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.

Japan has been granted the world's-first approval for two stem cell–based regenerative therapies, one for Parkinson’s disease and one for severe heart failure.

Stem cells are unspecialized foundational cells with the unique ability to self-renew and differentiate into various specialized cell types, such as muscle, blood or brain cells. They are essential for tissue repair, regeneration, and development, acting as an internal repair system.

Stem cell therapy, or regenerative medicine, uses stem cells or their derivatives to repair, replace, or regenerate diseased, dysfunctional, or injured tissue. It involves guiding stem cells to become specialized cells (heart muscle, nerve, or blood cells) to treat conditions like blood cancers, orthopaedic injuries, and neurodegenerative diseases.

Based on the Japanese approval, the Parkinson’s stem cell therapy treatment uses induced pluripotent stem cells (iPSCs) that are converted into dopamine-producing neurons and transplanted into the brain to replace cells lost during the disease.

Moreover, the heart failure therapy involves placing sheets of stem cell–derived heart muscle cells onto the heart, which may help restore cardiac function by promoting tissue repair and new blood vessel growth.

Both therapies received conditional approval, meaning they can be used clinically while researchers continue to collect additional safety and effectiveness data from patients.

What Is Parkinson's Disease?

Parkinson's disease is a progressive, neurodegenerative movement disorder caused by the loss of dopamine-producing brain cells, primarily affecting people over 60. Apart from motor loss, the disease also causes cognitive decline, depression, anxiety and swallowing problems.

The first symptom may be a barely noticeable tremor in just one hand or sometimes a foot or the jaw. Over time, swinging your arms may become difficult and your speech may become soft or slurred. The disorder also causes stiffness, slowing of movement and trouble with balance that raises the risk of falls.

Lifestyle Changes Can Prevent Parkinson's Disease

While Parkinson’s disease cannot be entirely prevented, experts suggest several lifestyle modifications that may reduce the risk. Dr Himanshu Champaneri, Senior Consultant in the Department of Neurosciences and Neurosurgery at Marengo Asia Hospitals in Gurugram told India Today that physical activity could aid in maintaining brain health. He recommends engaging in at least 150 minutes of moderate-to-intense exercise per week, including walking, running, swimming, and dancing.

Meanwhile, other experts have suggested that certain types of Parkinson's disease such as vascular Parkinsonism, are linked to the hardening of brain blood vessels. To mitigate this risk, she advises regular exercise, a low-fat diet, and monitoring blood pressure, sugar, and cholesterol levels. Additionally, industrial pollution is associated with an increased incidence of Parkinson's.

She suggests spending time in natural environments away from industrial pollutants to help lower the risk.

Menstruation is not a disability, and therefore, there is no need for mandatory period leaves, said experts, a day after the Supreme Court of India quashed the petition seeking a menstrual leave policy.

The top court expressed concerns that a law making paid leave during menstrual pain compulsory could harm the careers of young women and deprive them of equal opportunities.

While such a policy may look appealing from a “rights perspective,” the court noted it could have “long-term impacts.”

According to the 2025 Periodic Labor Force Survey (PLFS) data released by the Ministry of Statistics and Program Implementation (MoSPI), women’s labor force participation (LFPR) showed significant growth, reaching 35.3 percent in December 2025, driven largely by a consistent rise in rural areas, which peaked at 40.1 percent.

The female worker population ratio (WPR) also increased, reaching a yearly high in December, highlighting greater engagement in the workforce.

However, India’s female participation remains notably lower than the global average of nearly 49 percent and the OECD average of 67 percent, indicating a persistent, though shrinking, gender gap.

In this context, the court observed that a mandatory period leave policy could create the impression that women “still have some natural issues” and “are not at par with male persons.”

“Will an employer be happy if an employee takes leave every month? You risk creating a situation where employers may be reluctant to hire women,” the bench said.

Period Pain is Real. Paid Leave Unnecessary

HealthandMe spoke to several experts who agreed with the Supreme Court’s view, noting that while period pain and related concerns are real, they do not warrant paid leave for all women employees.

Periods affect women worldwide. For some, it comes with severe back pain, headaches, cramps, fatigue, and other symptoms. For others, the days pass with little discomfort.

“I feel mandatory menstrual leave for all female employees is unnecessary. While menstrual issues are real, not everyone suffers from them. Young women experience debilitating pain in about 1 in 10 cases, while women in their 40s may experience heavier bleeding, perhaps debilitating in 1 out of 7 individuals,” Dr. Ruma Satwik, Senior Consultant at Sir Ganga Ram Hospital, New Delhi, told HealthandMe.

Dr. Sabine Kapasi, a public health expert and UN advisor, emphasized that menstrual health deserves significant policy attention.

“But a universal requirement for leave may not be sufficient and is not necessarily the best approach,” she added.

Women have long faced societal and workplace stereotypes, with gender bias evident in wages, hierarchies, and opportunities. A LinkedIn report shows that gender disparity is more pronounced in leadership roles: in 2025, women held only 18 percent of top positions in India, far lower than their overall workforce representation.

“A policy must avoid inadvertently perpetuating gender bias in employment or career advancement,” Kapasi told HealthandMe.

During the Supreme Court hearing, Chief Justice Surya Kant said that with the mandatory menstrual leave law, employers might hesitate to hire women.

“We are creating ‘All Women Teams’ and ‘All Women Service Centers.’ How will they function if such a leave policy is approved? Menstruation is not a disability. It is a biological fact that women have managed over generations,” Indira Murthy, Retired Joint Secretary, Government of India, Advocate, High Court and Supreme Court, and Arbitrator, told HealthandMe.

A Sustained and Flexible Approach

Experts acknowledged the genuine challenges women face during menstruation and suggested alternative measures, including work-from-home arrangements.

Murthy noted that the Supreme Court emphasized voluntary employer initiatives, while also stating that proper institutional arrangements should ensure hygiene and safety for women and children.

“For some women, periods are very uncomfortable. They may be unable to work during these days. Companies can provide flexibility and allow period leaves,” said Dr. Alpna Kansal, President of IMA Ghaziabad.

Kapasi recommended a more sustained approach in workplaces, urging employers to recognize that conditions like endometriosis or severe dysmenorrhea can significantly impact well-being and productivity.

Flexible, stigma-free policies can help women while maintaining workplace fairness.

“Menstrual health awareness, workplace flexibility, access to care, and supportive leave policies integrated into broader occupational health frameworks should be priorities. Women’s health can be safeguarded with a balanced strategy without causing structural disadvantages at work,” Kapasi added.

Dr. Satwik noted that most cases of pain or heavy bleeding can be managed with medication.

“Only in rare cases would symptoms be refractory to treatment, requiring injections or surgical intervention. Those experiencing debilitating symptoms should be granted leave as part of standard sick leave,” she said.

Murthy emphasized that the Supreme Court did not propose a blanket ban.

“No one-size-fits-all policy works. Policy-making should benefit even the last person in the queue. Work-from-home arrangements are a sustainable solution to this issue,” she said.

The American Heart Association (AHA), along with the American College of Cardiology (ACC), today released new guidelines for managing dyslipidemia.

Dyslipidemia can be defined as abnormal levels of one or more types of lipids or lipoproteins in the blood, including cholesterol and triglycerides.

The new guidelines, jointly published in JACC, the flagship journal of ACC, and Circulation, the flagship journal of the AHA, emphasize the need to reduce cardiovascular risk by starting to screen early. It also calls for making lifestyle changes with a proper diet, weight control with exercise, to curb the risk of atherosclerotic cardiovascular disease (ASCVD).

ASCVD is caused by the buildup of fatty deposits in the arteries and is the leading cause of death globally.

The guidelines replace the 2018 Guideline on the Management of Blood Cholesterol and offer a comprehensive “one-stop shop”.

Instead of the usual focus on just bad cholesterol, it addresses the need to evaluate, manage, and monitor all dyslipidemias, including high blood cholesterol, hypertriglyceridemia, and elevated lipoprotein(a) (Lp[a]).

“While we want to try to optimize healthy lifestyle habits as the first step to lower cholesterol, we realize that if lipid numbers aren’t within the desirable range after a period of lifestyle optimization, we should consider adding lipid-lowering medication earlier than we would have considered 10 years ago,” said Roger S. Blumenthal, chair of the guideline writing committee.

“Lower [LDL-C] for longer, just like lower blood pressure for longer, results in much greater protection against future heart attack and stroke risk,” he added.

What Does The Guideline Say:

1. Early Screening

Early intervention through early screening and healthy lifestyle changes, starting from childhood, is the primary focus of the guidelines. It recommends:

• Children (9-11 years): Cholesterol screening if never done before.
• Adults (30-79 years): Evaluate 10- and 30-year ASCVD risk to determine the need for early intervention
• Considering lipid-lowering therapy for young adults with -- persistent LDL of at least 160 mg/dL, strong family history of ASCVD and/or at least 10 percent 30-year risk for ASCVD

• Family history of heart disease
• Chronic inflammatory diseases (e.g., lupus, rheumatoid arthritis)
• Metabolic conditions like obesity, diabetes, or chronic kidney disease
• Higher-risk ancestries, including South Asian or Filipino
• Early menopause, preeclampsia, gestational diabetes

• A healthy weight,
• regular physical activity,
• avoiding tobacco,
• healthy sleep habits
• cholesterol-lowering medications

2. LDL-C cholesterol

The guidelines state that individuals with healthy LDL-cholesterol levels or high-density lipoprotein-cholesterol (HDL-C), “cannot ‘get out of jail free’ card”. It is important to measure other biomarkers, such as:

• lipoprotein(a) [Lp(a)],
• apolipoprotein B (apoB),
• high-sensitivity C-reactive protein (hsCRP)
• elevated triglycerides

Further, it indicates that LDL-C should be less than

• 100 mg/dL borderline or intermediate risk
• 70 mg/dL for people at high risk
• 55 mg/dL for people at very high risk/need secondary prevention

The guidelines recommend:

• Starting lipid-lowering therapy for people age 40 or older with chronic kidney disease (stage 3 or higher), HIV or Type 1 or Type 2 diabetes
• Continuing lipid-lowering therapy in people being treated for cancer, unless contraindicated
• Deferring most lipid-lowering therapies during conception, pregnancy and lactation