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 Union Ministry of Health and Family Welfare has proposed three separate amendments to the Drugs Rules, 1945, to strengthen pharmaceutical quality control, manufacturing accountability and patient safety.

The proposals include immediate suspension of manufacturing licences for drugs failing specified critical quality tests, stricter microbial monitoring in sterile manufacturing areas, and mandatory authorisation of qualified personnel for batch release.

The announcements aim to strengthen India's drug regulatory framework and align manufacturing standards with international guidelines.

Immediate Suspension Of Licences For Drugs Failing Critical Quality Tests

Also read: India To Introduce QR Code Verification for Vaccines And Cancer Drugs: Here's What Patients Can Check

In a significant move to enable faster action against substandard medicines, the Ministry has proposed immediate suspension of manufacturing licences for drugs declared Not of Standard Quality (NSQ) on specified critical parameters.

Under the existing provisions, suspension or cancellation of a manufacturing licence involves a prescribed regulatory process, including the issuance of a show-cause notice. This can create a time gap between the identification of a quality failure and regulatory action, during which the drug may remain in circulation.

To address this, the proposed amendment would allow the Central Licensing Approving Authority or the State Licensing Authority, as applicable, to immediately suspend the manufacturing licence upon receiving a Government Analyst's report declaring a drug NSQ on any of the following parameters:

• Assay
• Dissolution
• Related substances
• Impurities
• Sterility

These parameters are critical to determining the quality and safety of medicines. The proposed provision seeks to enable prompt intervention and minimise potential risks to patients.

Stricter Microbial Monitoring In Sterile Drug Manufacturing

Read More: Centre Bans Cough & Cold Medicines For Children Under 4: What Parents Need To Know

The Ministry has proposed amendments to Schedule M of the Drugs Rules, 1945, to revise microbial contamination limits in Grade A clean areas in line with the World Health Organization's (WHO) Good Manufacturing Practices (GMP) guidelines for sterile pharmaceutical products.

Grade A areas are critical zones in sterile pharmaceutical manufacturing, where exposed products, containers and sterilised components are handled. Maintaining strict microbial controls in these areas is essential to preventing contamination and ensuring product safety.

The proposed revision addresses differences between the existing Schedule M requirements and WHO guidelines. It also provides for any microbial growth detected in Grade A areas to trigger an investigation, in accordance with WHO guidance.

The amendment aims to strengthen contamination monitoring and bring India's sterile manufacturing standards in line with internationally recognised benchmarks.

The development comes in the backdrop of an episode involving India’s biggest drug maker Sun Pharma, which was recently ordered to halt production at its manufacturing plant in Assam after reports of contamination in some of the eye drops made there.

Mandatory Authorization For Drug Batch Release

In another proposal, the Ministry has sought to make it mandatory for drug manufacturers to formally designate a suitably qualified and experienced person responsible for batch release.

Although manufacturers are currently required to provide details of competent technical staff responsible for manufacturing and testing while applying for licences, the rules do not specifically require them to identify the person authorised to release drug batches.

Under the proposed framework, manufacturers applying for licences under the relevant provisions of the Drugs Rules, 1945, would have to:

• Designate a qualified and experienced person responsible for batch release.
• Maintain prescribed records for every batch manufactured.
• Follow a prescribed format for the Batch Release Certificate.

Batch release is a critical stage in pharmaceutical manufacturing. It involves reviewing quality parameters and relevant documentation before a batch is cleared for distribution.

The proposed requirements seek to establish clear accountability for batch-release decisions, improve traceability and strengthen quality assurance.

The World Health Organization (WHO) has reported significant global progress against neglected tropical diseases (NTDs), with fewer people requiring treatment. However, the rising burden of dengue remains a major concern.

The Global Report on Neglected Tropical Diseases 2026 found that 63 countries had eliminated at least one NTD by June 2026, up from 42 at the end of 2020.

“Elimination of neglected tropical diseases is one of the standout success stories of global health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

However, he warned that these gains could be lost without increased domestic financing, sustained external support and the integration of NTD services into primary healthcare.

Global Progress Against NTDs

Also read: World Chagas Disease Day: Women Key To Prevent, Eliminate The Fatal Neglected Tropical Disease

The number of people requiring interventions for NTDs fell to 1.41 billion in 2024, a 36% decline since 2010 and a 19% decline since 2020.

Cases of sleeping sickness have dropped by 98% since 1999, while Guinea worm disease recorded just 10 human cases in 2025, its lowest number yet.

Between 2021 and 2025, 31 countries eliminated at least one NTD. Of these, 16 received WHO recognition for the first time. Between January and June 2026, five more countries received recognition: Algeria, Australia, Libya and Tunisia for trachoma, and Chile for leprosy.

By June 2026, 42 countries had eliminated one disease each, 16 had eliminated two, four had eliminated three and one country, Togo, had eliminated four.

India has eliminated three NTDs: Guinea worm disease in 2000, yaws in 2016 and trachoma in 2024.

Why Dengue Remains A Concern

Read More: Dengue Is Spreading Beyond Monsoons And Into New Regions Across India, Says Expert

Despite progress against several NTDs, the report highlights uneven progress, with these diseases continuing to disproportionately affect the world's poorest and most vulnerable communities.

Dengue remains a major concern. Cases of the mosquito-borne disease reached a record 15.1 million in 2024, up from 2.74 million in 2020.

Locally acquired cases were reported across all six WHO regions. The organisation also classified dengue as a Grade 3 emergency, its highest emergency level, in 2024.

The Region of the Americas accounted for most reported cases, with Brazil contributing the largest share of the regional burden.

WHO said climate and environmental change, rapid and often unplanned urbanisation, population movement and the geographical expansion of Aedes mosquitoes are contributing to the spread of dengue.

WHO also warned that the geographical expansion of dengue into previously unaffected populations increases the risk of severe disease from secondary infections, making health system preparedness and the management of severe cases increasingly important.

In 2024, 12,554 deaths were reported across dengue, visceral leishmaniasis and chikungunya, against the 2030 target of 1,291 or fewer annual deaths.

Dengue accounted for 11,827 of these deaths, followed by visceral leishmaniasis (482) and chikungunya (245). Compared with the 2016 baseline of 5,163 deaths, reported deaths from these three diseases increased by 143.2%.

Other NTD Targets Remain Off Track

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The report also identified several challenges to achieving the 2030 targets. Deaths from vector-borne NTDs have increased, while progress towards yaws eradication remains off track. Only three disease-specific indicators achieved their 2025 milestones.

The WHO's 2021–2030 road map aims to:

• Reduce by 90% the number of people requiring NTD interventions

• Reduce NTD-related disability and premature deaths by 75%.

• Enable 100 countries to eliminate at least one NTD

• Eradicate Guinea worm disease and yaws

With five years remaining to meet these targets, WHO called for accelerated action, increased domestic financing and the integration of NTD interventions into universal health coverage to protect progress and address persistent gaps.

Utah has become the first US state to authorise an artificial intelligence (AI) system to issue prescriptions for certain medications, marking a significant development in the use of AI in healthcare.

The pilot programme allows Nolla Health, a healthcare technology startup, to use its AI-powered dermatology app, Nolla Derm, to examine adults with mild-to-moderate acne and recommend prescription treatments without requiring an doctor's and supervision.

The programme is currently limited to adults aged 18 and above in Utah and covers a small list of topical acne medications. However, the initiative is significant as AI systems can eventually issue prescriptions without a doctors reviewing every case beforehand.

The development has also raised questions about whether AI can make decisions that are normally made by licensed medical professionals, especially when a prescription depends on assessing a patient's symptoms, medical history and treatment risks.

How Does Utah's AI Prescription Work?

Patients using Nolla Derm are required to verify their identity, provide informed consent and complete a medical questionnaire. They then submit photographs of their face through the app.

The AI system analyses the images to check acne severity and combines this information with the patient's medical history to determine whether treatment is appropriate.

It can then select from a limited list of topical acne treatments approved by physicians and generate a prescription.

The programme is being introduced in three stages, with different levels of medical supervision.

• First 100 patients: Two Utah-licensed physicians independently review and approve every AI-generated prescription before it is sent to a pharmacy.
• Next 400 patients: The AI can issue prescriptions directly and physicians will review cases retrospectively.
• Subsequent patients: Physicians review at least 10% of prescriptions each month, along with cases involving complications or side effects.

Advancing in stages requires the company to meet safety targets, including at least 95% agreement with physician assessments and no serious adverse events, as well as written approval from the state. Patients can also contact a licensed physician through the app.

Also read: Woman With Epilepsy Dies After Following ChatGPT’s Advice To Stop Medication: Why AI Cannot Replace A Doctor

Patient Safety Concerns

While AI can analyse information quickly, prescribing medication involves more than identifying a condition and selecting a drug. Doctors consider a patient's medical history, allergies, existing medications, and other health conditions. There are several concerns surrounding the use of AI for these decisions.

1. Incorrect diagnosis

An AI system assessing acne through photographs may not always be able to distinguish it from other skin conditions. Some skin disorders require different treatments or deeper medical investigation.

If the system incorrectly classifies a condition as acne, a patient could receive inappropriate medication, which could delay correct diagnosis.

Also read: New AI Tool Uses Facial Photos To Predict Cancer Patients’ Survival Risk

2. Missing important medical details

A prescription may be unsuitable because of a patient's allergies, medical history, pregnancy status or other medications.

Although Nolla Derm collects medical information through a questionnaire, questions remain about whether an automated system can consistently identify important details.

Also read: AI-Created Virus Injected Into A Human For The First Time To Fight Antibiotic Resistance

3. Delayed treatment

Not every skin problem is acne. Some lesions or changes in the skin may require an examination to rule out other conditions, including skin cancer.

If patients rely on an automated assessment instead of seeking medical attention, there is a risk that a condition could be overlooked and its diagnosis could be delayed.

4. Limited ability to detect complications

Patients may experience side effects after starting treatment. An AI system may not be able to assess these developments as comprehensively as a clinician who can examine the patient, order investigations or modify treatment.

5. Accountability when something goes wrong

Another concern is determining who is responsible if an AI-generated prescription causes harm. The Utah pilot includes oversight and malpractice insurance requirements, but the bigger question of accountability remains an important issue.

Doctors Question Whether AI Should Prescribe Without Human Oversight

Also read: AI May Suggest 3 Times More Expensive Medical Tests And Drugs Than Doctors, New Study Finds

The initiative has prompted concerns among medical professionals about how much responsibility AI systems should be given in healthcare. John Whyte, chief executive of the American Medical Association (AMA), has questioned whether AI should independently make medical decisions.

"These tools can play a very effective role, but they shouldn't autonomously be trying to practice medicine, and if they are, then they need to be held to very high standards, just as humans are," he told the Los Angeles Times. "And I don't think they can meet that burden," he added.

Earlier in 2026, Utah authorised another AI pilot involving prescription refills through the healthcare startup Doctronic. The programme attracted criticism from the state's Medical Licensing Board, which raised concerns about allowing AI to handle medication decisions without medical professionals.

Can AI Prescribing Improve Access To Healthcare?

Supporters argue that AI could help address gaps in access to medical care, especially for conditions that are commonly straightforward.

Zach Boyd, director of Utah's Office of Artificial Intelligence Policy, said the programme was designed to encourage healthcare innovation while maintaining safeguards.

"The Nolla Health pilot program represents a significant step forward in leveraging AI to improve healthcare access for Utahns, while maintaining rigorous oversight and safety," he said. "Our office facilitates innovative AI solutions while ensuring that public health and patient safety remain paramount."

Nolla's chief medical adviser, Dr Zaid Fadul, also highlighted the importance of independent oversight.

"The real test for AI in healthcare isn't how smart it is. It's whether someone other than the company can shut it off," he said.

"In Utah, the state can, and physicians can. That's the standard every AI in medicine should meet."