As global HIV prevention efforts face mounting fiscal pressures and persistent coverage gaps, digital health interventions (DHIs), including artificial intelligence, promise improved effectiveness, equity, and reach. Across several countries in sub-Saharan Africa, digital health tools, including mobile applications and health information systems, are extending service delivery, optimising resource allocation, improving client engagement, and strengthening HIV prevention service delivery. Artificial intelligence applications are further enhancing data analytics, epidemic modelling, hotspot prediction, and differentiated service delivery models for HIV care and prevention programmes. However, crucial challenges that reduce the effectiveness of DHIs include poor interoperability, low digital literacy, suboptimal data use and interpretation, insufficient connectivity, privacy concerns, and fragmented governance. Intentional integration of DHIs into national health strategies, supported by robust data protection frameworks, culturally relevant design, investments in workforce capacity, and sustainable financing mechanisms is essential to ensure these tools drive lasting gains in the reach, quality, and equity of HIV care and other health services. If properly resourced, governed, and integrated into health systems, DHIs, supported by artificial intelligence, can help countries deliver smarter, faster, and more equitable HIV prevention services, while also contributing to broader health system strengthening.

Long-acting injectable cabotegravir and rilpivirine (LAI cabotegravir and rilpivirine) is recommended as maintenance therapy for people living with HIV who achieved viral suppression on oral antiretroviral therapy (ART). However, its effect on drug resistance evolution in resource-limited settings remains uncertain. We aimed to assess this effect under different roll-out strategies and explore key factors for resistance.

Governmental agencies often implement evidence-based interventions with a one-size-fits-all approach, which ignores site differences. We compared a tailored approach, accounting for sites' needs, to a standard approach to implement systems navigation and psychosocial counselling (SNaP) to improve HIV outcomes for people who inject drugs (PWID).

The global HIV response has delivered substantial progress, largely through vertical programmes that created parallel systems of financing, governance, and service delivery. Sustaining these gains requires embedding HIV prevention more fully within routine public health systems, particularly as external funding declines and health priorities evolve. This Series paper examines how the principal functions of HIV prevention-risk-based prioritisation, demand generation, quality service provision, and continuity of use-are grounded in long-standing public health principles and essential functions. By tracing these shared roots, we show that integration is not an abandonment of HIV prevention's distinctive achievements but an evolution towards more coherent and sustainable public health systems. Although integration moves HIV prevention beyond exceptionalist approaches, it should be understood as an advance that reinforces durability and equity rather than a compromise that dilutes past gains. Drawing on literature, expert consultations, and country experiences, we compare HIV prevention functions against frameworks, such as WHO's Essential Public Health Functions. This comparison highlights integration as a technically sound and conceptually coherent path and acknowledges the financial, political, and structural legacies of vertical programming. We conclude that system-level integration can sustain HIV outcomes and strengthen overall health system resilience.

Affordability concerns have become increasingly relevant in health systems globally when deciding on the adoption and coverage of new interventions. However, a standardised approach for defining budget impact remains elusive. This study aimed to contribute to filling this gap by systematically identifying budget impact thresholds (BITs) currently in use, proposing BIT categories, and illustrating how these estimates could be applied across 182 countries to support local deliberations.

In low-income and middle-income countries in southeast Asia, most deaths occur outside of the health-care system without a medically certified cause of death. We did a verbal autopsy study to determine the underlying causes of death in rural areas of the region and to estimate premature mortality using years of life lost (YLLs).

Preoperative anaemia is a major risk factor for perioperative morbidity. Because iron deficiency is widely assumed to be the main cause of anaemia in surgical patients, treatment efforts have focused mostly on iron supplementation. However, the aetiology of anaemia is multifactorial. To further understand the underlying causes and consider a comprehensive approach to anaemia management, we studied the prevalence and aetiology of preoperative anaemia in patients undergoing major surgery.

Partner treatment is an essential component of sexually transmitted infection (STI) case management. We aimed to compare the uptake of partner treatment for STIs within antenatal care in Zimbabwe, with and without the provision of a financial incentive.

Domestic violence harms women and girls, their families, and society. It takes multiple forms-physical, sexual, emotional, coercive control, economic abuse, and neglect-and comes from both intimate partners and other family members. We assessed the effects of community mobilisation on disclosure and support for survivors, community attitudes to, and prevalence of domestic violence.

Typhoid is an important global public health problem, despite efforts to enhance access to clean water and sanitation facilities, appropriate diagnostics, treatments, and vaccines. We aimed to assess the safety and non-inferiority of single-dose and multidose EuTCV Vi-CRM197 typhoid conjugate vaccine (TCV) formulations compared with Typbar TCV.

Although substantial progress has been made with the global scale-up of antiretroviral therapy, primary prevention efforts remain fragmented, underfunded, and susceptible to external shocks. Programmatic approaches that prioritise isolated interventions over strengthening the health system functions and infrastructure needed to deliver primary prevention at scale have increasingly proven inadequate, especially given recent funding disruptions. Together, these challenges underscore the urgent need for new thinking. The Sustainable HIV Prevention in Africa Series draws links between what had often been verticalised, partner-driven HIV prevention efforts and their corresponding health system functions. It also examines how HIV prevention links with primary health-care frameworks, and how strengthening integrated systems, supported by enablers such as digital health and artificial intelligence, systematic community engagement, and systems approaches to new product introduction, can enhance HIV prevention. This Series paper synthesises lessons from the Series and puts forward a call for an urgent action agenda on practical, short-term opportunities to strengthen HIV prevention, especially considering the funding and governance disruptions that many countries are facing.

Intermittent preventive treatment (IPT) of school-aged children with antimalarial drugs decreases rates of infection, anaemia, and clinical malaria. Since school-aged children are a major transmission reservoir, we estimated the effect of IPT for this group on Plasmodium falciparum transmission to younger children and adults across three epidemiological settings.

One-dose vaccination and increased vaccine supply provide the opportunity for low-income countries (LICs) and lower-middle-income countries (LMICs) to extend human papillomavirus (HPV) vaccination to populations other than girls aged 9-14 years targeted by routine vaccination. The aim of our study was to use mathematical modelling to identify and rank HPV vaccination strategies according to their efficiency at reducing cervical cancer in LICs and LMICs.

Almost half of the global population do not have access to universal health coverage and the current shortfall of health-care professionals (including doctors and nurses) is estimated to reach a deficit of 11 million by 2030, disproportionately affecting low-income and middle-income countries (LMICs). Against this backdrop, of the 8 million deaths per year from bacterial sepsis worldwide, over 3 million are from treatable antibiotic-sensitive infections. This number suggests that access to antibiotics under the current model is insufficient. In many LMICs, over-the-counter antibiotic sellers that range from informal drug procurers to small-sized and medium-sized private pharmacies are the primary and most accessible care providers. Yet global health narratives, often shaped by the traditional doctor-led prescribing model, portray them as drivers of misuse rather than recognising them as politically and economically embedded actors that meet unmet health and antibiotic needs. In this Viewpoint, we argue that over-the-counter antibiotic sellers need to be integrated into a solution for antibiotic misuse and overuse, rather than being seen as part of the problem. Furthermore, we provide a framework with which to achieve integration, so that the concept of global health care for all becomes a reality.

Efforts to reduce the global burden of small vulnerable newborns (SVNs) by scaling up existing preventive interventions must be complemented with new preventive approaches to achieve global targets. Intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) was originally designed to protect pregnant women from malaria infection, but appears to retain efficacy against low birthweight even when Plasmodium infection is absent or the parasite is highly resistant to sulphadoxine-pyrimethamine. This specific effect might occur through the antimicrobial activity of sulphadoxine-pyrimethamine against maternal genitourinary tract infections and pathogenic gut bacteria, direct effects on maternal gut physiology that might reverse environmental enteric dysfunction, or anti-inflammatory actions. Refining our understanding of the pathways underlying the protective efficacy of sulphadoxine-pyrimethamine will require mechanistic studies and placebo-controlled randomised trials of IPTp-SP in non-malarious settings. These studies will be crucial to confirm whether sulphadoxine-pyrimethamine could be considered for reducing the risk of SVNs in settings with high prevalence of SVNs and little or no malaria transmission.

Alcohol per capita consumption (APC; total pure alcohol consumed per person 15 years or older per year) is the primary indicator used to track global progress in reducing harms associated with alcohol use. However, in many low-income and middle-income countries (LMICs), where most of the population abstain from alcohol and risk of alcohol-associated harm is concentrated in a heavy-drinking minority, APC can misrepresent both exposure and risk. This Viewpoint argues for the routine inclusion of drinker-adjusted metrics, specifically litres of alcohol consumed per drinker (alcohol per drinker), alongside the standard APC indicator. By use of data from WHO's Global Information System on Alcohol and Health, we show how alcohol per drinker reveals patterns hidden by population averages, particularly in high-abstention LMICs. For example, South Africa and the UK have similar APC but starkly different alcohol-attributable harm profiles, which are better explained by differences in alcohol per drinker. Although APC remains valuable, relying on this metric alone risks misinterpreting progress and misdirecting policy in contexts where drinking is concentrated among a minority of the population who drink heavily. As global monitoring evolves, we call for the inclusion of additional metrics that better reflect risk in diverse contexts.