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.

Even after recovery, the deadly Ebola virus (EBOV) can persist for a longer duration — more than three months — in breastmilk, according to a case report.

Ebola virus disease (EVD) is a severe viral illness that has a 25 percent – 90 percent fatality rate.

Ebola in pregnancy raises significant complications ranging from spontaneous abortion to maternal and neonatal death.

In a case report published in the New England Journal of Medicine, a team of researchers from the Republic of Congo and Senegal shared the case history of a 23-year-old woman in whom Ebola was still detectable in breast milk at 14 weeks.

The case reported the rare occurrence of a pregnant woman who survived EVD with no complications, neither to the mother nor the baby. However, the deadly virus was still present in the mothers' breast milk, which cited the potential risk of post-illness transmission to infants.

What Is Ebola Virus Disease?

As per the World Health Organization (WHO), EVD is a rare but severe illness in humans and is often fatal.

People can get infected with the virus if they touch an infected animal when preparing food, or touch body fluids of an infected person such as saliva, urine, feces or semen, or things that have body fluids of an infected person like clothes or sheets.

Ebola enters the body through cuts in the skin or when one is touching their eyes, nose or mouth. Early symptoms include fever, fatigue and headache.

What Was The Case

The woman from the Democratic Republic of the Congo (DRC) contracted EBOV during pregnancy in 2019.

Soon after, she was administered monoclonal antibody therapy and was discharged after three negative reverse-transcriptase–polymerase-chain-reaction blood tests for EBOV.

The woman delivered a healthy baby at 42 weeks of gestation. No evidence of EBOV infection was found in maternal blood, amniotic fluid, vaginal secretions, or the newborn.

Ebola Detectable In Breast Milk At 14 Weeks

Yet surprisingly, the EBOV virus persisted in the placenta and breast milk.

Tests revealed that while the mother’s blood remained negative, viral RNA was still detectable in breast milk at 14 weeks after illness onset. To protect the newborn from transmission, clinicians used the drug bromocriptine to suppress lactation.

As per the World Health Organization (WHO) guidelines, the mother was also isolated from the baby and not breastfed. A prophylactic (preventive) monoclonal antibody was also given to the newborn. During follow-up, the infant exhibited no signs of infection.

Ebola Virus: WHO Guidelines

During the 2018–2020 EVD outbreak in the northeast of DRC, 3,481 confirmed cases were reported. Of these, nearly 60 percent occurred in females, and about 45 percent occurred in children below 18 years of age.

Current WHO guidance recommends that Ebola survivors avoid breastfeeding until viral clearance is confirmed.

The global health body advises women with suspected or confirmed Ebola to immediately stop breastfeeding and be prioritized for diagnostic testing.

Children exposed to Ebola through breast milk

• Must be placed under care,
• Closely monitored for symptoms over 21 days
• Fed with an appropriate breast milk substitute.
• Restarted on breastfeeding after two consecutive negative tests of breast milk.

Meningitis – the inflammation of the brain and spinal cord lining – has claimed 259,000 lives worldwide in 2023, according to a new study, published in The Lancet Neurology.

A total of 2.5 million people globally were infected with meningitis, which is also the leading infectious cause of neurological disabilities.

Importantly, children accounted for a third of the deaths, many of which were in Africa, according to research that described itself as the most comprehensive global assessment of meningitis yet.

The study comes amidst a “unprecedented” meningitis outbreak in the UK’s Kent, where two people died, and many were infected.

Meningitis: Achieving WHO 2030 goals

According to the study, global vaccination campaigns since 2000, played a significant role in reducing the number of infections and deaths by bacterial meningitis, in both high-income and low-income countries.

The Global Burden of Disease study led by an international team of researchers led by those from the University of Washington, showed that although mortality and incidence have declined significantly since 1990, progress is insufficient to meet the WHO 2030 targets.

The WHO targets a 50 percent reduction in meningitis infections and 70 percent reduction in deaths by 2030. However, a substantial meningitis burden persists. It also lags behind other vaccine-preventable diseases.

The driving factor are:

• common pathogens such as S pneumoniae and N meningitidis
• emerging non-bacterial pathogens such as Candida spp
• drug-resistant fungi.

Also read: Bacterial Meningitis May Cause Long-term Fatigue, Vision Problems, Raise Suicide Risk: Study

What Is Meningitis?

Meningitis is a serious medical condition that affects the protective membranes covering the brain and spinal cord, the meninges. While fever is not always present, it is usually considered as one of the classic symptoms of meningitis.

It is important to know the varied symptoms, causes, and treatments of meningitis for early diagnosis and proper management of the disease.

Meningitis is an infectious illness that brings about inflammation in the meninges. The most common cause of such inflammation is bacterial or viral infections, though other causes are also possible including fungal, parasitic, or non-infectious causes (autoimmune disease, head injury, or brain surgery).

Meningitis may also be caused by bacterial meningitis, which the Centers for Disease Control and Prevention (CDC) indicates can be so severe and bring about conditions like hearing loss, vision problems, and death if not received on time.

Also read: From Vaping to Worm Attack: 5 Unimaginable Ways to Contract Meningitis

Meningitis: Risk factors

As per the Lancet study, the greatest risk factors for deaths was

• low birthweight
• premature birth
• air pollution (both household and atmospheric).

Streptococcus pneumoniae, Neisseria meningitidis, non-polio enteroviruses, and other viruses were the leading causes of death, while non-polio enteroviruses caused the most cases.

To achieve further reductions in the disease globally, the researchers called for greater efforts, including:

• expanding vaccination programs,
• greater antibiotic stewardship,
• improving access to care,
• strengthening diagnostics and monitoring for meningitis.

Also read: Unique Symptoms Of Meningitis That Caused An Outbreak In Kent University

Common Symptoms Of Meningitis

• Rash
• Headaches
• Neck stiffness
• Fever
• Drowsiness
• Nausea or vomiting
• Increased sensitivity to light.

World Doctors’ Day is celebrated every year on March 30 to honor physicians for their dedication and compassion in saving lives and ensuring healthy communities.

Doctors are often regarded as God as they work tirelessly to save lives, even amidst conflicts or pandemics, without counting their own lives.

Often referred to as a noble profession, their mission transcends boundaries and also showcases profound human values rooted in compassion, dedication, and responsibility.

They play a significant role in building resilient, healthy societies and the world.

While there is no universally declared theme to mark the day, several campaigns are held focusing on the well-being and resilience of doctors, especially in the post-pandemic era.

World Doctors’ Day: History

World Doctors’ Day is the same as US National Doctors Day.

It was first observed in 1933 in Georgia and officially recognized in 1990 when George H. W. Bush signed it into law.

The first Doctors' Day was initiated by Eudora Brown Almond, wife of Dr. Charles B. Almond, and was adopted by the Barrow County Alliance.

The day was also observed to mark the anniversary of the first use of general anesthesia in surgery by Dr. Crawford W. Long in Jefferson, Georgia, in 1842.

The idea was then presented to the Georgia State Medical Alliance in 1933 by E. R. Harris of Winder, president of the Barrow County Alliance.

On May 10, 1934, the resolution was adopted at the annual state meeting in Augusta, Georgia.

Later, it was resolved by the Senate and House of Representatives of the US in Congress to designate March 30 as “National Doctors’ Day.”

The symbol for Doctors' Day is often the red carnation, chosen for its color that represents love, charity, and sacrifice — that highlights the profession.

The US reportedly has over 985,000 to 1 million practicing physicians.

World Doctors’ Day: Significance:

The day honors physicians' commitment, service, and contributions to healthcare, often highlighting their role in patient care. Their role is also in medical innovations that have given life to people across the globe.

It also highlights challenges faced by the physician community, like burnout, workforce shortages, and rising health demands.

Doctors are also overburdened with increasing patient load and staff shortages. Some also face workplace violence and safety concerns.

Notably, digital healthcare and evolving technologies have also added pressures and an additional burden to their practice.

Countries Celebrating World Doctors’ Day

World Doctors’ Day is celebrated on March 30 in the US, the UAE, and Australia.

India celebrates National Doctors’ Day on July 1, commemorating the birth and death anniversary of renowned physician Dr. Bidhan Chandra Roy.