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Re:PEP – An open source PDF editor for Mac by strogonoff on Tuesday September 15, 2020 @09:37AM (#24481019)
Prawn was considered and IIRC unfortunately it has very limited styling support.

It looks like there are only commercial and quite expensive options for programmatic generation (Antenna House: XSL-FO, Prince: CSS). Apart from that, the one option that works appears to be Apache FOP. It’s built on Java and uses XSL-FO, which is somewhat limited and seemingly on the way to becoming outdated.

Re:PEP – An open source PDF editor for Mac by phonon on Tuesday September 15, 2020 @01:27PM (#24483995)
https://weasyprint.org/ is quite nice, though has limited header/footer support (for now).