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 Trump administration is reportedly preparing to announce changes to the childhood immunisation schedule early next year, with a proposal that would recommend fewer vaccines and bring U.S. policy closer to Denmark’s model. A source familiar with the discussions told NewsNation correspondent Libbey Dean that the revised schedule, expected next year, would involve fewer shots and would be “more in line with Denmark’s vaccination schedule,” according to The Hill. This has raised an important question: what does Denmark’s vaccine schedule look like, and is it realistic for the U.S. to follow it?

Denmark Vaccine Schedule: What Is It?

Denmark runs a clearly defined childhood vaccination programme that is free and voluntary, aimed at protecting children from serious infectious diseases. Infants are given combination vaccines that cover diphtheria, tetanus, whooping cough, polio, and Haemophilus influenzae type b, along with the pneumococcal vaccine, at 3, 5, and 12 months. Children receive their first dose of the measles, mumps, and rubella (MMR) vaccine at 15 months, with a second dose at 4 years.

A booster shot for diphtheria, tetanus, whooping cough, and polio is administered at 5 years. Around the age of 12, both boys and girls are offered the HPV vaccine to reduce the risk of cancers linked to the virus. Vaccines for chickenpox, rotavirus, hepatitis A, or meningococcal disease are not routinely included in Denmark’s standard schedule, according to official guidance from the Danish Health Authority’s Childhood Vaccination Programme.

RFK Jr. Is Considering Denmark Vaccine Schedule For US

Reports suggest that the Department of Health and Human Services (HHS) is exploring additional changes to federal childhood vaccine recommendations, with a focus on aligning them more closely with those followed by other developed nations, especially Denmark, as per The Washington Post. This discussion comes after a meeting earlier this month of the CDC’s Advisory Committee on Immunization Practices (ACIP), where childhood vaccine schedules in the U.S. and Denmark were reviewed and adjustments to the U.S. schedule were made. It was followed by a memorandum from President Trump directing HHS to begin a “process to align U.S. core childhood vaccine recommendations with best practices from peer, developed countries.”

Denmark Vaccine Schedule: What Happens If the US Adopts It?

If the U.S. were to adopt Denmark’s schedule in full, it would result in fewer vaccines being recommended for children up to age 18. When comparing vaccines that are universally advised in both countries, Denmark’s programme covers protection against 10 diseases, while the U.S. schedule includes vaccines for 16 diseases, following the removal of hepatitis B from universal recommendations. The additional vaccines recommended in the U.S. address respiratory syncytial virus (RSV), rotavirus, varicella, hepatitis A, and meningococcal disease. Although the U.S. advises more childhood vaccines than many comparable countries, Denmark stands out for recommending fewer than most. Data from the European Centre for Disease Prevention and Control (ECDC) vaccine scheduler shows that none of the other 29 ECDC member countries limits its routine childhood schedule to just 10 diseases. Several countries, including Germany, Greece, Ireland, Italy, and Poland, recommend vaccines against 15 or more diseases, while Austria’s schedule covers 17 diseases, which is even more than the U.S. currently recommends.

Every country follows its own process when setting vaccine recommendations, shaped by its specific circumstances. Childhood immunisation schedules are built over years by reviewing available evidence and weighing factors such as healthcare systems, insurance coverage, public health infrastructure, and national priorities. This explains why vaccine schedules vary across countries, and so far, no developed nation has based its decisions solely on what another “peer” country does.

Importantly, Denmark’s approach is not based on a different interpretation of vaccine science or effectiveness. Instead, Danish health authorities prioritise recommending vaccines that significantly lower the risk of death or serious illness in children. For instance, while rotavirus infections do occur among children in Denmark, they rarely result in death or long-term harm in a setting with universal healthcare access, strong medical systems, and lower inequality than in the U.S. By contrast, neighbouring countries such as Norway and Finland do include the rotavirus vaccine in their routine schedules, as does the U.S., where before the vaccine was introduced, rotavirus caused an estimated 2.7 million infections each year, leading to 55,000 to 70,000 hospitalisations and 20 to 60 deaths among children under five.

Delhi yet again woke up to a thick smog blanketed Saturday morning. The AQI stood at 380 for the city, which puts it under the 'very poor' category, as of 7am, according to the Central Pollution Control Board (CPCB). Several parts of the city also recorded with in the 'severe' limits of air pollution, with multiple stations recording AQI above 400. These areas include Anand Vihar and Sarai Kale Khan recorded 428 AQI, ITO recorded 429, Akshardham recorded 420, Ashok Vihar recorded 407, and Rao Tularam Marg recorded 403.

While GRAP Stage IV is enforced in the capital to combat the pollution problem, amid this, Minister of State for Environment and Climate Change Kriti Vardhan Singh told the Rajya Sabha on Thursday that there is no direct correlation between higher Air Quality Index or AQI levels and lung diseases. He said that there is no "conclusive data" to establish such a link. However, he did say that air pollution is one of the "triggering factors" for respiratory ailments and associated diseases.

Read: AQI Explained: It’s Not Temperature, As Delhi CM Says, Here’s What the Air Quality Index Really Means

What Do Doctors And Research Say On The Link of Lung Diseases And Air Pollution

"Lung cancer is no longer a smoker’s but a breather’s disease," said Dr Arvind Kumar, chairman, Lung Transplant, Chest Surgery and Oncosurgery at Medanta, Gurugram, as reported by The Indian Express. He treated a 31-year-old patient from Ghaziabad with lung cancer, who had never smoked in her life.

Read: Lung Cancer No Longer A Smoker's Disease, It's A Breather's Disease: Story Of A 31-year-old Non-smoker NCR Woman Who Had Stage 2 Lung Cancer

"Younger non-smokers are being diagnosed. And there are as many women as men. This indicates that lung cancer is no longer a smoker’s but a breather’s disease. While we talk of particulate matter, the ambient air in the urban environment is full of carcinogenic gases. And this is emerging as a real threat to everybody," the doctor said.

Dr Shivanshu Raj Goyal, a pulmonologist and Associate Director Pulmonary Medicine at MAX Healthcare in Gurugram and Delhi, in an Instagram video said that breathing this toxic air is equivalent to smoking 20 cigarettes in a day. The doctor starts his video with a rather strong statement, "At present, no one in Delhi-NCR is a non-smoker."

The doctor also states that on an average, a person breathes around 20,000 times in a day, so it means we are inhaling the toxic air at least 20,000 times a day.

As per a 2017 study titled Pulmonary Health Effects of Air Pollution, it is clear that lung cancer could be exacerbated due to exposure to a variety of environmental air pollutants with greatest effects due to particulate matter (PM), ozone, and nitrogen oxides.

Also Read: Lancet Study Estimates 15 Lakh Annual Air Pollution Deaths in India; Centre Calls Data 'Inconclusive'

As per Action on Smoking and Health (ASH), a cigarette contains nicotine, and tar, which is composed of chemicals like benzene, benzopyrene, and the gas includes carbon monoxide, ammonia, dimethyl nitrosamine, cadmium, formaldehyde, hydrogen cyanide and acrolein. Some of these marked irritant properties are also carcinogen, meaning, it can cause cancer.

Whereas Air Pollution contains pollutants like particulate matter PM 10 and PM 2.5, ozone, nitrogen dioxide, carbon monoxide, cadmium and sulfur dioxide. Air pollution, which is often a byproduct of combustion or released from vehicle exhaust also contain formaldehyde, benzopyrene, and benzene. As per the World Health Organization (WHO), the pollutants contain carcinogens, and the outdoor air pollution is in fact classified as Group 1 carcinogen.

Read: Breathing Delhi's Toxic Air Is Like Smoking 20 Cigarettes A Day

Common Chemicals We Inhale When We Breathe Delhi's Toxic Air And When We Smoke A Cigarette

Carbon Monoxide: a poisonous, flammable gas that is colorless, odorless, tasteless, and slightly less dense than air.

Benzene: a colorless and highly flammable liquid with a sweet smell, and is partially responsible for the aroma of gasoline.

Cadmium: a soft, silvery-white metal (atomic number 48) that is toxic and naturally found in the environment, but human activities have increased its levels. It is used in products like batteries, pigments, and coatings, and exposure can occur through tobacco smoke, contaminated food, and occupational inhalation. Cadmium is a known human carcinogen that can damage the kidneys and bones.

Formaldehyde: a colorless, flammable gas with a strong odor, whose exposure could cause cancer.

Benzopyrene: a group of organic compounds known as polycyclic aromatic hydrocarbons. It is a colorless crystalline solid found in sources like cigarette smoke, coal tar and is a known carcinogen that can cause cancer and other health problems like skin rashes and bronchitis, and exposure requires medical attention for any symptoms.

H3N2 flu is spreading in Canada, and hospitalization has nearly doubled up. The Health Canada data shows that influenza is up by almost 30 per cent. The week ending December 13, Canada saw 11,646 new cases of flu, which equals to 27.7 per cent of all tests conducted in the country were positive. Now, as compared to the week before, there is an increase of 71 per cent, which saw 6,799 new cases and a positivity rate of 20.2 per cent.

The hospitalization rate has also gone up from 3.6 people per 10,000 of the population to 6.2 in this week. The number of reported outbreaks is now up from 91 to 186 and 44 regions across 11 provinces and territories reported influenza.

Which Flu Strain Is Hitting Canada Hard?

Doctors explain that subclade K enhances the ability of the virus to slip through our immune protection. However, it does not mean that vaccination offers no protection against the flu. In fact, experts and doctors have been emphasizing the need to get yourself vaccinated to help you protect from the worst effects of the virus.

“If you look at deaths and severe illness with flu, the vast majority both in adults and in children are unvaccinated,” said Dr Fahad Razak, internal medicine physician and professor at the University of Toronto.

“Yes, you may get sick, even if you are vaccinated, it’s that the severity, the chance that you’re going to end up in hospital and worst-case scenario in the ICU or die does seem to be significantly protected against by being vaccinated.”

Health Canada too noted that vaccination can prevent anyone infected with influenza from developing any further complications.

Are Any Other Countries Impacted?

UK and US are among the other countries impacted with the subclade K or the super flu. The National Health Service (NHS), UK, has already sent out a 'flu jab SOS' to vulnerable people.

NHS has confirmed that the super flu is circulating in England this year, and due to less immunity, it is making it easier to spread across people. The UK Health Security Agency (UKHSA) has urged people to get a flu jab. As per the early data, this year's vaccine has offered good protection despite the new strain.

Daniel Elkeles, chief executive of NHS Providers, said that the major concern is that H3N2 is associated with a more severe illness and superflu could be "a very nasty strain of flu". He said that UK could be experiencing a "tidal wave" of illness.

The main strain circulating this winter is a drifted H3N2 variant, which the UKHSA says has left the community with “less natural immunity.” H3N2 strains tend to cause more serious illness in older adults than H1N1 strains and are linked to higher hospitalizations and deaths. This pattern adds further strain to the NHS during the winter months.

How To Know If It Is Flu Or COVID?

Dr Rupa Parmar, a GP and medical director at Midland Health tells The Mirror, that shortness of breath could be a key symptom that could differentiate between the two.

Dr Parmar highlights that it is a key indicator for COVID. "Shortness of breath is rare in both a cold and the flu, but as COVID more so affects the lungs due to inflammation, it is a common symptom."

The NHS website supports her advice, noting that breathlessness is a symptom more often tied to Covid, not the flu or a common cold. This kind of breathing difficulty is usually associated with infections like Covid or respiratory syncytial virus (RSV).