The World Health Organization has recommended the use of novel weight-loss drugs to curb soaring obesity rates, and urged pharma companies to lower their prices and expand production so that lower-income countries can also benefit. The WHO’s new treatment guideline includes a conditional recommendation to use the so-called GLP-1s — such as Wegovy, Ozempic and Mounjaro — as part of a wider approach that includes healthy diet, exercise and support from doctors. The WHO described its recommendation as “conditional” due to limited data on the long-term efficacy and safety of GLP-1s. The recommendation excludes pregnant women. While GLP-1s are a now well-established treatment in high-income countries, the WHO warns they could reach fewer than 10 percent of people who could benefit by 2030. Among the countries with the highest rates of obesity are those in the Middle East, Latin America and Pacific islands. Meanwhile, Wegovy was only available in around 15 countries as of the start of this year. The WHO wants pharma companies to consider tiered pricing (lower prices in lower-income countries) and voluntary licensing of patents and technology to allow other producers around the word to manufacture GLP-1s, to help expand access to these drugs. Jeremy Farrar, an assistant director general at the WHO, told POLITICO the guidelines would also give an “amber and green light” to generic drugmakers to produce cheaper versions of GLP-1s when the patents expire. Francesca Celletti, a senior adviser on obesity at the WHO, told POLITICO “decisive action” was needed to expand access to GLP-1s, citing the example of antiretroviral HIV drugs earlier this century. “We all thought it was impossible … and then the price went down,” she said.  Key patents on semaglutide, the ingredient in Novo Nordisk’s diabetes and weight-loss drugs Ozempic and Wegovy, will lift in some countries next year, including India, Brazil and China. Indian generics giant Dr. Reddy’s plans to launch a generic semaglutide-based weight-loss drug in 87 countries in 2026, its CEO Erez Israeli said earlier this year, reported Reuters. “U.S. and Europe will open later … (and) all the other Western markets will be open between 2029 to 2033,” Israeli told reporters after the release of quarterly earnings in July. Prices should fall once generics are on the market, but that isn’t the only barrier. Injectable drugs, for example, need cold chain storage. And health systems need to be equipped to roll out the drug once it’s affordable, Celletti said. 

LONDON — You might say they have nothing left to lose. Britain’s once-dominant Conservatives are still reeling from their worst-ever general election defeat. Polls put them third, behind populist insurgent Nigel Farage’s Reform UK and near-level with the leftist Green Party. Yet facing annihilation, Britain’s oldest political party has finally rediscovered attack mode. Kemi Badenoch — a year in as leader — is landing more consistent blows on Keir Starmer in their weekly clashes, after months of griping from her MPs. Badenoch’s job has been made easier by the Labour government’s plunging fortunes; changes in Tory personnel; a system that hands resources to the “official” opposition; and a secretive attack department that combines nerdy research with fighting like hell. Some Conservatives even seem to be — whisper it — enjoying themselves. “We’re not fighting dirty, just critiquing what the government is doing,” argued one person who has worked closely with Badenoch. But they added: “We’re starting to actually do the fun bit of opposition, which is whacking a failing government over the head.” Since August, the party has helped force Deputy Prime Minister Angela Rayner from office over a housing tax scandal, and scrutinized the personal affairs of Chancellor Rachel Reeves and (now sacked) Ambassador to the U.S. Peter Mandelson. Badenoch has also applied pressure to Starmer over Labour’s tax policy as she prepares to respond to this Wednesday’s budget. POLITICO spoke to over a dozen senior Tory aides and politicians, all of whom were granted anonymity to talk about internal strategy. Most of them doubted these successes would do anything to move the polls — or save Badenoch from a leadership challenge if local elections in May go as badly as expected. But the person above said: “It’s good for morale, right? We’re still deep in opposition, we’ve still got loads of problems to fix, but we’re in a much better place than we were a few months ago.” OUT WITH THE ‘YES MEN’ Prime minister’s questions (PMQs) guarantee Badenoch a weekly moment in the spotlight. Several people who spoke to POLITICO suggested changes in her top team have helped. Tory MP Alan Mak departed Badenoch’s tight-knit PMQs prep team when he left the shadow cabinet in a July reshuffle. Her chief of staff, Lee Rowley, and Political Secretary, James Roberts, both left the wider leader of the opposition (LOTO) team, while Badenoch’s Parliamentary Private Secretary (PPS) Julia Lopez — who liaises with backbenchers — was promoted to Mak’s old role. Into the Wednesday prep sessions came Badenoch’s new PPS, John Glen, “policy renewal” chief Neil O’Brien (who shares some of her pugilism on social media), and the ex-MP and TV presenter Rob Butler, who has helped her work on her presentation skills. Kemi Badenoch is landing more consistent blows on Keir Starmer in their weekly clashes, after months of griping from her MPs. | Lucy North/Getty Images Stephen Gilbert, who spent five years as political secretary to David Cameron in No. 10, also joined the wider LOTO team. Mid-ranking aide Stephen Alton was promoted to head Badenoch’s “political office.” “The clearout of the prep team and frankly bringing in better people is at the core of why she has markedly improved her PMQs performances,” argued one Tory official. Allies suggest Glen has improved communication with backbenchers. On Mak’s involvement, the official was ruder: “Who the fuck thought that was a good idea?” A second Tory official argued: “They’ve got rid of the yes men.” Others argue the opposite — that there is continuity, and loyalists abound. Badenoch aide Henry Newman, promoted to chief of staff after Rowley’s departure, still attends PMQs prep alongside Lopez, her spokesperson Dylan Sharpe, and uber-loyalist shadow cabinet minister Alex Burghart. There are still misses. When Rayner admitted she had underpaid housing tax moments before the first PMQs of September — a clear open goal for the opposition — Badenoch asked only a brief question before pivoting to economics. But her team is showing signs of greater agility. The following week, Badenoch pressed Starmer hard over his appointment of Mandelson. The PM stood by the ambassador, yet sacked him the next day over his ties to convicted sex offender Jeffrey Epstein. When Shadow Defence Secretary James Cartlidge stood in for Badenoch earlier this month, he quickly pivoted to ask about an accidental prisoner release — which wasn’t yet public — and succeeded in tying Deputy PM David Lammy in knots. A person with knowledge of that day’s preparation said six “beautifully crafted economy questions” were ready for Cartlidge, but “we collectively found out a bit in advance [about the prisoner] — like, 10 or 15 minutes — and we all felt he should go on it, and if he wasn’t getting a serious answer he would just need to keep going. It was a horrible decision to have to make 10 minutes beforehand, but ultimately it was the right one.” Other people offer to help. Shadow Cabinet ministers join PMQs prep on their brief. And while Badenoch’s relationship with former Cabinet colleague (now Spectator editor) Michael Gove is far cooler than it once was, he still speaks to Grimstone and Newman, who used to work for him. One person said Gove has even suggested jokes, claiming one about the government’s plan being “so thin it could have been sponsored by Ozempic” came from him. (Another person denied that Gove provides Badenoch with jokes.) ‘WE’RE GETTING KEMI TO BE MORE HERSELF’ Allies of Badenoch insist much of the improvement is down to the leader herself. “Kemi has basically cracked a way of getting at the prime minister and not letting him off the hook,” said a second person who has worked closely with Badenoch. “Her confidence has been a big change.” Badenoch’s initial style as leader had puzzled — and in some cases infuriated — some on the right who knew her as one of Westminster’s most headline-grabbing MPs. She began with a focus on “rebuilding trust,” serious reform, and policy renewal that would take years. Nigel Farage’s radical right-wing party overtook the Tories in opinion polls last Christmas and has seized the agenda since. | Oli Scarff/Getty Images Then Reform came along. Farage’s radical right-wing party overtook the Tories in opinion polls last Christmas and has seized the agenda since. “Reform became the most interesting, hottest thing in politics,” said a third person who has worked closely with Badenoch. “So the timeline got sped up, and we needed to make sure we were part of the conversation.” The scale of internal frustration at Badenoch was painted in a brutal July profile in the New Statesman. Her former performance coach Graham Davies, who parted ways with her acrimoniously after her 2024 campaign, told the author she “doesn’t do the process, doesn’t do the practice and doesn’t like it.” But Badenoch is still here, and a leadership challenge appears to be parked — at least until May. Over the summer, Badenoch decided she wanted to cut through more with the public and show the kind of politician she wanted to be, said a person with knowledge of her thinking. She even noted how public awareness of Farage soared after he took part in the reality TV show “I’m a Celebrity … Get Me Out Of Here!”. (Badenoch will not, however, be eating any animal testicles.) She also realized that the “rebuttals are as important as the questions” at PMQs, said a fourth person who has worked closely with Badenoch: “While the initial initial view was that this needs to be very prosecutorial, it’s much more of a theater event.” Allies worked to help her bring out her “sassy” side, said the second person quoted above. “Her voice has got a lot stronger,” they added. “We’re getting Kemi to be more herself.” WELCOME TO THE ‘ATTACK CELL’ The other side of the story is in Conservative Campaign Headquarters (CCHQ) — where it all began with two parliamentary questions. Known by few people beyond the Westminster bubble, the obscure “PQ” system lets MPs send technical queries to ministers. It is faster and more effective than Britain’s exemption-filled freedom of information regime. One PQ asked if Starmer paid full council tax on his grace-and-favor flat; he did. But when the other asked if Rayner did the same, ministers replied with a non-answer. This pricked up the ears of Sheridan Westlake, a veteran operator at CCHQ who spent 14 years in government — and is now turning his knowledge of its diversionary tactics against Labour. Government officials are said to sigh in frustration when another Westlake PQ comes in. Despite being signed off by different MPs three months apart, the two questions had both been crafted by Westlake and his small CCHQ team. The discrepancy triggered months of Tory and journalists’ digging into Rayner’s housing arrangements that — eventually — led to her resignation in September over a separate issue (she had failed to pay enough stamp duty on her new home.) Into the Wednesday prep sessions came Badenoch’s new PPS, John Glen, “policy renewal” chief Neil O’Brien, and the ex-MP and TV presenter Rob Butler. | Wiktor Szymanowicz/Getty Images The Rayner chase was “great fun,” said a third Tory official. They said CCHQ formed a five-man “attack cell” to co-ordinate lines with Badenoch’s office a few streets away. Much of it was based on work from the Conservative Research Department (CRD), a secretive team who keep their names hidden. The five men in the so-called cell were Westlake, CRD Director Marcus Natale, a member of his CRD, CCHQ Executive Political Director Josh Grimstone, who oversees the story “grid,” and Head of Media Caspar Michie. Rayner was not the only hit job. Three Tory officials said the CRD was involved in a story about Chancellor Rachel Reeves’ housing arrangements, though they would not be drawn on exactly how. (Reeves admitted breaking rental licensing rules for her family home, but was backed by Starmer.) CCHQ has been gathering attack material on Starmer’s likely successors, given the expectation of a Labour leadership challenge next year. It works closely with right-wing newspapers such as the Mail on Sunday, Telegraph and Sun to keep up momentum by furnishing attack research and quotes. At the same time, officials try to pump stories into the TV bloodstream by helping Badenoch work up lines to say on camera. “You force the BBC to pay attention,” the third official said. There are parallel operations too. The Guido Fawkes blog, whose publisher is former CRD director and serving Tory peer Ross Kempsell, keeps up communication with CCHQ and has always run a drumbeat of critical journalism on Labour — though a fifth Tory official said there had been some twitchiness inside CCHQ at the tone of Guido’s coverage of Reform UK, too. NOT THERE YET The Tory fightback has also involved plenty of luck. Issues the Conservatives found out about — such as Rayner’s tax arrangements, and a trust on her former family home — were neither the full picture nor proof of wrongdoing. Newspaper journalists did much of the digging. And while one person said the CRD now has about 10 members, numbers were slashed after the election. The first Tory official quoted above said the unit is “still not firing on all cylinders. They’re doing some good work, but probably the redundancies and scaling back post-election cut too deeply into what should be a key function.” CCHQ staff who survived the brutal post-election redundancies insist the operation is becoming more organized and morale has improved — but that is from a low base. New Chief Executive Mark McInnes has “oiled up the machine,” argued the third Tory official: “The sackings were brutal at the time, but we couldn’t just keep operating how CCHQ always had.” OUT OF PRACTICE Life back in opposition has taken some getting used to. The second person who has worked closely with Badenoch said: “When we were in opposition last time, it was a very different world. There was a handful of TV stations and newspapers, and now we’re in the modern age. We’ve had to bed in and learn what this crazy new environment is.” The Tories now get barely any media coverage for their initiatives unless they are genuinely head-turning. Some shadow ministers even complained internally about this at first, said one person with knowledge of the conversations. Kemi Badenoch decided she wanted to cut through more with the public and show the kind of politician she wanted to be. | Gary Roberts/Getty Images But now, argued a fourth Tory official, “the penny has dropped … unless voters hear from us, they’ll think we no longer exist.” There is no denying that much of the Tory boost has come from a Labour collapse. Badenoch simply has “way more material to attack,” argued a fifth person who has worked closely with her. “It’s an abundance of riches every week now.” The first person who has worked with her added: “[Labour] are uncannily reminiscent of our last days in government — beset by scandal, one thing goes wrong after another, no sense of direction, everyone is miserable. You can actually see it physically in the Commons … little knots of Labour MPs all whispering to each other.” With public opinion moving against Labour, Tory MPs worry less about looking like hypocrites. Many of the crises that they highlight — prisons, for example — are in public services that arguably collapsed under their tenure. The fifth person who worked with Badenoch said: “At the beginning there was a hesitancy to attack Labour because we were carrying the baggage of 14 years of mistakes.” As time wears on, collective memory might start to fade. IS ANYONE LISTENING? Even if it all goes to plan, a big challenge remains: outgunning Farage. As the “official” opposition, the Conservatives get the most money for researchers, and opportunities to hold the government to account through PQs, PMQs, committee hearings and debates in the Commons. Yet it is Reform that cost the Tories many of their seats in 2024 and now has a soaraway poll lead. Farage’s ascendant party has announced policies outside parliament, where (thanks to having only five MPs) it is barely a presence. Farage sits on the same side of the Commons chamber as Badenoch; this system is not designed to hold him to account. The fourth Tory official above voiced a fear that the public will see two establishment parties scrapping in parliament while Reform floods the zone on TV and social media. In short, the Tories are honing their game, but there’s a new game in town. Then there is May. Scotland, Wales and English metropolitan councils, including in London, will go to the polls. The elections are the closest thing Britain has to “mid-terms,” and while many areas are already Labour-controlled, Badenoch’s rivals will be watching closely. One former minister and current MP said: “The expectation is that May election results will be very bad … Tory MPs want to see an uptick in the poll performance or talk of a leadership challenge will persist. Her [party] conference speech was good and bought her more time, but clearly everyone realizes we can’t stay on 17 percent for the next three years.” The first Tory official quoted above was even blunter: “It’s ultimately froth. None of it is moving the polling needle, and that’s what we live or die by.”

Ozempic-maker Novo Nordisk is to lay off 9,000 of its staff, with 5,000 of those coming from its sites in Denmark, the company announced today. The firm has around 78,400 staff worldwide; the redundancies account for 11.5 percent of its workforce. “It is always difficult to see talented and valued colleagues go, but we are convinced that this is the right thing to do for the long-term success of Novo Nordisk,” CEO Mike Doustdar said.  “By realigning our resources now, we will be able to prioritise investments to drive sustainable growth and future innovation for the millions of patients with chronic diseases globally, particularly in diabetes and obesity.” It’s one of Doustdar’s first moves as head of the company after he replaced Lars Fruergaard Jørgensen earlier this year. Jørgensen, who had helmed the Danish drugmaker for eight years, saw Novo become Europe’s most valuable company under his leadership. But the firm saw its share price tumble over the past year amid increased competition in the weight-loss drug market from Eli Lilly’s Mounjaro, and disappointing trial results for its next-generation treatments. “Our markets are evolving, particularly in obesity, as it has become more competitive and consumer-driven. Our company must evolve as well,” Doustdar said. The company said the layoffs would mean a one-off cost of 8 billion danish krone (€1.07 billion) It now expects full-year operating profit growth of 4 percent to 10 percent, down from the 10 percent to 16 percent outlined in August.