With humanitarian funding slashed by the US and other countries, including the UK, this year’s global health headlines have made grim reading. But good things have still been happening in vaccine research and the development of new and improved treatments for some of the most intractable illnesses.
Millions of girls protected against cervical cancer
A target to protect 86 million girls against cervical cancer by the end of 2025 was achieved ahead of schedule, boosting hopes among experts that cervical cancer can be eliminated within the next century.
Gavi, the vaccine alliance, launched its human papillomavirus (HPV) vaccination programme in 2014, when vaccine coverage in Africa was just 4%. By the end of 2022, it was only 15% – but scientists had discovered that a single dose could give comparable protection to the two doses originally used. That would make it simpler to deliver vaccination programmes, and stretch supplies twice as far.
HPV vaccines are administered in Chikowa village in Malawi. It is hoped that the vaccination of 86 million girls will save 1.4 million lives. Photograph: Francisco María Galeazzi/WHO
In 2023, Gavi announced its ambitious target to protect 86 million girls by 2025 and a concerted push saw coverage in Africa rise. By the end of 2024 it was at 44% – higher than Europe’s 38%.
In November, Dr Sania Nishtar, Gavi’s chief executive, credited “countries, partners, civil society and communities” for reaching the 86m target early, and “driving major global progress towards eliminating one of the deadliest diseases affecting women”.
Cervical cancer remains widespread and deadly in poorer parts of the world – 85% of new cases are in sub-Saharan Africa – and a woman dies from the disease every two minutes.
But a jab against the virus can avert 17.4 deaths for every 1,000 children vaccinated, according to Gavi, meaning the 86m vaccinations will prevent an estimated 1.4m cervical cancer deaths.
First new type of malaria treatment in decades
After successful clinical trials, the first new type of malaria treatment in decades is to seek regulatory approval. GanLum, from pharma company Novartis, outperformed the standard treatment by demonstrating a cure rate of 99.2% compared with 96.7%.
Nets are a traditional way to keep mosquitoes at bay. A new treatment should be effective against the drug-resistant parasites they can carry. Photograph: Riccardo Lennart Niels Mayer/Alamy
Crucially, it should also be effective against malaria parasites that have developed resistance to artemisinin, a component of the current standard treatment.
Drug resistance to artemisinin is a growing concern. In the 1990s, resistance to chloroquine, then the standard malaria treatment, led to millions of deaths, says Dr George Jagoe of the Medicines for Malaria Venture. The prospect of an antimalarial such as GanLum gives a “sense of relief”, he said at the American Society of Tropical Medicine and Hygiene’s annual meeting, like “having a fire extinguisher” ready to use.
Drug resistance is a growing threat to Africa, so new treatment options can’t come a moment too soonDr Abdoulaye Djimdé
Researchers also hope GanLum will be more effective at stopping transmission, because of how it affects parasites at certain stages of their life cycle.
“GanLum could represent the biggest advance in malaria treatment for decades,” says Dr Abdoulaye Djimdé, professor of parasitology and mycology at the University of Science, Techniques and Technologies of Bamako, Mali, who was involved in the drug’s development. “Drug resistance is a growing threat to Africa, so new treatment options can’t come a moment too soon.”
More countries eliminating measles
Cape Verde, Mauritius and Seychelles became the first three sub-Saharan countries to officially eliminate measles and rubella.
The milestone came despite a surge in measles cases worldwide, with an estimated 11m infections in 2024. In November, the Americas region lost its measles-free status because of outbreaks in Canada, while the US is facing its worst outbreak in decades.
A baby has the measles, mumps and rubella vaccination at Beau Vallon health centre in Victoria, Seychelles’ capital. Photograph: WHO
The three African countries’ success was described as “a major public health achievement”.
“It shows what’s possible when countries put prevention first and make vaccines a priority,” says Dr Mohamed Janabi, the World Health Organization’s director for Africa.
“We must build on this success so that every child in Africa can grow up healthy and protected.”
Twenty-one Pacific island countries also eliminated measles and rubella this year. The status means they have interrupted endemic transmission for more than three years, and also have surveillance systems to rapidly pick up and contain any cases coming into the country.
Botswana and Rwanda have achieved 95% coverage with measles and rubella vaccination, the benchmark needed to interrupt transmission.
Globally, measles deaths dropped 88% between 2000 and 2024, with a WHO report finding nearly 59 million lives had been saved by the measles vaccine since 2000.
A new HIV-prevention drug
A drug described as a potential “gamechanger” for the HIV epidemic arrived in sub-Saharan Africa within months of its approval in the US.
Lenacapavir, given as an injection twice a year, can almost completely prevent HIV infection. It was approved by US regulators in June and recommended by the WHO in July.
The manufacturer of lenacapavir, Gilead, will provide the drug at no profit for up to two million people over the next two years. Photograph: Nardus Engelbrecht/AP
Manufacturer Gilead has signed agreements with six manufacturers of generic drugs, allowing them to produce cheaper versions for use in 120 countries. Those will be provided at about $40 (£30) for each patient for a year under deals struck with Unitaid and the Global Fund.
Until that production comes online, Gilead has committed to providing lenacapavir at no profit for up to two million people over the next two years. In November, the first shipments arrived in Eswatini and Zambia. Rollout is expected to begin in early 2026.
Campaigners say access needs to go further – poor communities in countries excluded from Gilead’s generic agreements will still struggle to afford the drug, at a list price of $28,218 to treat one person for a year. The drug will need to be rolled out at vast scale to turn the tide of new infections. And funding for HIV services is fragile.
Peter Sands, executive director of the Global Fund, said the introduction in low- and middle-income countries “nearly simultaneously with high-income countries […] alone is a breakthrough, as previous drugs for HIV prevention have taken an average of five years to become available in these settings after evidence of their efficacy is first known”.
Advances in fight against TB
Since it was named in 1882, tuberculosis has killed more than a billion people and remains the world’s leading killer from infectious disease.
But treatment options are advancing at pace. Four vaccines are in their final testing stages; easier to use tests, including simple tongue swabs, could improve detection; and a new treatment could boost cure rates and shorten the time needed to treat TB.
A TB trial participant at Setshaba research centre in Soshanguve, South Africa. Photograph: Jonathan Torgovnik/TB Alliance
A new antibiotic, sorfequiline, showed stronger action than existing treatments in trial results presented at the Union World Conference on Lung Health in November.
“Science continues to surge forward, to the benefit of healthcare systems, people with TB, their families and their communities,” says Dr Mel Spigelman, president of TB Alliance, which developed the drug.
Goals that once seemed wholly aspirational, such as the eradication of TB, are made increasingly possibleDr Rod Dawson
The advance builds on a new regimen for people with more complicated forms of TB, introduced in 2019, which itself shortened treatment from more than 18 months to six.
Replacing one drug in that regimen with sorfequiline could shorten treatment further, with more trials planned for 2026.
“Goals that once seemed wholly aspirational, such as the eradication of TB, are made increasingly possible because of advancements like sorfequiline,” says Dr Rod Dawson of the University of Cape Town Lung Institute. “But we have a lot of work ahead of us and cannot stop until TB is no longer a threat.”
