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.

NBA star Kevin Love has once again opened up about mental health, saying the late actor Robin Williams transformed the way he understands depression by showing that the condition often stays hidden until its too late.

Speaking during a recent conversation about mental health, Love reflected on Williams' life and legacy, saying his death challenged the common belief that depression is often evident on people's faces.

"You would have thought that's not a face of depression," Love said, explaining that Williams helped him realise that people can appear joyful, successful, and full of life while silently battling emotional distress.

Love, one of the most prominent athletes advocating for mental health awareness, said the experience reinforced an important lesson: depression cannot be judged by outward appearances.

Depression Doesn't Always Look Like Depression

Mental health experts have long warned that depression is an invisible illness. While some people experience persistent sadness, others continue working, socialising, and smiling despite struggling internally.

This is one reason the condition often goes unnoticed by family, friends, and even healthcare providers.

Love's remarks reflect his own journey. After experiencing a panic attack during an NBA game in 2017, he began speaking publicly about anxiety and depression, encouraging others to seek help instead of suffering in silence.

In a previous essay, he wrote, "You would be amazed at how freeing it is just to talk to somebody, and tell them the truth about what you're going through," adding that "it does get better."

Also read: Laughing Gas Can Relieve Long Term Depression—New Study Finds

Recognising The Symptoms

According to mental health experts, depression is more than feeling sad for a few days. It comes with a bunch of symptoms that often get neglected. Common symptoms include:

• Changes in mood: Persistent feelings of sadness, irritability, or apathy can be indicative of depression or anxiety.
• Loss of interest: Decreased enjoyment in activities that were once pleasurable is a common sign of mental health struggles.
• Difficulty concentrating: Problems with focus, memory, or decision-making can significantly impact daily life.
• Changes in sleep patterns: Insomnia, excessive sleep, or disrupted sleep may be related to underlying emotional distress.
• Withdrawal from social activities: Isolating oneself from friends and family can be a sign of deteriorating mental health.

It's important to note that these are general indicators, and individual experiences may vary. If you or someone you know is experiencing persistent symptoms, seeking professional help is crucial.

Symptoms vary from person to person, and many individuals may not openly express what they are experiencing.

Love said Robin Williams changed his perspective because his story challenged stereotypes surrounding depression. His message serves as a reminder that mental health conditions do not discriminate based on fame, success, or personality.

By continuing to share his own experiences, Love hopes more people will feel comfortable asking for help and checking in with those around them.

His words also reinforce an important public health message: emotional struggles are not always visible, making compassion, open conversations, and early support essential for recognising depression before it becomes a crisis.

The Cyclospora outbreak that has spread across the US for more than three months has turned deadly, with Michigan—the hardest-hit state—reporting the country's first two deaths linked to the diarrhea-causing parasite.

According to the Michigan Department of Health and Human Services (MDHHS), both individuals had significant underlying health conditions.

"Two deaths have been identified as part of the cyclosporiasis outbreak affecting Michigan. According to medical records, both individuals had significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration," the department said.

Health officials stressed that deaths from cyclosporiasis are rare, as the infection is generally not life-threatening. Michigan has reported 11,234 cases, including 193 hospitalizations.

The US Centers for Disease Control and Prevention (CDC) also confirmed the two outbreak-related deaths in Michigan. As of its July 28 update, the agency has recorded 6,707 laboratory-confirmed cases across 45 states since May 1, along with more than 11,500 suspected cases—primarily in Michigan and Ohio—that are yet to be laboratory confirmed. The outbreak has resulted in 423 hospitalizations.

FDA Links Outbreak to Recalled Iceberg Lettuce

The US Food and Drug Administration (FDA) has linked part of the outbreak to iceberg lettuce supplied by Taylor Farms de Mexico. The company voluntarily recalled affected products on July 17 and said it will no longer source iceberg lettuce from central Mexico for the rest of the growing season.

The recalled lettuce has been linked to illnesses in Indiana, Kentucky, Michigan, Ohio, and West Virginia. Separately, the CDC, FDA, and state health officials are investigating another Cyclospora outbreak linked to iceberg lettuce in nine states, which has sickened at least 1,947 people and hospitalized 98.

Officials are also investigating whether parsley and cilantro may be linked to the outbreak.

What Is Cyclospora?

Cyclospora is a parasite that infects the intestines and is usually spread through contaminated food or water.

Symptoms include:

• Frequent watery diarrhea
• Abdominal cramps
• Bloating
• Nausea
• Excessive gas
• Low-grade fever
• Loss of appetite
• Weight loss

What Should You Do If You Think You Have Cyclosporiasis?

Most infections are mild and resolve without treatment. However, the illness can be prolonged or severe in people with weakened immune systems, who may require antibiotic treatment.

If you develop symptoms:

• See a healthcare provider and request a stool test to confirm a Cyclospora infection.
• Drink plenty of fluids to prevent dehydration caused by diarrhea.
• Because diarrhea can have many causes, getting the right diagnosis is important, as cyclosporiasis is treatable with a specific antibiotic.
• Seek immediate medical attention if you have severe diarrhea, feel dizzy when standing, or have a rapid heartbeat, as these may be signs of serious dehydration.

How Is It Diagnosed and Treated?

Doctors diagnose cyclosporiasis with a stool test that detects the Cyclospora parasite shed in stool.

Although some mild infections may resolve on their own, confirmed cases should be treated with antibiotics. The recommended treatment is the antibiotic trimethoprim/sulfamethoxazole (TMP-SMX).

Your doctor may also recommend:

• Medicines to relieve diarrhea, if appropriate.
• Oral or intravenous fluids to prevent or treat dehydration.

How To Reduce Your Risk

• Check whether recently purchased iceberg lettuce was sourced from Taylor Farms de Mexico, Guanajuato.

• The recall includes:

1. 12-ounce and 24-ounce Iceberg Salad with best-by dates July 18–August 3
2. 8-ounce and 16-ounce Shredded Lettuce with best-by dates July 18–August 3

• Discard or return any recalled products. An additional 33 recalled products were supplied to restaurants and are unlikely to be in home refrigerators.
• No other lettuce varieties, including romaine and butter lettuce, have been linked to the outbreak.
• Avoid eating recalled shredded iceberg lettuce.
• Wash all fresh fruits and vegetables thoroughly under running water, even if labeled pre-washed.
• Choose whole heads of lettuce over bagged greens when possible. Remove the outer leaves and wash the inner leaves thoroughly.
• Cook produce whenever possible, as heat is the most effective way to kill Cyclospora.
• Follow safe food-handling practices and stay updated on food recalls.

An 86-year-old sheep farmer from Wales recently shared how he unknowingly lived with a rare parasitic disease for years before experiencing what he described as "the worst pain" of his life.

The rare case has highlighted a little-known infection that experts say can remain hidden inside the body for decades.

Meredydd Jones, from Trecastle in Powys, was diagnosed with hydatid disease, a parasitic infection caused by the tapeworm Echinococcus granulosus.

He said that slow-growing cysts had been developing in his lungs for years before he was rushed to the hospital after he complained of severe pain in 2016.

"I hadn't been able to control the pain, and it was more intense than anything I had before," Jones recalled. He later underwent two surgeries in 2018 and 2019 to remove cysts from both lungs, while another cyst in his liver continues to be monitored.

The case comes as Public Health Wales raise concerns that the disease, though uncommon, remains a significant public health issue in sheep-farming regions.

What Is Hydatid Disease?

Hydatid disease, also known as cystic echinococcosis, is caused by the larval stage of the Echinococcus tapeworm.

The parasite typically circulates between dogs and livestock such as sheep and cattle. Humans become accidental hosts after ingesting microscopic tapeworm eggs, usually through contact with infected dogs or contaminated food, water, or soil.

Unlike many infections, hydatid disease develops very slowly and gradually. The parasite forms fluid-filled cysts that most commonly affect the liver and lungs, although they can also develop in the brain, bones, or other organs.

Also read: Milestone In Kala-Azar Treatment: WHO Updates Treatment Guidelines, Recommends Shorter & Safer Regimens

Why Symptoms Take Years To Appear?

According to Dr Chris Williams, consultant epidemiologist at Public Health Wales, the disease can remain hidden for an unusually long time.

"What happens is normally the tapeworm transmits between farm animals like sheep and cows to dogs, and the dogs excrete eggs," he explained. "Unfortunately, if humans ingest the eggs, they can then form cysts within humans."

He added that symptoms may not appear for 10 to 20 years, which is why infections are often discovered only after cysts become large enough to cause complications. Depending on where the cysts develop, people may experience:

• Persistent abdominal pain or swelling
• Chest pain, chronic cough or shortness of breath
• Unexplained lumps
• Fever if cysts become infected
• Severe allergic reactions if a cyst ruptures

Public Health Wales says hydatid disease is uncommon but can have serious health consequences if left untreated.

Researchers at Aberystwyth University are now studying dogs, livestock and farming practices to better understand whether the parasite is emerging again in parts of Wales.

The project includes analysing dog faecal samples and tracking farm dogs to understand how the parasite may spread between farms. Experts say prevention remains the most effective strategy.

Regular deworming of dogs, proper disposal of livestock carcasses, avoiding feeding dogs raw offal, and practising good hand hygiene after handling animals can significantly reduce the risk of infection.