Science

A medicine injected just twice a year could transform the fight against HIV.

In a 2024 clinical trial involving more than 2,000 young women in South Africa and Uganda, no participants who received lenacapavir contracted HIV.

Developed by United States pharmaceutical company Gilead Sciences, the injectable drug can be used to prevent HIV.

“It’s the most innovative tool that has reached the HIV arena for the last decade, because it’s the closest we have [to] a vaccine,” Carlota Baptista da Silva, global HIV lead at Doctors Without Borders (known by its French initials, MSF), told Al Jazeera.

The World Health Organization has recommended the long-acting injectable as an additional form of pre-exposure prophylaxis, or PrEP – medicine to reduce the risk of getting HIV.

But the arrival of the drug comes at a challenging juncture in the global fight against HIV.

International funding for HIV fell 18 percent in 2025, to $7.3bn, its lowest level in nearly two decades, according to the United Nations programme on HIV/AIDS (UNAIDS). The squeeze has already hit prevention programmes: The number of people receiving medicine to reduce risk fell from 1.4 million in 2024 to 1.1 million in 2025.

That makes the arrival of a highly effective, twice-yearly prevention option significant. The question of who can access it is now more urgent.

For MSF, the scientific question has largely been answered: lenacapavir can prevent HIV with remarkable efficacy.

The fight now is whether the rules governing manufacture, price and supply will allow that scientific breakthrough to reach the people who need it.

Why some countries are excluded

In the United States, lenacapavir costs about $28,000 per person annually. Generic versions are expected to cost about $40 a year.

A generic version is a copy of the original drug made by another manufacturer after the patent holder licenses the technology. It contains the same active ingredient, but it can be produced and sold at a much lower price.

In June 2025, the US Food and Drug Administration (FDA) approved lenacapavir for HIV prevention, giving people the option of an injection twice a year. But in several low- and middle-income countries, access to cheaper versions is not expected at scale until 2027.

Gilead is supplying its own version of lenacapavir at no profit for programmes supported by the Global Fund and the US President’s Emergency Plan for AIDS Relief (PEPFAR), with rollouts under way in countries including South Africa, Kenya, Zambia, Nigeria and Eswatini.

These are not the cheaper generic versions expected to cost about $40 per person a year. Gilead has licensed six manufacturers to produce those, with large-scale generic rollout expected in 2027.

At least 26 middle-income countries are excluded from Gilead’s generics agreement, MSF says, including countries with rising HIV infections and some that helped test the drug. Among them are Brazil, Mexico, Argentina and Peru.

“People should not really help generate the evidence for breakthrough medicine and then find that their country is excluded from affordable generic access,” da Silva said.

According to MSF, countries excluded from the licence accounted for close to 23 percent of new HIV infections globally in 2023.

Gilead has since announced a separate agreement with the Pan American Health Organization, creating an access pathway for 14 Latin American and Caribbean countries outside its generic licensing territory, including Brazil, Mexico, Argentina and Peru.

MSF argues that leaves those countries dependent on Gilead rather than able to automatically buy the cheaper generics.

MSF says it still cannot buy the drug

For more than a year, MSF says it has sought permission to purchase lenacapavir directly from Gilead for its medical programmes, without demanding a discounted price.

“Despite those requests, Gilead has not allowed MSF to purchase this medicine directly,” da Silva said.

That matters particularly in humanitarian emergencies, she argues. People displaced by conflict or disaster may struggle to take a prevention pill every day, while sexual violence and other vulnerabilities can increase the risk of HIV.

Daily PrEP pills are already available as an alternative to the injection. But unlike lenacapavir, they need to be taken consistently to provide protection. An injection offering six months of protection could be particularly valuable.

“People living through conflict [and] humanitarian crises cannot be the last in line for medical innovation,” da Silva said.

Gilead declined Al Jazeera’s request for an interview due to scheduling constraints.  In its emailed statement, it said its access strategy combines no-profit supplies, royalty-free licensing and regional agreements. It didn’t reply to questions about why it won’t sell its drug to MSF, or why certain countries were excluded from its generics agreement.

The company plans to provide enough lenacapavir for up to three million people through 2028 as generic manufacturers scale up production, with large-scale generic rollout expected in 2027.

MSF says that is nowhere near the scale required, pointing to projections that close to 20 million people worldwide need access to PrEP to substantially reduce new HIV infections. That includes all forms of PrEP, not just lenacapavir.

But countries left outside Gilead’s generic licensing deal may have another option.

Can governments bypass the patent barriers?

World Trade Organization (WTO) rules allow governments, in some cases, to bypass a drug company’s patent so cheaper versions of a medicine can be made or imported without the company’s permission.

They can also authorise government use of patents and challenge patents they consider weak or unjustified. The 2001 Doha Declaration affirmed WTO members’ right to use such safeguards to protect public health.

Brazil has used them before in the fight against HIV. In 2007, after negotiations with pharmaceutical company Merck over the price of the HIV drug efavirenz failed, Brazil issued a compulsory licence allowing it to access cheaper generic versions of the medicine.

Nearly two decades later, activists are urging Brazil to consider using those powers again for lenacapavir if patent barriers prevent affordable generic access.

MSF says governments excluded from Gilead’s licence could consider those same legal safeguards for lenacapavir, including compulsory licensing, government-use authorisations and challenges to patents.

It is also calling on Gilead to ensure its agreements with generic manufacturers do not prevent them from supplying countries where patent barriers have been removed through such measures.

For MSF, the stakes go beyond lenacapavir. The way the drug is made available could determine whether one of the greatest advances in HIV prevention in decades reaches people based on need, rather than where they live or what their health systems can afford.

“For a humanitarian medical organisation, we should not have to spend more than a year trying to find a way to buy a WHO-recommended medicine,” da Silva said.

United States President Donald Trump and China’s President Xi Jinping are set to meet in Washington, DC on Thursday for a summit that is expected to cover trade, artificial intelligence (AI), Taiwan and the US-Israel war on Iran.

In advance of the talks, US Treasury Secretary Scott Bessent said Washington had proposed an AI “notification mechanism” with China – effectively a hotline to alert each other when AI incidents threaten national security.

The meeting comes as leading AI companies warn about the technology’s risks, while both superpowers push to accelerate their AI race. In this visual explainer, Al Jazeera compares the US and China’s AI strength in computing power, AI models, spending and research.

Who has more computing power?

Training and running AI requires enormous amounts of computing power. The more powerful chips and computers a country has, the faster it can build and improve AI models, making computing power one of the biggest advantages in the AI race.

Computing power is measured in FLOP/s (floating-point operations per second) – or how many calculations a computer can perform in one second.

Adding up the computing power of all the AI chips a country has gives a sense of its total AI capacity. By that measure, the US is well ahead, accounting for nearly three-quarters of the world’s total AI computing power, while China holds just more than 14 percent, according to Epoch AI, an AI research institute.

The US lead comes largely from its access to the most advanced chips. US company Nvidia accounts for more than 60 percent of global AI computing capacity among major chip designers, while China’s Huawei holds a much smaller, but growing share, according to Stanford University’s 2026 AI Index.

Those chips also need somewhere to run. The US has more than 5,400 data centres – the large buildings which house thousands of computers – about 10 times as many as any other country. It also leads in dedicated AI data centres, with 84, more than the next eight countries combined.

Whose AI models are people using?

Frontier models are the most advanced AI systems, such as OpenAI’s GPT, Anthropic’s Claude and DeepSeek’s models in China. They are trained using vast amounts of data and computing power to write, reason and code.

The US has led the development of these models, but Chinese models are gaining ground.

As of March 2026, US and Chinese AI models were closely matched on Arena, a leaderboard where users compare two anonymous models and vote for the better answer. US companies Anthropic, xAI, Google and OpenAI ranked near the top, alongside China’s Alibaba and DeepSeek.

On OpenRouter, a platform that ranks AI models by real-world use, Chinese models dominate the leaderboard. Models from Chinese companies DeepSeek, Z.ai and Tencent hold the top three spots on OpenRouter by tokens processed, the units of text that AI models read and generate.

This is partly because Chinese models are cheaper to use. Many are also open-weight, meaning developers can download, adapt and run them themselves.

Chinese models can now compete with US ones in many real-world tasks, with Chinese AI models “months, not years, behind US frontier models”, according to a July analysis by the Centre for Strategic and International Studies (CSIS).

In May, the US government’s Center for AI Standards and Innovation (CAISI) estimated that DeepSeek V4 Pro, released in April, was about eight months behind leading US models.

Who is spending more?

The US is spending far more than China on the infrastructure needed to build AI, giving its tech companies a significant advantage in the race for computing power.

Goldman Sachs estimates that US hyperscalers, the giant tech companies that run large-scale cloud computing and data centres, will spend about $764bn in 2026. That includes Amazon, Microsoft, Google, Meta and Oracle. By comparison, China’s Alibaba, Tencent, Baidu and ByteDance are expected to spend $102bn.

But China’s spending is increasing faster. TrendForce, a market research firm, expects China’s four hyperscalers’ capital expenditure to rise by more than 80 percent in 2026, compared with a projected growth of 76 percent for US hyperscalers, according to the news agency Reuters.

The spending gap reflects the scale of the US tech sector, whose companies have larger revenues to reinvest in chips, data centres and talent.

Who is leading in AI research and talent?

China is producing more AI research and training more technical talent, but the US remains a magnet for the world’s top AI researchers.

China accounted for more than 27 percent of global AI publications in 2024, including journal articles, conference papers, working papers and preprints compared with 12 percent from the US, according to the Center for Security and Emerging Technology. The figures only cover publications with an English-language title or abstract.

China also trains more top researchers. According to a study by MacroPolo, 47 percent of the world’s top 20 percent of AI researchers completed their undergraduate studies in China in 2022, up from 29 percent in 2019. The study also found that 72 percent of the top AI researchers educated in China were working in the US.

DUBLIN — President Trump on Sunday again played down the need for his administration to check the development of artificial intelligence, saying he worried about ceding America’s edge over China in a global competition and that winning would help address the risks from the advancing technology.

While acknowledging the need for some regulation, Trump provided no specifics about potential rules and attributed warnings about the technology moving too quickly and with little oversight to “negative forces” he did not identify, though industry pioneers have raised such concerns.

“We can put guardrails, we can do this and that, but I think you have a lot of negative forces that are bringing it up that … shouldn’t be bringing it up, and they’re bringing up things that won’t happen,” Trump told reporters during a weekend trip to Ireland. “But whoever wins with AI wins.”

The president has made similar comments in the last week. His remarks Sunday came a day after Dario Amodei, chief executive of the artificial intelligence company Anthropic, said the industry should put the brakes on its fast-moving development to give safety measures time to catch up. Other AI corporate leaders, including Elon Musk and Sam Altman, chief of OpenAI, publicly agreed with Amodei.

Asked by a reporter if the industry should slow down or be regulated, Trump said, after watching a golfer tee off in the Irish Open at his resort in Doonbeg, that the United States is leading China in the development of AI, and, “frankly, I want to keep it that way, because whoever wins AI wins.”

Chinese President Xi Jinping is due to visit the U.S. next week to meet with Trump, and AI seems certain to be among the items they discuss.

AI has become a major election-year issue in the U.S. as some of the country’s largest companies seed small towns with a national network of computing warehouses while Americans from across the political spectrum increasingly voice concerns about less farmland and water supplies and rising electricity bills. Trump has kept up his support for data centers even as both Republicans and Democrats run from them and many communities try to block them.

Former President Obama said his party should make AI a campaign issue.

“I would talk about this, and I would say, ‘Here’s our plan for safety, here’s our plan for making sure our kids are not corrupted by this.’ … I would be thinking about the economic impacts in very concrete ways and understanding what does it mean if there’s going to be job displacement. Where is that going to hit? How are we going to respond?” he said at an event last week with the top Democrat in the House, New York Rep. Hakeem Jeffries, according to a transcript released by his office.

Next steps

Kevin Hassett, director of the National Economic Council at the White House, said he expects meetings will be held this week involving administration officials who oversee cyber and science and technology policy to discuss the next steps. Trump also could meet with members of Congress, some of whom have also been sounding alarms about the fast pace of AI development.

“I think the president wants to hear from them as well,” Hassett said.

U.S. House Speaker Mike Johnson acknowledged the need for “some guardrails, some safety measures” so AI “doesn’t run away.” But he echoed Trump’s position that he wants to ensure the U.S. does not “lose our edge in the global competition on this with China because that would be a national security threat.”

Johnson (R-La.) said industry leaders need to be summoned for “one big meeting and work this out together in the same room.” He said he has discussed the issue with Trump and believes a meeting held quickly should be the “next step.”

“So we’re going to pull everybody together and make sure we do this in the right way,” Johnson said, adding that it is a “top priority for me and for the Congress.”

“But we don’t need everybody to panic right now,” Johnson said.

Jeffries criticized Republican leaders for allowing members to go back to their districts for the final part of September.

“We should take decisive action now so that we can slow down, as the CEOs have recently acknowledged, … the pace of development in order to protect the American people and ensure that AI is proceeding safely,” Jeffries said. Action on AI will be a “high priority” when House Democrats meet Tuesday as a group.

Neither Johnson nor Jeffries provided concrete steps about what Congress might do. Lawmakers agree that more guardrails are needed, but even narrow attempts at imposing rules have fallen apart over the years, evidence of the congressional reluctance to regulate the technology industry.

Cooperation between U.S. and China urged

Jacob Coxon, a former Anthropic employee who resigned over AI concerns and has gone public with his fears, argued for international rules along with self-regulation by the industry.

Coxon said he has grown concerned that AI models would soon gain capabilities that could exceed human control.

“You’re building a human-level or superhuman-level mind, without understanding what it wants, or thinks, or the way it thinks,” Coxon said.

At a time of a fierce global competition for AI dominance, Coxon also urged cooperation between the U.S. and China, the two countries who are leading the race, to slow down and address safety.

“I do hope that the people in China who are looking at the same problems as we are, so they’re trying to build the same technology, will come to the same conclusion that it has to be done in a measured manner, and it should be easy to cooperate on some sort of mutual — of mutual slowing,” Coxon said.

Otherwise, he said, “we risk running the same race with China, which could be equally dangerous,.”

White House challenges AI leaders

Tech founder and investor David Sacks responded to the AI leaders’ calls for regulation with a social media post challenging them. Sacks, co-chairman of a White House advisory council on science and technology, said Amodei and others are the ones setting the pace for development.

Sacks said they have the power to slow development on their own.

“The easiest way not to build superintelligence is for you to agree not to build it,” Sacks wrote.

Superville and Tang write for the Associated Press. Tang reported from Washington.

THE UK’s most famous observatory will soon close for two years for a massive renovation project.

Royal Greenwich Observatory in London dates back 350 years and will close for two years on November 2 to undergo a £77million upgrade.

The project, dubbed ‘First Light’, “will bring the story of this historic site to life”, according to the Observatory, as well as “give everyone the chance to experience the wonders of space and time for themselves”.

The Observatory will be home to new galleries, refreshed displays, innovative architecture, as well as improved access for visitors.

As part of the project, there will be a new visitor centre which will be “the jewel in the crown of Greenwich’s UNESCO World Heritage Site”.

Inside the pavilion, there will be a gateway to the rest of the site, which will also have improved access overall, including full accessibility to the Great Equatorial Telescope for the first time.

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There will be new galleries too, in which visitors can explore observation and scientific work that took place at the Observatory.

And there will be new, interactive astronomer galleries, ideal for kids who want to become scientists themselves.

They will explore the fundamentals of astronomy: Light, Matter and Motion.

Many of the existing displays at the attraction will get a refresh including John Harrison’s timekeepers and instruments used for the Prime Meridian line itself.

Visitors can meet astronomers and scientists as well, in the ‘Astronomers’ Court’, with events including live science shows.

Outside the Observatory, Greenwich Park will get new landscaping as well as plants.

The First Light project already began in autumn last year and it is set to be complete by spring 2028

The Royal Observatory will close on November 2, 2026 but parts of the attraction such as the Meridian Courtyard, are expected to reopen in summer 2027.

NEW YORK — Whenever Venus and Serena Williams decide to permanently close the door on their storied careers — the duo are competing in the U.S. Open’s women’s doubles this week after receiving a wild-card invitation — the extraordinary tale of two sisters from Compton, just 15 months apart, who both reached No. 1 and won bushels of major titles will continue to reverberate. It might be the most implausible sports story of the last 50 years.

Although Serena’s career accomplishments exceed her older sister’s by considerable margins, including a 23-7 advantage in singles majors, what if Venus had been the baby of the Williams bunch? Would those numbers have evened out?

It’s a fair question.

Research has shown that younger siblings often benefit from being last in the birth order, sometimes called a “younger-sibling effect.” Turns out, the proverbial runt of the litter may have an edge. And while the Williams sisters remain the gold-standard example in tennis, the sport has no dearth of cases, from Alexander Zverev and Andy Murray to Naomi Osaka and Tracy Austin, to name a few.

The birth-order advantage

Serena and Venus Williams hold their trophies after winning the women’s doubles final at Wimbledon on July 9, 2016.

(Tim Ireland / Associated Press)

To researchers, Serena’s rise is not an isolated miracle of genetics, but a classic expression of family dynamics. Dr. Joseph Baker, a sports scientist at the University of Toronto, has found that elite athletes are statistically far more likely to be later-born children. “The birth-order effect means there’s some kind of social or genetic element in the family environment that’s driving it,” Baker says.

Dr. Frank Sulloway, a psychology research associate at the University of California, Berkeley, has found that the younger-sibling effect is a modest but reliable and statistically significant trend. While not deterministic — elite firstborns like John McEnroe and Novak Djokovic remain towering counter-examples, and both had younger siblings that played professionally — the later-born tilt repeats across the athletic landscape.

The backyard crucible

Some investigators trace the younger sibling effect to “situated learning.” That is, developing mastery through hands-on engagement, social modeling, and “vicarious experience,” according to Baker.

“Seeing someone from the same family unit achieve greatness gives the younger sibling the confidence to achieve the same,” he says.

For Serena, who is the youngest of five sisters in the blended Williams family, that meant learning to return Venus’s blistering serve on Compton’s public courts. It meant watching her more heralded older sibling navigate a mostly white women’s tour as a teenager. Because Venus was more experienced and stronger, Serena was forced to accelerate her development just to compete. And since their father, Richard Williams, largely kept them out of junior tournaments, that interdependent learning likely proved especially potent.

“I was able to learn, so I didn’t make the same mistakes she made,” Serena said in 2009. Now 44, Serena returned to compete at Wimbledon in singles and has teamed up for several doubles events this season, including in Cincinnati last month with 46-year-old Venus, after saying she was “evolving away from tennis” following her last appearance at the 2022 U.S. Open.

Sisters Jessica Korda and Nelly Korda walk on the ninth green at the Aramco Championship on April 3 in Las Vegas.

(Harry How / Getty Images)

This crucible is not unique to tennis.

Michael Jordan famously credited his older brother, Larry, with igniting his competitive fire. Golfer Nelly Korda followed older sister Jessica onto the LPGA Tour before surpassing her with major titles and an Olympic gold medal, while Peyton and Eli Manning grew up amid the backyard competition of a football-obsessed family that produced two Super Bowl-winning quarterbacks.

The “rough draft” of parenting

Beyond hardwood or turf battles, younger siblings can benefit from a profound shift in parental behavior, a phenomenon Louisiana Tech University sport and exercise psychology professor Dr. Jordan Blazo calls the “rough draft hypothesis.”

Firstborn children are often a parent’s athletic test drive. Parents often face a steep, expensive learning curve when navigating youth sports with older children, overscheduling them and committing developmental mistakes. By the time a younger sibling arrives, parents know the ropes and the pathways to pursue, according to Blazo, who studies sibling relationships and social comparison in sports. They are more attuned to financial and other feasibilities, which gives them a clearer road map to success.

Southern California native Austin, the youngest of three accomplished tennis children and the youngest U.S. Open champion in history at 16 years and 9 months, says her physicist father maintained healthy boundaries. When Tracy once invited him to watch her play German great Steffi Graf, he declined because of a computer club meeting. “Having a parent that wasn’t overly engrossed in my winning and losing was the healthiest thing,” Austin says.

Meanwhile, her mother, having navigated four older siblings’ athletic careers, was free to travel with 14-year-old Tracy because the nest was empty.

Russia’s Mirra Andreeva, 19, agrees. The reigning French Open winner followed her sister, Erika, three years older, onto the pro tour. “I had more benefits because I’m younger,” said fifth-ranked Mirra of her sister, who has been ranked as high as No. 65. “[My] parents obviously knew what to do. Tennis-wise… maybe that saved me some time.”

Zverev, who followed brother Mischa, 9 years his senior, says traveling to pro events as a kid helped normalized the ATP Tour early. “Maybe I wasn’t as nervous… because I’ve seen them and known them for years,” says Germany’s Zverev, who captured his first major title at this year’s French Open and is the top seed in New York.

Swing for the fences: Risk-taking

This competitive ecosystem also shapes how younger siblings play. Sulloway’s research on birth order and risk-taking reveals that later-borns are more psychologically wired to take strategic risks to carve out their own niche and stand out in the family.

Sulloway’s 2010 study of Major League Baseball brothers, conducted in collaboration with psychologist Richard Zweigenhaft, found that later-born siblings were vastly more likely to attempt to steal bases (and were more successful at it) than their first-born brothers. They were also far more likely to strike out because they were literally swinging for the fences, a high-risk, high-reward strategy. In tennis, this could translate to a willingness to play more aggressively, such as going for more on second serves rather than playing it safe, according to Sulloway.

Warmth over hostility

Yet, this sibling incubator seems to work best with one critical condition: the familial relationship is based on warmth and companionship. Blazo’s research shows that when sibling dynamics are colored by hostility and toxic comparisons, younger siblings experience “differentiation.” They can suffer from lower perceived competence, burn out, and ultimately quit or flee to other sports to escape the older sibling’s shadow, which isn’t necessarily a negative course correction. Sometimes it works out best for both.

In other words, the most successful sporting siblings preserve their emotional bonds. Richard and Oracene Williams famously enforced a sisters-first rule, allowing Venus and Serena to battle on court but walk off as best friends. Mirra Andreeva says her parents taught them that sisters are “the closest people we’re gonna have in life,” and to protect that bond they rarely practice together to keep emotions from getting “messy.”

Sisters Venus and Serena Williams hold the U.S. Open doubles winners’ trophy on Sept. 12, 1999.

(Al Bello / Getty Images)

When Venus and Serena were leapfrogging each other early in their careers, often clashing in Grand Slam finals across continents and surfaces, Serena insisted their competition existed in a supportive environment. Certainly it did in doubles, where they teamed up to win three Olympic gold medals and 14 major titles, including two at the U.S. Open in 1999 and 2009.

At the 2001 U.S. Open, where Venus beat Serena in the first all-Williams Grand Slam final, Serena said: “If anything I prefer to play Venus because that means that we have reached our maximum potential and that we’ll both go home winners. So for me, I always want to see Venus do well. I never want to see Venus lose.”

The long shadow

The McEnroe brothers, John and Patrick, separated by seven years, also saw their supportive relationship boost Patrick’s career. When Patrick, the youngest of three boys, was struggling in college and his mother pressured him to take the law boards, John stepped in, telling her to let Patrick chase his pro tennis dreams. Patrick eventually cracked the top 30 in singles and reached No. 3 in doubles, though he never reached the heights of John, who won seven Grand Slam titles and reached No. 1 in both singles and doubles.

“I think it holds water,” Stanford University alum Patrick said of his last-born experience, citing other examples such as Andy Roddick, whose older brother John was an accomplished collegiate player, and Hall-of-Famer Arantxa Sánchez Vicario, the youngest of four whose two older brothers, Emilio and Javier, were top ATP players. “It just so happened that my brother was exponentially more talented than I was as an athlete, but it’s definitely what at least got me into tennis.”

John McEnroe, left, and his younger brother Patrick compete during in a doubles match in Richmond, Va., on Sunday, Feb. 6, 1984.

(Joanna Pinneo / Associated Press)

The comparisons to John, however, played both ways. Patrick said they motivated him as a junior, but felt like a burden when he was trying to establish himself on tour.

With many physical, emotional and psychological variables in play, researchers admit it’s hard to pinpoint where DNA ends and drive begins when it comes to sibling dynamics. Ultimately, genetics and talent establish the ceiling, but the evidence suggests a supportive sibling ecosystem helps alchemize raw potential into greatness, and the sibling that benefits most is the one that comes later.

For Serena, the competitive yet protective shield provided by Venus was critical to her own success. Venus went first. She absorbed the bulk of pressure, provided the model and set the standard her younger sister spent a lifetime chasing, and eventually surpassing.

“Just everything that she does inspires me,” Serena said.