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.

Liver injuries reported to US poison centres increased by nearly 400% between 2000 and 2024, with acetaminophen, sold under brand names such as Tylenol, the most frequently implicated substance, according to a study.

The study analysed poison-centre calls involving liver injuries linked to “xenobiotics”—foreign substances not naturally found in the human body. These include medications, food additives, alcohol and environmental pollutants.

Acetaminophen Among Leading Causes

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Researchers identified 220,160 cases of xenobiotic-related liver injury over the 24 years. Population-adjusted exposure rates increased from 10.9 per million people to 52.9 per million.

More than 80% of the liver injury cases required inpatient care, with medications accounting for the majority of cases. Acetaminophen was the substance most frequently implicated.

“Liver injuries reported to poison centers have increased substantially over the past 25 years, with acetaminophen emerging as a growing contributor,” said Christopher P. Holstege of UVA Health.

Acetaminophen Exposure Trends

The study found that exposures involving acetaminophen-containing combination drugs decreased by 60%-85% after the US Food and Drug Administration capped the amount of acetaminophen allowed in combination prescription products.

However, potentially harmful exposures to acetaminophen alone increased steadily over the 24 years. The findings suggest that regulatory action reduced liver injuries linked to combination products, while acetaminophen alone remained a leading contributor to poison-centre-reported liver injuries.

Females had higher rates of acetaminophen-associated liver injury than males. Suspected suicide was the most common reason for exposure in both sexes.

Alcohol and Other Substances

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Alcohol was the second most common cause of liver injuries, although it was far less common than acetaminophen. Alcohol-related injuries were more frequent in men than women but increased in both sexes during the COVID-19 pandemic.

Researchers also identified increases in liver injuries linked to stimulants and street drugs, herbal and dietary supplements, and environmental toxins. However, these were much less common than injuries associated with acetaminophen and alcohol.

“Medications should always be taken as directed by clinicians and per pharmaceutical label instructions,” Holstege said. He also advised caution with emerging substances that are not regulated.

Why Tylenol Is Linked To Liver Injuries

"Acetaminophen is widely available without a prescription, and it’s contained in many combination medications — more than 600. It’s likely that many people taking acetaminophen do not realize they’re taking too much since, for example, you take acetaminophen tablets for the achy feeling that comes with a cold and also use a combination cough medicine that contains acetaminophen," Howard E. LeWine, Chief Medical Editor, Harvard Health said.

Tylenol and Autism Claims

The debate has also triggered legal action, as Texas sued Kenvue over alleged failures to warn pregnant consumers, and a US appeals court this month revived more than 500 private lawsuits making similar claims.

Retinal disorders are among the leading causes of irreversible vision loss. Doctors at AIIMS New Delhi said the growing burden of these conditions is being driven in part by diabetes, stressing the need for retinal screening to protect long-term eye health.

Speaking to HealthandMe, experts emphasized the importance of starting eye screening from the time of diabetes diagnosis.

Retinal diseases affect the retina, the light-sensitive tissue at the back of the eye. One of the most common is diabetic retinopathy.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, diabetic eye disease is a group of eye problems that can affect people with diabetes. These include diabetic retinopathy, diabetic macular oedema, cataracts and glaucoma.

What Happens In Diabetic Retinopathy?

In diabetic retinopathy, high blood sugar levels damage blood vessels in the retina, causing them to swell, leak fluid or bleed.

This can lead to blurred vision, dark spots or floaters, difficulty seeing at night and distorted vision. In advanced stages, abnormal blood vessels can develop, potentially causing severe vision loss or blindness due to complications such as macular oedema or retinal detachment.

Why Is Retinal Screening A Must?

“Every person who is newly diagnosed with diabetes, especially those with type 2 diabetes, should undergo mandatory eye screening at the time of diagnosis,” said Dr. Vinod Kumar, Professor of Ophthalmology at RP Centre, AIIMS.

“Type 2 diabetes is often detected at a relatively older age, which means a person may have had diabetes for a long time without knowing it. We do not know how long they have actually had the disease. That is why newly diagnosed type 2 diabetics should undergo mandatory eye screening,” he added

For young, insulin-dependent diabetics, the expert noted that diagnosis usually occurs when insulin dependence begins, meaning they are detected earlier.

“Therefore, they are not required to undergo eye or retinal examination at the time of diagnosis. It is recommended that after five years of their diagnosis, they should undergo eye screening to check whether they have diabetic retinopathy or not,” Dr Vinod said.

Are Eye Screening And Retinal Screening The Same?

No. A general eye or vision screening is a basic check of how well a person can see, while retinal screening uses specialized digital cameras to take detailed images of the retina at the back of the eye.

Are Retinal Diseases Rising In India?

As India is the diabetic capital of the world, retinal diseases are very common, the expert said. However, many people may not realize they have vision loss due to diabetic retinopathy because the disease progresses slowly.

“Even if you do not have symptoms, you should undergo eye or retinal screening so that diabetic retinopathy can be diagnosed and appropriate steps can be taken to correct the effects of vision loss,” Dr Vinod said.

Lack Of Retinal Specialists A Concern In India

Retinal disorders are among the leading causes of irreversible vision loss in India. The growing burden of these conditions, along with gaps in the availability of retina specialists and infrastructure, highlights the need to strengthen retinal care.

According to the Vitreo-Retina Society of India (VRSI), there are around 1,700 retinologists in the country, which is inadequate to address the burden of retinal diseases.

To address the shortage of trained retinal specialists, AIIMS, in collaboration with Roche, launched a customized Retina Training Program at the National Retina Skill Development Centre.

Developed with the Roche India Healthcare Institute (RIHI), the program aims to strengthen retinal care through hands-on training, research and innovation.

“The need for strengthening retinal care capabilities is underscored by gaps in specialized expertise,” said Dr. Radhika Tandon, Chief and Professor of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS New Delhi.

The program will provide ophthalmologists with structured, hands-on training and advanced infrastructure to improve early diagnosis and appropriate management of retinal diseases.

Australia has maintained its measles elimination status since 2014, but a new report has revealed a massive gap: an estimated 1.7 million Australians may not be adequately protected against the highly contagious virus.

The update comes as measles cases linked to overseas travel continue to rise, raising concerns that infections imported from other countries could trigger outbreaks in communities where vaccination coverage is not high enough.

The study, led by the National Centre for Immunisation Research and Surveillance (NCIRS), estimated that 6.7% of Australians were susceptible to measles in 2019, leaving overall population immunity at 93.3%.

Researchers say this is around the lower end of the 93-95% level generally considered necessary to prevent sustained measles transmission.

Australia Has Measles-Vulnerable People Despite Elimination Status

When a country has elimination status of measles, it does not mean that every person in the country is immune or that the virus can infiltrate.

Instead, elimination means there is no ongoing transmission of measles within the country. Imported cases can still occur when infected people arrive from countries where the virus continues to infect the local population.

Australia has previously maintained elimination despite imported infections because vaccination has kept the virus from spreading continuously through communities. But the new analysis suggests that this protection is not evenly distributed across the population.

“While we have maintained our measles elimination status since 2014, protection isn't shared evenly across the population, and the margin for error is relatively small,” lead author Zoë Croker said.

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Which Australians Are Most Vulnerable?

The researchers found important immunity gaps among several age groups in the country. People born from the late 1970s onwards showed increased susceptibility, with every birth group from 1977 onwards estimated to have at least 5% of people susceptible to measles.

Some of the gaps may be due to changes in Australia's vaccination programs over the years. People born between 1977 and 1983, for example, were more likely to have received only one dose of a measles-containing vaccine.

There are also younger adults who may have missed the second dose when it was introduced, while babies are naturally vulnerable because they are too young to have completed their routine vaccination schedule.

The analysis also found that people aged 15 to 35 accounted for half of all measles cases reported in Australia between 2008 and 2022.

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Experts' Take

Measles is among the most contagious infectious diseases known. That means even a relatively small immunity gap can become crucial when the virus is introduced into a susceptible community.

Australia recorded just single-digit measles cases in 2022, but notifications increased to 181 cases in 2025, with 113 cases already recorded in 2026, according to recent surveillance data.

“Even relatively small immunity gaps in communities can create opportunities for the virus to spread when cases are imported from overseas,” Croker said.

Senior author Professor Frank Beard also warned that some communities and regions could have considerably larger immunity gaps than the national average.

“What’s happened overseas is a reminder that elimination status isn’t guaranteed, it has to be actively maintained,” Beard said.

How To Prevent A Potential Infection?

Experts are urging Australians born during or after 1966, particularly those planning international travel, to check whether they have documented evidence of receiving two doses of a measles-containing vaccine.

People who cannot confirm their vaccination history are being advised to speak to their GP or immunisation provider.