will push the next mission of its Artemis program from late 2025 to early 2026.
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LONDON — As a landmark climate change case reached its halfway mark Friday at the International Court of Justice in The Hague, clear divisions have emerged over whether nation states can be held legally liable for global warming under international human rights laws.

The 15 judges at the United Nations’ top court have been asked to give an opinion on whether nation states are obliged under such laws to cut their greenhouse gas emissions and to address damage caused by climate change.

Existential threat

Small island and coastal states say their very existence is at stake due to rising sea levels. They argue that international human rights law must apply.

“Territories are disappearing. Livelihoods are being destroyed. Fundamental rights are being violated as we speak,” said Margaretha Wewerinke-Singh, the lead counsel for the Pacific Islands state of Vanuatu.

“The destruction of the Earth’s climate system and other parts of the environment constitutes grave breaches of international law. So, our hopeful expectation is that the court will recognize this and articulate the legal consequences of these violations,” she said.

“Legal consequences of violations of international law are always twofold. The wrongful conduct — the breaching conduct — must cease, it must be put to an end. And secondly, reparations must be made,” Wewerinke-Singh told reporters at The Hague at the opening of the hearing Monday.

Big polluters

However, the world’s biggest polluters — including the United States, China and India — argue that only global climate change agreements have any legal relevance. Human rights, they say, do not apply.

“In rendering its advisory opinion, the court may exercise due caution to avoid devising new or additional obligations beyond what is already agreed to under the existing climate change regime, which take into consideration historic emissions, climate justice and the principles of equity,” India’s representative, Luther Rangreji, told the court on Thursday.

Other major economies have made similar arguments during the first week of the hearing, according to analyst Elena Kosolapova of the International Institute for Sustainable Development.

“For example, Canada has argued that human rights obligations do not encompass the obligation to mitigate greenhouse gas emissions. Germany said the goal of human rights treaties is to protect actual victims of concrete violations and not abstract persons from abstract risks,” Kosolapova told VOA.

“Spain was a notable exception in this camp because it argued that governments actually have human rights obligations in relation to the response to climate change,” she said.

Reparations

Many developed nations fear the financial consequences if human rights laws are invoked, Kospolova said.

“Under the law of state responsibility, any breach of an international obligation, known as an ‘international wrongful act,’ entails certain consequences,” she said. “And many vulnerable countries have highlighted this during the hearings. The responsible state is obligated to make reparations for the injury caused by the wrongful act.”

Those reparations could take the form of compensation.

“Compensation was explicitly excluded from the loss and damage talks under the [climate change] convention and from the Paris Agreement itself,” Kospolova said. “So, I think it would be very interesting to see what the court has to say about it.”

Crucial year

The judges will hear another week of evidence before delivering their legal opinion next year, which is expected to be a crucial year for climate legislation. Over the next few months, nation states are due to publish action plans known as Nationally Determined Contributions, or NDCs, which outline how they plan to cut greenhouse gas emissions.

The NDCs will form a central part of the COP30 climate summit in November, to be held in the Brazilian city of Belem on the edge of the Amazon rainforest.
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Using sailing ships to move cargo may be making a comeback. These days, eco-friendly watercraft are equipped with the latest technology. Elena Wolf has the story, narrated by Anna Rice. Camera: Max Avloshenko 
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Tehran, Iran — Iran successfully launched on Friday its heaviest space payload, which includes a satellite and a space tug, using a domestically developed satellite carrier, official media reported.

Weighing 300 kilograms, the payload consisted of the Fakhr-1 telecommunications satellite and the Saman-1 space tug, according to state television.

The Saman-1 is an “orbital transmission system” designed to transport satellites from lower orbits to higher ones, as described by the Iran Space Research Center when it was unveiled in 2017.

The launch marks an “operational step” toward transferring satellites into higher orbits, the TV report said.

The system was first introduced in February 2017 at a ceremony attended by Iran’s then-president, Hassan Rouhani, and was test-launched in 2022.

The payloads were launched using the homegrown Simorgh satellite carrier from the Imam Khomeini launch base in Semnan province.

Named after a mythical Iranian bird, the Simorgh is a two-stage, liquid-fueled satellite launch vehicle developed by Iran’s defense ministry.

In September, Iran said it successfully put the Chamran-1 research satellite into orbit using the Ghaem-100 carrier, which is produced by the Revolutionary Guards’ aerospace division.

Western governments, including the United States, have repeatedly warned Iran against such launches, arguing technology used for satellites could be applied to ballistic missiles, potentially capable of carrying nuclear warheads.

Iran denies it wants nuclear weapons. It has consistently stated that its satellite and rocket launches are focused on civil and defense applications.

Last month, Russia launched 55 satellites, including two built by Iran — Koswar and Hodhod — reflecting the deepening political, economic and military relations between the two nations.
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KINSHASA, CONGO — Public health officials in Africa urged caution Thursday as Congo’s health minister said the government was on alert over a mystery flu-like disease that in recent weeks killed dozens of people.

Jean Kaseya, the head of Africa Centers for Disease Control and Prevention, told reporters that more details about the disease should be known in the next 48 hours as experts receive results from laboratory samples of infected people.

“First diagnostics are leading us to think it is a respiratory disease,” Kaseya said. “But we need to wait for the laboratory results.” He added that there are many things that are still unknown about the disease — including whether it is infectious and how it is transmitted.

Authorities in Congo have so far confirmed 71 deaths, including 27 people who died in hospitals and 44 in the community in the southern Kwango province, Health Minister Roger Kamba said.

“The Congolese government is on general alert regarding this disease,” Kamba said, without providing more details.

Of the victims at the hospitals, 10 died due to lack of blood transfusion and 17 because of respiratory problems, he said.

The deaths were recorded between November 10 and 25 in the Panzi health zone of Kwango province. There were around 380 cases, almost half of which were children under the age of 5, according to the minister.

The Africa CDC recorded slightly different numbers, with 376 cases and 79 deaths. The discrepancy was caused by problems with surveillance and case definition, Kaseya said.

Authorities have said that symptoms include fever, headache, cough and anemia. Epidemiological experts are in the region to take samples and investigate the disease, the minister said.

The Panzi health zone, located around 700 kilometers from the capital, Kinshasa, is a remote area of the Kwango province, making it hard to access.

The epidemiological experts took two days to arrive there, the minister said. Because of the lack of testing capacity, samples had to be taken to Kikwit, more than 500 kilometers away, said Dieudonne Mwamba, the head of the National Institute for Public Health.

“The health system is quite weak in our rural areas, but for certain types of care, the ministry has all the provisions, and we are waiting for the first results of the sample analysis to properly calibrate things,” Kaseya said.

Mwamba said that Panzi was already a “fragile” zone, with 40% of its residents experiencing malnutrition. It was also hit by an epidemic of typhoid fever two years ago, and there is currently a resurgence of seasonal flu across the country.

“We need to take into account all this as context,” Mwamba said.

A Panzi resident, Claude Niongo, said his wife and 7-year-old daughter died from the disease.

“We do not know the cause, but I only noticed high fevers, vomiting … and then death,” Niongo told The Associated Press over the phone. “Now, the authorities are talking to us about an epidemic, but in the meantime, there is a problem of care [and] people are dying.”
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FREETOWN, SIERRA LEONE — Authorities in Sierra Leone on Thursday started a nationwide rollout of the single-dose Ebola vaccine, the first such campaign in West Africa, where a deadly outbreak 10 years ago resulted in the death of thousands.

The 2014 Ebola outbreak — the deadliest in history — was primarily in West Africa but affected Sierra Leone the most, with nearly 4,000 deaths out of the more than 11,000 recorded globally. The country also lost 7% of its health care workforce to the outbreak.

The nationwide vaccine campaign, implemented by the government in partnership with the global vaccine alliance Gavi, the World Health Organization and the United Nations children’s agency, will target 20,000 front-line workers across the country, officials said.

“This is an investment in the safety of our people and a healthier Sierra Leone,” Health Minister Austin Demby said.

There had been no approved vaccine at the time of the 2014 outbreak, which recorded up to 28,000 cases, starting in Guinea before spreading across land borders to Sierra Leone and Liberia, the other two countries affected the most.

Three years have passed since the last case was recorded in Guinea, although officials have spoken of remaining threats in endemic regions.

Among those killed by the disease during the 2014 outbreak were nine relatives of Hassan Kamara, a resident of Freetown. Of the 11 people he was living with at the time, only he and his baby daughter survived.

“They died in front of me,” he said. “I feel bad sometimes speaking about this because of what I went through.”

Thursday’s campaign, which launched in the capital, Freetown, was welcomed by health workers.

Collins Thomas, a community health worker in Freetown, remembers losing many colleagues in 2014 as they managed patients during the outbreak in Freetown.

“It was scary, because we knew nothing about the disease and learned along the line. With this vaccine, we know we are protected,” Thomas said.

Gavi Chief Executive Sania Nishtar said the organization is “incredibly proud” of how its support for timely and equitable access to vaccines has helped save lives and protect communities.

“To have the first nationwide preventive vaccination campaign take place in the country most deeply impacted by the 2014 outbreak makes this historic milestone even more meaningful,” he said.
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WASHINGTON — The Supreme Court is hearing arguments Wednesday in just its second major transgender rights case, which is a challenge to a Tennessee law that bans gender-affirming health care for minors.

The justices’ decision, not expected for several months, could affect similar laws enacted by 25 other states and a range of efforts to regulate the lives of transgender people, including which sports competitions they can join and which bathrooms they can use.

The case is coming before a conservative-dominated court after a presidential election in which Donald Trump and his allies promised to roll back protections for transgender people.

There were dueling rallies outside the court in the hours before the arguments. Speeches and music filled the air on the sidewalk below the court’s marble steps. Advocates of the ban bore signs like “Champion God’s Design” and “Kids Health Matters,” while the other side proclaimed “Fight like a Mother for Trans Rights” and “Freedom to be Ourselves.”

Four years ago, the court ruled in favor of Aimee Stephens, who was fired by a Michigan funeral home after she informed its owner that she was a transgender woman. The court held that transgender people, as well as gay and lesbian people, are protected by a landmark federal civil rights law that prohibits sex discrimination in the workplace.

The Biden administration and the families and health care providers who challenged the Tennessee law are urging the justices to apply the same sort of analysis that the majority, made up of liberal and conservative justices, embraced in the case four years ago when it found that “sex plays an unmistakable role” in employers’ decisions to punish transgender people for traits and behavior they otherwise tolerate.

The issue in the Tennessee case is whether the law violates the equal protection clause of the 14th Amendment, which requires the government to treat similarly situated people the same.

Tennessee’s law bans puberty blockers and hormone treatments for transgender minors, but not “across the board,” lawyers for the families wrote in their Supreme Court brief. The lead lawyer, Chase Strangio of the American Civil Liberties Union, is the first openly transgender person to argue in front of the justices.

The administration argues there is no way to determine whether “treatments must be withheld from any particular minor” without considering the minor’s sex.

“That is sex discrimination,” Solicitor General Elizabeth Prelogar wrote in her main court filing.

The state acknowledges that the same treatments that are banned for transgender minors can be prescribed for other reasons. But it rejects the claim that it is discriminating on the basis of sex. Instead, it says lawmakers acted to protect minors from the risks of “life-altering gender-transition procedures.”

The law “draws a line between minors seeking drugs for gender transition and minors seeking drugs for other medical purposes. And boys and girls fall on both sides of that line,” Tennessee Attorney General Jonathan Skrmetti wrote in the state’s Supreme Court brief.

While the challengers invoke the 2020 ruling in Bostock v. Clayton County for support, Tennessee relies on the court’s precedent-shattering Dobbs decision in 2022 that ended nationwide protections for abortion and returned the issue to the states.

The two sides battled in their legal filings over the appropriate level of scrutiny the court should apply. It’s more than an academic exercise.

The lowest level is known as rational basis review and almost every law looked at that way is ultimately upheld. Indeed, the federal appeals court in Cincinnati that allowed the Tennessee law to be enforced held that lawmakers acted rationally to regulate medical procedures, well within their authority.

The appeals court reversed a trial court that employed a higher level of review, heightened scrutiny, that applies in cases of sex discrimination. Under this more searching examination, the state must identify an important objective and show that the law helps accomplish it.

If the justices opt for heightened scrutiny, they could return the case to the appeals court to apply it.

Gender-affirming care for youth is supported by every major medical organization, including the American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association.

But Tennessee is pointing to health authorities in Sweden, Finland, Norway and the United Kingdom that found the medical treatments “pose significant risks with unproven benefits.”

None of those countries has adopted a ban like the one in Tennessee, and individuals can still obtain treatment, Prelogar wrote in response.

The Williams family of Nashville, Tennessee, are among those challenging the state law. Brian Williams said that because of puberty blockers and hormone treatments, his transgender daughter, L.W., is a “16-year-old planning for her future, making her own music and looking at colleges.”

But because of Tennessee’s ban, she has to travel to another state to receive the health care that “we and her doctors know is right for her.”
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In Zambia, an education and prevention program known as the Total Control of the Epidemic project is focused on ending AIDS as a public health threat by 2030. Kathy Short reports from Petauke, Zambia. Camera: Jawadu Sumaili
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WASHINGTON — When the Supreme Court this week wades into the contentious issue of transgender rights, the justices will hear from an attorney with knowledge that runs deep.

Chase Strangio will be the first openly transgender attorney to argue before the nation’s highest court, representing families who say Tennessee’s ban on health care for transgender minors leaves their children terrified about the future.

Arguments in the case come amid heightened pushback to transgender rights, including a presidential campaign where Republican Donald Trumpput his fierce opposition front and center.

Strangio will bring months of intense legal preparation to the case as well as hard-won lessons from his own experience.

“I am able to do my job because I have had this health care that transformed and, frankly, saved my life,” he said. “I am a testament to the fact that we live among everyone.”

Strangio grew up outside of Boston and came out as trans when he was in law school. Now 42, he’s an American Civil Liberties Union attorney whose legal career has included representing former Army intelligence analyst Chelsea Manning, challenging a ban on transgender people serving in the military and helping win an LGBTQ+ worker-discrimination case at the Supreme Court. He’s also the father of a 12-year-old, the son of a father who supports Trump, and has a close relationship with his Army-veteran brother.

He’s also an advocate, speaking out as a series of U.S. states banned gender-affirming health care for transgender minors. The laws are part of a wave of restrictions on school sports participation and bathroom usage around the country. After the first openly transgender person was elected to Congress, Republican House Speaker Mike Johnson declared support for restricting bathroom use to sex assigned at birth.

Tennessee, meanwhile, will argue before the Supreme Court that treatments like puberty blockers and hormones carry risks for young people and that its law protects them from making treatment decisions prematurely.

“Tennessee, like many other states, acted to ensure that minors do not receive these treatments until they can fully understand the lifelong consequences or until the science is developed to the point that Tennessee might take a different view of their efficacy,” state attorneys wrote in court filings.

Arguing for Tennessee is state Solicitor General Matt Rice. He served in 2019 as a clerk for Justice Clarence Thomas, who dissented from the transgender worker-discrimination case Strangio worked on that term. The state attorney general’s office did not make Rice available for an interview ahead of arguments, but his background also includes a couple of years as a minor league baseball player for the Tampa Bay Rays before he earned his law degree from the University of California, Berkeley.

The Biden administration is supporting the challenge to Tennessee’s law, but the federal government’s position is expected to change after Trump takes office in January. 

Strangio said he’ll nevertheless keep advocating for transgender youth to access health care that wasn’t available when he was young.

“Many of us think about our childhood and young adulthood as lost years, when we were just simply disembodied from our core,” he said. Major medical groups, including the American Medical Association and the American Academy of Pediatrics, oppose the bans and have endorsed such care, saying it’s safe when administered properly. 

Strangio also pointed out that many medical interventions for young people, like gastric bypass surgeries for weight loss, carry some risk and it makes sense to inform families and let them decide.

“There is harm that is compounded when we are forcing young people to be denied care that their doctors and their parents and they themselves all agree they need,” he said.

The Supreme Court is expected to decide the case by the summer.
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Washington — President Joe Biden on Sunday had the AIDS Memorial Quilt spread on the White House South Lawn for the first time in observance of World AIDS Day.

Gathered with the president and his wife, Jill, were survivors, family members and advocates to memorialize the lives lost to the epidemic. The president emphasized the federal government’s support for the 1.2 million people in the United States living with the human immunodeficiency virus (HIV), which can lead to AIDS.

“This movement is fully woven into the fabric and history of America,” Biden said. “For all the lives lost, for all those that are still alive, look at what you’ve already done to change the hearts and minds, to save lives across the country and around the world. That’s the power of this movement.”

There were 124 sections of the quilt on the lawn to commemorate people who died due to AIDS-related illnesses. Conceived in 1985, the quilt made its first public appearance in 1987. There was also a red ribbon, a symbol of support and awareness for those with HIV and AIDS, draped across the South Portico of the White House.

There are 40 million people around the world with HIV, according to the White House.

Introducing Biden was Jeanne White-Ginder, whose son, Ryan White, contracted AIDS through a tainted blood transfusion at the age of 13 and died in 1990 at the age of 18. She said her son’s experience taught America that “we needed to fight AIDS and not the people who have it.”

The Ryan White CARE Act became law in 1990, and White-Grinder recalled being at the U.S. Capitol to speak for the measure and met Biden when he was a senator from Delaware.

The president also saluted Dr. Anthony Fauci, the top U.S. infectious disease expert until leaving the government in 2022, Fauci was in attendance at the event as he worked to treat AIDS, though he’s known by much of the country for his efforts to address the coronavirus pandemic that made him a target of criticism by many Republican lawmakers.

The Biden administration has sought to make investments to stop the epidemic, and the stigmas attached to people with HIV. Among other steps, it has worked to expand access to PrEP, or the pre-exposure prophylaxis, which at-risk populations use to prevent HIV infections.
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The Hague — The top United Nations court will take up the largest case in its history Monday, when it opens two weeks of hearings into what countries worldwide are legally required to do to combat climate change and help vulnerable nations fight its devastating impact.

After years of lobbying by island nations who fear they could simply disappear under rising sea waters, the U.N. General Assembly asked the International Court of Justice last year for an opinion on “the obligations of States in respect of climate change.”

“We want the court to confirm that the conduct that has wrecked the climate is unlawful,” Margaretha Wewerinke-Singh, who is leading the legal team for the Pacific island nation of Vanuatu, told The Associated Press.

In the decade up to 2023, sea levels have risen by a global average of around 4.3 centimeters (1.7 inches), with parts of the Pacific rising higher still. The world has also warmed 1.3 degrees Celsius (2.3 Fahrenheit) since pre-industrial times because of the burning of fossil fuels.

Vanuatu is one of a group of small states pushing for international legal intervention in the climate crisis.

“We live on the front lines of climate change impact. We are witnesses to the destruction of our lands, our livelihoods, our culture and our human rights,” Vanuatu’s climate change envoy Ralph Regenvanu told reporters ahead of the hearing.

Any decision by the court would be non-binding advice and unable to directly force wealthy nations into action to help struggling countries. Yet it would be more than just a powerful symbol since it could serve as the basis for other legal actions, including domestic lawsuits.

On Sunday, ahead of the hearing, advocacy groups will bring together environmental organizations from around the world. Pacific Islands Students Fighting Climate Change — who first developed the idea of requesting an advisory opinion — together with World Youth for Climate Justice plan an afternoon of speeches, music and discussions.

From Monday, the Hague-based court will hear from 99 countries and more than a dozen intergovernmental organizations over two weeks. It’s the largest lineup in the institution’s nearly 80-year history.

Last month at the United Nations’ annual climate meeting, countries cobbled together an agreement on how rich countries can support poor countries in the face of climate disasters. Wealthy countries have agreed to pool together at least $300 billion a year by 2035 but the total is short of the $1.3 trillion that experts, and threatened nations, said is needed.

“For our generation and for the Pacific Islands, the climate crisis is an existential threat. It is a matter of survival, and the world’s biggest economies are not taking this crisis seriously. We need the ICJ to protect the rights of people at the front lines,” Vishal Prasad, of Pacific Islands Students Fighting Climate Change, told reporters in a briefing.

Fifteen judges from around the world will seek to answer two questions: What are countries obliged to do under international law to protect the climate and environment from human-caused greenhouse gas emissions? And what are the legal consequences for governments where their acts, or lack of action, have significantly harmed the climate and environment?

The second question refers to “small island developing States” likely to be hardest hit by climate change and to “members of “the present and future generations affected by the adverse effects of climate change.”

The judges were even briefed on the science behind rising global temperatures by the U.N.’s climate change body, the Intergovernmental Panel on Climate Change, ahead of the hearings.

The case at the ICJ follows a number of rulings around the world ordering governments to do more to reduce greenhouse gas emissions.

In May, a U.N. tribunal on maritime law said that carbon emissions qualify as marine pollution, and countries must take steps to adapt to and mitigate their adverse effects.

That ruling came a month after Europe’s highest human rights court said that countries must better protect their people from the consequences of climate change, in a landmark judgment that could have implications across the continent.

The ICJ’s host country of The Netherlands made history when a court ruled in 2015 that protection from the potentially devastating effects of climate change is a human right and that the government has a duty to protect its citizens. The judgment was upheld in 2019 by the Dutch Supreme Court.
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Mexico City — It’s been called the closest the world has ever come to a vaccine against the AIDS virus.

The twice-yearly shot was 100% effective in preventing HIV infections in a study of women, and results published Wednesday show it worked nearly as well in men.

Drugmaker Gilead said it will allow cheap, generic versions to be sold in 120 poor countries with high HIV rates — mostly in Africa, Southeast Asia and the Caribbean. But it has excluded nearly all of Latin America, where rates are far lower but increasing, sparking concern the world is missing a critical opportunity to stop the disease.

“This is so far superior to any other prevention method we have, that it’s unprecedented,” said Winnie Byanyima, executive director of UNAIDS. She credited Gilead for developing the drug but said the world’s ability to stop AIDS hinges on its use in at-risk countries.

In a report issued to mark World AIDS Day on Sunday, UNAIDS said that the number of AIDS death last year — an estimated 630,000 — was at its lowest since peaking in 2004, suggesting the world is now at “a historic crossroads” and has a chance to end the epidemic.

The drug called lenacapavir is already sold under the brand name Sunlenca to treat HIV infections in the U.S., Canada, Europe and elsewhere. The company plans to seek authorization soon for Sunlenca to be used for HIV prevention.

While there are other ways to guard against infection, like condoms, daily pills, vaginal rings and bi-monthly shots, experts say the Gilead twice-yearly shots would be particularly useful for marginalized people often fearful of seeking care, including gay men, sex workers and young women.

“It would be a miracle for these groups because it means they just have to show up twice a year at a clinic and then they’re protected,” said UNAIDS’ Byanyima.

Such was the case for Luis Ruvalcaba, a 32-year-old man in Guadalajara, Mexico, who participated in the latest published study. He said he was afraid to ask for the daily prevention pills provided by the government, fearing he would be discriminated against as a gay man. Because he took part in the study, he’ll continue to receive the shots for at least another year.

“In Latin American countries, there is still a lot of stigma; patients are ashamed to ask for the pills,” said Dr. Alma Minerva Pérez, who recruited and enrolled a dozen study volunteers at a private research center in Guadalajara.

How widely available the shots will be in Mexico through the country’s health care system isn’t yet known. Health officials declined to comment on any plans to buy Sunlenca for its citizens; daily pills to prevent HIV were made freely available via the country’s public health system in 2021.

“If the possibility of using generics has opened, I have faith that Mexico can join,” said Pérez.

Byanyima said other countries besides Mexico that took part in the research were also excluded from the generics deal, including Brazil, Peru and Argentina. “To now deny them that drug is unconscionable.” she said.

In a statement, Gilead said it has “an ongoing commitment to helping enable access to HIV prevention and treatment options where the need is the greatest.” Among the 120 countries eligible for generic version are 18 mostly African countries that comprise 70% of the world’s HIV burden.

The drugmaker said it is also working on establishing “fast, efficient pathways to reach all people who need or want lenacapavir for HIV prevention.”

On Thursday, 15 advocacy groups in Peru, Argentina, Ecuador, Chile, Guatemala and Colombia wrote to Gilead, asking for generic Sunlenca to be made available in Latin America, citing the “alarming” inequity in access to new HIV prevention tools while infection rates were rising.

While countries including Norway, France, Spain and the United States have paid more than $40,000 per year for Sunlenca, experts have calculated it could be produced for as little as $40 per treatment once generic production expands to cover 10 million people.

Dr. Chris Beyrer, director of the Global Health Institute at Duke University, said it will be enormously useful to have Sunlenca available in the hardest-hit countries in Africa and Asia. But he said the rising HIV rates among groups including gay men and transgender populations constituted “a public health emergency” in Latin America.

Hannya Danielle Torres, a 30-year-old trans woman and artist who was in the Sunlenca study in Mexico, said she hoped the government would find a way to provide the shots. “Mexico may have some of the richest people in the world but it also has some of the most vulnerable people living in extreme poverty and violence,” Torres said.

Another drugmaker, Viiv Healthcare, also left out most of Latin America when it allowed generics of its HIV prevention shot in about 90 countries. Sold as Apretude, the bi-monthly shots are about 80% to 90% effective in preventing HIV. They cost about $1,500 a year in middle-income countries, beyond what most can afford to pay.

Asia Russell, executive director of the advocacy group Health Gap, said that with more than 1 million new HIV infections globally every year, established prevention methods are not enough. She urged countries like Brazil and Mexico to issue “compulsory licenses,” a mechanism where countries suspend patents in a health crisis.

It’s a strategy some countries embraced for previous HIV treatments, including in the late 1990s and 2000s when AIDS drugs were first discovered. More recently, Colombia issued its first-ever compulsory license for the key HIV treatment Tivicay in April, without permission from its drugmaker, Viiv.

Dr. Salim Abdool Karim, an AIDS expert at South Africa’s University of KwaZulu-Natal, said he had never seen a drug that appeared to be as effective as Sunlenca in preventing HIV.

“The missing piece in the puzzle now is how we get it to everyone who needs it,” he said.
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