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.

Cancer death rates among American men and women declined from 2019 to 2023, continuing a downward trend that has lasted more than 20 years, according to a new CDC report.

The 2026 Annual Report to the Nation on the Status of Cancer, published in the journal Cancer, found that the continued decline in cancer mortality was driven largely by sustained progress against lung cancer.

“Cancer incidence was stable among males but increased slowly among females. Cancer mortality continued to decline, largely because of sustained progress against lung cancer,” the report said.

Cancer Death Rates Continue To Fall

The overall cancer death rate during 2019–2023 was 145.4 per 100,000. It was higher among males (171.5 per 100,000) than females (126.3 per 100,000)

Cancer death rates decreased among males and females of every race and ethnicity. From 2004 to 2023, the cancer death rate declined by:

• 1.6%–2.1% per year among males

• 1.1%–1.8% per year among females

Between 2019 and 2023, death rates among males decreased for 12 of the 18 most common cancers, remained stable for four and increased for two.

Among females, death rates decreased for 12 of the 19 most common cancers, remained stable for three and increased for four. The largest declines were seen in lung cancer and myeloma.

Lung Cancer Progress Drives Decline

Lung cancer recorded the largest decline in cancer mortality between 2019 and 2023:

• Males: 4.7% decline per year

• Females: 3.0% decline per year

Lung cancer incidence also decreased between 2018 and 2022:

• Males: 3.5% decline per year

• Females: 1.9% decline per year

Researchers attributed the progress partly to:

• A roughly 50% decline in smoking since the early 2000s

• A two-thirds increase in early-stage lung cancer diagnoses

• A doubling of the five-year relative survival rate for lung cancer

Lung cancer remains the leading cause of cancer death among both men and women in the United States. It is also the second most commonly diagnosed cancer among men, after prostate cancer, and among women, after breast cancer.

Cancer Incidence Trends

While cancer mortality continued to decline, incidence trends were different.

Overall cancer incidence rates were 504.6 per 100,000 among males and 443.0 among females during 2018–2019 and 2021–2022. The year 2020 was excluded because of pandemic-related diagnostic delays.

Incidence rates:

• Remained stable among males from 2013 to 2022

• Increased 0.4% per year among females from 2011 to 2022

Among males, stable overall incidence was driven by a decline in lung cancer, which offset an increase in prostate cancer.

Incidence decreased for cancers of the:

• Larynx

• Bladder

• Liver

• Non-Hodgkin lymphoma

• Colorectal cancer

• Thyroid

• Brain and other nervous system

Rates increased for cancers of the oral cavity and pharynx and pancreas, while rates for seven of the 18 most common cancers remained stable.

Prostate cancer incidence increased while lung cancer incidence decreased among males across every race and ethnicity. Colorectal cancer incidence decreased among White males but remained stable among other males.

Breast And Prostate Cancer Drive New Cases

The report also examined trends in new U.S. cancer cases from 2003 to 2022. Overall cancer incidence rose slightly each year from 2018 to 2022, driven by increases in breast cancer among women and prostate cancer among men.

Breast and prostate cancer remained the most commonly diagnosed cancers among women and men, respectively.

Despite the increase in prostate cancer, the overall rate of new cancer cases among men remained stable.

The report also noted that continued progress in cancer prevention and control will depend on tobacco-free environments, preventive care, screening, timely diagnosis, state-of-the-art treatment and survivorship care.

The World Health Organization (WHO) has updated its contraception guidance, recommending mifepristone as an additional emergency contraception option and providing new guidance on contraceptive pills and implants.

The recommendations aim to expand access and give people more flexibility in choosing and using contraception.

“Choice is a gender equality issue,” said Pascale Allotey, Director of WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing.

“Contraception isn't one-size-fits-all. Men and women both need a range of options that reflect what science and innovation can now offer, weighed against convenience, invasiveness, behavior, reliability and accessibility. Real choice means the confidence and control to choose a method, change it, or stop it.”

What’s New In The WHO Guidance?

The guideline covers five areas: three contraceptive methods not previously included in WHO guidance and two changes to existing contraceptive practices.

These include:

• Mifepristone: Recommended as an additional emergency contraception option.
• Ormeloxifene: WHO suggests against adding it because more high-quality safety and efficacy evidence is needed.
• Quinestrol-containing pills: WHO recommends against adding the specified combinations, citing limited evidence and the need for safety monitoring.
• Combined oral contraceptive pills: Can be used for extended periods of up to six months or continuously for up to one year, alongside cyclical use.
• Etonogestrel implants: Can be used for up to five years, in line with the updated manufacturer-approved duration.

Mifepristone For Emergency Contraception

WHO recommends a 10–50 mg single dose of mifepristone for emergency contraception, taken as soon as possible and within five days of unprotected sex. A 10–25 mg dose may be preferred where available.

Ormeloxifene And Quinestrol

• WHO suggests against ormeloxifene due to insufficient safety and efficacy evidence.
• It also recommends against quinestrol-quingestanol and quinestrol-norgestrel, and suggests against quinestrol-levonorgestrel. Safety monitoring is advised where quinestrol products are used.

Longer Use Of Pills And Implants

• Combined oral contraceptive pills can be used for up to six months in extended regimens or continuously for up to one year.
• WHO also supports etonogestrel implants for up to five years, potentially reducing replacement procedures and clinic visits.

Why Contraceptive Access Matters

The number of women of reproductive age using modern contraception rose 87% between 1990 and 2022, from 467 million to 874 million. Yet an estimated 164 million women who want to delay or avoid pregnancy are not using contraception and have an unmet need for family planning.

WHO says expanding access must go hand in hand with identifying methods that lack sufficient evidence for wider use.

WHO Pushes For More Male Contraceptive Choices

Men currently have relatively few contraceptive methods under their control, mainly condoms, withdrawal and vasectomy. Still, around 30% of couples rely on a male method.

A new global study in Contraception found that more than 75% of couples surveyed would be willing to use a new male contraceptive, while more than 85% of women said they would trust their male partners to take responsibility for contraception.

The WHO also developed its first Target Product Profile for male contraceptive methods, outlining desired characteristics such as safety, effectiveness, acceptability and affordability.

Several hormonal and non-hormonal male contraceptives are in development, with some candidates in advanced clinical trials. New reversible male contraceptives could potentially reach the market within the next five to 10 years, according to WHO.

The Democratic Republic of the Congo is actively expanding Ebola treatment capacity as the country battles its worst and fastest-growing Ebola outbreak. But a growing shortage of health workers is threatening the ability to run the new treatment centres and contain and manage transmission and infections.

According to the latest figures by Congolese authorities on September 23, the outbreak has across into seven provinces, with 7,773 confirmed cases and 3,759 deaths. The WHO says transmission remains out of control, even though cases are going down in some areas.

The situation is particularly grim in North Kivu, where cases increased by 73% over three weeks. At the same time, cases fell by 26% in Ituri and 15% in Haut-Uele between August 31 and September 20, highlighting how differently the outbreak is behaving across provinces.

More Treatment Centres May Not Be Enough

The country has rapidly increased its capacity to treat patients. By September 1, affected provinces had 59 facilities with 1,346 beds, compared with just one nine-bed treatment centre when the response began in May. More than 4,000 additional health workers had also been deployed.

But beds and buildings can only help if there are enough people to staff them. According to WHO officials, an Ebola treatment centre can require around 300 healthcare professionals, including doctors, nurses, anaesthetists and hygiene staff. Some newly established centres therefore do not have enough personnel to operate at full capacity.

This creates a difficult situation of treatment infrastructure being expanded, but the workforce needed to run it is not keeping pace.

Also read: DR Congo Begins Ebola Vaccinations Targeting 20,000 Health Workers As Fatalities Cross 3,500

Ebola Pressure On Health Workers

Ebola treatment is particularly laborious as healthcare workers must provide intensive care while following strict infection-prevention measures.

Patients may require monitoring for dehydration, bleeding and other complications, while staff must work in protective equipment and follow procedures designed to prevent transmission.

The response has also been impacted by insecurity, population displacement, movement between communities and a strike by some health workers over unpaid wages. These factors can make it harder to maintain staffing.

Early treatment is key as many patients are still reaching healthcare facilities late. WHO previously reported that around 60% of weekly Ebola deaths were occurring in communities rather than treatment centres, pointing to delays in detection and access to care.

Also read: Ebola Transmission Falls In Some Areas Of Congo, But Outbreak Still Kills: WHO

Early Treatment Is Important

Ebola can cause fever, weakness, vomiting, diarrhoea and, in severe cases, bleeding and organ failure. The longer a severely ill patient remains without appropriate supportive care, the harder the disease can be to manage. Treatment centres help isolate infectious patients helps break transmission chains.

Children are another major concern in the current outbreak. Nearly one in four confirmed cases are children, but they account for almost one in three deaths. Children under five have been particularly vulnerable as more than 60% of confirmed cases in this age group resulting in death, compared to fewer than 30% among adults, according to WHO.

Developments In Vaccine & Treatment So Far

The outbreak has been identified as being caused by Bundibugyo virus, one of the viruses in the Ebola family. WHO reported a case fatality ratio of 48.3% among confirmed cases in the DRC as of September 7.

There is currently no approved vaccine or specific treatment for Bundibugyo ebolavirus, which means, health officials are completely relying on breaking transmission chain and providing prompt medical care to control the spread.

But the latest unfortunate developments point to a problem that could make containment even more challenging. The response desperately needs enough trained people, supplies and access to affected communities.

As there is currently no vaccine for Bundibugyo virus, health authorities have approved 70,000 doses of Ervebo, vaccine meant for a much familiar Zaire strain of Ebola. Health workers in DRC have begun receiving the Ervebo doses as part of an experimental trial to test if it would work on current Ebola outbreak.