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.

In the trailer for the eighth season of The Kardashians, Kim Kardashian revealed that she has been diagnosed with esophagitis, a condition involving inflammation and irritation of the esophagus. The conversation sparked memories of her father Robert Kardashian, who died of esophageal cancer in 2003.

In the trailer, someone asks her, “Didn't your father ... isn't it what he died of?” to which she responds, “Yeah.”

Her mother, Kris Jenner, is also seen becoming emotional. Kardashian is shown in a hospital bed, although the trailer does not reveal the exact cause or severity of her esophagitis or any procedure she may have undergone.

But it is important to clarify that esophagitis and esophageal cancer are two different conditions.

What Is Esophagitis?

Esophagitis is a condition in which the lining of the esophagus, the tube that carries food and liquids from the mouth to the stomach, becomes inflamed.

There are several possible causes for the inflammation of the esophagus. The most common is gastroesophageal reflux disease (GERD), a condition in which stomach acid flows back into the esophagus repeatedly. Other causes include certain medications, infections and allergic or conditions related to immune system.

Symptoms can include heartburn, chest pain, painful or difficult swallowing, coughing, hoarseness and a sore throat.

The treatment for esophagitis depends on what is causing the inflammation and can include medicines that reduce stomach acid, treatment for an infection or changes to diet and other habits. The condition is often manageable with treatment.

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Does Esophagitis Increase Cancer Risk?

Esophagitis itself does not mean a person will develop esophageal cancer. The concern refers to when chronic acid reflux continues for years. Repeated exposure to stomach acid can damage the esophageal lining and, in some people, lead to Barrett's esophagus.

Barrett's esophagus involves changes in the cells lining the lower esophagus and is associated with an increased risk of esophageal adenocarcinoma, one of the major types of esophageal cancer. However, most people with Barrett's esophagus do not develop cancer.

Rather, in some people, long-standing reflux can cause chronic damage, which can lead to Barrett's esophagus, which in turn is associated with a higher cancer risk.

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Kim Kardashian’s Family History

According to reports, Kim Kardashian's father Robert Kardashian died from esophageal cancer in September 2003 at the age of 59, only about two months after his diagnosis. This family history makes Kim's diagnosis particularly significant.

However, there is currently no public information showing that her esophagitis is hereditary or that it is connected to the cancer her father had. Her diagnosis also does not establish that she has Barrett's esophagus or esophageal cancer. The trailer does not disclose those details.

The Kardashian family has nevertheless remained involved in awareness about esophageal health since Robert's death. In 2019, the family helped establish the Robert G. Kardashian Center for Esophageal Health at UCLA, dedicated to research, treatment and education about diseases of the esophagus.

When Should Esophageal Symptoms Be Checked?

Persistent difficulty swallowing, painful swallowing, unexplained weight loss, recurrent vomiting, bleeding or discomfort in chest should not simply be dismissed as normal acidity.

Doctors may use tests such as an upper endoscopy to examine the esophagus and determine whether inflammation, structural changes or other abnormalities are present. Persistent inflammation, particularly when driven by untreated chronic reflux, can sometimes signal a problem that needs medical evaluation and follow-up.

India’s first approved dengue vaccine, QDENGA, could be available in the private market by the first half of 2027, Dr Reddy’s Laboratories said. The company is partnering with Japan’s Takeda to promote and distribute the vaccine in India.

“Subject to the completion of applicable processes with local authorities, the vaccine is anticipated to become available in the first half of 2027,” the companies said.

QDENGA Vaccine: Why The Launch Matters

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India’s dengue burden has risen 11-fold over the past two decades. Rapid urbanization, climate change and mosquito breeding have contributed to the growing public health challenge.

A nationwide ICMR dengue surveillance study found that all four dengue virus serotypes — DENV-1 to DENV-4 — are circulating across multiple regions. About one in 14 patients had concurrent infections with multiple serotypes.

QDENGA Approved In India: Who Can Take It?

QDENGA received market authorization from the Drug Controller General of India (DCGI) in July to prevent dengue in people aged 4 to 60 years.

According to Takeda, it can be given regardless of previous dengue infection and does not require pre-vaccination testing.

Since 2022, QDENGA has been approved in 43 countries across Asia, Latin America and Europe. It is also part of Brazil’s National Immunization Program and public immunization programs in Argentina, Colombia and Indonesia.

How Effective Is QDENGA?

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QDENGA is designed to protect against all four dengue virus serotypes, regardless of previous dengue exposure.

The DCGI approval is supported by Takeda’s clinical program, which included 19 Phase 1, 2 and 3 trials involving more than 28,000 participants.

The pivotal Phase III TIDES trial included more than 20,000 participants across eight countries. Key findings included:

• 80.2% efficacy against virologically confirmed dengue one year after the second dose.
• 90.4% efficacy against dengue-related hospitalization at 18 months.
• 84.1% protection against dengue-related hospitalization after 4.5 years.
• Data showed protection across all four serotypes for up to seven years.

An Indian Phase III trial involving people aged 4 to 60 years also found the vaccine safe, well tolerated and immunogenic.

What Is QDENGA?

QDENGA (TAK-003) is a live-attenuated tetravalent dengue vaccine targeting all four dengue virus serotypes.

It is given as two 0.5 mL subcutaneous doses, three months apart. The vaccine uses a DENV-2 backbone with structural proteins from DENV-1, DENV-3 and DENV-4.

The WHO recommends QDENGA for use in dengue-endemic settings without pre-vaccination screening. It is also WHO-prequalified for procurement through agencies including UNICEF and PAHO.

QDENGA Manufacturing In India

Dr Reddy’s will handle promotion and distribution in the private market, while Takeda will retain rights to promote and distribute QDENGA in India’s public market.

In February 2024, Takeda partnered with Hyderabad-based vaccine maker Biological E to expand QDENGA production.

Biological E plans to manufacture 50 million doses annually, supporting Takeda’s goal of producing 100 million doses globally each year by the end of the decade.

The company’s production will focus heavily on multi-dose vials for public health sectors and National Immunization Programs in dengue-endemic countries globally.

Nearly one in four doctors globally is aged 55 or older and could reach retirement age within the next decade, according to a new World Health Organization (WHO) report, highlighting growing pressure on health systems.

The WHO has published its National Health Workforce Accounts: Health Workforce Levels and Trends 2026, the first in an annual series providing a global picture of health workforce levels and trends.

The report flagged that ageing among health workers is intensifying workforce shortages in some countries, while an ageing population is simultaneously increasing demand for healthcare services.

The global health worker shortage fell from 20 million in 2013 to 15 million in 2020 and was earlier projected to reach 10 million by 2030. However, newer analysis has revised the 2030 shortage estimate upward to 11.1 million.

“Ageing is the hidden health workforce crisis that requires urgent attention. It is creating a double pressure on health systems, primarily in high-income countries,” said Dr Khassoum Diallo, Acting Unit Head of Health Workforce Policies and Data, WHO Academy.

“We know that better data drives better policy, and these findings reinforce the importance of future-focused action to strengthen health workforce planning, education, employment and retention,” Dr Diallo added.

Also read: Japan Has 107,677 Centenarians; 88% Are Women: Challenges Of An Aging Population

Key Findings From The WHO Report

Based on the latest available data from 122 countries, nearly 25% of doctors are aged 55 or older and could reach retirement age within the next decade. In high-income countries, this rises to nearly one in three.

There are currently more than 70 million health and care workers worldwide. Global health workforce density increased by 52%, from 44.8 per 10,000 people in 2006 to 67.9 in 2025.

The WHO estimates that:

• 67 countries will not have enough health workers to maintain population health needs by 2030.
• The global health workforce shortage is projected to reach 11.1 million by 2030.
• An additional 832,000 health workers are needed just to maintain current age-standardized workforce density, primarily in high-income countries.

Major Gaps Between Rich And Poor Countries

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The report also found major disparities in health worker availability between regions and income groups.

The density of medical doctors is 13 times higher, while the density of nurses and midwifery personnel is six times higher, in the WHO European Region than in the WHO African Region.

Health worker density also remains strongly linked to national income, with high-income countries having substantially greater workforce density than low-income countries.

“Despite gains in workforce production and data reporting, uneven and severe shortages of health and care workers remain, and health worker density remains strongly correlated with national income,” explained Dr Diallo. “Addressing these inequities is essential to achieving Health for All.”

Ageing Population Could Further Increase Demand

The workforce challenge is also unfolding as the global population ages. About one in 10 people worldwide was aged 65 or older in 2024. In high-income countries, the share was nearly one in five. Globally, the proportion is projected to reach about one in eight by 2030.

The WHO noted that population ageing will increase healthcare needs, meaning countries cannot simply aim to maintain their current health workforce density.

“Investing in the health and care workforce is essential to strengthening health systems, safeguarding health security and advancing sustainable development,” said Dr Diallo.