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.

Paul Alexander woke up inside a 600-pound giant metal tube and never left until he died. Paul depended on an iron lung for every breath, a machine that had largely disappeared from modern medicine.

Known as "the man in the iron lung," Alexander spent more than seven decades living inside the metal cylinder after contracting polio as a child. Paul became a symbol of resilience, determination, and the life-saving power of vaccines. His remarkable story is recalled even after his death in March 2024 at the age of 78.

Who Was Paul Alexander?

The doctors placed him inside an iron lung, a mechanical ventilator that kept him alive by helping his lungs expand and contract.

Although everyone initially believed he might not survive, Alexander defied expectations. He went on to graduate from college, earn a law degree, become a practicing attorney, publish a memoir, and inspire millions through interviews and social media.

Also read: Who Was Martha Lillard? Last U.S. Polio Survivor To Depend On An Iron Lung Who Breathed Her Last At 78

Life Beyond The Iron Lung

Paul Alexander refused to let the machine define him. Doctors taught him a technique called "frog breathing" or glossopharyngeal breathing. By using the muscles of his mouth and throat, he learned to gulp air into his lungs in small amounts.

This helped him to leave the iron lung for short durations, attend school, pursue higher education, and eventually work as a lawyer. Still, he depended on the iron lung for most of his life, especially while sleeping.

Despite his conditions, Alexander earned a bachelor's degree, graduated from law school, practiced as a lawyer in Texas, and wrote his memoir - Three Minutes for a Dog: My Life in an Iron Lung.

His determination challenged and defied assumptions about disability and demonstrated that severe physical limitations need not prevent education, work, or meaningful relationships.

Also read: Even Light Exercise Could Help People With COPD Live Longer, Study Finds

Iron Lung Is An Obsolete Technology In Medicine

An iron lung, also called a negative-pressure ventilator, is a large cylindrical machine that helps people breathe when the muscles controlling respiration become paralyzed.

Unlike today's ventilators, which push air directly into the lungs through a tube or mask using positive pressure, an iron lung works by changing air pressure around the patient's body. The patient lies inside an airtight metal chamber with only the head remaining outside.

The machine then repeatedly lowers the air pressure inside the chamber. This causes the chest to expand naturally, drawing air into the lungs. The pressure then returns to normal. The chest relaxes, allowing air to flow back out. This cycle mimics normal breathing and can continue around the clock.

Iron lungs became obsolete eventually after polio vaccines and modern ventilators were developed.

The introduction of effective polio vaccines in the 1950s and 1960s dramatically reduced cases of paralytic polio worldwide.

The positive-pressure ventilators we use today are smaller, more portable, and better suited to intensive care. They deliver oxygen directly into the lungs, replacing bulky iron lungs.

Paul Alexander's life is more than a remarkable survival story. It serves as a reminder of the devastating impact infectious diseases once had before vaccines transformed public health.

Amid earthquake rescue efforts, Venezuela has reported an outbreak of rat-borne hantavirus that has claimed three lives so far, according to the country's health ministry.

Three people with confirmed hantavirus infection died in the eastern state of Anzoátegui. Two other deaths—both involving health professionals in the state of Barinas—are still under investigation and are not linked to the Anzoátegui cases, the ministry said.

"We report the regrettable deaths of three patients in Anzoátegui with confirmed diagnoses of hantavirus," the ministry said in a statement.

The ministry added that there is "no scientific evidence of person-to-person transmission in our country," noting that the virus is primarily spread by rodents in rural and agricultural areas.

The fresh cases are reported barely two weeks after the World Health Organization (WHO) declared the end of the hantavirus outbreak linked to the MV Hondius luxury expedition ship, which infected 11 people and claimed three lives earlier this year.

What Is Hantavirus?

According to the WHO, hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans. In humans, the infection can cause severe illness and may be fatal, although symptoms vary depending on the virus strain and geographic region.

The virus is primarily transmitted through contact with infected rodents or their urine, droppings, saliva, and, less commonly, through scratches or bites.

According to the CDC, symptoms can appear one to eight weeks after exposure, initially presenting fatigue, fever, and muscle aches. As the disease progresses, it can cause coughing, shortness of breath, and chest tightness as fluid accumulates in the lungs.

Also read: Can Hantavirus Spread Through Semen And Breast Milk? What Experts Say

What The Virus Does To The Brain

A recent review published in JAMA Neurology highlights the often-overlooked neurologic complications of hantavirus infection. Hantaviruses cause two major clinical syndromes:

• Hantavirus Pulmonary Syndrome (HPS), seen mainly in the Americas, primarily affects the lungs and cardiovascular system and has a mortality rate of 35% to 50%. Neurologic complications can include headache, delirium, seizures, and, in rare cases, brain hemorrhage or post-viral encephalitis.

• Hemorrhagic Fever with Renal Syndrome (HFRS), which is endemic to Asia and Eastern Russia, presents with fever and kidney involvement and is more commonly associated with direct neurologic complications.

Headaches, Vision Problems, and Hormonal Disorders

Read More: Immunotherapy Shows Early Promise Against Severe Hantavirus Lung Disease: Study

Researchers from the US National Institutes of Health's (NIH) National Institute of Neurological Disorders and Stroke reviewed data from 811 patients infected with the Puumala strain of HFRS.

They found that 97% experienced headaches, 40% reported blurred vision, and 31% experienced vomiting. About 1% developed severe complications such as meningitis or encephalitis, while rare cases involved peripheral neuropathy or stroke.

Pituitary damage was identified as a significant complication of HFRS. It can lead to hormonal disorders weeks or even months after infection. These may include fatigue, adrenal insufficiency, diabetes insipidus, sexual dysfunction, amenorrhea, and symptoms of hypothyroidism.

The studies also reported cerebrospinal fluid abnormalities, sudden vision loss among hantavirus patients.

Long-Term Effects and Treatment

The long-term neurologic consequences of hantavirus remain poorly understood, according to Avindra Nath of the NIH. However, one study found that 20 years after Puumala infection, 78% of patients had persistent hypertension and 8% had chronic kidney disease.

Currently, there are no US Food and Drug Administration (FDA)-approved antiviral treatments or licensed vaccines for hantavirus infection, although several vaccine candidates are in preclinical trials. Several antiviral drugs—including favipiravir, molnupiravir, griffithsin, and ribavirin—have shown promise in early studies, but more research is needed, Nath said.

Nearly all countries are overusing antibiotics—particularly those meant for specific conditions—fueling the global threat of antimicrobial resistance (AMR), according to a study published in The Lancet Public Health.

The study, led by researchers from the Universities of London and Oxford, found that 99% of countries overuse "Watch" antibiotics, while 60% continue to use antibiotics that the World Health Organization (WHO) advises should no longer be prescribed.

"Our findings show the world faces a double challenge – while some antibiotics are being overused, millions of people may still lack access to the medicines they need to treat their infections," said Aislinn Cook, lead author and Senior Research Fellow in Infectious Diseases Epidemiology at City St George's, University of London.

Understanding WHO's AWaRe Classification

Also read: Shigella Driving Antibiotic-Resistant Bacterial Diarrhea Among Gay Men in UK, Lancet Study Finds

The WHO groups antibiotics into three categories under its AWaRe framework:

• Access antibiotics: First-line medicines, such as amoxicillin, recommended for most common bacterial infections.
• Watch antibiotics: Broader-spectrum drugs that should be reserved for specific infections when Access antibiotics are ineffective.
• Reserve antibiotics: Last-resort treatments for severe drug-resistant infections.

In 2024, UN member states agreed that at least 70% of global antibiotic use should come from the Access group by 2030.

What the Study Found

Researchers estimated that around 43 billion antibiotic courses were needed globally in 2019—roughly one course per person per year to treat bacterial infections. About 77% of these should have been Access antibiotics, suggesting the UN's 70% target is achievable.

However, analysis of antibiotic use across 67 countries revealed widespread inappropriate prescribing:

• Nearly three-quarters of countries used more antibiotics overall than required.
• 99% of countries overused Watch antibiotics, increasing the risk of antimicrobial resistance.
• More than half of countries and territories underused Reserve antibiotics, potentially limiting treatment options for patients with life-threatening drug-resistant infections.
• 60% of countries continued using antibiotics that WHO recommends should no longer be prescribed.

Read More: 645 Million People Went Hungry in 2025; Middle East Conflict Driving Food Prices: UN

Global Inequality in Antibiotic Access

The study also highlighted major disparities in antibiotic access. Researchers noted that low- and middle-income countries, which bear a higher burden of infectious diseases and antimicrobial resistance, often need greater access to specialized Watch and Reserve antibiotics.

Yet these medicines are used more frequently in high-income countries, pointing to unequal access rather than clinical need.

Antibiotic Resistance Rising Among Children

A separate study found that antibiotic-resistant bacteria are increasingly leaving children vulnerable to common infections.

The research, led by the Murdoch Children's Research Institute (MCRI) and covering 82 countries, found that antibiotic resistance increased across every region between 2004 and 2022, making many life-saving drugs used to treat common childhood infections less effective.

Published in the Journal of the American Medical Association, the study found that babies, children in intensive care, and those living in countries with limited healthcare resources are the most affected.

What Can Be Done?

Researchers called for stronger national policies to curb unnecessary antibiotic prescribing while ensuring patients who genuinely need specialized antibiotics can access them.

They stressed that improving access will require coordinated action at both local and national levels. This includes:

• ensuring quality-assured antibiotics are available and affordable in frontline healthcare settings,
• procuring the right antibiotics in adequate quantities,
• strengthening surveillance of antibiotic use,
• setting country-specific prescribing targets based on local disease burden and public health needs.