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 approved Tzield (teplizumab-mzwv), for use in children at stage 2 of type 1 diabetes (T1D) ages one and older.

The drug was first approved in the US in November 2022 to delay the onset of stage 3 T1D in adults and children eight years and older diagnosed with stage 2 T1D.

The FDA has now expanded its use to children as young as one year of age to delay the onset of stage 3 T1D. This means that children at risk for advancing to stage 3 T1D, which is when insulin therapy is required, can get an average of two extra years without T1D.

"This approval opens an important new chapter in diabetes care for young children with stage 2 type 1 diabetes and their families,” said Kimber Simmons, MD, MS, Associate Professor of Pediatrics at the Barbara Davis Center, Colorado, US.

“This is especially important because these children are often at the highest risk of progressing quickly and without warning. Delaying the onset of stage 3 type 1 diabetes during the years when management is often most difficult because of a child’s small size and dependence on caregivers could have a truly meaningful impact for families," Simmons added.

What is Tzield? How Its Administered?

Developed by drugmaker Sanofi, Tzield is a CD3-directed monoclonal antibody and is the first disease-modifying medicine in T1D.

It is a 14-day, once-daily intravenous (IV) infusion treatment designed to delay the onset of Stage 3 type 1 diabetes in adults and children (aged 8+) with Stage 2 diabetes.

Each dose is administered over at least 30 minutes, usually in a clinical setting, to stop the immune system from destroying insulin-producing beta cells.

Stage 2 T1D is defined by the presence of two or more T1D-related autoantibodies and abnormal blood sugar levels (dysglycemia).

Tzield has also been approved in the EU (under the name Teizeild), the UK, China, Canada, Israel, Saudi Arabia, the UAE, Kuwait, and Brazil to delay the onset of stage 3 T1D in adults and children eight years and older.

The FDA is also reviewing Tzield for a potential indication to delay the progression of stage 3 T1D in patients eight years of age and older who have recently been diagnosed with stage 3 T1D.

The new approval was granted under a priority review process and is supported by one-year data from the PETITE-T1D Phase 4 study, which evaluated safety and pharmacokinetics in young children.

What Is Type 1 diabetes?

Around 2 million Americans have type 1 diabetes, which typically develops in childhood or early adulthood. It occurs when the immune system mistakenly attacks and destroys the islet cells in the pancreas. Without these cells, the body cannot produce insulin.

The progressive autoimmune disease develops in four stages:

The stage 1 T1D is presymptomatic, where the autoimmune attack on the beta cells has started, and this can be detected by the presence of two or more T1D-related autoantibodies in the blood. In this stage, the blood sugar levels are in a normal range.

Stage 2 is also presymptomatic, but blood sugar levels become abnormal due to the progressive loss of beta cells.

Stage 3 (also known as the clinical stage) sets in once a significant portion of the beta cells have been destroyed. At this point, rising blood sugar levels reach the point of clinical hyperglycemia (which defines diabetes), and many people will start to experience the classic symptoms such as:

• increased thirst,
• frequent urination
• unexplained weight loss
• blurred vision
• generalized fatigue.

Stage 4 is defined as long-standing autoimmune T1D, often accompanied by evidence of chronic diabetic complications, where little to no beta-cell function remains.

ndia’s Ministry of Health and Family Welfare (MoHFW) today outlined a roadmap to ensure universal access to safe blood in every district by December 2026.

The government’s goal of ensuring timely access to safe blood is in line with the National Blood Policy and was reiterated during a high-level national review meeting with States and Union Territories. The meeting, held via video conference, assessed the preparedness of blood banks and transfusion services across 36 States and UTs in the country.

Current Gaps

The review comprehensively assessed the status of blood transfusion services across the country, covering the five critical stages of service delivery:

• Licensing and Renewal;
• Donor Screening and Blood Collection;
• Testing for Transfusion-Transmitted Infections (TTIs) and referral/linkage of reactive donors;
• Processing, Storage, and Issuance;
• Reporting and Record-keeping.

According to the official statement by the Ministry, approximately 10 per cent of districts in the country currently do not have a blood center.

It also flagged other gaps in digital integration, with a significant number of blood centers yet to be onboarded on eRaktKosh and BBMS. This is limiting real-time visibility and monitoring, revealed the national-level meeting.

"While several states and Union Territories have demonstrated strong performance across multiple indicators, variability persists in areas such as district-level availability of blood centers, licensing compliance, voluntary blood donation rates, referral and linkage of TTI-reactive donors, component separation capacity, and real-time digital reporting," the review found.

Also read: Why Hemophilia Care in India Lags Behind Globally, Expert Reveals: World Hemophilia Day

Access To Safe Blood By 2026 End

Dr Rakesh Gupta, Additional Secretary (Public Health) and Director General, National AIDS Control Organization (NACO), reiterated the national goal of ensuring timely access to safe blood in every district, with zero transfusion-transmitted infections (TTI).

He emphasized "the milestone of establishing at least one blood center in every district by December 2026, in line with the National Blood Policy".

The review also noted encouraging practices in several states and Union Territories, including

• high levels of voluntary blood donation,
• strong testing proficiency under External Quality Assessment Schemes (EQAS)
• Effective referral and linkage mechanisms for TTI- reactive donors.

Priority Actions

The Ministry outlined a set of priority actions, which include:

• strengthening district-level ownership and administrative convergence; ensuring 100 per cent licensing compliance of all operational blood centers;
• enforcing standard operating procedures for blood collection and donation camps;
• scaling up voluntary blood donation through structured outreach and awareness campaigns
• adopting advanced testing protocols such as ELISA and CLIA-based screening
• strengthening referral and linkage systems
• 100 per cent digital integration of blood services through eRaktKosh and BBMS,
• The use of biometric donor identification under the Ayushman Bharat Digital Mission aims to improve traceability and efficiency.

Advancing Blood Safety In India

According to data from the World Health Organization, India’s annual blood collection increased from 12.6 million units in 2023 to 14.6 million units in 2024. Voluntary blood donation accounted for 74.55 per cent of total collections, reflecting strong public participation and the impact of effective awareness campaigns.

In 2025, Union Minister of State for Health and Family Welfare Anupriya Patel told the Parliament that the country has made significant strides in strengthening blood transfusion services and has ensured its safety and availability.

Patel said that the country has established a multi-tiered system to ensure safe and efficient blood transfusion services. These include measures such as mandatory testing for five TTIs, expansion of Nucleic Acid Testing (NAT), proposed capital blood centers, National External Quality Assessment (EQA) program expansion, and transition to a community-based approach.

While the government has placed a complete ban on professional blood donation, every unit of collected blood undergoes mandatory testing for five transfusion-transmissible infections (TTIs) — HIV/AIDS, Hepatitis B, Hepatitis C, Syphilis, and Malaria, Patel said.

Even as the Indian Meteorological Department (IMD) issued a yellow alert for heatwave and rising temperature in Delhi, the state government issued guidelines for all schools, focusing on hydration and safety measures.

The IMD has forecast heatwave conditions at isolated places in Delhi from today, with maximum temperatures expected to climb between 41 °C and 44 °C through April 24.

The guidelines issued by the Directorate of Education (National Capital Territory of Delhi) are applied to all government-aided and private unaided recognized schools. The guidelines call for:

Outdoor Assemblies: Outdoor assemblies are to be curtailed or conducted in shaded/indoor areas with minimal duration. No open-air classes are to be conducted.

Water Bell Initiative: Schools shall implement a "Water Bell" system, whereby a bell is rung at regular intervals (every 45-60 minutes), reminding students to drink water to prevent dehydration.

Display of IEC Material: IEC (Information, Education and Communication) material issued by the Health Department, Government of NCT of Delhi, on heat wave precautions shall be prominently displayed at visible locations in schools, including notice boards, corridors, and classrooms.

Awareness Sessions: Schools shall conduct short awareness sessions/briefings for students during class hours/assembly to educate them about preventive measures, the importance of hydration, and the identification of symptoms of heat-related illnesses. Immediate first aid and medical attention must be ensured wherever required.

Buddy System: Establishing a buddy system wherein each student may be paired up with another student during school hours to monitor and take care of each other's physical well-being.

Outdoor Activities: It must be ensured that students avoid outdoor physical activities.

Regular Advisory Updates: Class teachers shall share advisories of the India Meteorological Department (IMD) with parents through their respective class-specific WhatsApp groups, ensuring regular guidance and awareness regarding heat safety measures. Schools shall share daily heat wave forecasts and alerts with students through prayer time/assembly and notice boards to ensure timely awareness and necessary precautions.

Appropriate Clothing and Personal Hygiene: Parents are advised to ensure that their wards come to school dressed in light, breathable cotton clothing. They should also reinforce the importance of personal hygiene, including daily bathing, to help children stay fresh and reduce the impact of heat.

The DoE also directed each school to designate nodal officers who will be responsible for the implementation of monitoring the water bell initiative, awareness sessions, and display of IEC materials.

Heat-Related Illnesses: Symptoms And First Aid Measures

The DoE noted that the symptoms of heat-related illnesses include:

• Nausea and increased sweating
• Vomiting
• Acts or talks confused
• Muscle cramps
• Fainting,
• Weakness,
• Dizziness
• Body temperature rises to 40.5°C (105°F) or higher

First aid measures to follow if you feel dizzy or uneasy

• Drink water to rehydrate
• Move to a cooler place immediately
• Loosen clothes if possible
• Sponge with water
• If unconscious, do not force-feed or give water
• If symptoms persist, immediately visit the nearest health centre or call an ambulance.

Heatwave In India: Which States Are On Alert?

Beyond Delhi, a heatwave alert has been issued for:

• East Uttar Pradesh from April 21 to 25.
• Madhya Pradesh, Chhattisgarh, and West Uttar Pradesh from April 22 to 25,
• Odisha and Rajasthan between April 23 and 25.
• Gangetic West Bengal and Bihar for April 21 and 22,
• Vidarbha from April 24 to 26.