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.

Spain’s Health Ministry has confirmed a hantavirus case in a person evacuated from the MV Hondius cruise ship and currently under medical quarantine in Madrid, taking the total number of cases to 13.

According to the ministry, this is the second hantavirus case among Spaniards who remain in quarantine at the Gómez Ulla Central Defence Hospital in Madrid. Around 12 people continue to remain under medical quarantine.

Hantavirus Detected During Routine PCR Testing

The new positive case involves one of the individuals identified as a close contact of the initial outbreak, who was already in isolation and under medical supervision in accordance with protocols established by the Early Warning and Rapid Response System. Health authorities said the case was detected during routine PCR testing and does not pose an increased risk to the general population, Euronews reported.

The remaining 12 Spaniards continue to stay in quarantine and under medical observation, while authorities maintain isolation measures until the 42 days outlined in international protocols have elapsed.

Also read: WHO Chief Warns Ebola Epidemic ‘Outpacing Us’; India Intensifies Screening At Airports

Hantavirus Outbreak Remains Stable: WHO

The new case comes after Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, stated during the 159th session of the Executive Board that no new deaths and infections linked to the rat-borne virus have been reported.

“The hantavirus outbreak is now stable, with one new case in the past two weeks, and no new deaths since May 2,” he said.

According to the WHO, the outbreak has resulted in 12 total cases, including 10 confirmed and two probable infections, along with three deaths.

“All passengers and crew remain in quarantine and under close monitoring to ensure they receive care if needed,” Tedros added.

Passengers And Crew Still Under Monitoring

All passengers have now been repatriated and will remain under monitoring until the quarantine period ends on June 21. Crew members will remain in quarantine until June 29.

A Dutch couple is believed to have first been exposed to the virus while visiting a birdwatching site in Argentina.

“There is no sign that we are seeing the start of a larger outbreak. But of course, that could change, and we urge all affected countries to continue monitoring the passengers and crew carefully. I thank the many countries involved in the response,” Tedros said.

What Is Hantavirus?

As per the WHO, hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans.

Globally, an estimated 100,000 to 200,000 hantavirus infections occur each year. The majority of these cases are in Asia, particularly China. Most are sporadic or occur in small clusters, linked to contact with infected rodents.

Infection in people can result in severe illness and often death, although the diseases vary by type of virus and geographical location.

The WHO has confirmed that the Andes strain of hantavirus — the only strain known to spread from person to person — is responsible for the outbreak. There is currently no vaccine available for the strain.

Notably, the WHO has not specified the type of hantavirus or syndrome in the cruise incident, but did mention respiratory risks.

The hantavirus is primarily spread by rodents through

• exposure to their urine,
• droppings,
• saliva,
• less commonly through a scratch or bite.

The Health Ministry in Italy has issued a health alert after two suspected cases of Ebola were detected in the province of Como.

While the official statement stressed that “the risk of Ebola in Italy remains very low", it has raised concerns of a larger outbreak of the deadly virus that has so far affected over 900 people in Africa’s Democratic Republic of Congo and Uganda. More than 200 deaths have also been reported.

The health alert in Italy's northern Lombardy region concerns a woman from Lurate Caccivio and a man from Bulgarograsso, both of whom returned from Uganda in the past 24 hours after spending around three months there as humanitarian aid workers, EuroNews reported.

“Both have developed symptoms consistent with the Ebola virus, including high fever, nausea, vomiting, and intestinal problems,” the statement said.

“They were quickly transferred to Milan's Sacco Hospital, a specialist facility for the management of high-risk infectious diseases, where tests required under national and international protocols are underway,” it added.

Ebola Not Confirmed Yet

Although the emergency procedures had been activated, there is currently no official confirmation of the presence of the Ebola virus, said Lombardy's regional welfare minister, Guido Bertolaso.

"There is still no certainty that this is Ebola," Bertolaso said at a press conference, explaining that the results of diagnostic tests are expected later on Monday and that "we are hopeful they will be negative."

Doctors reportedly also consider a form of malaria to be the more likely diagnosis, possibly cerebral malaria in the case of the 30-year-old woman, who may need to be admitted to intensive care.

The woman is reported to have developed more severe symptoms, including a very high fever and mild neurological issues. Her daughter is also thought to have contracted malaria while they were in Uganda, the report said.

The clinical picture is milder for the 31-year-old resident of Bulgarograsso, who has a temperature of around 38 degrees Fahrenheit and gastrointestinal problems, but health authorities nonetheless immediately activated surveillance protocols for suspected Ebola cases because of where the patients had travelled from.

The other five members of the two families involved are also being monitored and kept under surveillance by the health authorities.

Read More: Ebola Alert: India And US Step Up Airport Screening; WHO Warns Bundibugyo Vaccine Could Take Months

Ebola Outbreak: 10 countries at risk

The outbreak, which has also spread from DR Congo to Uganda, has been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO).

According to the African Union's health agency, more countries on the continent are at risk of being affected by the Ebola virus.

"We have 10 countries at risk," said Jean Kaseya, head of the Africa Centres for Disease Control and Prevention (Africa CDC), listing the following:

1. Angola
2. Burundi
3. Central African Republic
4. Republic of Congo
5. Ethiopia
6. Kenya
7. Rwanda
8. South Sudan
9. Tanzania

Why Ebola Spread Is Not Like COVID

The virus is raising serious global health concerns, with Tedros Adhanom Ghebreyesus, WHO Director General, stating that the ongoing Ebola outbreak "is spreading rapidly" and "outpacing us". Yet experts say that it is not COVID and cannot spread like it.

“Ebola does NOT spread through casual airborne exposure like influenza or COVID-19. Individuals become infectious only after symptoms begin, not during the incubation period. The incubation period ranges from 2 to 21 days,” said Dr. Ishwar Gilada, Secretary General, People’s Health Organisation (India).

Experts further explained that Ebola is far more difficult to spread than airborne respiratory viruses such as influenza, COVID-19, measles, and even the Andes strain of hantavirus, which recently caused an outbreak on a cruise ship.

It is because Ebola is not airborne. Ebola does not spread through coughing, sneezing, or casual contact like shaking hands. It spreads only via body fluid contact.

In addition, people with Ebola also do not spread the virus before developing symptoms. This means that during Ebola’s incubation period, which ranges from 2–21 days, an infected person is generally not contagious, unlike COVID-19, where transmission can occur before symptoms appear.

The hantavirus outbreak, which began late in April aboard the MV Hondius cruise ship, is now stable, according to the World Health Organization (WHO).

Sharing opening remarks at the 159th session of the Executive Board today, WHO Director-General Tedros Adhanom Ghebreyesus said that no new cases and deaths of the rat-borne virus have been reported.

“The hantavirus outbreak is now stable, with one new case in the past two weeks, and no new deaths since May 2,” he said.

The outbreak resulted in 12 total cases (10 confirmed, 2 probable) and 3 deaths.

“All passengers and crew remain in quarantine and under close monitoring to ensure they receive care if needed,” the WHO Chief added.

All the passengers have been repatriated and will be monitored until the quarantine period ends on June 21. The crew will also be quarantined until June 29.

A Dutch couple is believed to have been first exposed to the virus while visiting a birdwatching site in Argentina.

“There is no sign that we are seeing the start of a larger outbreak. But of course, that could change, and we urge all affected countries to continue monitoring the passengers and crew carefully. I thank the many countries involved in the response,” Tedros said.

Also read: WHO Chief Warns Ebola Epidemic ‘Outpacing Us’; India Intensifies Screening At Airports

The current outbreaks of Ebola and hantavirus remind us that the next pandemic will not wait for us, he noted, urging countries to work on making the Pandemic Agreement operational.

The WHO has confirmed that the Andes strain of hantavirus — the only strain known to spread from person to person — is behind the outbreak. The strain has no vaccine.

Meanwhile, the Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said he signed a targeted Public Readiness and Emergency Preparedness Act declaration “to support the development and deployment of medical countermeasures related to the Andes virus” strain of hantavirus.

“This action helps remove barriers to research and response efforts while we continue monitoring the recent outbreak linked to the South Atlantic cruise ship,” Kennedy said in a statement posted to social media. “HHS is taking this situation seriously and will continue working to protect public health and support the safe development of potential treatments and countermeasures.”

What Is Hantavirus?

As per the WHO, hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans.

Globally, an estimated 100,000 to 200,000 hantavirus infections occur each year. The majority of these cases are in Asia, particularly China. Most are sporadic or occur in small clusters, linked to contact with infected rodents.

Infection in people can result in severe illness and often death, although the diseases vary by type of virus and geographical location.

Notably, the WHO has not specified the type of hantavirus or syndrome in the cruise incident, but did mention respiratory risks.

The hantavirus is primarily spread by rodents through

• exposure to their urine,
• droppings,
• saliva,
• less commonly through a scratch or bite.