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.

Vitiligo, an autoimmune condition that causes patches of skin to lose pigment, can be difficult to treat. Repigmentation often takes months, and results vary.

Now, two Phase 3 clinical trials, led by an international team of scientists from France, the US and Canada, found that an experimental oral drug, povorcitinib, improved skin pigmentation in adults with moderate-to-severe nonsegmental vitiligo.

What Did The Study Find?

Published in Nature Medicine, the trials STOP-V1 and STOP-V2 involved 916 adults and evaluated once-daily povorcitinib, which blocks JAK1, a protein involved in immune signalling. Key findings include:

• Facial repigmentation: After 52 weeks, 18.9% of patients receiving povorcitinib in both trials achieved at least 75% improvement, compared with 6.8% and 3.1% in the placebo groups.
• Whole-body repigmentation: At least 50% improvement was reported in 18.4% and 12.9% of treated patients, compared with 6.5% and 4.8% in the placebo groups. Only 2.6% and 2.3% achieved at least 75% improvement.
• Disease stabilisation: Exploratory analyses found that 94.3% and 87.6% of treated patients had no increase in disease severity at week 52, compared with 71.8% and 69.2% in the placebo groups.

Are Their Any Safety Concerns?

Overall adverse event rates were broadly similar between the treatment and placebo groups. However, four patients receiving povorcitinib developed basal cell carcinoma, with one case considered treatment-related. One patient experienced blood-clotting complications, including pulmonary embolism and deep vein thrombosis, also considered treatment-related.

Although the findings are encouraging, most patients did not achieve at least 75% facial improvement, and substantial whole-body repigmentation remained uncommon. Longer-term safety data are also needed. Povorcitinib remains investigational and is not yet an established vitiligo treatment.

What Is Vitiligo?

Vitiligo occurs when the immune system attacks melanocytes, the cells responsible for producing skin pigment. Although it is not life-threatening, it can significantly affect emotional and psychological well-being.

Speaking to HealthandMe, Dr Hetanshu Parekh, Consultant Plastic, Reconstructive and Cosmetic Surgeon, Bhailal Amin General Hospital, said vitiligo is more complex than a skin condition alone.

He explained that stress, sleep, diet and skin trauma may influence the disease.

Stress: Stress can disrupt immune balance and increase inflammation, potentially worsening vitiligo. New or expanding patches may appear following major life events, including illness, work pressure or bereavement.

Sleep: Chronic sleep deprivation and irregular sleep schedules may affect immune regulation and potentially worsen autoimmune conditions.

Diet: There is no specific vitiligo diet or food that can cure the condition. Deficiencies in vitamin B12, vitamin D, folate and copper may affect immune and skin health. A balanced diet rich in fruits, vegetables, whole grains, nuts, seeds and omega-3 fatty acids is recommended. Smoking and excessive alcohol consumption should be avoided.

Skin Protection: Friction, cuts, burns and other skin injuries may trigger new patches through a phenomenon known as the Koebner phenomenon. Regular sunscreen use, protective clothing and avoiding repeated skin trauma can help protect the skin.

Is Vitiligo Treatable?

Treatment depends on the extent and stability of the condition.

• Topical medications: Corticosteroid creams and tacrolimus ointment for limited patches.
• Phototherapy: Narrowband UVB and excimer laser to encourage repigmentation.
• Oral medications: Corticosteroids and selected JAK inhibitors for extensive or rapidly spreading disease.
• Surgery: Skin grafting and melanocyte transplantation for selected patients with stable vitiligo.
• Camouflage: Medical tattooing and cosmetic products to conceal patches.

Healthcare has emerged as a major concern in US midterm elections. Voters have been actively weighing surging medical costs, quality and access to reproductive healthcare, Medicaid funding and vaccination policies.

While the elections will determine control of Congress and several state legislatures, their outcome could also influence how Americans navigate healthcare, what treatments insurance plans cover and how public health programmes are funded.

Healthcare costs are particularly pressing for majority of Americans. An October KFF poll found that 25% of voters were very worried about affording healthcare, while another 35% were somewhat worried.

According to ABC News, rising insurance premiums, prescription drug costs and the growing use of expensive weight-loss GLP-1 medications are adding to these concerns.

Here are all the major healthcare issues at stake.

Rising Healthcare Costs And Insurance Premiums

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Affordability is one of the biggest healthcare concerns for voters. The enhanced Affordable Care Act (ACA) premium tax credits expired at the end of 2025, increasing what many people pay for health insurance.

According to KFF, the average monthly benchmark premium for ACA coverage rose from $497 in 2025 to $625 in 2026. The benchmark silver premiums are projected to increase by an average of 13% in 2027.

The rising cost of insurance sponsored by employers, deductibles and prescription medicines has contributed to the burden. Experts are examining the contribution of healthcare AI tools, tariffs on medical supplies and increased spending on GLP-1 medications.

The debate centres on how to make healthcare more affordable. Democrats have been emphasising the restoration of ACA subsidies and Republicans highlighting alternative insurance policies and drug-pricing initiatives.

Medicaid Funding And Work Requirements

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Medicaid, the government health insurance programme for Americans with low income, is another major election issue.

Changes introduced under the 2025 budget reconciliation law will bring new eligibility and work requirements. Starting January 1, 2027, most states will be required to implement work requirements for certain adults enrolled through Medicaid expansion.

Supporters argue that the requirements will encourage employment and protect public resources. Critics warn that administrative red tape, reporting requirements and difficulties documenting eligibility could cause people who qualify to lose coverage.

According to KFF, Congressional Budget Office projections cited in its analysis estimate that the Medicaid provisions could leave 7.5 million more people uninsured by 2034.

Abortion Rights And Reproductive Healthcare

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Abortion remains a major issue in several state-level elections, particularly after the overturning of Roe v. Wade in 2022, which put an end to the constitutional protection for abortion access.

According to the Guttmacher Institute, voters in four states will consider ballot measures related to abortion.

Idaho, Nevada and Virginia have measures seeking to protect reproductive freedom, while Missouri voters will decide whether to repeal established abortion protections.

Virginia’s measure includes protections related to contraception, fertility care, pregnancy and childbirth, while Nevada’s proposal seeks constitutional protection for abortion access. Idaho’s initiative would challenge the state’s abortion ban.

Missouri’s Amendment 3, meanwhile, seeks to reverse the reproductive freedom protections approved by voters in 2024.

The results could shape access to abortion and other reproductive healthcare services.

Measles Outbreaks And Vaccination Policies

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Vaccination and public health debates have also become politically inflammatory, especially amid the resurgence of measles in the United States.

The CDC reported 4,852 confirmed measles cases across 47 jurisdictions as of October 29, 2026. This compares with 2,289 cases reported during the whole of 2025. Nearly 96% of this year’s confirmed cases were linked with outbreaks.

Declining childhood vaccination coverage has contributed to the concerns. CDC data shows that MMR vaccination coverage among kindergarten children fell from 95.2% in the 2019–2020 school year to 92.4% in 2025–2026, below the 95% level that is generally needed to maintain community protection.

Federal vaccine policy has also become a subject of debate as changes to childhood vaccine recommendations and emphasis on individual decision making has drawn scrutiny from public health experts.

Prescription Drug Prices And Access To Medicines

The cost of prescription medicines is another issue. Democrats have emphasised Medicare’s ability to negotiate prices for selected prescription drugs under the Inflation Reduction Act.

Republicans have highlighted the administration’s most-favoured-nation drug-pricing agreements, which seek to link US medicine prices to those paid in other developed countries.

The growing use of GLP-1 medications has also intensified the debate over prescription spending and insurance coverage.

A recent report stated that spending on GLP-1 medicines increased from $13.7 billion in 2018 to $71.7 billion in 2023. These medicines accounted for approximately 14% of US prescription drug spending in 2025, according to the American Society of Health-System Pharmacists.

The primary question for voters is whether proposed pricing measures will translate into lower costs and better access to essential medicines.

With all 435 seats in the House of Representatives and 33 Senate seats up for election, the midterm elections will determine the composition of the next Congress. Although healthcare is not the only issue for voters, rising medical costs, insurance affordability, reproductive rights and public health policies have become an important part of the debate.

Spanish striker Jesus de Miguel, who played for Tenerife, died on Tuesday at the age of 30, a day after suffering a cardiac arrest following a collision during a match, the Spanish second-tier club said.

His death has brought attention to commotio cordis, a rare condition in which a sudden, blunt impact to the chest disrupts the heart's electrical rhythm and triggers cardiac arrest.

What Happened To Jesus De Miguel?

De Miguel collapsed following a clash with visiting goalkeeper Jesus Owono. Owono had rushed out of his area to clear a long ball and struck the forward with his knee.

De Miguel lay motionless as players from both teams signalled for medical assistance. Owono was shown a straight red card.

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Medical staff treated De Miguel on the pitch for more than five minutes before he was taken to hospital by ambulance.

Police in Spain have opened proceedings for possible involuntary manslaughter following De Miguel's death, a source from the National Police said. The investigation is a routine procedure under Spanish law when a death is deemed non-natural.

"Racked with pain, with a lump in our throats and unable to believe that this is true, from CD Tenerife we communicate the tragic passing of Jesus de Miguel Alameda," the club said.

"There are no words of comfort; there is absolutely nothing that can alleviate this feeling overflowing with sadness."

De Miguel was born in Madrid in 1996 and joined Tenerife from Castellon ahead of the 2025-26 campaign, scoring 11 goals last season.

Tenerife confirmed that De Miguel died at 8 am local time on Tuesday. Spanish media subsequently reported that emergency-services specialist Javier G. Rendo had raised the possibility of commotio cordis, suggesting that the impact to the chest may have triggered an electrical disturbance in the heart. This has not been established as the confirmed cause of death.

What Is Commotio Cordis?

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According to Cleveland Clinic, commotio cordis occurs when a blow directly over the heart strikes at a particularly vulnerable moment in the heartbeat, triggering an abnormal rhythm called ventricular fibrillation.

It is most commonly associated with sports in which hard objects, such as baseballs, hockey pucks or lacrosse balls, hit the chest. A punch or other blunt impact can also trigger the condition under specific circumstances.

Commotio cordis is most common among young male athletes, particularly those under 20, with cases often reported around the age of 15.

Symptoms may include:

• Sudden collapse after a blow to the chest.
• Loss of consciousness or unresponsiveness.
• Abnormal heart rhythm, particularly ventricular fibrillation.
• Cardiac arrest.

Can Commotio Cordis Be Fatal?

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Yes. Commotio cordis can cause sudden cardiac arrest and can be fatal without immediate treatment.

The US National Commotio Cordis Registry documented 224 cases between 1996 and 2010, although its records have not been publicly updated since 2013. A 2026 review identified 434 reported cases worldwide. These figures refer to reported cases, not deaths.

However, prompt CPR and the use of an automated external defibrillator (AED) can improve the chances of survival.

What Should Be Done Immediately After Suspected Commotio Cordis?

Commotio cordis is a medical emergency. If someone collapses after a blow to the chest and is unresponsive or not breathing normally, immediate action is critical.

• Call emergency services: Seek immediate medical help.
• Start CPR: Begin chest compressions at 100–120 per minute.
• Use an automated external defibrillator (AED): Switch it on and follow the voice instructions.
• Continue CPR: Resume chest compressions immediately after the AED analysis or shock and continue until medical help arrives.