Pakistan continues to be dealing with a polio outbreak as four fresh cases have emerged, pushing the national tally to 37 this year, according to health officials on October 19, 2024. Health officials said that the regional reference laboratory for polio eradication at the National Institute of Health in Islamabad confirmed wild poliovirus type-1 (WPV1) in two children-one from each Balochistan and Khyber-Pakhtunkhwa.

In recent cases, a girl has been affected from Pishin, and two boys from Chaman and Noshki of Balochistan, and a girl from Lakki Marwat in KP. These are the first detections of the virus within Noshki and Lakki Marwat this year; isolated cases of poliovirus were previously reported within Chaman and Pishin. The province of Balochistan was the worst hit with 20 cases, Sindh had 10, Khyber Pakhtunkhwa had five, and Punjab and Islamabad had one case each.

A gigantic fight against polio has been on going in Pakistan- especially in Balochistan and southern KP-over the last two years. Immunisation campaigns have often been suspended or delayed because of local protests, insecurity, and community boycotts. Consequently, quite a number of children did not get the necessary vaccinations, making existing patches of vulnerability for the virus to flow within those pockets.

Noshki, located near Afghanistan's border, and Lakki Marwat have also recently reported some positive environmental samples that confirm the virus is present here, said a local reference laboratory official. Samples of latest cases are currently under genetic sequencing for checking spread of virus and origin.

As the threat of polio continues to grow, Pakistan has vowed to mount a nationwide campaign against it beginning from October 28. With the zeal to tackle the menace in the most effective manner, over 45 million children under the age of five will be vaccinated across the country.

Today, Afghanistan and Pakistan remain one of the few countries where polio has not yet been eradicated. The WHO said the virus remains a potential serious public health threat in areas with low vaccination coverage and weak surveillance.

India On Alert Against Polio

The country declared itself polio-free since 2014 and has kept the disease on bay almost a decade with very robust vaccination programs; however, two cases of vaccine-derived poliovirus cases reported in recent days from Meghalaya create some amount of doubts over a possible resurgence. Experts observe that in India, despite these detections taking place, strong coverage of vaccination at 90-95% and mandatory surveillance measures keep the risk of this widespread outbreak at bay.

The experts point out, however, that such stable situation in India requires continued surveillance. "Countries like Pakistan and parts of Africa remain at a high risk because vaccination rates in those areas are much lower," Dr. Siddharth, public health expert, said. Vaccination is an indispensable act in order to avoid the spread of this incapacitating disease that manifests most importantly as a nervous system affliction leading to the paralysis of a long period.

With concerted efforts from health authorities, there is hope someday that the scourge of polio will be completely eradicated from the face of the earth and future generations will never suffer from its effects.

The Supreme Court of India has urged the All India Institute of Medical Sciences (AIIMS) to set up an expert panel

to examine how brain death is certified in India.

The apex Court has sought to know whether additional tests, such as electroencephalogram (EEG) and angiogram, are needed to declare a person brain dead.

A bench of Justices Vikram Nath and Sandeep Mehta was hearing a petition filed by Kerala-based medic and activist S Ganapathy, alleging malpractices in brain death certification, Times of India reported.

Ganapathy alleged that patients who may not be brain dead are sometimes declared so to facilitate organ donation. The petition also questioned the reliability of the apnea test—the standard method used to confirm brain death—calling it subjective and claiming that the legal requirement of video graphing the procedure is often not followed.

What is Brain Death?

Brain death, technically referred to as brain-stem death, is the irreversible end of all brain activity.

In India, according to the Transplantation of Human Organs (THO) Act, 1994 (Subsection 6 of Section 3), 'brain stem death' refers to the stage at which all functions of the brain stem have permanently and irreversibly ceased.

This is to be certified by a 'Board of Medical Experts' consisting of:

(1) The medical superintendent (MS)/In-Charge of the hospital in which 'brain stem' death has occurred,

(2) a specialist,

(3) a neurologist or a neurosurgeon nominated by the MS, from a panel approved by the Appropriate Authority, and the doctor under whose care the 'brain- stem' death has occurred.

Amendments in the THO Act 2011 have allowed the selection of a surgeon/physician and an anesthetist, if an approved neurosurgeon or neurologist is unavailable.

“Brain stem death has to be certified by a panel of four independent doctors, including a neurologist or neurosurgeon, and confirmed twice with a minimum gap of six hours. The process is carried out with due diligence and seriousness,” Dr Manjari Tripathi, head of neurology at AIIMS, was quoted as saying.

“While the guidelines require the team of doctors to meet and declare brain death at least twice, we end up doing it sometimes three times for the patients. The current guidelines require various bedside tests for the declaration of brain death. It does not specify the need for tests such as an EEG or angiogram,” added Dr. Tripathi.

Experts said additional tests could add to the system burden. EEG is not routinely recommended for brainstem death certification, while an angiogram is used only in select cases where the apnea test cannot be performed. Globally, the apnea test remains the gold standard. These criteria are clearly laid down and cannot be altered, said experts.

Challenges To Brain Death Certification In India

The Indian Express reported that the lack of knowledge even among physicians is a significant challenge in India.

This leads to several patients never being officially declared and asked to be organ donors.

An AIIMS-led study, published in the journal Neurology India last year, found that more than half the doctors — including neurosurgeons, neurologists, and critical care specialists who are most commonly included in the certification process — did not receive any training on brain death certification at the time of their graduation.

The US Food and Drug Administration (FDA) has approved Merck's Idvynso (doravirine/islatravir), a new, once-daily pill for the treatment of HIV-1 infection in adults.

The two-drug single tablet replaces the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA <50 copies per mL).

The single tablet contains 100 mg doravirine and 0.25 mg islatravir. The FDA has approved it for adults on a stable antiretroviral regimen with no history of virologic treatment failure and no known substitutions associated with resistance to doravirine.

“IDVYNSO combines islatravir, a next-generation NRTI with multiple mechanisms of action, including translocation inhibition, with doravirine, an NNRTI with an established efficacy and safety profile,” said Dr. Eliav Barr, senior vice president and chief medical officer, Merck Research Laboratories, in a statement.

How Was The Pill Approved?

The approval is based on data from two randomized, active-controlled, noninferiority trials. In the double-blind Trial 052, participants were randomly assigned to stay on Glilead's Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide; 171 individuals) or switch to Idvynso (342 individuals).

Results showed that 1 per cent of participants in both groups had a viral load of ≥50 copies/mL at 48 weeks.

In the open-label Trial 051, participants were randomly assigned to stay on their oral antiretroviral therapy (ART) regimen (185 individuals) or switch to Idvynso (366 individuals).

Results showed that 1 per cent of participants who were switched to Idvynso had a viral load of ≥50 copies/mL at week 48 versus 5 per cent who continued on ART.

"As the only two-drug, non-integrase strand transfer inhibitor, tenofovir-free regimen, Idvynso expands therapeutic diversity beyond the currently available oral treatment options," Barr said.

"As the health needs of adults living with HIV change over time, Idvynso gives clinicians a new choice for HIV treatment."

What Is IDVYNSO? How Does It Work?

IDVYNSO is a fixed-dose combination of two medicines, doravirine with islatravir.

Doravirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that inhibits HIV-1 replication by non-competitive inhibition of HIV-1 reverse transcriptase.

Islatravir is a potent, next-generation nucleoside analog reverse transcriptase inhibitor (NRTI) that blocks HIV-1 replication by multiple mechanisms, including:

• inhibition of reverse transcriptase translocation, resulting in immediate chain termination,
• induction of structural changes in the viral DNA (delayed chain termination).

Global Burden Of HIV

According to the latest data from UNAIDS, 40.8 million people globally were living with HIV in 2024. Of these, 39.4 million were adults (15 years or older) and 1.4 million were children (0–14 years).

While 1.3 million people became newly infected with HIV in 2024, 630,000 died from AIDS-related illnesses.

About 87 per cent of all people living with HIV knew their HIV status, and 5.3 million people did not know that they were living with HIV.

The US eliminated measles in 2000, but since 2025, the highly infectious disease has spread to 45 states. As of early May 2026, the US has recorded 1,814 confirmed measles cases this year across 36 states. This follows a record-high 2,288 cases in 2025.

Now, the US Centers for Disease Control (CDC) has warned about additional measles cases ahead of the travel season.

The CDC urged public health agencies across the US to be prepared for more measles cases in the coming months.

"With continued measles transmission in areas across North America and expected increases in international and domestic travel and large events during spring and summer, additional measles cases are anticipated in the coming months," the agency said.

Travel Guidance By CDC

The guidance advised public health agencies to document and report details of each case of measles, including close contacts and locations visited while a person was infectious.

Active surveillance should be conducted to identify any additional suspected cases and quickly transport specimens for laboratory confirmation, the guidance said.

The agency also encouraged outreach to under-vaccinated communities and suggested using state-based syndromic surveillance systems to detect changes in health care–seeking behavior for fever and rash illnesses or signs of vitamin A toxicity.

Measles is a highly contagious virus that spreads through direct contact or through the air when an infected person coughs or sneezes. It is a vaccine-preventable disease that can cause devastating complications, including blindness, pneumonia, encephalitis, and long-term immune dysfunction.

Is The US At Risk Of Losing Measles Elimination Status?

Also read: Robert F. Kennedy Jr. Denies Link To Measles Outbreak At Senate Hearing

So far, there have been 24 new outbreaks reported in 2026, and 93 per cent of confirmed cases (1,688 of 1,814) are outbreak-associated (415 from outbreaks starting in 2026 and 1,273 from outbreaks that started in 2025).

In 2025, 48 outbreaks were reported, and 90 per cent of confirmed cases (2,065 of 2,288) were outbreak-associated.

According to researchers at Boston Children's Hospital, the US has missed four of the seven criteria for measles elimination status, which could put the country off track. More are at risk, they said.

In a Correspondence published in The Lancet, the researchers explained the missed indicators of measles elimination status in the US.

• Low number of cases with a cutoff of less than one case per 10 million people. As of early 2026, the US had about 93 cases per 10 million people, exceeding this limit.

• Most of the measles cases should come from abroad rather than from internal spread. Since the start of 2025, only 6–7 per cent of the measles cases have come from abroad, meaning most cases derive from within the US.

• A limited number of outbreaks (a cutoff of approximately four) with no more than about six cases each. Last year in the US, 48 outbreaks resulted in more than 2,000 cases. And in early 2026, at least 19 outbreaks have already resulted in more than 1,600 cases.

• A level of transmission less than one, meaning one infected person only spreads measles to fewer than one other person on average. The US exceeded this rate more than 75 per cent of the time since early 2025.

Indicators At Risk

Read More: India Concerned Over Measles Outbreak, Action Underway: Dr N K Arora| Exclusive

• The country achieves four weeks with all infections deriving from outside the US. Since the first infection in January 2025, the US hasn't gone four weeks without infections, with 90 per cent of cases acquired here.

• Herd immunity through vaccination. An estimated 95 per cent of people need to receive two doses of the measles vaccine to achieve herd immunity, typically given as part of the MMR (measles, mumps, and rubella) vaccine. However, the US average vaccination rate of kindergartners in the 2024–2025 school year was 92 per cent, meaning this indicator is at high risk.

• Measles cases don't share a common viral strain. From ongoing genetic analyses, preliminary data show that the majority of cases share the same viral strain and are likely part of the same transmission chain.

The researchers believe these findings make a strong case for vaccinating children to protect them from a young age.

"Viral infections aren't all benign, and a measles infection, even when cleared, can result in lifelong problems," said Maimuna Majumder, from Boston Children's.

"Babies less than a year old are among those at greatest risk for severe complications, and the full impact on children exposed during the current outbreak may only show up years later," Majumder added.