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 (FDA) has granted tentative approval to Dr. Reddy's Laboratories for the first generic version of lenacapavir, a long-acting injectable for HIV prevention. The development raises hopes of making HIV prevention more affordable in 120 low- and middle-income countries, including India.

The approval is considered “tentative”, the FDA’s standard designation for generics while the originator remains under patent.

The development comes just 16 months after Gilead Sciences received approval for its original product, marking one of the fastest timelines for a major HIV innovation.

Lenacapavir is the first twice-yearly injectable pre-exposure prophylaxis (PrEP) option for HIV prevention. Dr. Reddy's generic injection is expected to cost US$40 per person annually across the 120 eligible countries, with initial supplies expected by the end of 2026.

Calling it “a moment of immense pride”, Deepak Sapra, Chief Executive Officer, API and Services, at Dr. Reddy's, said the FDA approval validates the company's efforts to expand access to twice-yearly HIV prevention across low- and middle-income countries.

Also read: South Africa Receives 1st Batch Of HIV Prevention Medicine Lenacapavir

Dr Reddy's First Of 6 Generic Drugmakers To Get FDA Nod

In October 2024, Gilead Sciences signed voluntary licensing agreements with six generic manufacturers to produce and supply low-cost versions of lenacapavir in 120 low- and middle-income countries.

The six manufacturers are:

• Dr. Reddy's Laboratories (India)
• Emcure Pharmaceuticals (India)
• Hetero Labs (India)
• Eva Pharma (Egypt)
• Ferozsons Laboratories (Pakistan)
• Mylan (a subsidiary of Viatris)

Dr. Reddy's is the first among the six licensees to receive tentative US FDA approval. The other five companies are at various stages of product development, bioequivalence testing and regulatory filing.

What Will Cheaper Lenacapavir Mean For India?

At its August 11, 2026, meeting, the Indian drug regulator's Subject Expert Committee recommended waiving local Phase III clinical trials and bioequivalence studies for generic injectable lenacapavir applications submitted by Dr. Reddy's and Emcure Pharmaceuticals for PrEP.

The proposed price of approximately US$40 per person annually could make twice-yearly HIV prevention more accessible.

However, this is an indicative price for generic supplies, not a confirmed retail price in India. The eventual Indian price will depend on regulatory approval, manufacturing costs, supply capacity, competition and distribution.

Read More: Exclusive With Leading HIV Expert: What's Driving Rising HIV Cases Among India's Youth And How To Prevent It

What Does The Approval Mean For HIV Prevention?

Generic lenacapavir could offer people at risk of HIV an alternative to daily oral PrEP pills. Its twice-yearly dosing may help those who struggle with daily medication adherence or face stigma and barriers to healthcare access.

“For someone at risk of HIV, taking a pill every day to prevent a disease they do not have is a hard thing to ask. Two injections a year of a product that is almost 100% effective at preventing HIV changes that entirely.”

“Generic lenacapavir has the potential to transform HIV prevention, and this is a significant milestone, but an affordable drug alone is not enough,” said Professor Saiqa Mullick, Director of Implementation Science at Wits RHI, University of the Witwatersrand, which partnered with Dr. Reddy's.

Lenacapavir: How Does It Work?

Lenacapavir is a long-acting antiretroviral drug developed by Gilead. For HIV prevention, it is administered as two injections in the abdomen, providing protection for six months.

People must test negative for HIV before receiving it. The drug does not treat existing HIV infections or prevent other sexually transmitted infections.

Two major clinical trials demonstrated its high efficacy. In one study involving adolescent girls and young women in South Africa and Uganda, there were zero new HIV infections among participants who received lenacapavir. A second trial involving gay men and gender-diverse individuals also demonstrated high efficacy with twice-yearly injections.

Increasing consumption of caffeinated energy drinks and stimulant-containing supplements has been linked to a higher frequency of reported serious cardiovascular events, including cardiac arrest, heart attacks and abnormal heart rhythms, particularly among young adults, according to preliminary research.

The findings, based on an analysis of US Food and Drug Administration (FDA) safety reports, will be presented at the American Heart Association's (AHA) Scientific Sessions 2026, scheduled for November 6-9 in Chicago.

Researchers found that cardiac arrest was reported about 11 times more frequently in connection with caffeine- and

stimulant-containing products than products without these ingredients.

Energy Drinks And Heart Problems: What Did The Study Find?

Researchers analyzed 28,345 reports of possible adverse events submitted to an FDA safety database between 2017 and 2025. Of these, 854 involved energy drinks and supplements containing caffeine or other stimulants.

Key findings included:

• Cardiac arrest was reported about 11 times more frequently with caffeine- and stimulant-containing products.
• Heart attacks were 4.5 times more likely to appear in these reports.
• Ventricular arrhythmias and heart palpitations were reported about four times more frequently.
• Elevated heart rate was reported nearly three times more frequently.
• Chest pain was reported 2.71 times more frequently, while fainting was reported about twice as frequently.

About 45% of reports involving cardiovascular events and these products concerned adults aged 18 to 34. Similar patterns were observed among men and women.

Also read: FSSAI Targets 6 Energy Drink Brands; Experts Link Them to Obesity, Liver Problems

Why Are Energy Drinks Raising Concerns?

Sales of caffeinated energy drinks have more than doubled over the past decade, reaching over $20 billion in 2024.

According to the AHA's 2026 scientific statement on caffeine and cardiovascular disease, consuming up to 400 mg of caffeine daily is generally safe for most adults.

However, some energy drinks contain up to three times more caffeine per fluid ounce than brewed coffee. Certain pre-workout supplements contain more than 12 times as much.

High caffeine intake has been associated with cardiovascular harm. Healthcare professionals have also reported cases of arrhythmias and sudden cardiac death following consumption of these products, including among young adults without known heart disease.

Why Are Young Adults Particularly Affected?

Researchers do not yet know why young adults account for such a large proportion of the cardiovascular event reports.

Possible explanations include frequent consumption, using these products before intense exercise, combining them with alcohol or other drugs, and undiagnosed heart conditions.

"These products are marketed as everyday pick-me-ups and sold next to soda and bottled water, so most people assume they carry no real risk," said study author Sai Samayamanthula, a fourth-year medical student at the University of Virginia School of Medicine.

He cautioned that regular consumers could quickly exceed recommended daily caffeine limits.

The researchers recommended better safety monitoring and urged healthcare professionals to ask younger patients experiencing palpitations, chest pain or fainting about their energy drink and stimulant supplement consumption.

Do Energy Drinks Cause Cardiac Arrest?

Read More: Excessive Energy Drinks Damaging Young Adults’ Livers, Experts Warn

The findings indicate an association, not proof that energy drinks cause cardiac arrest or other cardiovascular conditions.

Gregory M. Marcus, chair of the AHA's 2026 scientific statement on caffeine and cardiovascular disease, said the research raises concerns about products containing very high amounts of caffeine.

"Although there are biological reasons why that connection could be possible, the study does not prove that caffeine products cause these events, because other factors may have influenced the results," said Marcus, who was not involved in the study, and a professor of medicine at the University of California, San Francisco School of Medicine.

What Are The Study's Limitations?

The study relied on voluntary reports submitted to the FDA by consumers, healthcare professionals and manufacturers. Researchers could not determine how many people consumed these products without experiencing adverse events or how many cardiovascular events went unreported.

Billionaire investor Warren Buffett has reportedly said that he has not drunk plain water in 48 years, preferring his favourite soft drink instead.

Billionaire Bill Ackman recalled a dinner conversation with Buffett during an appearance on a recent podcast, where the legendary investor's drinking habits left him surprised, Business Insider reported.

During the dinner, Ackman offered Buffett a choice between still and sparkling water. However, the investor declined both. Curious about his preference, Ackman asked whether he drank water at all.

Buffett's reported response left him surprised.

"Bill, I haven't had water in 48 years," Buffett reportedly told Ackman.

Ackman, knowing about Buffett's fondness for Cherry Coke, had stocked up on the beverage ahead of the meeting.

Buffett's fondness for Coca-Cola is no secret and goes back decades. He has spoken about his preference for the beverage for years, and his association with the brand goes back to the 1980s. He also declared Cherry Coke the official beverage of Berkshire Hathaway's annual shareholder meeting.

Also read: What Happens To Your Body When You Stop Drinking Water?

What Happens If You Replace Plain Water With Coke?

Coca-Cola can contribute to your daily fluid intake, but that does not make it a healthy substitute for plain water. Regular Coke contains added sugar and calories, which can have consequences for health when consumed frequently.

According to the US Centers for Disease Control and Prevention (CDC), frequent consumption of sugar-sweetened beverages is associated with several health problems, including:

• Weight gain and obesity.
• Type 2 diabetes.
• Heart disease.
• Non-alcoholic fatty liver disease.
• Tooth decay and cavities.
• Gout, a type of arthritis.

Unlike plain water, which contains no calories, regular soft drinks add sugar and calories to the diet without providing comparable nutritional benefits.

Replacing water with sugary drinks regularly can therefore increase a person's overall sugar and calorie intake, potentially affecting metabolic and dental health over time.

Sugar-sweetened beverages include regular sodas, fruit drinks, sports drinks, energy drinks, sweetened water, and coffee and tea beverages with added sugars.

The CDC notes that replacing added sugars with low- or no-calorie sweeteners may reduce calorie intake in the short term and help with weight management. However, questions remain about their effectiveness as a long-term weight management strategy.

Read More: Olympian Ciara Mageean Dies At 34 After Bowel Cancer Battle: Warning Signs In Young Adults

Why Is Drinking Enough Water Important?

According to the CDC, getting enough water every day is essential for health. Water helps prevent dehydration and allows the body to function normally.

Dehydration can cause unclear thinking, mood changes, overheating, constipation and kidney stones.

Water plays several important roles in the body. It helps:

• Maintain a normal body temperature.
• Lubricate and cushion joints.
• Protect the spinal cord and other sensitive tissues.
• Remove waste through urination, perspiration and bowel movements.

The body's water requirements may also increase in hot climates, during physical activity, or when a person has a fever, diarrhoea or vomiting.

Water contains no calories. Replacing sugary drinks with plain water can therefore help reduce overall calorie intake.