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.

Policymakers attending the 31st Conference of the Parties (COP31) in Türkiye must put health at the centre of every climate negotiation, Professor Marina Romanello, Executive Director of the Lancet Countdown, told HealthandMe in an exclusive interview.

Marina, who led the 2026 Lancet Countdown on Health and Climate Change report released ahead of COP31, outlined the growing health consequences of global warming and the urgent need for stronger climate action.

Drawing on findings from the report, Marina warned that climate inaction is putting lives, livelihoods and public health at risk.

The report noted that climate commitments made since the Paris Agreement have delivered measurable health benefits, but progress remains too slow and uneven.

“One of the things that we are calling for negotiators to realise is that when they go to COP, they're not just negotiating budgets or carbon emissions or degrees of heating. What they're negotiating is people's health,” Marina told HealthandMe.

“They're negotiating how many people die from climate change. They're negotiating how many of our children will grow in these dangerous environments and have less of a chance in life.”

She stressed the need to recognise that climate change is not just an environmental issue.

“It's important to be very clear that climate change is not just a problem of the inanimate world or even of nature and polar bears. It's a problem of people here and today, and that our failure to act is costing people's lives, livelihood and health.”

Health Must Be Included Across All COP Negotiations

Also read: Climate Change Is Already Harming Health: WHO Chief Pushes Antalya Initiative At COP31

Marina, who is also a researcher at University College London's Institute for Global Health, urged policymakers to integrate health into all COP31 discussions rather than confining it to side events.

“We're also calling for countries not just to have climate change as one of the action agenda items and side events, but to actually consider climate change throughout their whole negotiations. Every negotiation stream needs to have health considerations so that we are aware of the hazards and the dangers that we're dealing with here.”

Countries Must Go Beyond COP Commitments

Read More: COP31 Begins On Health Day: How Will Countries Measure The Health Impact Of Climate Change?

Marina described COP as “a baseline” and “a starting point”, stressing that countries could go much further than the commitments agreed at the conference.

She cited India as an example of a country that stands to gain significantly from accelerating its climate transition, pointing to its natural resources, technological capabilities and opportunities to improve public health.

“In a country like India, where you have so many natural resources, where you have such impressive technology development, where you have so many opportunities from healthier air, improving access to energy, improving the transition towards more resilient, sustainable food systems, you are standing to win so massively from an accelerated transition at a country level.”

Marina also pointed out that countries rarely account for the health implications of their mitigation and adaptation plans. These include both potential negative impacts and the significant health benefits that stronger climate action could deliver.

Taking these benefits into account, she told HealthandMe, that it could increase the overall return on investment and make climate action more cost-effective.

Three Policy Interventions Governments Must Prioritise

READ: Climate Crisis Is A Health Crisis: Just 6 Actions Could Save 1.6 Million Lives, Says WHO

Marina outlined three key areas for government action at COP31:

1. Phase Out Fossil Fuels

Governments must prioritise phasing out fossil fuel use, particularly in urban centres where people live, she said.

“That will reduce the burden of air pollution and will mean that people have much less burden of chronic conditions and much less exacerbation of those conditions that they already have.”

2. Strengthen Healthcare Systems

Marina called for health systems to be equipped to respond to climate hazards and for healthcare professionals to receive training on climate change and health.

“They should know how to recommend better care and better preventative measures to their patients.”

3. Accelerate Emissions Reductions

Marina stressed that reducing greenhouse gas emissions must remain a priority for every country.

“We absolutely need to stop our emissions, our greenhouse gas emissions. Every country needs to pursue efforts to reduce their greenhouse gas emissions. It's a global health imperative.”

She added: “Reducing our greenhouse gas emissions in line with the Paris Agreement, redoubling efforts to mitigate climate change is a health imperative.”

Ozempic and Wegovy, whose active ingredient is semaglutide, have transformed the treatment of type 2 diabetes and obesity. These medications have also been linked to improved fertility in some cases. However, GLP-1 medications are not recommended during pregnancy.

Now, a study in pregnant sheep has found that semaglutide significantly reduced blood flow to the uterus and oxygen levels in developing fetuses.

Led by researchers at Adelaide University, the animal study raises questions about the potential effects of these medications on fetal development.

While the findings are preliminary and have not been established in humans, they highlight the need to understand the risks of exposure during pregnancy, particularly among women who may conceive unexpectedly or continue treatment before realising they are pregnant.

Semaglutide Reduced Blood Flow Within Two Hours

Also read: Woman Says GLP-1 Drug Helped Her Conceive

Adelaide University researcher Dr Mitchell Lock noted that although weight-loss medications have become incredibly popular, there's still a lot we don't know about how they might affect a developing baby.

With the new study, they aimed to better understand the potential effects of GLP-1 drugs during pregnancy so women and health care professionals can make informed and safe decisions about their use.

In the study, the researchers used magnetic resonance imaging (MRI) to assess maternal heart function and uterine blood flow before and after administering semaglutide to pregnant sheep. They also collected fetal blood samples and monitored blood pressure and heart rate to evaluate the drug's immediate effects.

The findings, published as a conference abstract in the journal Heart, Lung and Circulation, showed that semaglutide affected the mother's cardiovascular system and the supply of blood and oxygen to the developing fetus.

"Within two hours of administering semaglutide, we found that the amount of blood pumped by the mother's heart had significantly decreased, reducing blood flow to the uterus and lowering oxygen levels in the developing fetus," Lock said.

"Oxygen is essential for healthy fetal growth and development, so any reduction in its supply raises questions about what might happen if exposure to the drug continues throughout pregnancy."

Long-Term Effects On Fetal Development Remain Unclear

Read More: GLP-1 Drugs Ozempic, Zepbound Use Rises 24-Fold Among American Women After Childbirth

Senior researcher Janna Morrison said the findings highlight the need for further research into the potential effects of prolonged semaglutide exposure during pregnancy.

"Our findings suggest a potential risk to fetal development, but we haven't yet established whether these short-term changes affect fetal growth, what happens over a longer period of semaglutide use or whether similar effects could occur in human pregnancies," Morrison said.

Can GLP-1 Drugs Be Used During Pregnancy?

READ: GLP-1 Weight-Loss Drugs May Improve Fertility In Men With Obesity, Study Suggests

GLP-1 medications are not recommended for weight loss during pregnancy. Women planning to conceive should consult their healthcare professionals about discontinuing treatment.

For semaglutide, prescribing guidance recommends stopping the medication at least two months before a planned pregnancy.

Women who become pregnant while taking the medication should seek medical advice. Those who are breastfeeding should also discuss its use with their healthcare professional.

The American College of Obstetricians and Gynecologists advises against weight-loss medications during pregnancy. Women considering GLP-1 treatment should discuss its risks, benefits and timing with their healthcare professionals, particularly if they are planning to conceive.

Flu cases are rising earlier than usual in the US, with influenza A H1N1 driving most infections. A new mutation, G155E, may be contributing to the surge.

The 2026-2027 flu season began earlier than usual, with infections increasing as early as August. As of November 5, flu activity was growing or likely growing in 42 states, according to the US Centers for Disease Control and Prevention (CDC).

At least 1.7 million illnesses, 25,000 hospitalisations and 1,400 deaths have been reported so far this season.

“Early-season influenza activity is currently higher than typically observed at this time of year,” the CDC said in its FluView report for the week ending October 31.

Is The G155E H1N1 Mutation Driving The Surge?

Also read: G155E H1N1 Mutation In US Raises Concerns: Can This Year’s Flu Shot Still Protect You?

H1N1 is currently responsible for the vast majority of flu cases, marking a shift from last winter, when influenza A H3N2 subclade K, also known as the “superflu”, dominated.

The circulating H1N1 strain has acquired a new mutation called G155E. Early laboratory findings suggest it may make some strains harder for existing antibodies to recognise, potentially helping the virus evade immunity from previous infections or vaccination.

“It is different from last year’s H1N1 virus, and that mutation position (G155E) we know is important for generating protective antibody responses,” Andrew Pekosz, PhD, a virologist at the Johns Hopkins Bloomberg School of Public Health, told TODAY.com.

However, it is not yet clear whether the mutation is contributing to the early surge or making infections more severe.

“How that (mutation) is going to affect the disease spread and severity is not clear,” Pekosz said.

Will The Flu Vaccine Protect Against G155E?

READ: Flu Activity Rises Early In US, UK And Japan: Why Experts Urge Vaccination Before Winter

The impact of G155E on vaccine effectiveness remains uncertain. The CDC said it was too early to determine whether the mutation would affect protection this season.

The 2026-2027 flu vaccines target three viruses: influenza A H1N1 (pdm09), influenza A H3N2 and influenza B.

Even if the circulating H1N1 strain differs from the vaccine strain, vaccination can still protect against severe illness and other circulating flu viruses.

“Even if there’s a mismatched strain, there’s two other strains that the vaccine will provide better protection against,” Pekosz said.

The American Medical Association recommends annual flu vaccination for everyone aged six months and older, unless medically contraindicated.

What Are The Symptoms Of H1N1 Flu?

Read More: Flu 2026: Symptoms To Watch For As New Season Begins

Common symptoms include:

• Fever and chills
• Fatigue
• Body aches
• Runny nose
• Cough

Flu symptoms can overlap with those of COVID-19, making testing important.

Antiviral medications can help reduce the severity and duration of influenza, particularly among people at higher risk of complications, including adults over 65, children under five, and immunocompromised individuals.

“You have to get that prescription fast ... within the first 48 hours after symptom onset, (or else) they don’t work as well,” Pekosz said.

When Should You Get Vaccinated?

Experts say the emergence of G155E is not a reason to panic but reinforces the importance of flu vaccination.

“View (this) as a sign to go out and get the flu vaccine,” Pekosz said.

It takes approximately two weeks for vaccine-induced protection to develop. Annual vaccination remains an important way to reduce the risk of severe flu, complications and hospitalisation. Regular hand hygiene can also help limit the spread of infection.

Flu and COVID-19 vaccines target different viruses. A flu shot does not protect against COVID-19, so eligible people may need separate vaccinations to reduce their risk of severe illness from both infections.

“Flu vaccination doesn't protect just yourself against the risk of having influenza but it also prevents transmission of infection to other vulnerable people around ourselves like little ones, elderly family members and people with medical conditions,” Dr. Bhawna Malik, Senior Consultant-Neonatologist and Pediatric Intensivist at Motherhood Hospitals, Greater Noida, told HealthandMe.