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.

India is witnessing a shift in its disease landscape. While greater awareness, improved hygiene and national health policies have helped curb communicable and preventable diseases, the country is now facing a growing burden of metabolic conditions such as fatty liver and colorectal cancer, alongside persistent infections including Helicobacter pylori and intestinal worm infestations, health experts said.

The concerns come ahead of the World Congress of Gastroenterology (WCOG) 2026, to be held in India for the first time from September 30 to October 3 at Yashobhoomi, Dwarka, under the theme “Transforming Gastrointestinal Health, Preserving Nature.”

Fatty Liver a Major Concern

Fatty liver disease has emerged as a key metabolic health challenge in India. An AIIMS-led systematic review and meta-analysis found the condition in 38.6 per cent of Indian adults and 35.4 per cent of children. It is closely associated with diabetes, obesity and hypertension and can remain silent until liver damage progresses.

A recent study found that one in four patients with type 2 diabetes has clinically significant fibrosis.

“India is facing an epidemiological shift at this time. We have made significant strides in controlling preventable disease through awareness, vaccinations and improving quality of life, however alongside these we are now seeing metabolic disease on a scale we have never handled before,” said Dr. Pramod Garg, Professor and Head, Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi.

“Fatty liver is the clearest example. The disease is easy to find if we look for it, and we become aware only after the patient falls ill. This is a greater challenge than before—we must move away from only treating diseases—we must now actively promote good health,” he added.

To address the rising burden, India included fatty liver disease in its National Programme for Prevention and Control of Non-Communicable Diseases in 2021, followed by guidelines for its detection at the primary-care level.

Colorectal Cancer Cases Growing Among Young

The experts also flagged colorectal cancer as a growing concern, with cases increasingly being seen among younger adults. India recorded 40,430 new cases among men and 24,433 among women in 2022.

“India has never been short of gastroenterologists or technology. What we have lacked is the habit of taking early symptoms seriously. We often misattribute our symptoms to stress or simply overlook them,” said Dr. Govind Makharia, Professor, Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi.

“Every time we fail to identify a disease early, we lose the opportunity to potentially modify its natural history. Any symptom that persists beyond two to three weeks should be evaluated,” he added.

Persistent Infections and Chronic Gut Diseases

H. pylori remains widespread and is associated with peptic ulcer disease and gastric cancer. Intestinal worm infections continue to affect children and can contribute to anaemia and undernutrition.

Chronic gastrointestinal conditions such as celiac disease and inflammatory bowel disease (IBD) are also increasingly being recognized in India. Community-based research led by AIIMS found celiac disease in approximately one in 96 people in northern India.

Dr. Vineet Ahuja, Professor, Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi, said conditions such as IBD and celiac disease, once considered rare in India, are now regularly encountered in clinical practice.

“Advances in endoscopy, artificial intelligence and microbiome research are improving diagnosis and treatment. The challenge now is to make these advances more widely accessible,” he said.

“With the advent of AI, we potentially stand at a new era of medicine—we must not dismiss it, but learn to adapt to it and improve the quality of care we provide to our patients,” he added.

The experts stressed the importance of early detection and urged people not to ignore persistent gastrointestinal symptoms, blood in the stool, unexplained weight loss or sustained changes in bowel habits. Earlier testing and preventive interventions can help identify and manage several GI conditions before they progress

Researchers in the Netherlands are exploring a possibility to reach into remote, difficult areas in the brain without an open surgery. They have developed a tiny, screw-shaped robot that can move through brain tissue under the control of a magnet placed outside the body.

The method is yet to be tested on humans. They used sheep brain tissue, including a model in which blood was pumped through the brain's vessels to more closely mimic a living brain.

In laboratory experiments, the robot successfully travelled through real sheep brain tissue, offering an early glimpse of a less invasive way to reach areas that are difficult to access with conventional surgery.

The technology could eventually be useful to treat deep brain tumours, blood clots following stroke and vascular abnormalities.

How Does The Tiny Robot Work?

Scientists have made the robot in a spiral, screw-like shape. It does not have a conventional motor inside it. Instead, researchers control it using a rotating magnetic field generated outside the body. As the magnet rotates, the robot moves with it. Its screw-shaped body converts that rotation into forward movement, allowing it to drill its way through soft brain tissue.

The researchers also created a mathematical model to predict when the robot could lose synchronisation with the magnetic field. Simply making the magnet spin faster does not mean the robot will keep moving faster.

“Push a magnetic robot too fast and it simply stops listening to the magnet,” said Ewout Ligtenberg, first author of the study. He added, “We can now predict exactly when that happens, for any tissue, from a single test. That takes out a lot of guesswork when designing robots for the brain.”

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Navigating Inside A Brain Is Not Easy

One of the biggest challenges of brain surgery is that is that brain tissue is soft, delicate and mechanically complex. The researchers initially tested their robot in gelatin before moving to actual sheep brain tissue.

In the sheep tissue, the robot remained synchronised with the magnetic field up to about 1.8 rotations per second when there was no blood flow. But once blood was pumped through the vessels, it fell to below 0.45 rotations per second. In other words, making the conditions that resemble a living brain made the robot harder to control.

The robot moved through the brain tissue at around 0.2 millimetres per second. When researchers reversed it, it was able to travel back through the pathway it had already created much faster, at about 2.9 millimetres per second.

Also read: New AI Tool Reads ECG In 2 Seconds, Detects Up To 90% Of Heart Valve Disease Cases

This May Help With Brain Lesions

The technology may have applications in treating brain lesions as some lesions sit deep inside the brain, where reaching them can mean passing through healthy tissue or opening the skull.

The researchers are look for a futuristic approach in which the tiny robot could potentially be guided through blood vessels to a location near the target, pass through the artery wall and then travel through brain tissue towards the lesion.

The robot has not been used to treat a brain tumour, remove a clot or operate on a person. Despite promising outcome, there are still major questions around safety, navigation, bleeding, tissue damage.

India has the medical expertise and infrastructure to perform significantly more corneal transplants, but a shortage of suitable donor corneas continues to leave thousands of patients waiting for treatment.

While an estimated 1 lakh corneal transplants are needed annually, only 25,000–30,000 are performed, meeting just 25–30% of the estimated need, said health experts as part of the 41st National Eye Donation Fortnight.

The shortage is also reflected in the availability of suitable donor tissue. In 2023–24, more than 49,000 corneas were retrieved in India, but only around 27,394 were considered suitable for transplantation.

Why Corneal Transplants Matter

Corneal blindness is a significant cause of treatable vision loss in India. “There is too much burden of corneal blindness in India, which is a leading cause of treatable blindness. Almost 1.1 to 1.3 million people are affected because of this corneal blindness,” said Dr Anita Gangar, Consultant Corneal Transplant Surgeon, Eye Department, Sir Ganga Ram Hospital, in a video posted on X.

The cornea is the transparent front surface of the eye that allows light to enter. When it becomes damaged, scarred or opaque, vision can be severely affected.

A corneal transplant replaces the damaged cornea with clear donor tissue, helping restore the eye’s optical pathway and vision.

Also read: World’s First Live AI-Assisted Brain Surgery Saves Patient’s Sight: How Does The Technology Work?

Common Causes of Corneal Blindness

• Corneal infections
• Eye trauma
• Surgery-related complications
• Hereditary conditions

Why Timely Eye Donation Matters

The availability of donor tissue remains a major constraint despite advances in corneal surgery.

“Corneal blindness is among the significant causes of vision loss that can potentially be treated through transplantation, yet thousands of patients continue to face a long and uncertain wait for suitable donor tissue,” said Padma Shri Prof. Dr Jeevan Titiyal, Regional Head – Clinical Services, Dr Agarwals Eye Hospital, at a press conference held in New Delhi.

The experts added that increasing eye donation requires not only greater public awareness but also stronger retrieval systems, efficient eye-bank networks and better coordination between hospitals and eye banks.

Timely retrieval is particularly important for preserving donor corneal tissue. Families are encouraged to contact an eye bank as soon as possible after the death of a loved one, with retrieval generally targeted within approximately six hours under appropriate conditions.

Read More: Diabetics Must Undergo Retinal Screening To Protect Eye Health: AIIMS Doctors

Eye Donation: Myths vs Facts

Myth: Diabetes or high blood pressure prevents eye donation.

Fact: These conditions do not automatically rule out donation. The medical team assesses tissue suitability after death.

Myth: Eye donation will disfigure the face.

Fact: Corneal retrieval is performed respectfully by trained professionals and does not cause visible facial disfigurement.

Myth: People who wear spectacles cannot donate their eyes.

Fact: Wearing spectacles or contact lenses does not automatically prevent donation. Eligibility is determined after death.

Myth: Only young people can donate.

Fact: People of different ages may be eligible, depending on the suitability of the donated tissue.

Advances in Corneal Transplantation

Corneal transplantation has evolved from conventional full-thickness procedures to more selective, layer-specific techniques. In suitable cases, surgeons can replace only the affected portion of the cornea, allowing for more targeted treatment and faster visual rehabilitation.

“Advances in corneal surgery now allow us to treat specific layers of the cornea, offering more targeted treatment and faster visual rehabilitation for appropriately selected patients. However, these advances can translate into better outcomes only when suitable donor tissue is available,” said Dr Prabjot Kaur, Senior Consultant Ophthalmologist, Dr Agarwals Eye Hospital.

41st National Eye Donation Fortnight

The 41st National Eye Donation Fortnight is being observed from 25 August to 8 September 2026. The 15-day nationwide awareness campaign, observed in India since 1985, aims to encourage eye donation and help bridge the gap between the demand for and availability of donor corneas.