Weight-loss injections originally developed for diabetes and obesity treatment are increasingly being marketed to soon-to-be brides and grooms in India, as clinics incorporate the drugs into pre-wedding transformation packages amid rising demand and regulatory scrutiny.

Wellness centres across major cities are promoting such treatments as part of broader grooming services traditionally focused on skincare and styling. A New Delhi-based clinic, Klarity Skin Clinic, advertises a “Mounjaro bride” package combining medication with nutrition plans and exercise routines, reflecting a shift in how pharmaceutical interventions are being positioned in consumer wellness markets.

Doctors say inquiries for these drugs have surged in recent months, particularly among individuals preparing for weddings. Eight physicians interviewed by Reuters reported a noticeable rise in requests from brides and some grooms seeking rapid weight loss ahead of ceremonies, often within fixed timelines.

“Over the last few months, over 20% of the queries we’ve received for obesity injections are from to-be brides, who also openly give us a timeline on how soon they are getting married,” said Rajat Goel, a bariatric surgeon at Hindivine Healthcare in New Delhi. He added that prescriptions were issued only to patients meeting medical criteria, not for purely cosmetic purposes.

The growing interest reflects broader social and cultural dynamics in India, where weddings are often elaborate events shaped by family expectations and social norms. Physical appearance can carry significant weight in arranged marriage settings, contributing to demand for quick and visible results.

Several individuals who spoke to Reuters cited such pressures as a key factor behind their decision to use the drugs. Aditi, a 26-year-old finance professional from Mumbai, said she turned to the medication after conventional methods failed to deliver the desired outcome. She reported losing 10 kilograms before her wedding and said the results improved her confidence during the ceremony.

Others echoed similar motivations. Akshitha, who married last year in Hyderabad, said she opted for injections after struggling to balance fitness routines with wedding preparations. The treatment helped her lose 15 kilograms, bringing her weight to 76 kilograms before the event. She said she may consider using the drugs again after a future pregnancy.

In some cases, the decision has been linked to social stigma. Priya, a 27-year-old technology worker from Bengaluru, said she experienced rejection from prospective grooms’ families due to her weight, prompting her to seek pharmaceutical assistance. She initially used oral semaglutide before switching to injectable medication, losing more than 12 kilograms, though she said her search for a partner continues.

The drugs at the centre of this trend include Eli Lilly’s Mounjaro and Novo Nordisk’s Wegovy, both of which entered the Indian market last year. Physicians reported that Mounjaro has become particularly sought after, with demand rising rapidly following its introduction.

Market forecasts reflect the growing interest. India’s obesity drug market is projected to reach approximately 80 billion rupees (about $851.79 million) by 2030, driven by rising awareness, expanding availability, and increasing rates of obesity and related conditions.

Pricing remains a significant factor in accessibility. In India, monthly costs for Mounjaro range from 13,125 rupees for lower doses to 25,781 rupees for higher ones. Wegovy is priced between 5,660 rupees and 16,400 rupees per month, following recent price reductions by Novo Nordisk aimed at improving competitiveness.The market is also becoming more crowded.

Domestic pharmaceutical companies began introducing lower-cost versions of semaglutide-based treatments after the expiration of key patents, expanding access but also raising concerns about oversight and misuse.

India’s drug regulator has responded by increasing surveillance of unauthorized sales and promotional practices, particularly as demand extends beyond medically indicated use. The drugs are approved for individuals classified as obese or overweight with related health conditions such as diabetes, hypertension, or sleep apnea.

Manufacturers have reiterated that the medications should be used strictly under medical supervision. Eli Lilly said Mounjaro is approved only for specific indications and must be administered by qualified healthcare professionals, while Novo Nordisk has discouraged self-medication and off-label use.

Medical experts warn that positioning such treatments as quick solutions for cosmetic goals could undermine patient safety and long-term health outcomes. Dr. Swati Pradhan, founder of Live Light clinic, said she prescribes the injections sparingly and only when patients meet eligibility criteria, emphasizing the importance of sustained lifestyle changes.

The trend comes against a backdrop of rising obesity levels in India. A study published in The Lancet projects that the country could have more than 440 million overweight or obese individuals by 2050, among the highest totals globally. This has created a rapidly expanding market for weight-management solutions, spanning pharmaceuticals, fitness services, and wellness products.

As clinics continue to integrate medical treatments into lifestyle offerings, regulators and healthcare providers face the challenge of balancing expanding access with appropriate safeguards. The intersection of cultural expectations, commercial incentives, and medical innovation is reshaping how weight-loss therapies are perceived and used in one of the world’s fastest-growing healthcare markets.

The United States is restructuring how it delivers life-saving medical supplies for HIV and malaria to low-income countries, a shift that officials and health experts warn could disrupt treatment access across parts of Africa and Asia.

The changes centre on winding down the Global Health Supply Chain Program – Procurement and Supply Management, a U.S.-funded initiative run by Chemonics, which has coordinated the delivery of critical medicines and prevention tools since 2016. According to internal communications and multiple sources familiar with the matter, U.S. officials have been instructed to begin halting implementation of the programme by May 30.

From its inception through 2024, the programme distributed more than $5 billion worth of HIV and malaria-related commodities to 90 countries, with a primary focus on sub-Saharan Africa and parts of Asia. The supplies included antiretroviral drugs, malaria treatments and insecticide-treated bed nets, forming a key component of global disease control efforts.The restructuring follows broader changes to U.S.

foreign aid policy under the administration of Donald Trump, which has prioritised reducing reliance on contractors, cutting budgets and shifting toward direct agreements with recipient governments. The overhaul also comes after the dismantling of the United States Agency for International Development, which had previously overseen much of Washington’s development assistance.

Five sources familiar with the transition said the pace of the changes risks creating supply gaps for essential medicines, particularly in countries with fragile health systems. An internal email reviewed by Reuters warned that accelerating the transition without a clear implementation plan could jeopardise continuity of services.

The communication, sent by the U.S. State Department to staff in 17 African countries and Haiti, directed country teams to prepare for the end of programme operations while outlining potential risks. It did not provide a detailed roadmap for replacement mechanisms, instead asking local offices to identify vulnerabilities and report back to Washington.

A State Department spokesperson said the agency had not issued technical instructions for Chemonics to cease operations by May 30, though the contract is set to expire on September 30 in line with other USAID awards. The official end date is listed as November.

The uncertainty has revived concerns stemming from earlier disruptions. In January last year, a freeze on international aid left millions of dollars’ worth of medical supplies stranded in ports and warehouses worldwide, including HIV drugs and malaria prevention tools. Distribution resumed only after waivers were granted for life-saving interventions.

Six sources said the United States has been in discussions with the Global Fund to Fight AIDS, Tuberculosis and Malaria about potentially using its procurement and distribution systems to replace the existing programme. The Geneva-based institution already manages approximately $2 billion in annual purchases for HIV, tuberculosis and malaria programmes through partnerships with national governments and implementing agencies.

However, two sources said earlier plans had envisaged a transition timeline extending to November 2027, allowing sufficient time for procurement cycles and logistical adjustments. Compressing this timeline into a matter of months could create operational bottlenecks, they said, noting that delivering medical supplies to remote areas can take up to a year from order to distribution.

The Global Fund declined to comment on the discussions. The State Department did not directly confirm the talks but said it would rely on pooled procurement mechanisms to secure supplies at competitive prices from private manufacturers.The policy shift is part of a broader “America First” approach to global health funding, which aims to reduce what officials describe as inefficiencies in the existing system.

A strategy document released in September argued that contractor-led programmes had contributed to waste and inflated costs, and emphasised direct funding for frontline services and national governments.

Under the new approach, Washington has signed 28 bilateral health agreements with partner countries and is increasingly channeling funds directly to national authorities. It also plans to use private logistics firms to handle distribution rather than relying on large development contractors.

Recent agreements with countries such as Kenya, Rwanda and Uganda include commitments to increase domestic health spending alongside U.S. funding. However, implementation has encountered obstacles. In Kenya, a proposed deal faces legal challenges from activists concerned about data privacy, while negotiations with Zambia have been delayed as officials seek to safeguard national interests.

Health experts and aid practitioners say the transition risks compounding existing vulnerabilities in global disease control programmes. Previous disruptions linked to funding changes have already contributed to shortages of malaria treatments for children and gaps in HIV prevention services in several countries.

The State Department defended the overhaul, describing the current system as outdated and inefficient. A spokesperson said the new model would prioritise value for American taxpayers while maintaining support for critical health interventions.

Despite those assurances, several sources involved in programme delivery said the lack of a detailed transition plan remains a central concern. They warned that without clear coordination between donors, governments and implementing partners, the shift could interrupt supply chains that millions depend on for survival.

Zuwaira Hanafi stood outside a healthcare facility in Kaita, in Nigeria’s northern Katsina state, as medical staff hurried into a ward where her eight-month-old daughter lay semiconscious, underscoring the urgency confronting health workers in a region grappling with rising levels of severe malnutrition.

At the entrance, clinicians used colour-coded measuring tapes to assess the mid-upper arm circumference of children, a standard method for diagnosing malnutrition.

A steady flow of mothers, including teenagers, arrived with infants in critical condition, reflecting what humanitarian agencies describe as a deepening hunger crisis affecting large parts of the country.The International Federation of Red Cross and Red Crescent Societies has warned that as many as 33 million Nigerians could face severe hunger in 2026, a record level.

Data from the United Nations Office for the Coordination of Humanitarian Affairs indicates that approximately 6.4 million children in Nigeria are expected to be acutely malnourished by the end of the year, with the burden concentrated in northern regions such as Katsina.

Dr Soma Bahonan, head of the Nigeria mission for the Alliance for International Medical Action (Alima), which operates the Kaita facility in partnership with local authorities, said the crisis is expanding beyond children. Increasing numbers of mothers are also presenting with acute malnutrition, compounding the risks to infant health and survival.

Alima has expanded its operations to include mobile clinics designed to reach remote populations unable to travel to fixed facilities. These services include transport support for critical cases from surrounding communities.

However, Bahonan described the scale of need as exceeding operational capacity, particularly in Katsina, which has become a focal point of what aid workers describe as an intergenerational hunger crisis.Longstanding drivers of food insecurity, including climate variability and structural governance challenges, have been intensified by rising insecurity.

Attacks by jihadist groups and other non-state actors have disrupted farming activities and restricted access to agricultural land, further weakening household food production and income stability.The strain on the healthcare system is evident in workforce shortages. Nigeria’s doctor-to-patient ratio is estimated at roughly 1:9,000, significantly below the World Health Organization’s recommended ratio of 1:600.

Medical professionals continue to leave the country, citing delayed salary payments and limited career prospects, further reducing service capacity in already underserved areas.While digital health startups and private-sector partnerships have made progress in urban centres such as Lagos and Abuja, their reach remains limited in rural and conflict-affected regions due to infrastructure deficits and high inflation.

This uneven distribution of innovation has widened disparities in healthcare access.Analysts describe Nigeria’s current situation as a convergence of multiple crises. Joachim MacEbong, a senior analyst at Control Risks in Lagos, said the country faces overlapping economic, security, and human development challenges that reinforce one another.

He noted that these interconnected pressures are contributing to deteriorating health outcomes and weakening institutional response capacity.Humanitarian organisations have begun planning for the annual lean season, typically spanning June to September, when food stocks decline and malnutrition rates tend to rise.

The period is expected to place additional stress on already constrained health and nutrition services.Policy interventions have been introduced, though their impact remains uncertain.

In 2025, the Nigerian government partnered with the World Bank to implement the Accelerating Nutrition Results in Nigeria project, aimed at delivering basic nutrition services to vulnerable households.

A second phase of the programme is currently under way, but experts say broader structural reforms are required to improve food affordability and strengthen social protection systems.Supply chain inefficiencies continue to limit access to essential medicines and equipment.

Peter Bunor Jr, co-founder and head of growth at Field Intelligence, a health technology company focused on pharmaceutical logistics in Africa, said disruptions in global and domestic supply chains are contributing to shortages at the point of care.

Patients often travel long distances only to find that prescribed drugs are unavailable or replaced with alternatives, frequently at higher cost.Bunor said the impact of these shortages is amplified during a hunger crisis, as malnourished individuals are more susceptible to infections and require timely medical intervention.

He emphasised the need for better data integration and forecasting to prevent stockouts.In 2018, Field Intelligence launched the Nigeria Health Logistics Management Information System, a platform designed to track pharmaceutical supply data across public health programmes.

The system, now managed by the federal health ministry, has been expanded with support from UNICEF, and stakeholders are encouraging wider adoption among health agencies to improve coordination and anticipate shortages.Funding constraints remain a central concern.

Nigeria allocated approximately 5.2% of its 47.9 trillion naira national budget to the health sector, well below the 15% target set under the Abuja Declaration by African Union member states. Per capita health spending remains among the lowest on the continent.

In February, Health Minister Muhammad Ali Pate disclosed that of the 218 billion naira allocated for operations and capital projects under the ministry, only 36 million naira had been released. The figure, representing a small fraction of the approved budget, has raised concerns about implementation capacity and fiscal prioritisation.

MacEbong said the funding gap illustrates broader structural challenges in public finance management, noting that limited budget execution undermines service delivery even where allocations exist. He added that the scale of the crisis requires sustained government attention, particularly in sectors directly linked to human capital development.

Aid organisations continue to call for increased domestic investment in health and nutrition, alongside improved coordination with international partners.

As conditions in northern Nigeria worsen, frontline health workers face mounting pressure to manage a growing caseload with limited resources, highlighting systemic vulnerabilities in one of Africa’s largest economies.