An injection to prevent HIV is to be offered to patients on the NHS in England and Wales for the first time, bringing the policy in line with Scotland.

The long-acting shot, given six times a year or every other month, is an alternative to taking daily pills to protect against the virus.

Experts hope the cabotegravir (CAB-LA) injections will help meet the ambition of ending new HIV cases by 2030 in the UK.

Meanwhile, early results for a different injection called lenacapavir suggest it may even be possible to move people on to an annual HIV prevention jab.

'This represents hope'

Wes Streeting, the Secretary of State for Health and Social Care, said: "The approval of this game-changing injection perfectly embodies what this government is determined to deliver - cutting-edge treatments that save lives and leave no one behind.

"For vulnerable people who are unable to take other methods of HIV prevention, this represents hope."

HIV prevention therapy, known as PrEP (pre-exposure prophylaxis), is taken by HIV-negative people to reduce the risk of getting HIV.

Pills have been available for years and are still extremely effective at stopping HIV infections, but are not always easy for some to take.

It can be hard to access, not practical, or feel embarrassing. For example, people might worry someone like parents or housemates could find their pills.

Homelessness and domestic violence can make it difficult to take oral PrEP every day.

An injection which lasts for months offers convenience and discretion.

HIV is a virus that damages the cells in the immune system and weakens the body's ability to fight everyday infections and diseases.

It can be caught during unprotected sex or through sharing needles. Mothers can also pass it to their baby at birth.

Cabotegravir should be used in combination with safer sex practices, such as use of condoms.

The NHS has an undisclosed discount from the manufacturer for the treatment that has a list price of around £7,000 per patient per year.

The jab will be considered for adults and adolescents with a healthy weight who are at high risk of sexually acquired HIV and eligible for PrEP, but for whom taking oral tablets would be difficult. It’s thought around 1,000 people will be offered it.

They will be able to get it from NHS-operated sexual health clinics "in coming months" says the National Institute for Health and Care Excellence (NICE).

Charities say some people face long waiting times for appointments at clinics and the rollout must happen quickly.

Richard Angell, of the Terrence Higgins Trust, said it was time to explore delivering the "transformative therapy" in other settings, not just sexual health clinics.

"It's highly effective and acceptable for patients, and a vital tool for tackling inequalities – with the potential to reach those who are not currently accessing other HIV prevention."

Official figures for England show the number of people taking PrEP in sexual health services is increasing.

Last year,146,098 HIV-negative people accessing sexual health services had a PrEP need because they were at substantial risk of acquiring HIV.

Of those, about 76% (111,123) began or continued PrEP - a 7.7% rise from 2023.

PrEP need is not being identified and met equitably though.

Access to the treatment varies significantly by group, with uptake highest among white (79.4%) and ethnic minority (77.8%) gay, bisexual and all men who have sex with men, but much lower among black African heterosexual women (34.6%) and men (36.4%).

At the same time, HIV testing has expanded across hospital A&E departments in England. Currently, 89 routinely test anyone who has blood taken, specifically in cities and towns with high HIV prevalence.

Live from New York: It's mayoral debate night.

The three leading candidates for New York City mayor took the stage at Rockefeller Center in Manhattan Thursday night to make a case to lead America's biggest city.

Early voting in the race is set to begin next week, and the most recent polling, suggests Zohran Mamdani has widened his lead to 46 percent, while Andrew Cuomo stands at 33 percent.

The outcome of the race could have political implications beyond the Empire State as President Donald Trump looms large, and whoever wins will likely face pressure from Washington in some form.

The Democratic Party nationally also is likely watching to see if the America's biggest Democratic stronghold chooses an establishment, centrist Cuomo, who is running as an independent or the progressive Mamdani. The winner could help determine the kind of candidate and platform Democrats choose in the future following their staggering 2024 loss to Trump.

Republicans also will watch to see if their candidate, Curtis Sliwa, continues to make inroads with his public safety platform.

Here are five big takeaways from tonight's debate.

Mamdani addresses his support for Palestinians

Mamdani's past statements on Israel and Palestinians came up several times during the night in questions from moderators and opponents' criticisms.

The candidate has stressed his support for Palestinians and statehood, and has criticized Israel's military operation in Gaza.

He also was criticized for declining to condemn the phrase "globalise the intifada" when probed by interviewers, but has said he would seek to serve as a mayor for all New Yorkers, including its large and ideologically diverse Jewish population.

Cuomo, however, attacked Mamdani for his views, calling the New York state assemblyman a "divisive personality across the board."

The fourth man: Donald Trump

Although there were three candidates at tonight's debate, another name kept coming up: Donald Trump.

President Trump has implied he wants to send the National Guard into cities controlled by Democrats - in spite of resistance - and has moved to withhold government funds for infrastructure projects in New York City. Trump also has prioritized New York City for his mass deportation policy, and the mayor — who has little power over federal immigration enforcement — will likely have to weigh the city's response.

Sliwa, the Republican, noted that the mayor would need to get along with Trump regardless of political views. But Mamdani made his opposition to Trump explicit from his very first response, promising to "take on Trump."

Cuomo positioned himself as the only candidate experienced enough to deal with the current White House, warning "it will be Mayor Trump" if Mamdani is elected.

"I fought Donald Trump," he told voters. "When I'm fighting for New York, I am not going to stop."

Affordability front and center

As large as Trump looms, the biggest policy issue around this mayoral election is affordability. New Yorkers face high costs of living on everything - especially rent and groceries.

In his opening statement, Sliwa acknowledged the "really serious issues of affordability" facing the city. He called for the next mayor to free up vacant apartments in NYCHA - New York's public housing programme — and allow people to move in.

The moderators directly asked each candidate how much they paid for rent, groceries and whether they paid off credit card debt monthly. The candidates pitched a volley of proposals, including Mamdani's plan to make buses free and Cuomo's proposal to place income limits on people who resided in rent-stabilized apartments.

He criticised Mamdani for living in a rent-stablised apartment, even though his parents are wealthy (his mother is the filmmaker Mira Nair).

"If you think that the problem in this city is that my rent is too low, vote for him," Mamdani said. "If you know the problem in this city is that your rent is too high, vote for me."

Cuomo also opposed Mamdani's proposed rent freeze on stabilized apartments, saying it would only postpone future increases, force building owners into bankruptcy, and fail New Yorkers who don't live in rent-stabilized apartments.

• Former Governor Andrew Cuomo announces run for New York City mayor
• FULL COVERAGE: Mamdani, Cuomo, Sliwa debate
• Who is Zohran Mamdani?
• How Mamdani stunned New York - and what Democrats can learn from his win

Cuomo's controversies still loom

Cuomo touted his decades of experience in office, rising from federal housing secretary during President Bill Clinton's administration to New York's governor.

But his controversies while governor have shadowed his campaign and Cuomo came prepared for a fight.

He resigned as governor in 2021 after an investigation by the state attorney general found he had sexually harassed 11 women. Cuomo apologised for acting "in a way that made people feel uncomfortable" but denied allegations.

The New York attorney general also investigated his administration for undercounting nursing home deaths during the Covid-19 pandemic, finding he understated the actual number of deaths.

Mamdani attacked Cuomo on these matters, accusing him of "sending seniors to their death in nursing homes," and accused him of lacking integrity.

Cuomo said the allegations about harming seniors in nursing homes was "totally false."

"During Covid, everyone did whatever they could in this state, and there have been numerous investigations where they've gone through it, and they said we followed federal guidance," Cuomo said. "But yes, people died during Covid. And my heart breaks for everyone that broken, that died in this state and across this nation."

Sliwa, too, attacked Cuomo for the "lawsuits filed against you for sexual harassment." The former governor rebutted that the case brought New York attorney general Letitia James, who investigated the misconduct claims, "was political."

Curtis Sliwa makes his mark

Sliwa held his own as the only Republican on stage.

His voting bloc might be in the minority in New York City, but the 2024 presidential election revealed that residents prioritise public safety issues and Sliwa hammered that repeatedly. As the founder of the Guardian Angels, a New York City organization devoted to crime prevention, he seized the opportunity to connect with voters.

The longtime New York media and political personality also knew how to make himself heard. He frequently interjected, telling moderators he wanted to speak, and elbowing his way into the debate's most heated moments. From centre stage, he took swings at both opponents in equal measure.

He felt confident after the debate, saying his night went "extraordinarily well" and likening his opponents to "two kids in the schoolyard.

News of the phone call between US President Donald Trump and Russian President Vladimir Putin on Thursday, in which they agreed to meet in person to discuss the war in Ukraine, will have come as an unwelcome surprise to Kyiv.

The country is being hit hard.

The last 24 hours alone have seen Russia launch dozens of missiles and more than 300 drones at multiple targets.

Once again, they include a large amount of civilian infrastructure with further damage to the country's gas supply network, just as the first signs of cold herald a long, hard winter ahead.

Attacks on the electrical grid are already leading to nationwide power outages.

For Ukraine's government it's a sign of Russian desperation.

The frontlines are at effective stalemate, involving huge loss of life for incremental territorial gains.

And the Russian economy is feeling the effects of the Ukrainian military's increasingly effective drone strikes on oil depots.

So, President Volodymyr Zelensky's big hope was for more American military assistance to keep up that pressure.

Before he boarded his plane to Washington, he seemed to believe that things were going his way.

There was optimistic talk about Trump beginning to see the world through Ukraine's eyes, a big shift from that angry, humiliating Oval Office exchange in February when he accused Zelensky of "gambling with World War Three".

The failure of the Trump-Putin Alaska summit in August and the intensifying bombardment of Ukraine were – it was thought – all causing the US president to lose patience with his "good friend", as he has called Putin.

There were high hopes that Friday's meeting would finally yield the prize Ukraine has been seeking - Trump's permission for the purchase of long-range Tomahawk missiles.

Trump's frustration with Putin was obvious on Sunday when he told reporters: "Do they [Russia] want Tomahawks going in their direction? I don't think so."

But how much of a game changer the missiles would really be is in much dispute among military experts and, with the complicated logistics, it could be months before they were deployed.

But at the very least they would add to Ukraine's ability to strike deep into the heart of Russia and with a much more powerful weapon than any it currently possesses.

They would also send a potent physical message to Putin about America's shifting allegiances.

So, the two-and-a-half-hour Trump-Putin phone call, that took place while Zelensky was in flight, somewhat steals a march on the Ukrainian president's big moment.

So far, though, he's putting something of a brave face on it, suggesting in a post sent on his arrival in Washington that Russia was panicking.

The Kremlin was "rushing to renew dialogue", he said, precisely because of all the talk of the Tomahawks.

Other analysts will see less panic and more of a classic Putin play at work in the phone call, which was said by the Kremlin to have taken place at Russia's behest.

The issue of the Tomahawks was indeed discussed, with Putin reinforcing his view that their deployment would be seen as a significant act of provocation.

The two men apparently discussed the "colossal prospects" – in Russia's words – for trade if peace were achieved.

And then they agreed to their summit in Hungary. That will probably happen within the next two weeks, Trump said.

• Trump says he will meet Putin in Hungary after 'very productive' call

As Ukraine faces its fourth winter of war, few people here had much belief in Trump's claim that he could turn his "success" in the Middle East into momentum towards peace in Ukraine.

One woman the BBC spoke to, badly injured in a Russian strike on a civilian railway carriage, shrugged her shoulders when we asked her if she saw an easy way out.

"A person like Putin can't be trusted," she said from her hospital bed.

After touching down in Washington on Thursday evening, Zelensky met representatives of defence companies who produce the powerful weapons he says he needs to strengthen Ukraine's protection.

He will still ask the White House for the Tomahawks.

But Trump's willingness to give them was always in doubt and must, surely, be now further called into question.

Meanwhile, Russia is being given something.

A familiar pattern is developing. Every time Trump grows increasingly frustrated with Putin's intransigence over Ukraine he is then placated by a conversation with the Russian president.

Each time they speak he seems to be persuaded of Putin's point of view and backs off his threats to apply tougher sanctions or supply more destructive weapons.

The Hungary summit, offered without concessions, doesn't look like much of a loss of American patience.

Never mind the Tomahawks.

For now, Ukraine has been given a long-range curveball instead.

Follow the twists and turns of Trump's second term with North America correspondent Anthony Zurcher's weekly US Politics Unspun newsletter. Readers in the UK can sign up here. Those outside the UK can sign up here.