Japan could become one of the first countries in the world to end the HIV epidemic, says the president of Gilead Sciences Japan, Kennet Brysting. The idea for now could seem a little too ambitious, but it is not entirely unrealistic, given that the availability of medicines that can prevent transmission of HIV. Drugs are not the cure, but control over the spread of virus to the point where the disease is no longer a major public health threat.

What Is The Role Of Preventative HIV Medicines?

Gilead's have two key drugs, Truvada and lenacapavir. These two are playing a crucial role in prevention. Truvada is taken as a daily pill, while lenacapavir requires two injections per year. It can make the virus undetectable in infected individuals and prevent transmission to those who are not infected yet. In trials, lenacapavir showed 100% efficacy in preventing HIV infections. This is why it is describe as "almost a vaccine".

In 2024, Japan also approved Truvada for HIV prevention, but the country has yet to approve lenacapavir for the same. Until now, people in Japan had been importing generic versions of Truvada or purchasing it from clinics that source it from overseas.

HIV In Japan

Up until now, Japan reported around 25,000 HIV infections, whereas 669 new cases were reported in 2023. For seven consecutive years, the number of new infections remained under 1,000. The downward trend thus shows that the virus has been controlled, however, getting to zero new infections remains the ultimate goal.

Brysting too acknowledged that simply having effective drug is not enough. What is important is to have a proper implementation, access and healthcare support to make sure that these treatments are widely available and effective.

What Are The Challenges In Implementation?

The biggest challenges is testing rates. There is a need to increase testing rates. At this very moment, around 86% people infective with Japan have been tested, but the goal is to increase it up to 95%, with an ideal goal of 100%. Without widespread testing, many infected people may not even know that they are infected and it could transmit the virus.

Another measure issue is the cost of preventative medication. While Japan's health insurance covers treatments for diseases, it does not cover preventative drugs. Those who purchase Truvada for prevention, pay around $470 per month. Some clinics in Tokyo offer generic alternatives too, which is cheaper, but they are not ideal.

Better Healthcare Support

Brysting expressed concern that individuals importing medications might not be consulting doctors regularly, which is essential for monitoring HIV status and overall health. Truvada users need to be tested for HIV initially and every three months, along with screenings for other infections and kidney function checks. Without proper medical supervision, there is a risk of misuse and inadequate protection.

Gilead is in discussions with Japanese authorities to improve access and insurance coverage for Truvada, and progress is being made. Japan has shown efficiency in approving critical medicines, as seen during the COVID-19 pandemic when Gilead’s remdesivir was approved in just three days.

What Is The Way Ahead?

Gilead at this moment is not only focused on HIV and hepatitis C, but also expanding into oncology with innovative treatments like CAR-T cell therapy, which strengthens a patient's immune system to fight cancer.

However, Japan’s strict approval processes can slow down drug availability. Phase 3 clinical trials often need to be conducted within the country, and Japan tends to approve medicines much later than other regions. For instance, Truvada was approved for prevention in Japan 12 years after the U.S. and nearly 20 years after its approval for treatment. inancial factors also play a role. The Japanese government adjusts drug prices annually, often reducing them, which can make long-term investment challenging for pharmaceutical companies.

A suspected case of pneumonic plague in Siberia has triggered quarantine measures after a laboratory worker at Russia’s Irkutsk Anti-Plague Research Institute died following severe pneumonia.

Russian health authorities have not yet confirmed that the 28-year-old died due to plague. Rospotrebnadzor has described the illness as pneumonia of unknown origin and said tests have found no evidence linking her death to pathogens at the institute.

Reportedly, around 200 people who may have had contact with her have been placed under medical observation.

As of October 5, Russian health authorities said about 60% of contacts had completed observation successfully and no one reported symptoms of plague infection.

The incident has attracted international attention as unconfirmed reports claimed that the woman may have developed pneumonic plague after she accidentally broke a test tube at the research facility. Russian authorities have denied that there was a laboratory accident. The hospital where she died has also been placed under quarantine.

Pneumonic vs Bubonic vs Septicemic Plague: Which Is Deadlier?

Also read: Russia Plague Outbreak: Lab Worker Dies Of 'Unknown Infection' After Suspected Exposure; CDC Monitors The Situation

Bubonic plague is the most common form. It accounts for most number of naturally occurring human plague infections.

It usually develops after an infected flea bite. The bacteria this case travels to nearby lymph nodes and causing the characteristic painful swelling known as a bubo. If diagnosed early, it can be successfully treated with antibiotics.

Septicemic plague occurs when the bacteria enter the bloodstream. It can develop as a complication of bubonic plague, but it can also occur as a primary infection.

Because the bacteria are circulating throughout the body, patients can rapidly develop shock, bleeding and tissue death.

Pneumonic plague is the most dangerous from a transmission standpoint. It infects the lungs and can develop after inhaling Y. pestis or when infection spreads to the lungs from another form of plague.

Unlike bubonic and septicemic plague, pneumonic plague can spread directly from one person to another through respiratory droplets.

The CDC describes pneumonic plague as the most serious form of plague and says untreated pneumonic plague is almost always fatal. It can also progress rapidly, making early diagnosis and antibiotic treatment critical.

There isn’t a definitive answer to which one is deadlier as we have no simple ranking based purely on fatality percentage because outcomes depend heavily on how quickly treatment begins.

But pneumonic plague is generally regarded as the most dangerous form because it can be rapidly fatal and can spread directly between people.

The World Health Organization says untreated bubonic plague has a case-fatality rate of around 30% to 60%, while pneumonic and septicemic plague can be 100% fatal without treatment. Its incubation period is sometimes as short as one day.

Bubonic plague is less transmissible between humans and is usually more treatable when identified early.

Septicemic plague can also become rapidly life-threatening because the infection has entered the bloodstream.

Also read: Pneumonic Plague: COVID-19, Rhinovirus Detected in Russian Lab Worker’s Contacts; Trump Offers US Help

Russia Plague: Updates

Regarding Russia’s plague scare, the concern around pneumonic plague is not only its severity, but the possibility of respiratory transmission if a case were ever confirmed. No plague infection has been confirmed in the reported Russian case so far.

Russian authorities have repeatedly said there is no confirmed plague outbreak and urged people to rely on official information rather than rumours. The Kremlin has also said the situation is under control.

The WHO has said, based on unofficial information, that the risk to the general public appears to be low.

Meanwhile, the US State Department says it is monitoring the situation. Secretary of State Marco Rubio said the possibility of an infectious disease spreading from a laboratory was being watched closely, while stressing that it was not currently a cause for alarm.

There are also reports that preventive measures have been introduced in the region, including isolation of hospital contacts and mask use at a nearby aluminum plant.

For India’s national capital, air pollution is a year-round problem, but October marks the start of a prolonged deterioration as pollution typically worsens through winter.

Delhi recorded its worst AQI of the season at 187 on October 4, at the higher end of the ‘moderate’ category. At least 19 monitoring stations recorded ‘poor’ air quality that day. Slower winds as winter approaches are expected to contribute to more polluted days.

The Air Quality Early Warning System has forecast ‘moderate’ air quality for two days, followed by a likely shift to ‘poor’ over the next 10 days.

What Can Just Days Of Poor Air Quality Do to Your Lungs?

Also read: Delhi Winter Pollution Action Plan: How Poor Air Affects Your Health

Even short-term exposure to polluted air can affect health, with research linking air pollution to respiratory and cardiovascular problems, metabolic effects and several diseases.

“Even a week of poor air quality can irritate and inflame the respiratory system, particularly in people with asthma, allergies or other underlying lung conditions,” Dr Vikas Mittal, Director and Pulmonologist, CK Birla Hospital, Delhi, told HealthandMe.

PM2.5 exposure can cause throat irritation, cough, phlegm, wheezing and breathlessness, while some people may experience reduced exercise tolerance or worsening respiratory symptoms. A short period of exposure does not necessarily cause permanent lung damage in healthy people.

However, repeated pollution episodes can contribute to ongoing airway inflammation and increase the risk of respiratory problems over time.

What Happens After Days or Weeks of PM2.5 Exposure?

PM2.5 can reach the air sacs of the lungs, making people with asthma or other chronic respiratory conditions more likely to experience worsening symptoms or flare-ups.

“Repeated exposure can trigger inflammation and oxidative stress, irritating the airway lining and affecting normal lung function. Over days to weeks, this may manifest as persistent cough, increased mucus production, wheezing or breathlessness, particularly among susceptible individuals,” Dr Mittal said.

Why Can Symptoms Start Before AQI Becomes ‘Severe’?

Read More: Delhi’s Air Pollution May Be Harming The Brain, Not Just The Lungs: Report

There is no single AQI threshold at which respiratory symptoms begin. Individual responses depend on age, underlying health conditions, sensitivity and duration of exposure, Dr Mittal noted.

Even below the ‘severe’ category, elevated PM2.5 and other pollutants can irritate the airways. People with asthma, allergies, COPD or previous respiratory problems may therefore develop symptoms earlier.

Children, older adults and people who spend considerable time outdoors may also be more susceptible.

How Does Air Pollution Affect the Respiratory System?

“As the AQI increases, the concentration of pollutants in the air also increases, and these pollutants can have adverse effects on the respiratory system,” Dr Bobby Bhalotra, Vice Chairperson, Chest Medicine, Sir Ganga Ram Hospital, told HealthandMe.

Air pollution can trigger upper respiratory problems such as rhinitis and sinusitis, while the lower respiratory tract can be affected through bronchitis. It can also trigger symptoms and exacerbations in people with asthma and COPD.

READ: World Lung Day: Dry Cough, Breathlessness May Not Always Be Asthma — Could It Be ILD?

How Can You Reduce the Risk?

Experts recommend reducing exposure when AQI levels are high:

• Check the AQI before prolonged outdoor activity.
• Avoid strenuous outdoor exercise and peak traffic hours.
• Keep indoor spaces clean and minimize dust.
• Avoid cigarette smoke, incense and other indoor pollutants.
• Keep windows closed when outdoor pollution is high and ventilate when air quality improves.
• Use a well-fitted N95 respirator when outdoor exposure is unavoidable.
• Continue prescribed medication and follow your doctor’s action plan if you have asthma or other lung conditions.

Dr Bhalotra also recommended staying hydrated, practising yoga, using steam and gargling. He advised avoiding spicy and fried foods and foods that may irritate the throat, including those that are extremely hot or cold.

He also stressed the importance of plants indoors and outdoors as part of maintaining a healthier environment.

Toronto has reported 14 confirmed mpox cases since September, prompting public health officials to urge eligible residents to get vaccinated.

Toronto Public Health (TPH) said wastewater monitoring by the Public Health Agency of Canada has also “consistently detected mpox” in the city.

Mpox Risk to Public Remains Low

Officials say the risk to the general public remains low, as mpox is primarily spread through close or sexual contact with an infected person.

Toronto has reported 41 confirmed cases so far in 2026, compared with 118 during the same period last year. The city recorded 158 cases in 2025.

“Mpox continues to circulate in Toronto, and we are currently seeing a rise in infections. Vaccination is the best way eligible residents can protect themselves. If you haven’t received your first dose or still need your second, please book an appointment at a TPH Sexual Health Clinic or visit your 2SLGBTQ+ health-care service provider,” said Dr. Michelle Murti, Medical Officer of Health, Toronto Public Health.

“Mpox is making a comeback. Now is a good time to check in with yourself and your friends about protection against the virus. If you’re eligible, get your first dose, and if you started the series but haven’t received your second, now is the time to complete it,” added Gilles Charette, Director, Gay Men’s Sexual Health Alliance.

Who Should Get Vaccinated?

Also read: Mpox Case Detected In Congo’s Ituri Amid Ebola Outbreak: Why Are Health Officials Concerned?

People eligible for vaccination include men who have sex with men who have multiple partners, those who visit venues for sexual contact, people working at such venues and sex workers, regardless of gender.

Mpox Cases Continue Worldwide

The rise in Toronto comes amid continued mpox transmission globally.

Earlier this month, a laboratory-confirmed mpox case was identified in the northeastern Congolese city of Bunia, raising concerns about the disease's spread as the country battles its worst Ebola outbreak on record.

The CDC has assessed the overall risk from the clade I mpox outbreak in the US as low. As of May 27, 2026, 23 clade I cases had been identified in the country, all linked to travel or people who had travelled to outbreak areas.

The WHO reported 1,370 mpox cases and seven deaths globally in July and continues to assess the public health risk from the multi-country outbreak as moderate.

From January 2025 through July 31, 2026, 65,784 cases and 264 deaths were reported across 105 countries.

WHO said the outbreak remains a graded emergency, with new outbreaks reported in multiple countries and more than 1,000 confirmed cases reported every month.

Eleven African countries reported active transmission between July 6 and August 16, with 1,153 confirmed cases and seven deaths. Chile and Hungary also reported clade Ib mpox for the first time, while several European countries have reported community transmission.

Read More: Russia Plague Scare: Could It Trigger A New Pandemic? Experts Explain

Mpox Symptoms

Mpox is a viral disease that spreads mainly through close physical contact with an infected person.

Some people recover without complications, while others can develop serious symptoms, particularly those with weakened immune systems.

Mpox symptoms can include:

• Rash
• Fever
• Swollen lymph nodes
• Headache
• Muscle aches
• Fatigue.