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.

Even as global temperatures continue to climb, increased exposure to extreme heat may be more dangerous for people aged 60 and over than previously thought, according to a new study published in The Lancet Planetary Health.

The global study found that older adults may face serious health risks as their bodies struggle to keep up with extreme heat, a state physiologists call “uncompensable heat stress.” This occurs when sweating and other biological cooling mechanisms are overwhelmed and core body temperature continues to rise.

“The human body can tolerate only a limited range of ambient heat,” said lead author Qinqin Kong from Stanford Health Policy (SHP).

“Understanding where, when, and to what extent these limits are exceeded is critical for informing climate prevention policies,” Kong said.

What Did The Study Find?

Also read: AC Becomes ‘Must-Have’ For Offices As London Faces Fifth Heatwave; Here’s Why It Still Raises Dehydration Risk

The study accounts for age-related differences in heat tolerance on a global scale. Researchers drew on previously published laboratory experiments that measured heat tolerance across three age groups:

• Younger adults: 15–39 years
• Middle-aged adults: 40–59 years
• Older adults: 60 years and over

The researchers then mapped where heat would become dangerous for each group and how many people would be affected.

They used a high-resolution heat stress metric across scenarios ranging from 1°C to 4°C of global warming above pre-industrial levels, in 0.5°C increments, combined with population projections.

Based on at least 180 hours of dangerous heat annually, assuming roughly six hours of such heat per day:

• At 1.5°C warming: 22% of the world's older adults — about 290 million people — could face unsafe heat for at least one month each year.
• At 3°C or higher warming, older adults could face dangerous heat day and night for three months straight.
• A similar level of risk is not projected until 4°C warming, when about 17% (490 million people) could be affected.

Which Countries Will Be Most Affected?

Read More: UK, France Brace for Another Heatwave: How Hot Weather Can Affect Medicines

According to the study, South Asia and the Persian Gulf regions are projected to be among the most exposed.

At that level of warming, just four countries—India, China, Pakistan and Bangladesh—would account for 1.5 billion people, or 73% of the total population affected worldwide, across all age groups.

The researchers warned that the greatest challenge will fall on countries that combine high heat exposure with high poverty rates and limited access to cooling, including:

• India
• Pakistan
• Bangladesh
• Myanmar
• Niger

Why Are Older Adults at Higher Risk?

Each additional degree of warming exposes roughly 1 billion more people to at least 180 hours of uncompensable heat a year, with older adults bearing a disproportionate share of the risk.

When researchers accounted for the reduced heat tolerance associated with aging, the number of people facing repeated, uncompensable heat exposure was two to eight times higher than earlier estimates that used young-adult thresholds for everyone.

This is particularly concerning because extreme heat is already one of the leading causes of weather-related deaths worldwide. Heat-related mortality may also become the largest contributor to climate-related costs in a warming world.

Why Prolonged Heat Can Be Dangerous?

The researchers noted that sustained exposure beyond the body's heat tolerance limits can lead to dangerous or even fatal hyperthermia and can worsen pre-existing chronic illnesses, particularly those affecting the:

• Cardiovascular system
• Respiratory system
• Renal system

These findings underscore the urgent need for age-specific adaptation strategies alongside ambitious climate change-mitigation efforts to protect clinically vulnerable populations from escalating heat-related hazards.

The study calls on governments to develop heat emergency plans and improve access to cooling and heat-warning systems.

The team also stress that cutting emissions remains essential to reduce older people's risk of prolonged, round-the-clock heat exposure and protect future generations from widespread heat danger.

The Clarence High School in Bengaluru's Richards Town has suspended offline classes temporarily after more than 500 students and 21 staff members reported flu-like symptoms.

According to reports, at least two students have tested positive for H1N1 and one staff member is undergoing treatment at Bangalore Baptist Hospital. The school has been shut down as a precautionary measure as health officials continue to investigate the outbreak.

But before panicking, it is important to understand that 500-plus people falling sick suddenly does not mean there are 500 H1N1 cases. Many of those affected have reported common flu-like symptoms like fever, cough, cold, and body aches, and testing is needed to determine the exact cause.

What Is H1N1?

H1N1 is a subtype of influenza A virus. Patients with H1N1 may present common flu-like symptoms like fever, cough, sore throat, runny or blocked nose, headache, fatigue, and body aches. Some children may also experience gastrointestinal symptoms like vomiting or diarrhoea.

The contagious infection spreads mainly through respiratory droplets that get released when an infected person coughs, sneezes or talks. Crowded spaces like classrooms, school buses, and playgrounds can provide plenty of opportunities for virus transmission.

Children may spread the virus to others before realising they are sick, making it difficult to contain an outbreak.

Also read: H1N1 Flu Rising in India: Why Heart Patients Need to Watch

What Symptoms Must Parents Look For?

School settings are particularly prone to respiratory infections as children spend hours together indoors and frequently share objects and touch common surfaces.

In the Bengaluru case, school authorities have also raised concerns about sanitation and waste accumulation around nearby street-food vendors, although this has not been established as the cause of the H1N1 infections.

It is important to understand that not every seasonal flu is caused by H1N1 virus. But isolate your child if he or she child presents the following symptoms:

• High fever or chills
• Persistent cough
• Sore throat
• Runny or blocked nose
• Headache
• Significant body aches
• Unusual tiredness or weakness
• Vomiting or diarrhoea in some children

Please note that not every child with flu will develop a fever. So the absence of fever does not necessarily rule out influenza.

While most children recover without serious complications, some are at greater risk of severe influenza, including very young children and those with conditions like asthma, diabetes, heart disease, or neurological disorders.

Also read: Why Humidity Can Worsen Sinus Symptoms Even Without An Infection?

When Should Parents Seek Urgent Medical Help?

Certain symptoms should not be dismissed as 'just the flu'. Seek urgent medical attention if a child develops the following symptoms as they can indicate complications like pneumonia, severe dehydration, or other serious effects of influenza.

• Difficulty breathing or very rapid breathing
• Chest pain
• Blue or grey lips or face
• Severe dehydration or very little urine
• Persistent vomiting
• Seizures
• Severe weakness or unusual drowsiness
• A child who is difficult to wake or does not respond normally

India's National Centre for Disease Control lists breathlessness, chest pain, drowsiness, falling blood pressure and bluish discolouration among warning signs that warrant urgent medical attention.

Also read: Delhi Sees Nearly 6x Rise In H1N1 Cases: How Is It Different From Other Respiratory Infections?

Precautionary Measures Parents Must Take

Not every child with a cough or fever needs an H1N1 test. Testing decisions should be made by a doctor based on the child's symptoms, exposure, and risk factors.

Parents should also avoid administering antibiotics on their own. Remember that H1N1 is a viral infection, so antibiotics is not the right course of treatment.

If a child develops flu-like symptoms, the most important step is not to send them to school. Parents should also:

• Instruct them to wash hands frequently
• Teach children to cover while coughing and sneezing
• Avoid sharing bottles, utensils and towels
• Limit close contact with others while the child is sick
• Keep commonly touched surfaces clean
• Speak to a doctor about seasonal influenza vaccination, particularly for children at higher risk

American model and actress Paris Jackson has opened up about battling depression and dealing with suicide attempts.

In a recent podcast, Jackson revealed that she underwent electroconvulsive therapy (ECT), which she said helped her. While describing the treatment as “painful,” she said it was not a “barbaric” experience.

The 28-year-old said she underwent nine ECT sessions over three weeks, with each session performed under general anesthesia.

Paris Jackson Describes Her ECT Experience

Jackson recalled that she had to replace the metal from her facial piercings with plastic earrings before undergoing the treatment.

“You go in, you get your hospital gown, they knock you out, strap you down, put a bite guard on your mouth [and] electrocute you,” she said while describing the procedure.

“It helps with the neuroplasticity in your brain,” Paris continued. “If I’m not mistaken, it’s still the leading most effective form of depression treatment.”

She said the first couple of sessions were “painful” and that she experienced significant side effects.

“The first time I woke up, and it was the most sharp pain I have ever experienced inside of my head,” she recalled, describing it as soreness after being electrocuted. She also said there were days when she felt “completely not in my head at all.”

Jackson Tried Several Treatments Before ECT

Jackson has previously opened up about her suicide attempts, describing her experience of self-hatred, low self-esteem and feelings that she was not worthy of living.

She has also spoken about engaging in behaviours she felt were inappropriate for her age and trying to grow up too quickly.

Before undergoing ECT, Jackson said she had tried “everything,” including multiple medications and treatment at “five different institutions.”

She also tried CBD, dialectical behavioral therapy (DBT) and eye movement desensitization and reprocessing (EMDR).

She recalled trying different forms of therapy, saying, “I had talked to the empty chair, held the pillow, beat the things with bats while screaming.”

Jackson also underwent transcranial magnetic stimulation (TMS), which she said “helped a little bit with [her] OCD but had no effect on [her] depression.”

Her psychiatrist subsequently brought up ECT as another treatment option.

Jackson now focuses on “holistic health” to make her recovery “sustainable” and sees a behavioral specialist for her OCD.

What Is Electroconvulsive Therapy?

Electroconvulsive therapy (ECT) is a procedure performed under general anesthesia. During the treatment, small electric currents are passed through the brain, intentionally triggering a brief seizure.

According to Mayo Clinic, ECT appears to cause changes in brain chemistry that can quickly improve symptoms of certain mental health conditions.

When May ECT Be Recommended?

ECT is known to rapidly improve severe symptoms of several mental health conditions. It may be used for:

• Severe depression with suicide risk
• Treatment-resistant depression
• Severe mania
• Catatonia
• Agitation and aggression in people with dementia

ECT may be considered when a person cannot tolerate medicines or has not found relief from other forms of treatment.

Can ECT Reduce Suicide Risk?

ECT can be used for severe depression accompanied by suicide risk and is known for rapidly improving severe depressive symptoms.

However, ECT is not a universal treatment for suicidal thoughts or behaviour. Its use depends on the individual's condition, medical history and response to other treatments, and it is administered under medical supervision.

ECT Side Effects

Jackson also spoke about amnesia as one of the side effects of ECT.

“Friends visited me, and I don’t remember even seeing them [even though] I have evidence. … I don’t remember the conversations,” she said.

Memory problems are a known side effect of ECT and can affect a person's ability to recall events around the time of treatment.