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[In Focus] Pattanee Winichagoon—tackling malnutrition in rural Thailand

“Back then, the health perspective seemed to be that anaemia is something that needs treatment, that it's curative instead of preventative”, explains Pattanee Winichagoon, Associate Professor and Senior Adviser to the Institute of Nutrition, Mahidol University, Thailand. From her fieldwork experience with pregnant women in rural Thailand in the 1980s, she recalls that anaemia was as high as 35% in pregnant women in Thailand. “The problem of anaemia was certainly identified as a very serious one”, says Winichagoon, and she was keen to understand why it was so difficult to establish iron supplementation programmes in these communities.

[Comment] Advancing understanding of mature T-cell and natural killer-cell lymphomas

Mature T-cell and natural killer-cell lymphomas are rare, aggressive, and heterogenous malignancies, accounting for approximately 10–15% of non-Hodgkin lymphomas globally. Their striking geographic, ethnic, and molecular variations reflect the interplay between genetic predispositions, environmental exposures, and oncogenic drivers. For decades, outcomes have lagged behind those of aggressive B-cell lymphomas. This Series about mature T-cell and natural killer-cell lymphomas, published in The Lancet Regional Health—Western Pacific and The Lancet Haematology, offers a comprehensive, integrated perspective.

[Editorial] Sickle cell disease: a neglected health priority

September is National Sickle Cell Awareness Month in the USA, designated by Congress to help focus attention on the need for research and treatment of sickle cell disease. The Sickle Cell Disease Association of America (SCDAA)'s theme for this year is “Sickle Cell Matters 2025” and calls for Americans to donate blood, raise awareness, and dispel myths surrounding the disease. Sickle cell disease affects over 100 000 individuals in the USA, and there are about 7·7 million people living with the disease worldwide, with prevalence growing globally.

[Viewpoint] Lenacapavir-associated drug resistance: implications for scaling up long-acting HIV pre-exposure prophylaxis

Although drug resistance could emerge if lenacapavir is initiated during undiagnosed acute infection or if infection occurs during the drug's pharmacokinetic tail, these cases will not compromise the effectiveness of WHO-recommended therapies, as there is no cross-resistance between lenacapavir and other licensed antiretroviral drugs. Lenacapavir pre-exposure prophylaxis (PrEP) is also unlikely to drive population-level lenacapavir resistance given the rarity of breakthrough infections and the reduced replication capacity of most lenacapavir-resistant variants, which most likely reduces their transmission potential.

[Personal View] Lessons for long-acting lenacapavir: catalysing equitable PrEP access in low-income and middle-income countries

Despite substantial advances in biomedical HIV prevention, including long-acting injectable pre-exposure prophylaxis (PrEP) options such as cabotegravir, barriers to widespread adoption and scale-up persist in low-income and middle-income countries. Long-acting injectable lenacapavir is a potentially transformative HIV prevention tool, providing an unprecedented opportunity to accelerate progress. However, the global HIV response is under threat like never before, with drastic funding cuts undermining the gains of the past 25 years.

[Articles] The impact of cuts in the US President's Emergency Plan for AIDS Relief funding for HIV pre-exposure prophylaxis in sub-Saharan Africa: a modelling study

Our projections show the substantial detrimental impacts that cuts to PEPFAR funding could have. Mitigation measures, including funding through alternative international donors or domestic government budgets, are needed to maintain and increase existing coverage levels of PrEP and therefore prevent the detrimental impact of PEPFAR's funding cuts, particularly in high coverage countries.

[Articles] Dynamic choice HIV prevention with long-acting injectable cabotegravir pre-exposure prophylaxis in east, central, southern, and west Africa: a cost-effectiveness modelling analysis

Offering structured PrEP and PEP choice including long-acting cabotegravir and enabling risk-informed use could reduce HIV incidence by a third over 10 years. If projected generic production costs of long-acting cabotegravir can be realised, it is likely to be cost-effective across multiple settings in east, central, southern, and west Africa.

[Articles] Epstein–Barr virus and cytomegalovirus co-infections and mortality risk in patients with HIV-associated cryptococcal meningitis: a post-hoc analysis of a prospective nested cohort in the AMBITION-cm randomised controlled trial

These data indicate that cytomegalovirus might be an important copathogen in this context, and that cytomegalovirus viraemia represents a potentially modifiable risk factor to reduce mortality among adults with HIV-associated cryptococcal meningitis. Interventional trials are now required and planned to determine whether treatment of cytomegalovirus viraemia improves outcomes in advanced HIV disease.

[Articles] Safety, tolerability, and immunogenicity of an adult-specific pneumococcal conjugate vaccine, V116, in people living with HIV (STRIDE-7): a two-part, parallel-group, randomised, active comparator-controlled, international, phase 3 trial

V116 was well tolerated and immunogenic for all 21 serotypes, supporting the use of this vaccine in adults living with HIV. Adults at high risk of pneumococcal disease due to underlying comorbid conditions, such as HIV, might benefit from receiving V116. The serotypes in V116, including the eight unique serotypes, are expected to provide broader protection against pneumococcal disease than currently licensed vaccines.

[Culture] Iconic AIDS memorial on show

The US AIDS Memorial Quilt long outgrew the National Mall in Washington, DC, USA where it was first displayed in 1987. There are currently almost 50 000 panels (and counting), arranged in blocks of eight, honouring over 110 000 individuals. Stretched out, the Quilt would span 1·2 million square feet. It is easily the biggest piece of communal folk art ever created.

[Profile] Bridging the gap in Ecuador's health system

Kimirina, a reproductive health non-governmental organisation (NGO), has been working on HIV prevention and treatment in Ecuador since its foundation in 1999, operating as the South American country has been roiled by political and security crises. Kimirina takes its name from a word meaning “to walk or work together” in the Indigenous Quechua language spoken by around 2·5 million people in Ecuador. It provides HIV testing and counselling, carries out advocacy and research programmes, and works with the country's diverse communities to tackle stigma and discrimination.

[Correspondence] The promise and paradox of HIV self-testing in the era of twice-yearly PrEP

On July 12, WHO issued new guidelines recommending twice-yearly injectable lenacapavir as an additional option within combination HIV prevention—a pivotal moment in global prevention efforts.1 Relative to daily oral tenofovir disoproxil fumarate–emtricitabine, lenacapavir reduced HIV incidence by 100% in the PURPOSE 1 trial and by 89% in PURPOSE 2. Lenacapavir's high efficacy and biannual dosing could address adherence and access barriers hindering the scale-up of oral pre-exposure prophylaxis (PrEP).

[Comment] The imperative for increased investment for an HIV cure

The transformation of HIV from a fatal disease to a manageable condition represents one of medicine's greatest achievements. However, without a cure, HIV remains an urgent global health challenge. Despite widespread availability of prevention tools and treatments in high-income countries, globally, in 2024, 40·8 million people were living with HIV, 1·3 million people newly acquired HIV, and 630 000 people died from AIDS-related illnesses.1 These numbers represent people facing daily psychological, social, and physical burdens associated with lifelong therapy, persistent stigma, economic hardship, and uncertain access to care.

[Editorial] Russia spiralling into an HIV crisis

Recent reports on HIV in Russia suggest the country's response to the epidemic continues to spiral to new depths. Reduced state funding, prohibitions on external funding, and crackdowns on the activities of civil society organisations are severely affecting the HIV response. In August, the AIDS.CENTER Foundation, a Russian non-governmental organisation (NGO) providing essential services, including HIV testing, treatment, and education, failed to secure crucial state grants. In 2025, foreign funders, including the Elton John AIDS Foundation and Aidsfonds, ceased operations in the country.

Ethical Basis of the Pediatric Vaccine Encounter—Correcting the Record

In this Viewpoint, the authors argue that the Department of Health and Human Services’ use of medical ethics to justify its recent removal of the COVID-19 vaccine from the Centers for Disease Control and Prevention’s recommended immunization schedule for healthy children ignores the existing foundational functions of medical ethics in the vaccination encounter.