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.

The US Food and Drug Administration (FDA) has approved updated COVID vaccines from Moderna, Pfizer-BioNTech and Novavax-Sanofi for the 2026-27 season, the companies said.

Four COVID vaccines have been approved for use in the US after an advisory panel recommended that the shots target the dominant XFG variant.

What Are The New COVID Vaccines?

Moderna: mNEXSPIKE and Spikevax

• Spikevax: Approved for people aged 6 months through 64 who have an underlying condition, and anyone aged 65 or older.
• mNEXSPIKE: Approved for people aged 12 through 64 who have an underlying condition, and anyone aged 65 or older.

Pfizer-BioNTech: Comirnaty

It is approved for:

• All adults aged 65 and older.
• People aged 5 through 64 who have a condition that raises their risk of severe illness.

Novavax-Sanofi: Nuvaxovid

• Nuvaxovid is the only protein-based COVID vaccine available in the US. It is approved for everyone aged 65 and older and for those aged 12 through 64 who have underlying conditions.

The vaccine targets the JN.1 strain.

When Will The Updated Shots Be Available?

All manufacturers had previously said they could make the updated shots in time for the 2026-27 immunization season, although Novavax could take longer to manufacture its vaccine.

The Donald Trump administration had shelved the universal COVID vaccine recommendation. It now recommends that everyone aged 6 months and older consult a healthcare provider before getting the shot.

In May, eight of the committee's nine experts voted in favor of targeting the XFG variant for the 2026-27 campaign.

For the 2025-26 season, the FDA had recommended that COVID shots target LP.8.1, a subvariant of the JN.1 strain. The CDC has yet to make an official recommendation for this year's vaccines.

Experts say the vaccines should begin reaching pharmacies and doctors' offices in September, CNN reported.

What Is The Current COVID Situation In The US?

The CDC's latest respiratory illness data, updated August 21, shows that national and regional COVID-19 activity is increasing, although overall acute respiratory illness causing people to seek healthcare remains very low.

Doctors have been reporting an increase in patients testing positive through the summer. But some physicians are noticing a change in how the illness is presenting.

Reports have emerged stating that COVID is resurfacing with new symptoms including nausea, vomiting and diarrhoea.

COVID-19-related visits to the emergency room are also increasing.

Recent reports from doctors in Georgia describe patients arriving with gastrointestinal symptoms alongside, or sometimes instead of, the more familiar respiratory symptoms.

Although these symptoms may seem unusual compared with the classic COVID presentation, nausea, vomiting and diarrhoea are not new symptoms of COVID-19.

The CDC has included nausea, vomiting and diarrhoea among the possible symptoms of COVID-19 for years.

Dr James Black, medical director of emergency services at Phoebe Putney Memorial Hospital in Albany, Georgia, said doctors are still seeing fever, cough and upper-respiratory symptoms, but added, “A lot of people are coming in with gastrointestinal symptoms - nausea, vomiting, diarrhea, sometimes to the point of mild dehydration.”

Even as the Ebola outbreak caused by the rare Bundibugyo Ebola virus continues to spread, a new case study has revealed a striking finding: the lesser-known virus can remain at very high levels in a patient’s throat.

Ebola viruses are primarily known to attack the vascular system, damaging blood vessel integrity and disrupting the body’s ability to clot. This can lead to severe fluid loss, organ failure and, in some cases, internal or external bleeding.

However, a case study of a 39-year-old American healthcare worker infected with Bundibugyo Ebola virus in the Democratic Republic of the Congo (DRC) found that his throat carried more than 10 times as much viral RNA as his blood.

The patient was later medically evacuated to Germany, where he received experimental treatment at a high-level isolation unit in Berlin.

Throat Carried 10 Times More Virus

On day five of illness, testing showed:

• Throat: About 90 million viral RNA copies/mL
• Blood plasma: About 7 million copies/mL
• Difference: The throat had more than 10 times the viral RNA found in blood.

The case was published in Nature Medicine by researchers from Charité – Universitätsmedizin Berlin, with collaborators including the CDC, US Department of State, Robert Koch Institute, Emory University and Congo’s Institut National de Recherche Biomédicale.

How Was He Exposed?

The healthcare worker had performed an ultrasound nine days before symptoms began.

Eight days before symptoms, he performed two surgeries using standard personal protective equipment and reported no specific high-risk exposure.

He voluntarily isolated himself when symptoms began. His early symptoms included:

• Severe muscle pain and malaise
• 38.9°C fever despite acetaminophen
• Positive pan-Ebola PCR on plasma by day two

By day three, he developed abdominal pain, vomiting, confusion and orthostatic symptoms.

Experimental Treatment Was Given

Bundibugyo Ebola virus has so far caused three recorded outbreaks, but there are currently no licensed vaccines or specific treatments for the disease.

The patient had received a dose of rVSV-ZEBOV 41 months earlier, but that vaccine targets the Zaire species.

He received the investigational antibody cocktail MBP134 on day four, along with a 200 mg loading dose of remdesivir off-label.

He reached Berlin on day five with thrombocytopenia, lymphopenia and elevated liver enzymes.

Viral RNA Cleared From Most Samples

By day 13, viral RNA was below detection levels in his:

• Plasma
• Throat
• Urine
• Stool

However, the virus was still detected in semen on day 20 but was gone by day 25. Three laboratories failed to culture live virus from throat, plasma or semen samples, the report said.

The researchers cautioned that this cannot be directly attributed to MBP134 because pre-treatment culture data were unavailable. The patient was discharged 22 days after symptom onset.

His Immune System Also Responded

Researchers found rising antibodies against the virus between days five and six, along with virus-specific IgM and IgA, suggesting that his own immune system mounted a response despite receiving monoclonal antibodies.

However, the researchers stressed that the case does not prove MBP134, remdesivir or their combination works. Larger studies are needed.

Congo Ebola Outbreak

Congo declared the outbreak in Ituri Province on May 15, 2026, followed by a WHO public health emergency of international concern two days later.

As of August 22, the ECDC reported:

• 5,514 confirmed cases
• 2,642 deaths
• 4,607 cases and 2,065 deaths in Ituri

The Cyclospora outbreak ongoing in the US since May this year has reached 17,180 cases, compared with 1,180 cases through August last year, according to the latest figures released by the Centers for Disease Control and Prevention (CDC).

The cases, reported across 48 states plus the District of Columbia, include two deaths, while 922 people have been hospitalized.

In addition, the CDC is investigating 11,844 additional cases that have not yet been laboratory-confirmed. The federal agency added that the true number of people sick with cyclosporiasis is likely higher because some people recover without medical care and are not tested for Cyclospora.

“Recent illnesses may not yet be reported due to the time it takes to identify and report Cyclospora cases. It can take about six weeks from the start of symptoms to when CDC receives the case information,” the CDC said.

Cyclospora Cases Expected To Dwindle

Historically, the cyclosporiasis season in the United States runs from May 1 through August 31, so cases should dwindle as summer ends, the CDC said.

The largest outbreak this summer was reported in Michigan. Last week, Michigan noted a 3% increase in cases, bringing the state's total to 14,277 cases.

Outbreak Linked To Iceberg Lettuce

The outbreak has been linked to iceberg lettuce, particularly lettuce produced by Taylor Farms de Mexico. The lettuce was sold at stores and at Taco Bell restaurants across the US before it was recalled.

Cyclosporiasis is caused by a parasite that spreads through food and water contaminated with infected human feces.

The Food and Drug Administration, which oversees food safety, has said it is “confident that all recalled iceberg lettuce related to this specific Cyclospora outbreak is off the market.”

While an average American reportedly eats about 18.3 pounds of lettuce each year, consumers purchased about 7.6 million fewer pounds of lettuce during the four weeks ending July 18 compared with the same period last year, according to The Wall Street Journal.

Is It Safe To Eat Lettuce Right Now?

Food safety experts noted that people can eat lettuce now, but should choose their greens wisely.

“Consumers should make informed choices rather than avoiding leafy greens altogether,” said Darin Detwiler, a professor at Northeastern University, Food & Wine reported.

Because the recalls so far are tied to specific products from one producer and have not expanded to include other lettuce producers, other products are likely OK, Detwiler said.

“Consumers should follow FDA and CDC recall information rather than assuming every leafy green product is unsafe,” he said.

Wade Syers, an extension specialist for food safety at Michigan State University Extension, said the ongoing Cyclospora investigation “does not mean all lettuce or all leafy greens are unsafe.”

How To Prevent Cyclospora Infection

To reduce the risk of infection, the CDC recommends:

• Wash your hands before handling food.
• Wash fresh produce under running water before eating, preparing or cooking it.
• Cook food to at least 158°F (70°C) to kill Cyclospora.
• Follow CDC and FDA recall notices and avoid recalled products.
• Avoid bagged salad mixes.