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.

It is that time of the year when cough and colds are at its peak and everyone you know if affected by it. However, the health experts have warned that this winter could be worst, worse than the previous one. Why? Because this winter may have the most severe flu outbreaks in decades. The worst part? It is already wreaking havoc on the NHS.

The flu strain being talked about here is the H3N2 strain, what has also been named as the "unpleasant" by health experts. The experts have warned that NHS could face a "tidal wave" of illness ahead of Christmas. A per the reports, hospital admission rates for flu has already gone up to 56 per cent, as compared to the same week last year. As per the health experts, wearing a mask outside is must, especially if they feel unwell, and have encourages those who are eligible to get their vaccination.

What Is the H3N2 Strain?

H3N2 is one of the two main influenza strains currently in circulation. Also referred to as subclade K, it is the most prevalent flu strain in England right now, according to the UK Health Security Agency (UKHSA).

What Are The Doctors Saying?

The Independent spoke to Dr Giuseppe Aragona, GP and a medical adviser for Prescription Doctor, about this new strain and the ways to prevent sickness.

Dr Aragona explained that the letters and numbers used to classify flu strains come from the virus’s surface proteins called haemagglutinin, represented by H, and neuraminidase, represented by N.

He said that this specific combination can sometimes lead to more serious illness, particularly in older adults and people with underlying health conditions.

He added that H3N2 changes frequently, which means the version circulating this year may differ from earlier years or from the strain included in the seasonal vaccine. This can leave people more vulnerable to infection.

What are the symptoms?

According to the UKHSA, flu symptoms tend to appear suddenly. Extreme tiredness is common and this often helps distinguish flu from a cold, which develops more gradually.

The symptoms linked to H3N2 have been similar to typical seasonal flu. These may include fever, cough, a runny nose, body aches, vomiting or diarrhea.

People at higher risk of complications include children under five, especially those under two, adults over 65, pregnant women and individuals with chronic medical conditions such as asthma, diabetes, heart disease, weakened immunity or neurological illnesses.

If someone develops flu symptoms after close contact with pigs, doctors advise informing a healthcare provider immediately and mentioning that exposure.

How high are flu rates right now?

NHS England reported that an average of 1,717 patients a day were admitted to hospital with flu last week. This is a 56 per cent rise from the same period last year.

• The rates are seven times higher than in 2023, when hospitals saw an average of 243 flu patients a day.
• This spike follows Australia’s biggest flu season on record, which often predicts how the UK will fare.

Why is H3N2 hitting harder this winter?

Dr Aragona said several factors are contributing to a more challenging flu season. The season has begun earlier than usual, giving the virus more opportunity to spread.

He added that the strain has evolved from last year’s version, so immunity from previous infections and even the vaccine may offer less protection.

He also pointed out that fewer people have been exposed to flu in recent years, especially children. This means a larger portion of the population is susceptible. Cold weather, indoor gatherings and normal social habits are also helping the virus spread more easily.

Experts have already noted that this strain picked up seven new mutations over the summer, making it quite different from previous versions in the current vaccine.

With winter underway, the UK is preparing for a rise in flu related deaths. NHS leaders have issued a strong appeal for people to get vaccinated. Last winter saw around 8,000 deaths linked to flu. This was higher than the previous year’s 3,500 deaths but lower than the 16,000 recorded in the 2022 to 2023 season.

How can you protect yourself?

Dr Aragona said getting the flu vaccine is the most important step, especially for people who are older, pregnant, very young or managing long term health conditions.

He said the vaccine does not prevent every infection but it greatly reduces the chances of severe illness and hospitalisation.

Good hand hygiene, covering your mouth and nose when coughing or sneezing, avoiding close contact with sick individuals and keeping indoor spaces well ventilated can also help.

New data from the UKHSA shows the 2025 to 2026 vaccine is currently 70 to 75 per cent effective at preventing hospital visits in children aged two to seventeen, and 30 to 40 per cent effective in adults.

Dr Jamie Lopez Bernal of the UKHSA said the early results offer reassuring evidence that this year’s vaccine provides meaningful protection. He encouraged everyone eligible to get vaccinated as soon as possible.

Dr Thomas Waite, deputy chief medical officer, said flu can be unpleasant for many people and dangerous for some. He emphasised that vaccination is the best defence. He said the season has started early and that those eligible should get their vaccine now.

Last year’s flu vaccine significantly reduced the number of severe cases, cutting hospitalisation by nearly 40 per cent in people over 65 and by 75 per cent in children aged two to seventeen.

How worried should we be about H3N2?

Dr Aragona said that while flu can be uncomfortable, most healthy adults and children recover without complications. He advised against panic but highlighted that older people, those with chronic illnesses and other vulnerable groups could face more serious illness this season.

He said the key is staying alert, getting vaccinated, taking sensible precautions and seeking medical help early if symptoms worsen. With these steps, he said the risks can be managed, even in a year with higher flu activity.

Officials in California have now urged people to not forage for wild mushrooms after a rise in poisoning cases that caused at least one death. The California Poison Control System was able to identify at least 21 cases of poisoning in northern California. This has resulted from death cap mushrooms, confirmed the state's public health department.

How Bad Is The Mushroom Poisoning?

The poisoning has resulted in severe liver damage in people and have not spared even children. It has killed at least one of the patients who may have needed a liver transplant, confirmed the health department.

The problem is that death cap mushrooms could be easily mistaken for safe, edible mushrooms because of its similar taste, smell, and appearance.

What Do Health Officials Say?

Health officials have confirmed that the recent cases occurred between mid November and early December, a period marked by heavy rainfall in the region. The wet weather creates perfect conditions for the toxic death cap mushroom to thrive, especially around oaks and other hardwoods, including pine trees, according to the California Department of Public Health (CDPH).

While most cases have been concentrated in Monterey and the San Francisco Bay Area, the CDPH cautioned that the danger extends across California.

“Death cap mushrooms contain toxins that can cause life threatening liver failure,” said Dr Erica Pan, CDPH Director and State Public Health Officer. “Because these mushrooms can be easily confused with edible varieties, we strongly urge the public to avoid foraging for wild mushrooms during this high risk season.”

The agency stressed that death caps are unsafe under any circumstances. Cooking, freezing, boiling or drying them does not remove their toxicity.

Consuming the mushroom can trigger symptoms such as nausea, vomiting, watery diarrhoea, abdominal pain and dehydration within six to 24 hours. Although the discomfort may briefly subside, serious or even fatal liver damage can develop up to eight days later.

“Only individuals with significant expertise in identifying wild mushrooms should eat those they have harvested themselves,” Dr Edward Moreno, Health Officer for Monterey County, said.

Ways To Identify Death cap Mushroom

Inspect the cap: look for a green or yellow tint on top of the mushroom's white cap. The caps of mature mushrooms also have 1 to 2 large cracks running across them. Death caps often have 1 or more patches of thin, white, vein-like tissue.

A flat cap with diameter 3 to 6 inches: mature death caps are widely and nearly flat on top. However, young death caps have an almost spherical, bowl-shaped cap.

Gills underneath cap: the death mushroom cap has thin white gills on the underside of the cap.

Smell: hold the mushroom about 3 inches away from nose and take a sniff. A death cap mushroom shall smell slightly like ammonia or other chemical household cleaners.

Touch: Tap the death cap mushroom lightly so you do not break it off. The caps of death cap mushroom are often sticky and could leave a small amount of adhesive residue.

Look for white spores left behind: place the mushroom cap on a piece of dark colored paper with gills facing downward. Let the mushroom sit in this position and next morning lift up the mushroom cap and look for white spore print on the sheet. A death cap mushroom will leave a white spore print.

A commonly prescribed blood pressure medication is being pulled from shelves after routine testing revealed possible contamination with another drug. Glenmark Pharmaceuticals Inc., which has its U.S. headquarters in Elmwood Park, New Jersey, has voluntarily recalled more than eleven thousand bottles of bisoprolol fumarate and hydrochlorothiazide tablets, sold under the brand name Ziac. The recall was announced in an online report published by the U.S. Food and Drug Administration.

Why the Drug Was Recalled

According to the FDA, reserve sample testing detected traces of ezetimibe, a medication used to treat high cholesterol. Glenmark manufactures both drugs, and officials say the presence of ezetimibe suggests the tablets may have been cross contaminated during production. The recall affects the 2.5 milligram and 6.25 milligram strengths of the medication, which is used to treat hypertension by helping the heart beat more normally, reducing fluid retention and relaxing blood vessels.

The recall has been classified as Class III, which is the lowest risk category. This means that although the product violates FDA standards, the agency does not expect the contaminated tablets to pose serious or immediate health risks. Class III recalls generally involve issues that are unlikely to cause adverse health consequences. However, the FDA still requires the manufacturer to remove the affected lots from circulation.

Products and Lots Included

The recall covers several bottle sizes packaged for the U.S. market. The affected National Drug Codes are:

• 30 count bottles, NDC 68462 878 30
• 100 count bottles, NDC 68462 878 01
• 500 count bottles, NDC 68462 878 05

According to the FDA report, the impacted lots include Lot 17232401, which has an expiration date of November 2025, and Lot 17240974, which expires in May 2026. The tablets were manufactured in Madhya Pradesh, India for Glenmark’s U.S. division. In total, more than eleven thousand bottles are part of the recall.

What Patients Should Know

Neither Glenmark Pharmaceuticals nor the FDA has issued specific instructions for patients who may have the recalled medication at home. However, standard guidance from GoodRx and other pharmacy resources advises patients to take a few simple steps. Individuals should check the lot number on their medication bottle and compare it with the recalled lots. If the numbers match, patients are encouraged to contact their pharmacist or prescriber to discuss next steps. Most pharmacists will recommend safely discarding the recalled medication and arranging for a replacement prescription.

While the contamination involves only trace amounts of another drug and is not expected to cause serious harm, health experts note that taking medication that has been compromised in any way is not advisable. Patients who rely on bisoprolol fumarate and hydrochlorothiazide for blood pressure control should not stop treatment abruptly without consulting their healthcare provider.

Understanding the Medication

Bisoprolol and hydrochlorothiazide is a combination drug that lowers blood pressure by blocking beta 1 receptors in the heart, increasing urination to remove excess sodium and water, and relaxing blood vessels. It is commonly prescribed to reduce the risk of heart attacks and strokes in patients with hypertension.

With the recall in place, patients are encouraged to stay alert, review their medication labels and reach out to their healthcare team if they believe they have received an affected batch.