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.

Climate change is already driving illness, disrupting essential services and putting health at risk, WHO Director-General Dr Tedros Adhanom Ghebreyesus warned at COP31 in Türkiye on Monday. Calling the climate crisis a health crisis, he urged governments to strengthen health systems, implement existing climate plans and increase funding for proven interventions.

Speaking at a news briefing alongside Turkish Health Minister Kemal Memişoğlu, Tedros said the health impacts of climate change were no longer a distant threat.

"They are here and now," he said, pointing to heat, floods, droughts, wildfires and air pollution that are increasingly affecting healthcare services.

"Health is also the most compelling reason for climate action," he said.

COP31: WHO Chief Lists Three Priorities For Health

Also read: COP31 Begins On Health Day: How Will Countries Measure The Health Impact Of Climate Change?

Tedros outlined three priorities to address the health impacts of climate change, saying the newly launched Antalya Initiative for Health Resilience (AIR) could help countries put them into practice.

1. Build climate-resilient health systems

Hospitals and clinics must be able to operate through heatwaves, floods and storms. This requires reliable electricity and water, early warning systems, resilient supply chains and trained healthcare workers.

2. Move from plans to implementation

Countries already know many of the measures that work, but financing, capacity and coordination remain major barriers to implementing them at scale, Tedros said.

He stressed that climate-related health risks cannot be addressed by health ministries alone. Ministries overseeing finance, environment, energy, transport, housing and urban planning must work together and integrate health into national adaptation plans and climate commitments.

3. Increase funding for proven interventions

Tedros called for greater investment in measures that can save lives, reduce emissions and strengthen economies.

"Climate action is not simply a cost. It's an investment in healthier people, more resilient communities and stronger economies," he said.

A WHO technical analysis published on November 4 found that six priority climate-health actions could save 1.6 million lives annually and generate US$24 in benefits for every dollar invested.

What Is The Antalya Initiative For Health Resilience?

Read More: Climate Crisis Is A Health Crisis: Just 6 Actions Could Save 1.6 Million Lives, Says WHO

Launched by the COP31 Presidency, the Antalya Initiative for Health Resilience (AIR) is a voluntary, non-binding initiative to help countries share practical experience and strengthen health systems against climate-related risks.

It will support the documentation of successful interventions, peer learning and the exchange of approaches that countries can adapt to their own settings.

AIR complements the WHO-led Alliance for Transformative Action on Climate and Health (ATACH), which brings countries and partners together to make, renew and report climate-health commitments. While

ATACH provides a platform for coordination, AIR focuses on sharing practical lessons from implementation.

The initiative will also build on the Belém Health Action Plan (BHAP), adopted at COP30, with lessons and resources carried forward through ATACH at future COPs.

"The focus now should be implementation, implementation and implementation," Tedros said, urging countries to learn from existing best practices rather than reinvent solutions. He called on governments to strengthen climate resilience across health systems and urged climate negotiators and funders to make health an explicit part of climate decisions and financing.

COP31 Health Day: What To Expect

Health Day, which opens COP31 on November 9, focuses on building dynamic and resilient health systems. It features four high-level panel discussions and a ministerial roundtable covering climate-resilient healthcare, digital health, climate-sensitive health technologies, humanitarian assistance and climate-health financing.

The scale of the health threat underscores the urgency. Around 3.5 billion people live in contexts highly vulnerable to climate change.

More than 90% of deaths from climate-related disasters over the past two decades occurred in developing countries. Air pollution, including pollution from fossil fuel combustion, causes around seven million deaths globally each year, according to WHO.

Two experimental heart drugs developed by Novartis and Novo Nordisk have failed to reduce major cardiovascular events in separate late-stage trials, despite successfully targeting cholesterol and inflammation.

Novartis' pelacarsen lowered lipoprotein(a), or Lp(a), by 78%, while Novo Nordisk's ziltivekimab substantially reduced inflammatory markers. However, neither drug reduced heart attacks, strokes or cardiovascular deaths compared with a placebo.

"Everybody in the world, me included, thought that this was going to work," said Dr. Steven Nissen of Cleveland Clinic, presenting the pelacarsen results at the American Heart Association's Scientific Sessions 2026.

Novartis' Pelacarsen Fails To Reduce Heart Events

Also read: Confused By Your Cholesterol Report? Here's What LDL And ApoB Really Mean

The seven-year Phase III Lp(a) HORIZON trial involved 8,323 people with established cardiovascular disease and elevated Lp(a) levels across 42 countries.

Participants received monthly injections of pelacarsen or a placebo. Despite reducing Lp(a) by 78%, the drug did not lower the risk of non-fatal heart attacks, strokes, urgent procedures to unblock arteries or cardiovascular deaths.

Even participants with higher Lp(a) levels showed no cardiovascular benefit.

"I cannot avoid the disappointing conclusion – it didn’t work," Nissen said, adding that cardiovascular outcomes remained unchanged despite the significant reduction in Lp(a).

Novo Nordisk's Ziltivekimab Also Fails

Novo Nordisk's Phase III ZEUS trial tested whether ziltivekimab, an experimental anti-inflammatory drug, could reduce cardiovascular events by blocking interleukin-6 (IL-6).

The trial included 6,376 patients with atherosclerotic cardiovascular disease, chronic kidney disease and systemic inflammation.

In July 2026, Novo announced that the trial had failed to demonstrate a cardiovascular benefit. Results published in the New England Journal of Medicine on November 7 showed that although the drug substantially reduced inflammatory markers, it did not prevent major cardiovascular events.

During a median follow-up of 33 months, cardiovascular death, non-fatal heart attack or non-fatal stroke occurred in 17.6% of patients receiving ziltivekimab and 17.7% receiving placebo.

On September 7, Novo Nordisk discontinued two additional late-stage trials of ziltivekimab in patients with heart failure and inflammation.

An independent data monitoring committee recommended stopping the studies, concluding they were unlikely to succeed.

Read More: This Common Heart Attack Risk Starts Silently In Healthy People In Their 20s

Why Did The Drugs Fail?

Nissen suggested that participants may have had advanced cardiovascular disease, making it too late for the drug to prevent further events.

Dr. Roger Blumenthal of Johns Hopkins suggested that participants' blood pressure and LDL cholesterol were already well controlled, leaving limited scope for additional risk reduction.

Another hypothesis was that anti-clotting medications taken by all participants may have diluted pelacarsen's potential effect, since Lp(a) is thought to contribute to cardiovascular disease partly by promoting blood clots.

These remain hypotheses, not proven explanations.

The findings also do not mean that Lp(a) or inflammation is irrelevant to heart disease. They show that lowering these markers with these particular drugs did not reduce cardiovascular events in the populations studied.

What Happens Next?

People with elevated Lp(a) can manage their cardiovascular risk by addressing other risk factors.

Nissen recommended exercise, weight management and lowering LDL cholesterol with statins when appropriate.

Three other cardiovascular outcome trials involving investigational Lp(a)-lowering drugs are underway. Their results may help determine whether targeting this cholesterol particle can prevent heart attacks and strokes.

Climate change is no longer a distant environmental concern. The effects of increasing temperatures, extreme weather events, melting glaciers, changing rainfall patterns and worsening air pollution on human health are alarming. Countries are continually identifying these health risks but monitoring if their climate policies are actually effective is the big question. This is one of the important areas of discussion at the 31st United Nations Climate Change Conference (COP31), which starts on November 9, 2026 in Antalya, Türkiye.

The World Health Organization (WHO) is stressing upon health to become a central part of climate policy discussions. The health body has urged countries to increase focus on measurable action, healthcare systems that can withstand climate change and funding to execute those actions.

Ahead of the conference, Dr Diarmid Campbell Lendrum, Head of the Climate Change, Energy, and Air Quality Unit at WHO headquarters said, “Health is the strongest argument for climate action."

Countries Need Reliable Health Indicators For Climate Change

Also read: Climate Crisis Is A Health Crisis: Just 6 Actions Could Save 1.6 Million Lives, Says WHO

Climate change has numerous effects on health. Extreme heat can lead to dehydration, heat exhaustion and heatstroke, while floods and droughts can disrupt access to safe drinking water, food and healthcare. Changing temperatures and rainfall patterns can also fuel spread of infectious diseases, including mosquito-borne illnesses.

Air pollution, which is closely linked to the burning of fossil fuels, adds to the burden of respiratory and cardiovascular disease.

However, measuring these effects is not as straightforward as one might think.

An increase in hospital admissions during a heatwave, for instance, could be considered an indicator, but countries also need to monitor who is most affected, whether healthcare facilities can cope and whether preventive measures are working.

A WHO review published in October 2025, Mapping Climate Change and Health Indicators, examined 31 reports from 22 countries. It identified 3,880 indicators being used to assess health risks related to climate change. After removing overlaps and combining similar measures, researchers identified 1,684 unique indicators.

These indicators covered climate hazards, population exposure, vulnerability, health outcomes, the impact on healthcare systems, future risks, and the policies and resources available to address them.

What Will Countries Measure?

Also read: Big Lancet Report: Heat-Related Deaths Rise 36% Since Paris Climate Agreement, Global Warming Blamed

Health indicators can help governments think beyond recording extreme weather events and examine their consequences for public health and healthcare systems. Some of the areas that countries could monitor include:

• Heat-related illness and deaths: Hospital admissions, emergency visits and mortality linked to extreme temperatures.
• Infectious diseases: Changes in the geographical spread of climate-related diseases, including dengue and malaria.
• Food and water security: Malnutrition, food insecurity and illnesses linked with unsafe drinking water.
• Healthcare infrastructure: The number of hospitals vulnerable to floods, heatwaves and other extreme weather events.
• Healthcare preparedness: Availability of early warning systems, emergency response plans, trained health workers and essential emergency medicines.
• Population vulnerability: Health impacts on children, older adults, people with disabilities, outdoor workers and underprivileged communities.

What Is WHO Calling For At COP31?

WHO is using COP31 to push for stronger implementation of existing climate and health commitments. Its priorities include making healthcare systems resilient to climate change, reducing the health sector's environmental footprint and ensuring that health considerations are included in climate policies and financing decisions.

The conference will begin with a dedicated Health Day on November 9, featuring discussions on health technologies related to climate, digital health, humanitarian response and resilient healthcare systems.

WHO's November 2026 briefing estimates that 3.3 to 3.6 billion people live in contexts highly vulnerable to climate change. It also says that scaling up six climate health actions could save 1.6 million lives annually and generate around US$24 in returns for every dollar invested.

Ultimately the challenge for countries is to turn climate and health commitments into measurable improvements. Tracking heat-related deaths, diseases, healthcare preparedness and unequal health impacts can help governments understand where action is working and where gaps remain.