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.

The US Food and Drug Administration has approved a new breast cancer treatment that aims to act on signs of treatment resistance before the cancer starts progressing.

The US FDA has granted accelerated approval to Etcamah (camizestrant), in combination with a CDK4/6 inhibitor, for adults with hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer whose tumours develop an ESR1 mutation while being treated with an aromatase inhibitor and a CDK4/6 inhibitor.

All About The New Breast Cancer Treatment

The new approach uses a blood test to detect circulating tumour DNA (ctDNA) carrying an ESR1 mutation. If the mutation is detected, doctors can switch treatment to camizestrant rather than waiting for visible disease progression on scans.

The FDA described this as its first cancer therapy approval guided by detection of a resistance mutation in circulating tumour DNA before imaging shows progression of the disease.

Also read: Have Dense Breasts? What Women Should Know About Their Breast Cancer Risk

What Did The Clinical Trial Find?

The approval was based on results from the Phase III SERENA-6 trial, which included 315 patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer.

All participants were receiving an aromatase inhibitor plus a CDK4/6 inhibitor as their initial endocrine based treatment and had no evidence of disease progression when an ESR1 mutation was detected through blood testing.

Patients were randomly assigned to either switch to camizestrant while continuing their CDK4/6 inhibitor or continue their existing aromatase inhibitor with the CDK4/6 inhibitor.

Survival period without progression was 16 months with camizestrant compared with 9.2 months with standard treatment. The risk of disease progression or death was reduced by 56% with the camizestrant combination.

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Importance Of ESR1 Mutations

ESR1 mutations are one way hormone receptor-positive breast cancers can adapt to treatment. According to the FDA, fewer than 5% of patients have an ESR1 mutation when HR-positive metastatic breast cancer is first diagnosed. After disease progression on an aromatase inhibitor, however, the mutation is found in nearly 40% of patients.

This means that detecting the mutation earlier could potentially give doctors a chance to change treatment while the cancer is still controlled.

Dr Kevin Kalinsky, an investigator on SERENA-6, said, "The approach allows doctors to change treatment at an earlier opportunity ahead of disease progression rather than waiting until the cancer becomes harder to treat."

Risks And Limitations

The FDA approval is accelerated, meaning continued approval may depend on confirmatory studies that will verify clinical benefit.

The regulator specifically noted that it has not yet been established whether intervening when an ESR1 mutation is detected, before radiographic progression, ultimately translates into a meaningful overall survival benefit.

The FDA has simultaneously approved the Guardant360 CDx blood test as a companion diagnostic to identify patients whose tumours carry the relevant ESR1 mutations.

The significance of the approval therefore goes beyond a new drug. It represents a shift toward using molecular clues in the bloodstream to detect treatment resistance and change therapy before cancer progression becomes visible on a scan.

Illegal horse trade across the US-Mexico border are raising fresh concerns among US officials and ranchers as the country tries to contain the spread of New World screwworm, a flesh-eating parasite that can cause severe and possibly fatal wounds in animals.

According to Reuters, horses and other animals are continuing to cross the border outside regulated channels, bypassing veterinary inspections designed to detect diseases and parasites.

There is no confirmed link between individual smuggled horses and specific screwworm cases, but experts warn that uncontrolled animal movement creates a gap.

What Is New World Screwworm?

Unlike ordinary maggots that generally feed on dead tissue, screwworm larvae feed on living tissue, creating wounds that can become severe as more larvae develop. The parasite can infest cattle, horses, pets and wildlife and, more rarely, humans. An untreated infestation can cause serious tissue damage and death.

The US had previously eradicated the parasite through a decades-long campaign involving the release of sterilised male flies. But New World screwworm has been moving northward through Mexico and is now threatening US livestock again.

Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?

Smuggled Horses Are A Concern

Animals entering the US through legal channels undergo veterinary checks and must meet health requirements. Smuggled animals can bypass those safeguards.

Reuters reported that authorities in Presidio County, Texas, have intercepted more than 50 smuggled horses over two years. Some were reportedly moved through remote areas along the Texas-Mexico border, making them difficult to monitor.

That matters because an infected animal can potentially carry screwworm larvae or adult flies into new areas.

USDA officials have described animal trafficking as a biosecurity concern. However, authorities have not established that illegally transported horses are responsible for particular screwworm infections in the US.

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Why Is The US Worried About Screwworm Again?

The parasite was previously eliminated from the US, making its recent return a major agricultural concern.

The USDA says New World screwworm is a devastating pest capable of causing serious, often deadly damage to livestock. It can also affect pets, wildlife and, in rare circumstances, people.

The economic consequences include potential damage from a major Texas outbreak at up to $1.8 billion, reflecting losses to livestock and related industries.

The threat comes as the US is also navigating the difficult balance between controlling screwworm and maintaining livestock trade with Mexico.

In August, the US began a phased reopening of Mexican cattle imports after a more than year-long suspension linked to the screwworm threat. Mexico has simultaneously been releasing sterile flies and other containment efforts along its northern border.

How Is The US Trying To Stop It?

One of the main tools is the sterile insect technique. Large numbers of male screwworm flies are sterilised and released into affected areas. When they mate with wild females, they produce no viable offspring, helping reduce the population.

As of September 4, the agency said the current risk to animals and people in the US remained very low, and stressed that screwworm is not a food-safety issue. But illegal animal trade complicates those efforts.

The use of GLP-1 medications weight-loss medications among children under 12 in the US has risen in recent years, according to a new study. This has raised questions about how these drugs should be used in younger children and what is known about their long-term effects.

Researchers studied health records from more than 3.5 million children aged 8 to 11 with obesity and found that prescriptions for GLP-1 medications increased more than 300-fold between 2019 and June 2026.

Prescriptions Have Increased Dramatically

In 2019, only about 0.03% of children in the study group had been prescribed a GLP-1 drug. By June 2026, that figure had risen to 9.3%.

The medications included drugs like Wegovy and Saxenda, made by Novo Nordisk, and Eli Lilly's Zepbound.

The researchers used data from Epic Cosmos, a large electronic health-record database covering patients across the US. Epic was not involved in the study.

Also read: The New Nutrition Gap: Why Knowing What To Eat Doesn't Mean We Actually Eat It

Most Children Had Severe Obesity Or Other Health Problems

The rise does not appear to represent routine prescribing for children who are simply above a healthy weight.

Among children receiving GLP-1 medications, 94% had severe obesity, while about 65% had obesity-related health conditions, including high blood pressure or sleep apnea.

Childhood obesity can increase the risk of metabolic and cardiovascular problems. Hence, along with lifestyle changes, doctors are increasingly looking for treatments.

GLP-1 Drugs Are Not FDA-Approved For Under-12s

One of the major concerns surrounding the findings is that the GLP-1 medications included in the study are not formally FDA-approved for weight management in children younger than 12.

However, doctors can prescribe medicines off-label when they believe there is a medical reason to do so. Clinical guidelines can also support the use of obesity medications in certain circumstances involving younger children.

The study therefore does not necessarily mean that doctors are prescribing these drugs indiscriminately. Instead, it shows how rapidly their use has expanded among children with obesity.

Also read: The Postpartum Nutrition Gap: Why New Mothers Often Neglect Their Own Health After Delivery

Long-Term Safety

Dr Babak Orandi of NYU Langone Health, one of the researchers, highlighted the importance of long-term monitoring as these medications become more widely used in younger children.

He said that while the absolute numbers of children under 12 receiving GLP-1 treatment is still low, the study shows that GLP-1 use ‌is ⁠accelerating rapidly among that age group. Orandi also said that long-term safety monitoring is needed to ensure the drugs remain safe and effective for children.

Additionally, children from higher-income households were 55% more likely to be prescribed the drugs than lower-income communities. This suggested emerging disparities ⁠in access, according to the study published in the journal Pediatrics.

"Physicians and health policymakers alike have a responsibility to ensure ... these valuable and sometimes costly treatments become available to more than those who have ⁠access to health insurance and can afford to visit pediatric clinics," said Allan Massie, co-author of the study and associate professor of surgery at NYU Grossman School ⁠of Medicine.

So even if these medicines prove to be useful for treating severe childhood obesity, access may depend partly on a family's ability to obtain the medicine, insurance coverage and treatment.

GLP-1 drugs can cause side effects like nausea, vomiting, diarrhoea and constipation. But questions around prolonged use during childhood extend beyond short-term side effects, including how treatment may affect growth, development and nutritional health over time.