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.

One of the most effective ways to prevent rabies deaths could be by vaccinating dogs rather than just people before they are bitten. A new study published in The Lancet Regional Health – Southeast Asia modelled different strategies in Kerala for eradicating human rabies deaths between 2026 and 2035.

The study found that mass vaccination of dogs could bring the annual rabies deaths among people in Kerala close to zero within about three years even if 70% of the dog population were vaccinated.

On the other hand, vaccinating children before exposure to rabies was projected to prevent relatively few additional deaths at substantially higher cost.

India carries one of the worst largest rabies burdens. That's why the study could point towards a feasible and practical solution to eradicate the deadly infection.

Could Vaccinating Dogs Help?

Most human rabies deaths in India are linked to bites from infected dogs. This means that the disease can be tackled at its source by reducing transmission among dogs.

India records an estimated 9.1 million animal bites every year, with more than three-quarters caused by dogs. A 2024 estimate from the Indian Council of Medical Research's National Institute of Epidemiology estimates India's annual human rabies deaths to be about 5,726, which is an alarming public health issue.

The study puts emphasis on the fact that vaccinating a person after a bite protects that individual, whereas, vaccinating dogs reduces the probability that an infected dog will transmit rabies to many people in the first place.

Also read: Bhutan Eliminates Rabies While India Battles Persistent Deaths: What Can India Learn From Its Neighbour?

About The Study

Researchers from the University of Glasgow, Kerala's health and animal-husbandry departments, Kerala University of Health Sciences and the London School of Economics and Political Science used mathematical modelling to compare different strategies to combat rabies in Kerala.

One strategy was routine pre-exposure prophylaxis (PrEP) for children. Another focused on mass dog vaccination, while the model also considered improvements to post-exposure prophylaxis (PEP), the treatment given after a potentially rabid bite.

The researchers found that adding routine childhood PrEP provided minimal additional protection, preventing fewer than 10 deaths on average over a decade, while costing considerably more than strategies focused on controlling rabies transmission among dogs.

The model estimated that achieving 70% vaccination coverage among dogs could reduce annual human rabies deaths in Kerala to near zero within approximately three years.

Also read: Abhayrab Rabies Vaccine Batch Found Misbranded, ‘Not Of Standard Quality’: DCGI Alerts States

India's Alarming Rabies Situation

One of the study's striking findings was about the size of Kerala's stray-dog population. The researchers' modelling suggested that the state's actual stray-dog population could be around five times higher than official census estimates.

If vaccination programmes are based on an underestimated dog population, authorities could believe they have reached adequate coverage while a large proportion of dogs remain unvaccinated. That creates what epidemiologists call an immunity gap, allowing rabies transmission to continue.

Additionally, dog vaccination does not make human post-exposure treatment unnecessary. If a person is bitten or scratched by an animal that could have rabies, the wound should be washed thoroughly with soap and running water and medical care should be sought immediately.

Depending on the exposure, PEP can include rabies vaccine and rabies immunoglobulin (RIG). This is particularly important because rabies becomes extremely difficult to treat once symptoms begin.

The study also found that improving timely access to PEP could prevent more deaths than expanding routine pre-exposure vaccination of children.

The US Food and Drug Administration (FDA) is investigating an outbreak of Salmonella Bovismorbificans infections in multiple states. According to reports, the at least infection cases are being linked to recalled broccoli sprouts across four states, including two hospitalisations. The outbreak hasn't resulted in any casualties yet.

The outbreak has been linked to broccoli sprouts grown by Evergreen Fresh Sprouts, LLC, based in Moyie Springs, Idaho. The FDA and the US Centers for Disease Control and Prevention (CDC) are investigating the outbreak with state and local health authorities.

The FDA has issued a clear warning: “Do not eat, serve, or sell recalled broccoli sprouts grown by Evergreen Fresh Sprouts, LLC.”

How Were The Broccoli Sprouts Linked To The Outbreak?

Also read: Granola Marketed For Nursing Mothers In US Recalled Over Potential Salmonella Contamination

According to the FDA, illnesses began between July 7 and August 26, 2026. Out of the 19 infected people who were interviewed by investigators, all 19 reported eating sprouts, while 17 specifically reported eating broccoli sprouts. That epidemiological pattern helped investigators identify sprouts as the likely driver of the infection.

Traceback investigations by the FDA and state partners then identified Evergreen Fresh Sprouts as the common grower of broccoli sprouts eaten by patients before they became sick.

On September 4, the company initiated a recall after Montana state officials found Salmonella in a sample of its broccoli sprout. Whole-genome sequencing showed that the Salmonella found in the product was the same strain causing illnesses in the outbreak.

The recalled products were sold in plastic bags or plastic clamshell containers and have expiration dates of September 7, 9, 11, 14 or 16, 2026.

Distribution has been confirmed in Idaho, Montana and Washington, although the FDA said the products may have reached additional states. The 22 cases are from Idaho, Montana, Utah and Washington.

What Is Salmonella And How Serious Can It Be?

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Salmonella is a group of bacteria that can cause salmonellosis, a gastrointestinal infection usually acquired by consuming contaminated food or water.

Symptoms typically begin 12 to 72 hours after exposure and can include diarrhoea, fever and abdominal cramps. Most people recover within four to seven days without specific treatment, but some infections can become severe.

Young children, older adults and people with weakened immune systems are at greater risk of serious complications from the infection. In severe cases, Salmonella can cause dehydration or allow the bacteria to enter the bloodstream, potentially leading to invasive infection and complications affecting other organs.

Why Can Raw Sprouts Carry Salmonella?

Sprouts are grown in warm, moist conditions, which help seeds germinate but can also provide favourable conditions for bacterial growth.

The seeds themselves can become contaminated before sprouting. Once bacteria are present, the warm and humid environment used to produce sprouts can allow them to multiply. Since sprouts are often eaten raw, there may be no cooking step to eliminate the bacteria.

The current FDA investigation involves broccoli sprouts, and it is separate from another ongoing US investigation involving Salmonella and E. coli infections linked to alfalfa sprouts.

Consumers, restaurants and retailers should not eat, sell or serve the recalled Evergreen Fresh Sprouts broccoli sprouts.

The FDA also advises people who purchased or received the recalled product to carefully clean and sanitise surfaces and containers that may have come into contact with the sprouts. This is important because Salmonella can spread through cross-contamination.

Anyone who develops symptoms resembling Salmonella infection after eating the recalled sprouts should contact a healthcare provider.

Col Anurag Upadhyay, a former Indian Army officer and Special Forces veteran, is living with locked-in syndrome, a rare neurological condition in which a person can remain conscious and aware while losing the ability to speak and move most muscles.

While there is currently no medicine or injection proven to reverse established locked-in syndrome, experts stress the importance of specialized neurorehabilitation, communication aids and appropriate assistive technologies.

Col Anurag’s Journey

A decorated Army officer and Special Forces veteran, Col Upadhyay suffered a severe posterior circulation stroke in August 2025. The stroke reportedly caused extensive neurological damage and left him with locked-in syndrome.

Despite being unable to move or speak normally, Col Upadhyay is conscious and aware. According to a social media post seeking medical and rehabilitation support for him, he communicates complete thoughts through eye movements and an alphabet-based scanning system.

Also read: Bill Ackman’s Daughter Gets Experimental Treatment For Vision Loss: When Can Mitochondrial Transplants Help?

What Is Locked-In Syndrome?

Cleveland Clinic defines the syndrome as "a rare and serious neurological disorder that causes complete paralysis of all voluntary muscles except for the eyes, while leaving the person fully conscious and aware"

“Locked-in syndrome is one of the most devastating neurological conditions,” said Dr Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, in a post on social media platform X.

The condition can leave a person unable to speak or move most muscles despite remaining conscious and aware.

It can severely affect communication and physical independence. However, the extent of impairment and potential for recovery can vary depending on the cause, location and severity of the brain injury, as well as whether the syndrome is complete or incomplete.

Is There A Medicine To Reverse It?

Dr Kumar said, “The honest answer is: There is currently no medicine or injection proven to reverse established locked-in syndrome.”

However, the absence of a proven medicine does not mean that supportive treatment and rehabilitation have no role.

Even after 13 months, Dr Kumar strongly recommended assessment at a specialised centre with experience in long-term neurorehabilitation and assistive technology.

Why Neurorehabilitation and Communication Matters

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Dr Kumar recommended a detailed reassessment by a multidisciplinary team that could include a neurologist, rehabilitation physician, physiotherapist, occupational therapist, speech and swallowing therapist, respiratory therapist, psychologist and specialist nurses.

Such an assessment can help identify even small voluntary movements that may have been missed or may have emerged over time.

He also recommended intensive, individualised neurorehabilitation focused on maintaining joint mobility, preventing contractures, improving head and trunk control, increasing sitting tolerance and supporting any residual voluntary movement.

“Even a small movement of a finger, thumb, head or eye can sometimes become functionally very important,” Dr Kumar said.

For people with locked-in syndrome, establishing a reliable way to communicate can be particularly important.

Dr Kumar stressed that “communication should be a top priority” and recommended considering an eye-gaze or eye-tracking communication system where appropriate.

“Restoring a reliable means of communication can dramatically improve autonomy and quality of life,” he said.

Swallowing, Respiratory Care And Mental Health

Dr Kumar also suggested “periodic reassessment of swallowing and bulbar function” and “speech-language therapy”, along with “chest physiotherapy, respiratory exercises, secretion management and periodic reassessment of ventilatory requirements”.

Emphasising the importance of mental health and quality of life, he said, “Never assume that a person with locked-in syndrome does not understand what is happening around them.”

What New Technologies Could Offer

Dr Kumar also highlighted “exciting ongoing research” into several technologies that could potentially improve communication, interaction and rehabilitation for people with severe paralysis.

These include:

1. Eye-tracking and advanced communication systems
2. Brain-computer interfaces (BCIs) that translate brain signals into computer commands
3. BCI-assisted communication for people with severe paralysis
4. Robotics and functional electrical stimulation
5. Virtual reality and technology-assisted rehabilitation
6. Non-invasive brain stimulation, such as transcranial direct current stimulation, currently being explored as an adjunct to rehabilitation

However, these technologies should not be presented as established treatments for locked-in syndrome.

“These technologies are promising, but it is important to be realistic: most are not yet proven treatments capable of reliably reversing locked-in syndrome,” Dr Kumar said.

For people living with locked-in syndrome, continued access to evidence-based rehabilitation, communication tools, assistive technologies and specialised care can remain important.

“For a man who has served our country, we owe him continued care, respect and access to every evidence-based opportunity for rehabilitation,” Dr Kumar said.

“There may not be a miracle medicine today. But there is still meaningful medicine to be practiced and meaningful hope to be offered.”