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.

Long associated with factors such as obesity, lifestyle and genetics, cancer can also be linked to infections. A new study published in The Lancet Oncology found that an estimated 2.3 million new cancer cases globally in 2024 — 12%, or about one in eight of all cancers diagnosed that year — were attributable to infections.

The analysis included 12 infectious agents known to cause cancer in humans, including viruses, a bacterium and parasites. It also incorporated newly established infection-cancer associations and additional cancer types caused by known carcinogenic infections, including recent evidence linking Epstein-Barr virus (EBV) with gastric cancer.

“The findings underscore the major role that infection control can play in reducing the global cancer burden,” said Dr Harriet Rumgay, a scientist in the Cancer Surveillance Branch at IARC.

“Despite progress in vaccination and screening, infection-related cancers remain a major global challenge, with the burden falling disproportionately on populations in low- and middle-income countries,” Rumgay added.

Which Infections Are Driving Cancer?

Also read: US Cancer Death Rates Fall For Men, Women: Lung Cancer Progress Drives Decline

Based on cancer burden estimates from the IARC Global Cancer Observatory database, the researchers assessed 12 infectious agents known to cause cancer: Helicobacter pylori, human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), EBV, Kaposi sarcoma-associated herpesvirus (KSHV), Schistosoma haematobium, human T-cell lymphotropic virus type 1 (HTLV-1), Opisthorchis viverrini, Clonorchis sinensis, Merkel cell polyomavirus and HIV.

Five of these accounted for almost all infection-linked cancer cases in 2024:

• H. pylori, the stomach bacterium, was linked to 760,000 cases, or 4% of all cancers diagnosed that year.
• HPV was linked to 750,000 cases, also accounting for 4%.
• HBV was linked to 360,000 cases, or 2%.
• EBV was linked to 260,000 cases, or 1%.
• HCV was linked to 160,000 cases, or less than 1%.

Which Countries Bear Most Of The Burden?

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Low- and middle-income countries accounted for 77% of all infection-linked cancer cases.

Eastern Asia recorded the largest number of infection-attributable cancer cases, with 990,000 cases — 42% of the global total — driven mainly by H. pylori and HBV.

Sub-Saharan Africa had the highest proportion of cancers linked to infection, with a quarter of all cancers in the region attributed to infectious agents. The burden was driven largely by HPV, KSHV and HIV.

The study also found that EBV is the fourth-largest infectious cause of cancer globally, ahead of HCV. This reflects growing evidence that EBV contributes not only to nasopharyngeal cancer and lymphomas but also to a proportion of gastric cancers.

How To Prevent Infection-Related Cancers

Read More: Fatty Liver, Chronic Gut Diseases And Worm Infections: India’s Changing Disease Burden

The authors said the findings underline the importance of infection control in reducing cancer rates. They highlighted several measures that are already available but remain underused, including

• HPV and hepatitis B vaccination;
• testing and treatment for HIV, H. pylori, and hepatitis B and C;
• safe injection practices;
• access to condoms
• pre-exposure prophylaxis to prevent HIV transmission;
• screening for precancerous lesions in HPV-driven cervical and anal cancers.

Many of these measures are cost-effective but remain underused in many countries because of societal, financial and political barriers.

“This updated analysis shows that the landscape of infection-related cancers continues to evolve as scientific evidence advances,” said Dr Gary Clifford, senior co-author of the study.

“It also highlights where future investments in new prevention tools could have the greatest impact, particularly for infections such as EBV, for which effective vaccines are not yet available.”

The authors said reducing infection-related cancers will require wider implementation of established prevention strategies, alongside continued investment in new tools, particularly vaccines against EBV and other cancer-causing infections for which effective preventive measures are not yet available.

India is among 20 jurisdictions whose qualifying specialty pharmaceutical products and related ingredients can receive a zero per cent US tariff, according to a new notice from the US Commerce Department.

The exemption comes as the US begins applying a 100 per cent tariff on certain patented pharmaceutical products and associated ingredients from September 29.

The tariff measures stem from a presidential proclamation issued in April under Section 232 of the Trade Expansion Act, which sought to address US dependence on imported pharmaceuticals and encourage greater domestic production.

Which Medicines Are Covered By The Exemption?

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The waiver applies to specific pharmaceutical categories rather than the wider drug trade.

Products covered by the notice include:

• Rare-disease medicines, including qualifying orphan drugs
• Fertility and infertility medicines
• Nuclear medicines
• Plasma-derived therapies
• Cell therapies
• Gene therapies
• Antibody-drug conjugates (ADCs)
• Certain medical countermeasures for chemical, biological, radiological and nuclear threats
• Animal health pharmaceuticals

The provision also covers qualifying ingredients associated with these products.

Why Are These Medicines Exempt?

The Commerce Department said products from the listed jurisdictions can receive the zero tariff because those jurisdictions have a current or forthcoming trade and security framework agreement with the US.

The exemption therefore applies based on both the type of pharmaceutical product and the applicable country-level conditions.

The move comes against the backdrop of the US administration's broader effort to increase domestic pharmaceutical production and reduce reliance on imported medicines and pharmaceutical ingredients.

The 100 per cent tariff on specified patented pharmaceutical products and ingredients began applying to companies identified in one category from July 31, while the measure extends to additional covered companies from September 29.

Read More: IARC Says Low-Dose CT Can Cut Lung Cancer Deaths: AIIMS Expert Explains Why India Needs Its Own Screening Evidence

Generic Drugs Remain Outside Section 232 Tariffs

The Commerce Department notice also makes clear that generic pharmaceutical products, biosimilars and their associated ingredients are not currently subject to the Section 232 pharmaceutical tariffs.

This means the latest exemption should not be interpreted as a broad tariff concession covering India's entire pharmaceutical industry.

The guidance also makes technical changes to the Harmonized Tariff Schedule and clarifies the treatment and definitions of pharmaceutical articles and generic pharmaceutical products under the tariff framework.

Companies seeking an exemption on the basis of an urgent US health need can apply through a process established by the Commerce Department.

What Does This Mean For India?

India's inclusion in the zero-tariff category is relevant to pharmaceutical companies that export specialty medicines and their associated ingredients to the US.

However, the exemption is not a blanket waiver for medicines manufactured or exported from India.

Only products that fall within the specified categories and satisfy the applicable conditions are covered. Other pharmaceutical products remain subject to the tariff rules that apply to them.

For Indian drug makers, the distinction is important because the new provision specifically concerns specialty pharmaceutical categories, while generic medicines and biosimilars are already outside the current Section 232 pharmaceutical tariffs.

The impact on individual Indian pharmaceutical companies will therefore depend on the types of products they export to the US and whether those products meet the criteria set out under the new rules.

Which Countries Are Included?

Besides India, the zero-tariff category covers Argentina, Bangladesh, Cambodia, Ecuador, El Salvador, the European Union, Guatemala, Indonesia, Japan, Jordan, Malaysia, North Macedonia, South Korea, Switzerland, Liechtenstein, Taiwan, Thailand, the UK and Vietnam.

(With inputs from PTI)

Pennsylvania has recorded 903 measles cases, while the US national tally has climbed to 3,659.

Pennsylvania, which is among the worst-hit states in the ongoing outbreak, added 115 cases in the past week, according to the state Department of Health.

The Centers for Disease Control and Prevention (CDC) has also listed Pennsylvania among the states reporting the highest number of measles cases, followed by South Carolina and Utah.

Pennsylvania Reports 4 Measles Deaths

Pennsylvania has reported four deaths so far due to measles, although the CDC has acknowledged only two.

Two of the deaths were among unvaccinated adults — an 18-year-old and a 40-year-old. The other two deaths were among infants who were too young to have received the measles, mumps, rubella (MMR) vaccine.

According to Pennsylvania’s health department, less than 1% of measles cases occurred in people who were fully vaccinated against the virus. A total of 176 people have been hospitalized, while about 31% of cases occurred in people under 18.

US Measles Cases Reach 3,659

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This year has been one of the worst for measles in the US in more than 30 years, with the highest number of annual cases reported since 1992.

The US eliminated measles in 2000, but that status is set to be reevaluated at an upcoming November meeting with the Pan American Health Organization. Canada lost its measles elimination status last year.

As per the CDC, 3,659 confirmed measles cases were reported in the US through September 24. In comparison, a total of 2,289 confirmed measles cases were reported in the US during the full year of 2025.

About 95% of cases were among people who were unvaccinated or whose vaccination status was unknown. Around 9% of cases resulted in hospitalization, while 14% occurred among children under five.

Measles Cases By Age

• Under 5 years: 656 cases
• 5–19 years: 1,577 cases
• 20+ years: 1,407 cases

Measles Cases Rise In Other US States

Other states have also reported increases in measles cases.

Ohio added nine new cases this week and now has 189 cases for the year. Kentucky added 10 new cases and has 67 for the year, while Wisconsin added four new cases and has reported 171 cases so far this year.

WHO Warns Measles Is Making A Comeback

Read More: Bill Gates Says Vaccine Hesitancy Could Make Ending Measles Impossible

Commenting on the measles resurgence, Dr Saia Ma’u Piukala, Regional Director for the Western Pacific, said the world risks “bringing back a disease we have long known how to prevent”.

Piukala lamented the loss of years of progress in measles vaccination and attributed the resurgence to vaccination challenges during the COVID-19 pandemic, coupled with mounting anti-vaccine misinformation.

“Behind every outbreak is a gap: a missed child, delayed action, weakened trust or communities not reached through regular vaccination programs. In the Western Pacific – home to 2.2 billion people, more than a quarter of the world’s population – an immunity gap in one country quickly becomes a regional risk,” he said.

“This should concern all of us because measles is not only about one disease. It is one of the clearest signals of whether health systems are strong, consistent and serving everyone.”

The US Is Not Alone

Measles cases are also being reported in Bangladesh and India. Bangladesh, Guatemala, India and Yemen currently have some of the highest reported case counts.

India has reported 26,627 measles cases in the first half of 2026, making it the world’s second-highest tally. Recently, the country also reported two measles deaths in Kerala's Malappuram.

Bangladesh has reported 189,255 suspected measles cases nationwide since March. Confirmed and suspected measles-related deaths in Bangladesh have reportedly reached 1,099 this year.