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.

Healthcare in India is no longer a privilege but is steadily becoming a right, said Prime Minister Narendra Modi today while highlighting the government's efforts to expand affordable medical care, strengthen health infrastructure and improve access to treatment across the country.

Speaking at the foundation stone laying ceremony and launching development projects worth over ₹4,700 crore in Chandigarh, spanning healthcare, education and road infrastructure, PM Modi stated that India's healthcare journey has undergone a transformational change over the past 12 years.

The Prime Minister said lower and middle-income families have benefited the most from the country's healthcare transformation.

"Health services in India are no longer a privilege; they are becoming an absolute right," PM Modi said.

PGIMER Expansion To Boost Healthcare Access

Also read: Fourth COVID Death Reported in Andhra Pradesh: Experts Recommend Boosters For High-Risk Groups

In Chandigarh, the Prime Minister announced the expansion of healthcare facilities at the Postgraduate Institute of Medical Education and Research (PGIMER), including a new Neuroscience Centre, a Mother and Child Centre, and a Critical Care Hospital Block, saying the projects will provide better treatment facilities to millions of people.

He also announced the approval of a new MBBS college at PGIMER, saying the expansion of medical colleges and postgraduate seats will help address the shortage of doctors while creating more opportunities for aspiring medical students.

Healthcare Infrastructure Expanded Over The Past Decade

Highlighting the government's investments in healthcare, Modi said India has approved 15 new AIIMS since 2014, established hundreds of new medical colleges and expanded specialty hospitals across the country.

"Since 2014, fifteen new AIIMS have been approved, hundreds of new medical colleges have been established across the country, and specialized hospitals for the treatment of serious diseases such as cancer have been strengthened."

He added that strengthening primary healthcare remains a key priority under the Ayushman Bharat Health Infrastructure Mission.

The Prime Minister said that under the mission, critical care blocks, integrated public health laboratories and public health units have been established across the country. He added that over 1.75 lakh Ayushman Arogya Mandirs are now operational across rural, urban and tribal areas, providing comprehensive primary healthcare services, including twelve healthcare service packages.

He noted that crores of citizens have been screened for hypertension, diabetes and other non-communicable diseases through these centers.

Digital Health and Maternal Care Improvements

Read More: Novo Nordisk's GLP-1 Drug Wegovy Approved for Fatty Liver Disease in India

The Prime Minister highlighted the growing role of digital healthcare, noting that the e-Sanjeevani telemedicine platform has facilitated more than 48 crore consultations, enabling patients in remote areas to access specialist care without travelling long distances.

PM Modi said the healthcare improvements have contributed to better maternal and child health outcomes, with more than 90% of deliveries now taking place in healthcare institutions. He added that maternal mortality has declined by 86%, while infant mortality has also fallen significantly.

The Prime Minister also underlined the government's emphasis on preventive healthcare through initiatives such as the Poshan Abhiyan, Mission Indradhanush, yoga promotion, HPV vaccination and the U-WIN platform.

Focus On Tuberculosis Control

PM Modi reaffirmed the Government's commitment to eliminating tuberculosis, stating that the TB Mukt Bharat Abhiyan has strengthened awareness, screening and treatment.

He noted that TB treatment coverage in the country has now crossed 90% and, citing a recent World Health Organization (WHO) report, said India has recorded a 21% decline in tuberculosis cases over the past decade.

India Emerging As A Global Healthcare Destination

Recalling India's response during the COVID-19 pandemic, Modi said the country has evolved from a nation once perceived as dependent on external assistance to a global destination for advanced medical treatment.

He attributed the transformation to sustained investments in healthcare infrastructure and policies aimed at making quality treatment affordable and accessible.

Modi said "India must continue investing in modern healthcare infrastructure and emerging technologies as part of its vision of becoming a developed nation".

India's southern state of Andhra Pradesh has reported four COVID-19 deaths amid a rise in infections, prompting experts to reiterate the importance of booster vaccination for older adults and people at high risk of severe disease.

While sporadic COVID-19 cases have continued to be reported across the country, fatalities have remained relatively uncommon. Health experts say the current situation does not resemble previous pandemic waves, but immunity from earlier vaccinations has waned, making booster doses important for vulnerable groups.

Andhra Pradesh Reports Four COVID Deaths

In an official statement, Andhra Pradesh Health Commissioner G. Veerapandian said that 12 people tested positive for COVID-19 across the state between June 26 and July 16. Of these, four patients with multiple comorbidities died.

The deceased had underlying conditions including hypertension, diabetes, kidney disease, and other serious illnesses.

Although cases have increased in a few states and cities, hospitals are not experiencing the overwhelming admissions, oxygen shortages, or healthcare burden seen during earlier waves.

Also read: Omicron Sub-Lineages Likely Behind COVID Surge In India: Why Deaths Are Occurring

Who Is Most at Risk?

Experts say that while most current infections are mild, severe illness remains more likely in:

• Older adults

• Pregnant women

• People with diabetes

• Individuals with heart disease

• Those with chronic lung or kidney disease

• Cancer patients

• People with weakened immune systems

Experts Advise Boosters For Vulnerable Groups

Read More: COVID Spikes In India: Experts Allay Fears, Stress Vaccination And Masks

Speaking to HealthandMe, Dr. Atul Kakar, Chairperson, Internal Medicine, Sir Ganga Ram Hospital, said booster doses remain advisable for people at highest risk.

"COVID vaccines are now again recommended, especially for the elderly population, particularly those of advanced age or who are immunocompromised. It is a voluntary vaccine that is indicated because immunity from earlier vaccinations has declined."

Dr. Manjeeta Nath Das, Associate Director, Internal Medicine, PB Health, said COVID-19 cases are rising in small pockets, particularly in South India, while immunity from previous vaccination has gradually waned.

"COVID is rising in India, especially in small pockets in South India. So we should all get re-vaccinated. It has been several years since the pandemic, and immunity from previous vaccinations has waned," Das told HealthandMe.

She recommended booster doses for:

• Adults aged 65 years and above

• Immunocompromised children older than six months

• People with diabetes, hypertension, or asthma

• Patients undergoing chemotherapy

• Individuals taking steroids or other immunosuppressive medicines

• Adults with immunocompromising conditions

• Caregivers and healthcare workers caring for vulnerable patients

She also said eligible people may consider an annual COVID-19 booster as immunity declines over time.

Dr. Kakar added that people with weakened immunity, immunodeficiency, advanced age, and pregnant women are among those who would benefit most from a booster.

Heterologous Boosters May Be An Option

Dr. Neha Rastogi, Senior Consultant, Infectious Diseases, Fortis Memorial Research Institute, Gurugram, said booster vaccination should focus on those at the highest risk rather than the general population.

"The focus has shifted from broad herd immunity to priority boosters for the elderly and high-risk groups such as cancer patients, people on dialysis, those with uncontrolled diabetes, patients on steroids, and immunosuppressed individuals."

She told HealthandMe that people who have previously been vaccinated may also consider a heterologous booster—receiving a different COVID-19 vaccine from the one used for their earlier doses—where appropriate and based on medical advice.

India's drug regulator, the Central Drugs Standard Control Organization (CDSCO), has approved Wegovy (semaglutide injection 2.4 mg) for the treatment of adults with fatty liver disease, Novo Nordisk announced today.

According to the company, Wegovy is the first and only GLP-1 receptor agonist (GLP-1 RA) approved globally and in India for the treatment of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) in adults with moderate to advanced liver fibrosis, alongside a reduced-calorie diet and increased physical activity.

"People with MASH face a higher risk of serious liver complications and heart-related disease. This approval is an important milestone, giving doctors and patients a new treatment option while also helping address obesity and related heart and metabolic diseases," said Vikrant Shrotriya, Managing Director, Novo Nordisk India.

Clinical Trial Findings

The approval is based on findings from the ESSENCE clinical trial, which showed that:

• 63% of patients treated with Wegovy experienced resolution of steatohepatitis, an advanced form of fatty liver disease.
• 37% showed improvement in liver fibrosis.
• 33% achieved both resolution of steatohepatitis and improvement in liver fibrosis.

Who Should Take Wegovy?

Semaglutide injection (Wegovy) is indicated, alongside a reduced-calorie diet and increased physical activity, for:

• Chronic weight management in adults with a BMI of 30 kg/m² or higher, or 27 kg/m² or higher with at least one weight-related condition such as hypertension, type 2 diabetes, or dyslipidaemia.
• Chronic weight management in adolescents aged 12 years and older with obesity and a body weight above 60 kg.
• Reducing the risk of major adverse cardiovascular events (cardiovascular death, non-fatal heart attack, or non-fatal stroke) in adults with established cardiovascular disease who are overweight or have obesity.
• Treatment of noncirrhotic MASH with moderate to advanced liver fibrosis (F2-F3) in adults.

What Is MASH?

Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disease caused by excess fat accumulation in the liver, leading to chronic inflammation and liver damage.

According to Novo Nordisk, two in three Indians have fatty liver disease. The condition is often called a "silent disease" because many people do not develop symptoms until liver damage has become advanced. If left untreated, MASH can progress to severe liver complications.

"MASH is becoming more common in India as lifestyles change. In many people, early MASH has no obvious symptoms, so the condition may not be diagnosed until liver damage is more advanced," said Dr. Dharmesh Kapoor, Senior Consultant Hepatologist, Hyderabad.

He stressed the importance of early screening, particularly for people with obesity, type 2 diabetes, or other metabolic conditions.

"Wegovy has demonstrated benefits in reducing liver inflammation and fibrosis while also supporting weight management and blood sugar control, both of which are linked to MASH progression," Dr. Kapoor added.

Novo Nordisk said innovator semaglutide is backed by more than 50 clinical trials, 49 million patient-years of exposure, and extensive real-world evidence.

The medicine, manufactured using recombinant DNA (rDNA) technology, has been approved in 75 countries, including by the Drugs Controller General of India (DCGI), the European Medicines Agency (EMA), the US Food and Drug Administration (FDA), and Japan's Pharmaceuticals and Medical Devices Agency (PMDA).