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.

Toxic air persisted for months after the fatal 9/11 attacks on the World Trade Center, which killed more than 2,000 people, even as officials played down the health risks at Ground Zero in New York’s Manhattan, according to a trove of newly released files.

New York City Mayor Zohran Mamdani today released more than 170,000 documents from government agencies related to post-9/11 air quality and health risks. He accused officials of lying to the public about the dangers of toxic air at Ground Zero, where the World Trade Center towers collapsed in 2001.

“People got sick because the leaders they trusted lied and told them they were safe to breathe in toxic air,” Mamdani said at a news conference with survivors.

“As the years pass and the human toll grows, we reckon with the cost of September 11th whenever another New Yorker is stolen from us too soon. Now, close to 25 years later, more people have died from 9/11-related illnesses than were killed on the day itself.

“The very least our city owes the families, survivors and first responders whose lives were forever changed by the September 11th attacks is transparency and accountability. That is why I am proud that our administration has launched the City’s first public records portal dedicated to the environmental and health impacts of 9/11 and reached a settlement in these lawsuits,” said Mayor Mamdani.

What Do the Documents Reveal?

The files, released Tuesday and made available through an online portal, include 68 boxes of documents that were discovered last year, the Harding Memo and records concerning World Trade Center 7.

The 68 boxes had not been located until 2025, despite multiple Freedom of Information Law (FOIL) requests.

One key document is the October 2001 “Harding Memo”, in which an aide warned former Deputy Mayor Robert Harding, who served under then-Mayor Rudy Giuliani, that the city could face as many as 35,000 legal claims over its response to the attacks.

The memo states that the city could face lawsuits because health advisories had caused individuals “to return to the area too soon (causing toxic exposure or emotional harm).”

“There was poison in the air and on the ground and in the window sills and in your air conditioners and covering your pets and your clothes, and it stayed there for months. Everyone knew. And now it's very clear that the city knew as well,” said advocate Jon Stewart, CBS News reported.

Days after the attacks, city and federal officials, including the US Environmental Protection Agency (EPA), declared that the air near the Twin Towers was safe. Subsequent research, however, found that people had been exposed to toxic chemicals.

Christine Todd Whitman, who headed the EPA at the time, later apologized for the declaration, saying the agency “did the very best we could at the time with the knowledge we had,” BBC reported.

What Happened On 9/11?

In Lower Manhattan, the plane crashes and subsequent collapse of the Twin Towers created massive dust clouds that filled the air. Hundreds of highly populated city blocks were covered with ash, debris and harmful particles, including asbestos, silica, metals, concrete and glass.

According to the US CDC, fires within the debris pile and the collapse of 7 World Trade Center continued to burn through the end of December 2001, with flare-ups continuing into 2002. The fires released carcinogenic combustion by-products, while contaminants remained in Lower Manhattan and parts of Brooklyn for an undetermined period after 9/11.

Responders, local workers, residents, students and others faced potential exposure in the early days and in the months that followed. They could have been exposed to residual materials indoors and outdoors, as well as toxic gases, smoke, vapozrs and combustion by-products from continuing fires.

Manila is witnessing a sharp rise in leptospirosis cases, with infections now crossing the city’s epidemic threshold following widespread exposure to floodwaters in August.

Nearly 1,000 cases have been reported in Manila this year, with the number rising rapidly over the past two weeks, Manila City health officer Grace Padilla told ABS-CBN News.

Padilla said the city’s attack rate has reached three, signaling a high level of transmission in the affected population.

Health officials expect cases to continue rising as more residents who came into contact with floodwater in late August seek medical attention.

Hospitals Face Growing Pressure

The surge in cases has also put additional pressure on hospitals across Manila. The city is also providing post-exposure prophylaxis at 44 health centers to people considered at risk following exposure to potentially contaminated floodwater, the report said.

The situation extends beyond Manila. Metro Manila has recorded at least 1,961 cases, with Manila and Quezon City reporting the highest cumulative numbers, followed by Caloocan and Taguig.

Philippines Records Hundreds of Deaths

The outbreak is part of a wider national burden. From January 1 to August 29, the Philippines recorded 6,253 leptospirosis cases and 378 deaths, according to the health department’s epidemiology bureau.

Why Floodwater Raises Leptospirosis Risk

Leptospirosis is one of the most prevalent zoonotic diseases worldwide, often linked to poor sanitation and agricultural practices that involve contact with animals or contaminated water.

The bacteria can survive in contaminated water or soil for weeks to months, primarily spreading through the urine of infected animals. Humans can contract the disease through direct contact with infected urine or through contaminated food, water, or soil.

Flooding can increase the risk of exposure by spreading contaminated water through homes, streets and communities.

What Are Symptoms Of Leptospirosis?

Symptoms typically develop 2 to 30 days after exposure and can range from mild to severe. Initial signs often include high-grade fever, red eyes (conjunctival suffusion), calf tenderness, headache, dry cough, nausea, and diarrhea.

In more serious cases, the infection can lead to complications such as jaundice, kidney or liver damage, meningitis, respiratory issues, and hemorrhages.

The health authorities in Manila shared that people who have recently been exposed to floodwater should watch for symptoms such as fever, headache, muscle pain and joint pain and seek medical attention if they develop them.

The infection can be treated with antibiotics, including doxycycline, when prescribed by a doctor.

What Precautions Should Be Taken?

According to the Centers for Disease Control and Prevention (CDC), it is essential to avoid wading through dirty rainwater, especially during the rainy season, and to wear gumboots in such conditions.

Proper care of any injuries or cuts is crucial, and frequent handwashing, particularly after handling food or working in potentially contaminated environments, is highly recommended. Additionally, individuals should avoid contact with animals that appear sick or are known carriers of the bacteria.

Weight loss surgery may do more than help women living with obesity lose weight. A new study has found that metabolic bariatric surgery can improve menstrual cycles and several reproductive symptoms linked to Polycystic Ovary Syndrome, now renamed as Polyendocrine Metabolic Ovarian Syndrome (PMOS).

Researchers from the University of Surrey followed 84 women aged 18 to 45 who underwent bariatric surgery, including 49 gastric bypass and 35 gastric sleeve procedures, for 24 months. Another 18 women with obesity who did not undergo surgery were included for comparison. The findings were published in Obesity Surgery.

Bariatric Surgery Improved PMOS Symptoms

Women who underwent surgery lost more than 30 kg on average at both 12 and 24 months after the procedure. But researchers also observed improvements in reproductive health. Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery. The number of women with polycystic ovaries also fell significantly, with the condition persisting in only 10% of those affected after 24 months.

Another common PMOS symptom, hirsutism or excessive facial and body hair, had resolved in the women reporting the condition by 12 months.

Obesity and PMOS can team up in a way that worsens metabolic and reproductive problems. Insulin resistance and hormonal changes associated with excess weight can contribute to irregular ovulation, menstrual irregularity and difficulty conceiving.

Also read: PCOD vs PCOS vs PMOS: Why The Condition’s Name Has Changed Over Time

Weight Loss Could Improve PMOS Symptoms

The researchers suggest that reducing obesity may help correct some of the hormonal and metabolic disturbances affecting reproductive health.

Dr Kathryn Hart, co-author of the study and Associate Professor in Nutrition and Dietetics at the University of Surrey, said: “Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are impacted by obesity. By reducing this, what we have seen is that it can lead to improvements without the need for medication,” she added.

Despite promising results, this does not mean bariatric surgery is a treatment that every obese woman with PMOS should undergo.

The procedure is generally considered for people with obesity who meet a certain clinical criteria. Also it carries its own risks and nutritional considerations that are important.

Also read: From Insulin Resistance to Fertility: Understanding the Metabolic Side of PCOS

Fertility May Return Quickly After Surgery

The researchers also highlighted an important finding for women who may be planning pregnancy. Seventeen women in the study had healthy pregnancies following surgery.

The researchers said reproductive counselling and preconception care should be incorporated into care after bariatric surgery, particularly because fertility can improve as menstrual cycles and ovulation become more regular.

Professor Martin Whyte, co-author and Professor of Metabolic Medicine at the University of Surrey, said many people undergoing bariatric surgery are women of reproductive age who may be considering pregnancy.

“So much remains unknown about the impact of this type of surgery on women who are planning to have children,” he said, highlighting the need to understand when the ideal time to conceive may be after surgery.

Importance Of Combating PMOS-Related Obesity

The study adds to growing evidence that treating obesity can improve some reproductive symptoms of PMOS.

A 2026 systematic review and meta-analysis also found that bariatric surgery was associated with reductions in menstrual irregularities, hirsutism and several reproductive hormone abnormalities.

But bariatric surgery is not a cure for PMOS. PMOS is a complex hormonal and metabolic health condition and its symptomscan vary considerably between women.