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.

A few extra minutes during an upper gastrointestinal endoscopy may help doctors detect more gastric cancers and precancerous alternations, according to research recently discussed at the World Congress of Gastroenterology (WCOG) 2026 in New Delhi.

At WCOG, it was discussed that the quality and duration of an endoscopic examination can influence the chances of finding early cancer. An inspection time of an additional at least seven minutes was linked with about 3.4 times higher detection of gastric cancer and dysplasia.

The finding comes as gastrointestinal cancers continue to increase, contributing to a growing global health burden. GI cancers currently account for around one in four cancer cases and one in three cancer deaths worldwide. The overall burden of the disease is projected to nearly double by 2050.

Dr. Pramod Garg, Professor & Head, Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi; President, Indian Society of Gastroenterology and Co-Chair, Steering Committee, WCOG 2026, said, “Earlier detection depends on both identifying people at risk and ensuring that diagnostic procedures are performed to the highest possible standard. High-quality endoscopy can create an important opportunity to identify disease at a stage when intervention can make a greater difference.”

Could Endoscopy Time Affect Cancer Detection?

Also read: WCOG 2026: How Infections, Metabolic Disease Are Changing Digestive Health

An upper gastrointestinal endoscopy allows doctors to examine the lining of the oesophagus, stomach, and upper part of the small intestine using a flexible camera device.

Simply inserting the scope and looking quickly may not be enough to identify subtle abnormalities. A more systematic examination allows the endoscopist more time to examine the stomach lining, identify suspicious areas, improve mucosal visualisation and document findings accordingly.

The WCOG discussion therefore puts focus on not just whether endoscopy is performed, but also on how long and how well it is performed.

The reported 3.4 times association highlights the value of a careful, detailed examination that could help detect changes related to cancer early, prompting timely treatment.

Also read: Fatty Liver, Chronic Gut Diseases And Worm Infections: India’s Changing Disease Burden

India's GI Cancer Burden

The changes in India's gastrointestinal cancer burden were also discussed, including growing concern around early-onset colorectal cancer. Researchers are examining whether genetics, environmental exposures and changes in the gut microbiome could be contributing to colorectal cancer appearing at younger ages.

WCOG 2026 also included concerns related gallbladder cancer, liver cancer and the rising role of metabolic risk factors. Discussions also focused on the use of AI in gastrointestinal diagnosis and the importance of validating these tools before introducing them in standard practice.

Dr. Govind Makharia, Professor, Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi and Chairman, Local Organising Committee, WCOG 2026, said, “AI has the potential to strengthen diagnosis and decision-making across gastroenterology, while advanced endoscopy is expanding what can be treated through minimally invasive approaches. The next step is ensuring that these technologies are supported by robust evidence and integrated responsibly into clinical practice.”

H. pylori was also addressed as a preventable risk factor for gastric cancer.

Dr Barry Marshall, Nobel Laureate in Physiology or Medicine, said, “H. pylori is much more than an ulcer organism. If the infection persists for many years, it can cause chronic inflammation in the stomach and increase the risk of gastric cancer. That gives us an opportunity because this is a potentially preventable cause of cancer.”

Advances in minimally invasive procedures like POEM, endoscopic submucosal dissection and therapeutic EUS were also discussed, although access to advanced GI care remains uneven.

The President of the United States, Donald Trump, has revealed that he takes aspirin every day, sharing that he has been doing so for decades because he believes it helps keep his blood “thin”.

He said it while discussing his aspirin use and the bruising that was recently seen on his knuckles. He also said that doctors have advised he take a lower dose.

“I take an aspirin a day. I don’t know if it works but psychologically I need it. It thins the hell out of your blood I guess. I don’t know if it works or not but I’ve been doing it for a long time. And here I am making speeches. I like Bayer aspirin. And I take the big one. They want me to go down to the 80. I take the 386. I don’t know what the hell it is. It’s a monster. They said, ‘Sir, you don’t need that!’ I said, do me a favor, I’ve been doing okay for 35 years. Leave me alone.”

So, does taking an aspirin every day actually protect the heart? And if yes, does a higher dose necessarily provide better results?

Aspirin Reduces Blood Clot Formation

Aspirin affects platelets, which are tiny components of blood that help form clots. By making platelets less likely to clump together, aspirin can reduce the formation of blood clots that could block an artery supplying the heart or brain.

This is why doctors may prescribe daily aspirin to people who have already had a heart attack, stroke, or procedures like coronary stent placement.

But aspirin does not make the blood “thin” in a literal sense. It changes the way blood platelets clot. The US Food and Drug Administration (FDA) says daily aspirin can help people with cardiovascular disease or those who have already had a heart attack or stroke, but daily use is not suitable for everyone.

Aspirin can reduce the risk of certain blood clot formations, but it can also increase the risk of unwanted bleeding. The FDA warns that aspirin can lead to serious side effects like bleeding in the stomach and brain.

It recommends that people do not take daily aspirin without discussing it first with their healthcare professionals.

Mayo Clinic also says that daily aspirin is not right for everyone. Regular use can increase the risk of gastrointestinal bleeding and stomach ulcers, while in some people it can also increase the risk of a bleeding stroke.

Also read: Trump Administration Asks SC To Restrict Gender-Affirming Care In Prisons: What Happens If Treatment Stops

Who Should And Shouldn't Take It?

For people who have never had a heart attack or stroke or any other type of cardiovascular disease, taking aspirin routinely to prevent a cardiovascular event is generally not recommended.

The American Heart Association says routine daily aspirin is not recommended for most healthy adults without cardiovascular disease because its benefit can be offset by the risk of serious bleeding.

The FDA also says that for people without cardiovascular disease risk, the risks of long-term aspirin use may be greater than the benefits.

For someone who has already had a heart attack, stroke or any other cardiovascular event, doctors may prescribe daily aspirin because preventing another clot-related event can outweigh the bleeding risk.

According to Mayo Clinic, this is a secondary method of prevention. It says that the benefit of daily aspirin in this group is well established. This does not mean that patients should start, stop or change their aspirin dose on their own.

Also read: White House Chief Of Staff Susie Wiles Reveals Brutal Toll Of Fighting Cancer

Is A Bigger Aspirin Dose Better For Heart?

A higher dose does not automatically provide better protection against heart attacks. Low-dose aspirin prescribed for cardiovascular health is usually around 75 to 100 mg, with 81 mg frequently used.

Mayo Clinic says that the appropriate dose depends on the individual and should be discussed with a healthcare professional.

Taking higher doses of aspirin can increase the risk of bleeding. People with a history of stomach ulcers or gastrointestinal bleeding, bleeding disorders or aspirin allergy may also face greater risks.

The risk of bleeding also increases with age. The American Heart Association says routine aspirin for primary prevention is generally not recommended for healthy adults over 70.

According to the World Health Organisation, the global life expectancy has recovered to almost pre-pandemic levels, a significant public achievement, but the world is facing a growing burden from chronic diseases,

WHO's latest health estimates, which released recently, offer a glimpse into the pattern of life expectancy and disease burden between 2000 and 2023. It also says that while damages due to COVID-19 have been reversed, the world is grappling with a growing burden of noncommunicable diseases (NCDs).

Global Life Expectancy Is Almost Back To 2019 Levels

Global life expectancy reached 73.3 years in 2023, compared to 73.4 years in 2019, just before the COVID-19 pandemic hit. However, the pace at which healthy life expectancy has recovered has been slow and steady. It stood at 62.8 years in 2023, which was still 0.4 years below the 2019 level.

This means people are living almost as long as they were before the pandemic, but the number of years they can expect to live in good health has not fully recovered.

Dr Alain Labrique, Director of WHO’s Department of Data, Digital Health, Analytics and AI said, "Living longer is one of the great achievements of public health. The next challenge is to ensure that those additional years are lived in good health, while health systems are equipped to respond to the changing needs of populations."

Also read: 100% Blockage At 18, 25% Patients Under 40: On World Heart Day, Cardiologists Reveal An Alarming Heart Attack Pattern

NCDs Account For 74% Of Global Deaths

The WHO data also depicted a growing share of deaths caused by NCDs. In 2023, NCDs accounted for 74% of all deaths globally, compared to 58% in 2000.

In fact, eight of the world's 10 leading causes of death were NCDs in 2023. These include cardiovascular diseases, cancer, diabetes and chronic respiratory diseases.

The change is not limited to wealthier countries. The shift in NCD-related deaths was visible across all income levels.

In 2023, for the first time, communicable diseases accounted for less than half of all deaths in low-income countries, showing how disease patterns are changing even in populations that have traditionally carried a higher burden of infectious diseases.

Also read: Japan Has 107,677 Centenarians; 88% Are Women: Challenges Of An Aging Population

Heart Disease Remains The World's Biggest Killer

Cardiovascular disease continues to be the leading cause of death worldwide. Ischaemic heart disease alone caused about 9.5 million deaths in 2023, along with an estimated 210 million disability-adjusted life years, a measure that combines years lost because of premature death and years lived with disability.

While there has been progress in reducing the burden of ischaemic heart disease in many parts of the world since 2000, the WHO noted increases in individual-level cardiovascular risk in the South-East Asia and Western Pacific regions.

This highlights continuing differences in cardiovascular health between populations.

Also read: Blue Zones Diets: What the World’s Longest-Livers Eat

Diabetes And Dementia Also Among Major Contributors

The WHO estimates point to growing concerns around other chronic conditions like diabetes and dementia. The risk of dying from diabetes has increased substantially since 2000, especially in South-East Asia.

Dementia has also landed among major causes of death globally. Alzheimer disease and other dementias became the fifth leading cause of death worldwide in 2023, compared to 19th in 2000. Global deaths from dementia tripled between 2000 and 2023, according to the WHO.

Mental Health Adds To The Burden

Between 2019 and 2023, the global age-standardised DALY (disability-adjusted life year) rate increased by approximately 20% for depressive disorders and nearly 45% for anxiety disorders. Together, these conditions were responsible for an estimated 110 million years of healthy life lost through premature death and disability in 2023.

Drug use disorders have also been observed across different trends across regions. Between 2000 and 2023, the WHO Region of the Americas recorded the largest increases in the risk of death linked to these disorders, while the Western Pacific region saw declines.

In a nutshell, the world has largely recovered the ground lost in overall life expectancy during the pandemic. But simply living longer does not necessarily mean we are living healthier. As populations age and infectious diseases account for a smaller share of deaths in many regions, health systems are increasingly required to manage conditions that often need long-term prevention, diagnosis, treatment and care.

“The value of these estimates is not only in the numbers themselves,” said Dr Labrique. “By showing how causes of death and disease burden are changing over time and across populations, they give countries evidence to help shape health policies and priorities.”

“These capabilities are critical to better enable targeted, effective interventions and ultimately further improving health and well-being for all.”