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.

Chewing tobacco contributed to an estimated 251,000 deaths globally in 2023, according to a new study from the Institute for Health Metrics and Evaluation (IHME).

The analysis, part of the Global Burden of Disease Study 2023 (GBD 2023) and published in The Lancet Global Health, found that more than 90% of the health burden was concentrated in 10 countries, with India accounting for the largest share.

"Chewing tobacco is not a uniform public health problem, and our findings show that a relatively small number of countries bear an overwhelming share of its health burden," said Gabriela Gil, lead author and research scientist at IHME.

South Asia Bears 84% Of Global Deaths: India Leads

Also read: Trying For A Baby? Tobacco Smoking Hurting Male And Female Fertility, Warns WHO

South Asia accounted for an estimated 210,000 chewing tobacco-related deaths, or about 84% of the global total.

Nearly 15% of people aged 15 and older in the region used chewing tobacco in 2023.

The highest age-standardized prevalence was reported in:

• Palau: 24.4%
• Bangladesh: 23.4%
• Nepal: 17.5%

India recorded the highest number of chewing tobacco-related deaths among both males and females.

More than 90% of the male death and disability burden was concentrated in:

• India
• Bangladesh
• China
• Pakistan
• Myanmar
• US
• Nepal
• Sri Lanka
• Philippines
• Madagascar

Among females, the countries were:

• India
• Bangladesh
• Pakistan
• Indonesia
• Myanmar
• China
• Thailand
• Cambodia
• Vietnam
• Nepal

Chewing Tobacco Use Highest Among Elderly Females

Read More: Trying to Quit Tobacco? Yoga Could Improve Your Chances, Suggests Study

Globally, use was higher among males than females and increased with age before peaking at 60–64 years.

In South Asia:

• Nearly 1 in 5 males used chewing tobacco.
• Around 1 in 10 females used it.
• Male use peaked at 60–64 years.
• Female use peaked at 80 years and older.

Bangladesh showed a different pattern, with female use higher than male use across age groups older than 30.

"These findings show why chewing tobacco control cannot take a one-size-fits-all approach," said Dr. Emmanuela Gakidou, senior author and professor in the Department of Health Metrics Sciences at IHME.

"Prevention and cessation strategies need to reflect how patterns of use differ by country, age and sex, as well as the cultural and social factors that shape tobacco use in each setting," Dr Gakidou added.

Stroke, Oral Cancer Among Key Health Risks

Researchers assessed chewing tobacco-related burden across six outcomes:

• Stroke
• Lip and oral cavity cancer
• Esophageal cancer
• Other pharyngeal cancer
• Laryngeal cancer
• Nasopharyngeal cancer

Stroke accounted for the largest share of health loss, at 55.9 disability-adjusted life-years (DALYs) per 100,000 people, followed by lip and oral cavity cancer at 17.4 DALYs per 100,000.

Chewing tobacco accounted for 17.3% of lip and oral cavity cancer DALYs globally, rising to 30.5% in South Asia.

Global Burden More Than Doubled Since 1990

Chewing tobacco-related DALYs increased 116% between 1990 and 2023, reaching 6.48 million. Of this:

• 6.17 million years were lost to premature death.
• Total DALYs reached 6.48 million in 2023.

The researchers noted that chewing tobacco has received less attention than smoked tobacco in global tobacco-control efforts.

They said stronger prevention and cessation measures, tailored to age, sex, country and local patterns of use, are needed to reduce the burden.

Two Indian nationals have been held in the US over an alleged international scheme of smuggling and selling counterfeit Ozempic.

The US Food and Drug Administration (FDA) said Swapnadip Roy, 33, and Vicky Ramancha, 37, allegedly obtained counterfeit Ozempic from unauthorised sources in China and sold it to US distributors at deeply discounted prices between July 2023 and April 2024. Roy was extradited from Italy and has pleaded not guilty, while Ramancha remains at large.

This has raised fresh concerns about the risks of counterfeit GLP-1 medicines. The counterfeit products allegedly included fake packaging, package inserts, pen labels and needles, designed to make them appear like genuine Ozempic.

The alleged scheme continued even after the FDA seized some counterfeit products and issued a public warning in December 2023.

Risks Of Fake GLP-1 Drugs

Counterfeit medicines may not contain the primary drug they claim to contain. The FDA warns that fake drugs can contain the wrong ingredients, too much or too little of the active ingredient, no active ingredient at all, or harmful substances.

With injectable medicines like Ozempic, contaminated or counterfeit needles can also create an infection risk.

This is particularly concerning with GLP-1 drugs because medicines like semaglutide and tirzepatide are increasingly being used for diabetes and weight management. A person buying a fake injection may therefore have no reliable way of knowing what they are actually putting into their body.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

FDA Issued A Warning

Acting FDA Commissioner Kyle Diamantas said, "Infiltrating the American drug supply with counterfeit products isn’t just a crime — it’s also a direct threat to public health and patient safety."

He added, "The FDA will continue to trace illicit networks wherever they lead, across borders and through complex supply chains, to ensure that anyone who seeks to profit off counterfeit medicines face accountability — all in our mission to keep Americans safe."

The Justice Department has stressed that the charges are allegations and that the defendants are presumed innocent unless proven guilty.

Assistant Attorney General A. Tysen Duva of the US Justice Department said, “These defendants allegedly exploited people’s health to pay themselves. We will keep pursuing anyone who seeks to deceive American consumers with counterfeit drugs.”

Also read: From 365 Shots To 52: How Could Lilly’s Newly-Approved Weekly Insulin Injection Change Diabetes Care

How Can You Spot A Counterfeit GLP-1 Drug?

The FDA advises consumers to look for several warning signs.

1. Check The Packaging

Does the packaging look different from what you normally receive? Changes in fonts, spelling, labels, colours, printing quality or packaging can be warning signs of a counterfeit medicine.

2. Be Careful While Purchasing Online

The FDA specifically warns consumers to be cautious when buying GLP-1 medicines online. Unapproved or illegally marketed versions of semaglutide and tirzepatide may be counterfeit or contain harmful ingredients.

The agency recommends purchasing medicines only from state-licensed pharmacies.

3. Look At The Price

A dramatically lower price can be a red flag, particularly when an expensive prescription medicine is being offered through an unauthorised seller. In the alleged US scheme, counterfeit Ozempic was sold to distributors at deeply discounted prices.

4. Watch For Unexpected Side Effects

A new or unusual reaction after taking a medicine can also be a warning sign. The FDA lists unexpected side effects among possible indicators of counterfeit medicines.

What Should You Do If You Suspect You Have Bought A Fake Injection?

Contact your doctor or pharmacist and verify the product before taking a dose if you suspect your medicine is fake. Patients should also avoid buying GLP-1 medicines through social-media sellers, unverified websites or other unauthorised sources.

On Wednesday, Pennsylvania health officials reported its fifth measles-related death of 2026, as the state’s outbreak continues to expand in what can be described as the country’s most serious measles resurgence in decades.

The latest death involved Lancaster County resident who had tested positive for measles, according to the Pennsylvania Department of Health. The state now has 943 confirmed measles cases across 39 counties, with 40 new infections reported since September 28. At least 176 people have been hospitalised.

The latest death is the third reported in Lancaster County, which has remained one of the hardest-hit areas in Pennsylvania. This has raised the measles death toll in the state to 5, all of whom were unvaccinated.

Health Officials Are Concerned

Measles is one of the most contagious infectious diseases. It spreads when an infected person coughs or sneezes, with the virus capable of remaining in the air for up to two hours after the person has left an area.

The outbreak is particularly concerning because measles can cause serious complications, including pneumonia, dehydration, brain swelling and, in rare cases, death.

Pennsylvania’s news also comes as measles cases continue to increase across the country. The US has recorded 3,659 confirmed measles cases this year, according to CDC data cited by Reuters, making 2026 the country's worst measles outbreak in decades.

Also read: Pennsylvania Measles Cases Cross 900 As US Total Climbs To 3,659

People Who Died Were Unvaccinated

According to the Pennsylvania health officials, all the five people who died due to measles were unvaccinated. Of the state's 943 confirmed cases, only four people were vaccinated.

Three of the deaths were among unvaccinated adults. The other two deaths were among infants who were too young to have received the measles, mumps, rubella (MMR) vaccine.

The numbers highlight the role of vaccination in preventing severe disease and controlling transmission. The MMR vaccine, which protects against measles, mumps and rubella, is highly effective. Two doses provide about 97% protection against measles.

According to Pennsylvania’s health department, less than 1% of measles cases occurred in people who were fully vaccinated against the virus. A total of 176 people have been hospitalized, while about 31% of cases occurred in people under 18.

In response to the outbreak, Pennsylvania administered more than 53,000 MMR doses in September, more than double the number typically given in a month.

Also read: Rabies Day Exclusive: ‘We Need To Target The Source’ For A Rabies-Free India By 2030, Says Veterinary Epidemiologist

Officials Are Disagreeing Over The Death Toll

There is also a dispute over how measles-related deaths should be counted. Pennsylvania has reported five “measles-associated” deaths, using a state definition that includes people with confirmed measles who die within 30 days of developing symptoms, unless another unrelated event caused the death.

The CDC, on the other hand, has confirmed two measles-related deaths nationally after changing its approach to rely on mortality data from the National Center for Health Statistics rather than state health department reports.

The disagreement has triggered a public dispute between Pennsylvania Governor Josh Shapiro and US Health Secretary Robert F Kennedy Jr. The CDC has said it is working with state epidemiologists to establish a more consistent definition for measles-related deaths.

Measles is preventable, but protection depends on maintaining high vaccination coverage across communities. When vaccination rates fall, the virus can spread rapidly, particularly among people who are too young to be vaccinated, have medical reasons or have not completed their recommended doses.