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.

Long known to be a key risk factor for lungs and heart, a new study now shows that long-term exposure to air pollution and fine particulate matter (PM2.5) may increase the risk of developing type 2 diabetes by 16%.

A rise of 10 micrograms per cubic metre in PM2.5 concentration was associated with a 10% to 16% increase in diabetes risk.

The findings come amid rising pollution levels in Delhi, highlighting the potential metabolic health consequences of prolonged exposure to poor air quality.

Published in the Journal of Vascular Diseases, the analysis found that air pollution is not just a cardiopulmonary concern but also a potential contributor to metabolic health problems.

What Did The Study Find?

The researchers analysed 13 major previous reviews, covering more than 200 million participant observations worldwide.

Reviews examining new diabetes cases consistently found an association between air pollution exposure and a higher risk of developing the disease.

The studies also reported higher diabetes prevalence, elevated blood sugar levels and an increased burden of related health complications.

The association was observed even among populations living in areas classified as having clean air. Since nearly everyone is exposed to outdoor air pollution, even relatively small increases in individual risk could translate into millions of additional diabetes cases worldwide.

South and East Asia are among the regions likely to face a particularly high burden.

Air Pollution Must Be Part Of Diabetes Prevention

Dr. Anoop Misra, Padma Shri, Executive Chairman and Director, Diabetes and Endocrinology, Fortis C-Doc Hospital for Diabetes and Allied Sciences, said air pollution should be recognised as a potential contributor to metabolic disorders, including diabetes, rather than viewed only as a respiratory and environmental concern.

“Air quality management must become a core part of diabetes prevention,” he said.

He also highlighted the growing public health burden in heavily polluted South Asian cities and stressed the need to integrate air quality management into diabetes prevention.

Yashendra Sethi, first author of the study, said India must focus on improving environmental conditions to protect metabolic health.

“If India wants to tackle both diabetes and pollution, we must improve metabolic health and clean up our environment. We cannot fight diabetes while ignoring the air we breathe,” Sethi said.

The researchers emphasised that diabetes prevention should be considered alongside heart and lung health when framing clean-air guidelines.

They recommended strengthening continuous air quality monitoring, tightening emissions standards and incorporating environmental factors into national healthcare policies.

Delhi Air Quality In Very Poor Category

Delhi's air quality slipped into the 'very poor' category on November 11, with the 24-hour average Air Quality Index (AQI) settling at 313. This came a day after stronger winds brought some relief, pushing the AQI into the 'poor' category.

According to the Air Quality Early Warning System (EWS) for Delhi, PM2.5 and PM10 concentrations are also expected to rise over the next two days.

Of the 58 monitoring stations that recorded data on Wednesday, one reported 'severe' air quality, 34 were in the 'very poor' category, 22 in the 'poor' category and one in the 'moderate' category.

Weeks after revealing that she had been wrongly diagnosed with multiple sclerosis (MS), Emmy-winning actor Christina Applegate is exploring whether breast implant illness could explain her chronic pain and fatigue.

Applegate has been experiencing persistent pain and fatigue, which have also affected her mobility. She gradually withdrew from public life after her MS diagnosis in 2021, as she navigated the physical and emotional toll of the condition.

However, in October, the 54-year-old actor revealed that a doctor had told her she did not have MS. She is now undergoing tests for various conditions, including autoimmune diseases and Lyme disease, to determine the cause of her debilitating symptoms.

Applegate is also considering whether her breast implants could be contributing to her health problems. Speaking on the November 10 episode of her podcast, she said her suspicions were reinforced after someone sent her a study that described breast implant illness as "presenting as MS", USA Today reported.

"I swear, over the last five years I thought, 'What if they're leaking and they're poisoning me?'" Applegate said. "So that's one that I will be looking into, because it's something I've thought about."

Christina Applegate Opens Up About Her Symptoms

Also read: Christina Applegate Reveals Multiple Sclerosis Misdiagnosis: Why The Disease Is Hard To Diagnose

Applegate said she is struggling to understand what is causing her persistent pain and fatigue, describing how the symptoms have affected her mobility.

"I'm trying to figure out what's wrong with me; of course I know about these things," she said, referring to the messages she receives from people suggesting possible diagnoses.

She added that the number of possible explanations had become overwhelming.

"It's overwhelming because there's so many different things that could be going on, and this pain stuff – I don't know what's going on in my joints, but I can't move my right shoulder at all now. I can't lift my arm," she said.

In an earlier podcast episode in October, Applegate spoke emotionally about the uncertainty surrounding her health after learning that she did not have MS.

"I'm back at square one – that I don't know what's going on with me," she said.

Despite the news, Applegate said her symptoms have not improved.

“I haven’t gotten better. I still have to use wheelchairs when I go to the doctor’s office. I can’t walk from the car to the room. I’m still in this. Nothing magical happened when she said, ‘You don’t have MS.’ Nothing magical happened.”

Christina Applegate's Breast Cancer And Implant History

Applegate was diagnosed with early-stage breast cancer in 2008 and underwent a double mastectomy, followed by breast reconstruction.

She also discovered that she carries a BRCA1 gene mutation, which increases the risk of developing breast and ovarian cancers.

The actor has previously spoken about her breast implants, saying she was "way overdue for having [the implants] replaced."

What Is Breast Implant Illness?

Breast implant illness (BII) is a term used to describe a range of systemic symptoms that some people report experiencing after receiving breast implants.

The US Food and Drug Administration (FDA) has highlighted several potential complications associated with breast implants, including capsular contracture, implant rupture, certain cancers and symptoms collectively described as breast implant illness.

Reported BII symptoms include:

• Persistent fatigue
• Memory and concentration problems, often described as brain fog
• Joint and muscle pain
• Hair loss
• Weight changes
• Anxiety and depression

However, BII is not a formally recognised medical diagnosis. The FDA notes that there are no specific tests or established diagnostic criteria to define or identify the condition.

While some people report improvements in symptoms after implant removal, the relationship between breast implants and these systemic symptoms remains an area of ongoing research. Applegate's concerns about a possible connection with her symptoms have not yet been medically established.

Twenty-six years later, the country is facing its worst outbreak of the highly contagious disease and is on the verge of losing its hard-earned elimination status.

As of November 5, 2026, the US had reported 5,182 confirmed measles cases, according to the CDC. It is the first time that the country has crossed 5,000 mark since 1991.

Further, Pennsylvania (six), New York (one) and Wisconsin (one) have reported a combined eight measles-associated deaths this year — more than the total recorded between 2000 and 2024.

The Pan American Health Organization (PAHO), a regional office of the World Health Organization, is reviewing the country's status. An announcement is expected next week.

What Is Driving The Measles Resurgence In The US?

Also read: EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach

Vaccine hesitancy is a key factor behind the resurgence, said Professor Devi Sridhar, Professor and Chair of Global Public Health at the University of Edinburgh, in an exclusive conversation with HealthandMe.

"We're seeing more parents concerned about the side effects of vaccines. Perhaps they've seen a video online or read something that makes them nervous. So for a while in the 1990s, for example, the MMR vaccine was falsely linked to rising autism rates."

She noted that while the study has since been debunked, misinformation of this kind has contributed to vaccine hesitancy, with parents choosing not to vaccinate their children despite vaccines being available because they fear potential side effects.

Falling Vaccination Rates Allow Measles To Spread

Two doses of the MMR vaccine are approximately 97% effective at preventing measles. Even a single dose provides strong protection, offering about 93% effectiveness.

Sridhar said the number of vaccinated children was falling below the threshold needed to prevent the virus from circulating and causing deaths in the country.

"But what we're seeing is that the number of children vaccinated is falling underneath that threshold, which is around 85 to 90%. And once you get a population that is not vaccinated to that level, measles starts to circulate, then it starts to find children, and unfortunately they get infected. And because it's so serious, we are starting to see deaths even in the United States."

Sridhar also warned that misinformation online is undermining trust in vaccines. She said online claims about the MMR vaccine, including false links to autism and fears about side effects, can discourage parents from vaccinating their children.

"That's very dangerous now because as we know, the information on the internet and on social media isn't regulated."

Read More: What Happens After Measles Infection? The Hidden Risks That Can Last For Years

Can The US Rebuild Public Trust In Vaccines?

Sridhar pointed to changes in the country's public health and scientific institutions over the past two years, including the dismantling of the vaccine advisory group and a shift towards alternative therapies that has contributed to vaccine hesitancy.

However, with the recent Democratic gains in Congress, she is hopeful about the possibility of restoring science in government.

“Those who are scientifically trained, those who are doctors, clinicians, PhDs, people who have that kind of background will really help to hopefully bring science back into government and into government advice and help build that trust.”

How Is Measles-Elimination Status Determined?

PAHO considers endemic measles transmission to have been re-established when the same virus genotype and lineage circulates uninterrupted for at least 12 months within a country or defined geographical area.

The Regional Verification Commission reviews epidemiological and laboratory evidence, alongside information on vaccination coverage, surveillance and outbreak response, before making recommendations on a country's status.

Publicly available data shows that several chains of measles transmission have continued for more than a year in the US, according to scientists who analysed the data at the request of The New York Times.

Three separate transmission chains — two in Utah and one in Arizona — were continuing in July 2026 and could be traced to an outbreak in Texas more than a year earlier. One of these chains was still circulating in Utah in September, occasionally spilling over into Oregon and Washington.

Another transmission chain, detected in Virginia at the start of the year, was still spreading in Iowa, Indiana and Pennsylvania as of mid-October.