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.

About 30 to 83.7 million adults in the United States have Obstructive Sleep Apnea (OSA), notes American Lung Association. Roughly 80 per cent of these cases remain undiagnosed. However, now, a simple daily pill, an old drug, could just be the solution.

Scientists in Sweden and other places too, have been studying the anti-seizure medicine sultiame as a treatment for OSA. In their latest Phase II trial, the scientists found that people on sultiame experienced an improvement in their apsea symptoms, and their sleep quality too improved as compared to those taking placebo.

The results points towards the potential of sultiame becoming an effective option for people with sleep apnea, especially those who cannot tolerate continuous positive airway pressure (CPACP) machines. The findings are published in The Lancet, and the researchers noted: "These findings offer perspective for a pharmaceutical approach to treatment of patients with obstructive sleep apnea."

Sleep Apnea Pill: What Is This Condition?

OSA is the most common form of sleep apnea, and it happens when airway muscles physically block a person's breathing during sleep. This could pause the body to wake up enough to start breathing again, only for the cycle to restart throughout the night, anywhere from five to 100 times an hour. This also causes low oxygen levels and disturb people's sleep and, over time, can raise the risk of other long-term health problems, which could include heart diseases and even dementia.

What CPAP machines do is they use air pressure to keep the airways open during sleep. While machines are an effective way, some people have trouble using them long term, which is why some companies use less cumbersome interventions, including medicines.

Read: Harish Rana Case Highlights Why Planning For A Living Will Is Important

Sleep Apnea Pill: What Was It Used For?

Sultimae or sulthiame was first launched in the 1960s by Bayger AG as an anticonvulsant - which means, it was a drug designed to treat epilepsy and prevent seizures by stabilizing nerve cell membranes and reducing abnormal, excessive electrical activity in the brain.

What the drug does is, it inhibits carbonic anhydrase, an enzyme that plays a role in regulating our breathing. Research also suggested that this could help people with sleep apnea by preventing airway collapse. The US-based Apnimed, in collaboration with the Japenese company Shionogi & Co., Ltd., have been looking to develop sultiame as a sleep apnea treatment.

How Well Has The Sleep Apnea Pill Been Tested?

The phase II of the trial involved 298 patients. Of them were untreated, moderate and people with severe sleep apnea. The people were observed for over a 15-week period, of them, half were randomized to a placebo pill to be taken right before bed, while rest were given varying doses of sultiame.

The results showed that people who took sultiame saw a noticeable decrease in apnea symptoms and also witnessed improvements in their sleep quality and daytime sleepiness. People in the highest dose group saw the most improvement, with apnea symptoms being reduced up to 47 per cent.

“It feels like a breakthrough, and we now look forward to larger and longer studies to determine whether the effect is sustained over time and whether the treatment is safe for broader patient groups,” said study researcher Jan Hedner, a senior professor of pulmonary medicine at the University of Gothenburg.

Recent legal developments have highlighted the importance of advance planning for end-of-life care.

A Living Will is something every adult should consider discussing and creating at some point.

Conversations within families about individual preferences in the event of a terminal illness are an important first step, and these discussions should take place while everyone is still in good health.

Individuals may have very different views about how they wish to be treated if they develop a terminal illness or certain severe, irreversible conditions. For instance, some may not want ventilator support, while others may choose to avoid ICU care.

Some might accept ICU care but prefer not to undergo CPR. Others may prefer not to receive artificial feeding through tubes. Yet others may wish for every possible treatment to be attempted. A few may prefer to spend their final days at home.

Creating A Living Will

It should be noted that a Living Will does not impose any limitation on treatment for common medical conditions such as infections, surgery for curable illnesses, or routine hospital care.

These preferences apply only to situations such as terminal illness—for example, advanced cancer—or irreversible conditions such as a persistent vegetative state.

Creating a Living Will is now relatively straightforward. It must be signed in the presence of two witnesses and attested by a notary or a gazetted officer.

The earlier requirement of countersignature by a Judicial Magistrate has been removed to make the process easier. Templates are also available online that individuals can use as a basis for drafting their own. Before preparing one, it is helpful to discuss the pros and cons of their choices with the family doctor.

It is important to again emphasize that a Living Will is NOT about refusing all treatment, hospitalization, or ICU admission for routine medical care. Rather, it addresses only specific situations.

When such preferences are clearly documented in advance, important decisions about withholding or withdrawing treatment in select circumstances become less contentious.

Doctors and hospitals will no longer be hesitant to withhold unnecessary treatment measures in such situations, as it will already be documented in the patient’s own Living Will. Relatives also will not face the difficult decision of withholding or withdrawing futile medical treatment on behalf of their loved one.

Essentially, the Living Will protects the patient’s wishes when they are no longer able to speak for themselves.

What Happens Without A Living Will

In a terminally ill patient who is unable to communicate, the absence of a Living Will often leads to differences of opinion among family members about what the patient might have wanted.

This uncertainty frequently results in a collective decision to “do everything possible,” just to be on the safe side.

Doctors are reluctant to override the wishes of relatives, even when they believe that further treatment measures are unlikely to be beneficial.

As a result, the patient may receive prolonged medical interventions that neither improve the underlying condition nor enhance quality of life. Once started, these treatments may continue indefinitely until the patient dies naturally.

This may take months, years, or even decades, and also incur huge costs. In the absence of a Living Will, complex legal procedures are required to withdraw these treatments — even if all the relatives are convinced that they should be withdrawn.

Bolivia has reported an outbreak of mosquito-borne Chikungunya virus disease, with cases rising to more than 5,000 nationwide.

Chikungunya is transmitted by the Aedes aegypti and Aedes albopictus mosquitoes -- the same species that spread dengue fever and Zika virus disease. As a result, the disease becomes challenging to diagnose.

The South American country's Ministry of Health, in a statement, shared that "5,371 cases of chikungunya have been registered nationwide".

The worst areas in Bolivia include

• Santa Cruz (4,500 cases)
• Cochabamba (303 cases)
• Tarija (332 cases)
• Chuquisaca (81 cases)
• La Paz (68 cases)

The Ministry informed, "joint efforts to control and manage the vector".

It further noted that an investigation is being conducted to share the results and cause of death, as well as ongoing epidemiological surveillance for all vector-borne disease.

To curb the cases, the Health Ministry noted that "it is supporting the provision of biolarvicide and insecticide for departmental and municipal actions to prevent an increase in cases".

This includes the distribution of about 1,300 liters of insecticide and biological larvicides applied with backpack sprayers, Outbreak News Today reported.

The government also urged the general public to clean weeds from yards and gardens to eliminate the vector’s resting places

Global Cases

In January, the surveillance data from the European Centre for Disease Prevention and Control (ECDC) reported 2,881 cases of Chikungunya virus disease and no associated deaths from 11 countries in European Union this year.

The ECDC noted that the Americas have reported 2,879 cases and one associated death, with Brazil reporting the highest number of cases in 2026.

In addition to Bolivia, other countries in South America reporting chikungunya include Costa Rica, El Salvador, Honduras, and Mexico.

French health authorities also reported a significant rise in chikungunya disease in Mayotte, an overseas department in the Indian Ocean. Since the beginning of 2026, more than 270 confirmed cases have been recorded, Vax-Before-Travel reported.

ECDC data shows that the weekly average of cases in the last two weeks of February 2026 was around 65.

Symptoms And Prevention

There is currently no antiviral drug treatment for chikungunya. While two vaccines against chikungunya have received regulatory approval, it still lacks widespread rollout.

Common symptoms of chikungunya include:

• abrupt onset of fever
• joint and muscle pain
• headache
• nausea
• fatigue
• rash

While serious complications are rare, the elderly and children under one year old may be at risk of long-term symptoms and even death.

The ECDC advised people "to take enhanced measures to prevent mosquito bites".