The State Department on Tuesday announced PEPFAR has delivered the first doses of a groundbreaking HIV prevention drug to two African countries.

The lenacapavir doses arrived in Eswatini and Zambia.

The State Department in September unveiled an initiative with Gilead Sciences to bring lenacapavir “to market in high-burden HIV countries.”

Lenacapavir users inject the drug twice a year.

The State Department in its September announcement noted everyone who participated in Gilead’s clinical trials remained HIV negative. It also said lenacapavir “has the potential to be particularly helpful for pregnant and breastfeeding mothers, as it safely protects them during and after pregnancy to prevent mother-to-child transmission.”

“In our new America First Global Health Strategy, the Department of State is establishing a first-of-its-kind innovation fund to support American-led research, market-shaping, and other dynamic advancements in global health,” said PEPFAR on Tuesday in a press release.

“The arrivals of the first doses of lenacapavir in Eswatini and Zambia mark an important milestone in HIV prevention and reflect our commitment to supporting communities with the greatest need,” added Gilead CEO Daniel O’Day. “For the first time, a new HIV medicine is reaching communities in sub-Saharan Africa in the same year as its U.S. approval.”

The September announcement came against the backdrop of widespread criticism over the Trump-Vance administration’s reported plans to not fully fund PEPFAR and to cut domestic HIV/AIDS funding. The Washington Blade has previously reported PEPFAR-funded programs in Kenya and other African countries have been forced to curtail services or even close because of U.S. funding cuts.

Sanae Takaichi last month became Japan’s first female prime minister after she secured the Liberal Democratic Party’s leadership and both chambers of the Diet confirmed her.

She now leads a minority government after forming a coalition with the right-leaning Japan Innovation Party, following Komeito’s decision to end its 26-year partnership with the LDP. Her rise marks a historic break in Japanese politics, but the question remains whether she will advance the rights of Japan’s LGBTQ community?

Despite the milestone her election represents, Takaichi’s record on gender issues offers little indication of progressive change. 

She has long emphasized “equality of opportunity” over structural reforms and has opposed measures that include allowing married couples to use separate surnames, a policy many women say would ease workplace discrimination. During her leadership bid Takaichi pledged to elevate women’s representation in government to Nordic levels, yet she appointed only two women to her 19-member Cabinet. Takaichi has also resisted efforts to modernize the Imperial Household Law to permit female succession, reinforcing her reputation as a conservative on women’s rights.

Takaichi’s stance on LGBTQ rights has been similarly cautious. 

In a 2023 Diet budget committee session, she said there should be “no prejudice against sexual orientation or gender identity,” yet described extending marriage rights to same-sex couples as an “extremely difficult issue.” 

Her earlier record is consistent.

In 2021, she opposed an LGBTQ-inclusive anti-discrimination bill that members of her own party, arguing its wording was too vague. 

Even after becoming LDP leader in October 2025, she reiterated her opposition to marriage equality and emphasized traditional family values. Takaichi highlighted that Article 24 defines marriage as being based on “the mutual consent of both sexes” and frames the institution around “the equal rights of husband and wife,” language she argues leaves no constitutional room for extending marriage rights to same-sex couples.

While her rhetoric avoids overt hostility, her record suggests limited appetite for the structural reforms sought by Japan’s LGBTQ community.

A series of landmark court rulings has built escalating pressure for national reform. 

On March 17, 2021, the Sapporo District Court ruled that denying same-sex couples the legal benefits of marriage violated the constitution’s equality clause. In May 2023, the Nagoya District Court similarly declared the ban unconstitutional, with a subsequent decision from the Fukuoka District Court reaffirming Japan’s current legal framework clashes with constitutional equality principles. 

The momentum peaked on Oct. 30, 2024, when the Tokyo High Court found the marriage ban incompatible with guarantees of equality and individual dignity. 

Japan remains the only G7 country without legal recognition of same-sex couples.

Akira Nishiyama, a spokesperson for the Japan Alliance for LGBT Legislation, noted to the Washington Blade that in leadership surveys the group conducted within the LDP in 2021 and again in 2025, Takaichi offered only a cautious position on reforming Japan’s legal gender recognition law. When asked whether she supported easing the requirements under the Act on Special Cases in Handling Gender Status for Persons with Gender Identity Disorder, she responded that “multifaceted and careful discussion is necessary,” avoiding any commitment to substantive change.

Nishiyama added the legal landscape has already shifted. 

In October 2023, the Supreme Court ruled that the law’s sterilization requirement for legal gender recognition is unconstitutional, and several family courts have since struck down the appearance requirement on similar grounds. She urged the Takaichi administration to act quickly by amending the statute to remove these provisions, along with other elements long criticized as human rights violations.

“[Prime Minister] Takaichi has stated that ‘careful discussion is necessary’ regarding amendments to ‘Act on Special Cases in Handling Gender Status for Persons with Gender Identity Disorder’ and the enactment of anti-discrimination laws based on Sexual Orientation and Gender Identity (SOGI),” noted Nishiyama. “However, as indicated in Candidate (at that time) Takaichi’s responses to our survey, if she considers issues related to SOGI to be human rights issues, then she has to work hard to advance legal frameworks to address these issues.” 

“For example, regarding the government’s announcement that they will consider whether same-sex couples could be included or not in the 130 laws concerning common-law marriages couples, [Prime Minister] Takaichi responded to our survey that ‘the government should continue to advance its consideration,’” she added. “As per this response, the Takaichi Cabinet should continue deliberating on this matter and ensure that same-sex couples are included in each relevant law.”

Takeharu Kato, an advocate for marriage equality who spoke to the Blade in a personal capacity, urged observers not to view Takaichi’s appointment solely through a negative lens. 

He acknowledged she holds deeply conservative views within the LDP and has openly opposed marriage equality, but noted several aspects of her background could leave room for movement. 

“She is Japan’s first female prime minister in history. Furthermore, she does not come from a political family background but rather from an ordinary household,” said Kato. “She also has an unusual career path, having graduated from a local university and worked as a television news anchor before entering politics.” 

“Additionally, while her husband is a member of the Diet, he became partially paralyzed due to a cerebral infarction, and she has been caring for him,” he further noted. “She possesses several minority attributes like these, and depending on our future efforts, there is a possibility she could change her stance on same-sex marriage. It could also be said that, as a woman navigating the conservative Liberal Democratic Party, she has deliberately emphasized conservative attitudes to appeal to her base of right-wing supporters.” 

Kato stressed that “having reached the pinnacle as prime minister, it cannot be said she (Takaichi) has no potential to change.”

“We need not alter the strategy we have pursued thus far,” Kato told the Blade. “However, we believe some fine-tuning is necessary, such as refining our messaging to resonate with those holding more conservative values.”

The results of Chile’s presidential election will likely determine the future of LGBTQ rights in the country.

While Congresswoman Emilia Schneider, the first transgender woman elected to Congress, managed to retain her seat on Sunday, the runoff to determine who will succeed outgoing President Gabriel Boric will take place on Dec. 14 and will pit two diametrically opposed candidates against each other: the far-right José Antonio Kast and Communist Jeannette Jara.

Schneider, an emblematic figure in the LGBTQ rights movement and one of the most visible voices on trans rights in Latin America, won reelection in a polarized environment. Human rights organizations see her continued presence in Congress as a necessary institutional counterweight to the risks that could arise if the far-right comes to power.

Kast v. Jara

The presidential race has become a source of concern for LGBTQ groups in Chile and international observers.

Kast, leader of the Republican Party, has openly expressed his rejection of gender policies, comprehensive sex education, and reforms to anti-discrimination laws.

Throughout his career, he has supported conservative positions aligned with sectors that question LGBTQ rights through rhetoric that activists describe as stigmatizing. Observers say his victory in the second-round of the presidential election that will take place on Dec. 14 could result in regulatory and cultural setbacks.

Jara, who is the presidential candidate for the progressive Unidad por Chile coalition, on the other hand has publicly upheld her commitment to equal rights. She has promised to strengthen mechanisms against discrimination, expand health policies for trans people, and ensure state protection against hate speech.

For Schneider, this new legislative period is shaping up to be a political and symbolic challenge.

Her work has focused on combating gender violence, promoting reform of the Zamudio Law, the country’s LGBTQ-inclusive nondiscrimination and hate crimes law named after Daniel Zamudio, a gay man murdered in Santiago, the Chilean capital, in 2012, and denouncing transphobic rhetoric in Congress and elsewhere.

Schneider’s continued presence in Congress is a sign of continuity in the defense of recently won rights, but also a reminder of the fragility of those advances in a country where ideological tensions have intensified.

LGBTQ organizations point out that Schneider will be key to forging legislative alliances in a potentially divided Congress, especially if Kast consolidates conservative support.