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 World Health Organization (WHO) has validated El Salvador for eliminating trachoma, the world's leading infectious cause of blindness, as a public health problem.

El Salvador is the first country in Central America and the second in the Americas to achieve this milestone.

"I congratulate El Salvador on this remarkable achievement. It is a testament to the power of political commitment, strategic investment, and community engagement," said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

"El Salvador's success is a vital step towards our global target of eliminating trachoma worldwide by 2030 and a clear signal that a healthier, more equitable future is within reach," he added.

El Salvador's Journey To Trachoma Elimination

Also read: US Appeals Court Revives Over 500 Tylenol Lawsuits Over Autism Claims

Between 2023 and 2026, El Salvador conducted targeted assessments in communities identified as at higher environmental and social risk. The surveys found no evidence of active trachoma transmission.

As per the WHO, "no cases of active disease were detected in children, and no adults were found to have advanced trachoma capable of causing blindness". These findings confirmed that trachoma is no longer a public health problem in the country, the UN health agency said.

El Salvador's achievement was supported by a coordinated approach that included:

• Strengthening primary healthcare services
• Improving water, sanitation and hygiene (WASH)
• Expanding eye health services, including adult vision screening
• Collaboration between government agencies, communities and international partners

The country has also established trained health personnel, integrated surveillance systems and the capacity to detect and treat trichiasis—the advanced stage of trachoma in which eyelashes turn inward and can lead to blindness.

What Is Trachoma?

Trachoma is a bacterial eye infection caused by Chlamydia trachomatis. It can spread from person to person through contaminated fingers, fomites and flies that could come into contact with discharge from the eyes or nose of an infected person.

Environmental risks like poor hygiene, overcrowded households, and inadequate access to water and sanitation facilities can also lead to trachoma.

Repeated infections can scar the inner eyelid, causing the eyelashes to turn inward—a condition known as trichiasis. Without treatment, the eyelashes scratch the surface of the eye, potentially leading to irreversible blindness.

Read More: Wegovy More Likely To Cause Rare Blindness Than Ozempic And Other Similar Drugs, Recent Study Finds

Trachoma Still Persists In Parts Of The Americas

Although El Salvador has eliminated trachoma as a public health problem, the disease remains endemic in rural and remote areas of Brazil, Colombia, Guatemala and Peru.

WHO recommends that countries maintaining elimination continue surveillance and ensure access to quality eye care services to prevent the disease from re-emerging.

WHO Criteria For Elimination

WHO defines elimination of trachoma as a public health problem based on three key criteria:

• Trichiasis prevalence of less than 0.2% among people aged 15 years and older.
• Active trachoma (trachomatous inflammation–follicular) prevalence of less than 5% among children aged 1–9 years in every previously endemic district.
• A functioning health system capable of identifying and managing new trichiasis cases.

With this achievement, El Salvador joins 64 countries worldwide that have been validated by WHO for eliminating at least one neglected tropical disease. Seven of these countries are in the Americas.

While there is no firm scientific evidence linking Tylenol use during pregnancy to autism, a US federal appeals court has revived more than 500 private lawsuits against the painkiller's maker, Kenvue, over claims that prenatal exposure to acetaminophen contributed to autism and attention-deficit/hyperactivity disorder (ADHD) in children.

The ruling does not determine that Tylenol causes autism or ADHD. Rather, it held that expert testimony supporting the plaintiffs should not have been excluded from the lawsuits.

What Did The US Appeals Court Say

On July 13, the 2nd US Circuit Court of Appeals in Manhattan overturned a December 2024 ruling by US District Judge Denise Cote, who had dismissed the lawsuits after rejecting the methodology of the plaintiffs' expert witnesses.

In its 64-page decision, the three-judge panel said the district court had improperly excluded expert testimony from three doctors presented by parents and guardians seeking to link prenatal Tylenol use with autism and ADHD.

Circuit Judge Guido Calabresi wrote that the experts' methods reflected approaches used by other scientists and "constitute acceptable interpretations of scientific evidence where scientists may, and in fact do, disagree."

Court Did Not Rule That Tylenol Causes Autism

The appeals court emphasized that it was not deciding whether acetaminophen causes autism or ADHD, nor was it making any public health determination.

Instead, the ruling focused solely on whether the expert testimony met the legal standards required to be considered in court.

The three experts whose testimony was reinstated include:

• Andrea Baccarelli, Dean of Harvard University's School of Public Health
• Eric Hollander, Professor of Psychiatry at Albert Einstein College of Medicine
• Brandon Pearson, Toxicologist at Columbia University

Ashley Keller, a lawyer representing the families, said the panel unanimously found that the experts had reliably applied accepted scientific methods.

Kenvue Defends Tylenol's Safety

Kenvue, which was spun off from Johnson & Johnson in 2023, said it continues to stand by the safety of Tylenol.

"We stand behind the safety of our product and will continue to defend these cases," the company said in a statement.

Several retailers and pharmacy chains—including CVS, Kroger, Target, Walgreens, and Walmart—have also been named as defendants.

Trump Administration's Remarks Sparked Debate

The lawsuits gained attention after President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. issued guidance last year discouraging pregnant women from using acetaminophen, citing it as a possible contributor to autism.

The remarks triggered concern among expectant mothers and prompted criticism from many healthcare experts and medical organizations, which said the evidence does not support such definitive claims.

Is Acetaminophen Linked to Autism or ADHD?

The scientific evidence remains inconclusive. Some observational studies have reported a possible association between prolonged acetaminophen use during pregnancy and an increased risk of autism or ADHD in children. However, many other studies have found no significant link.

Importantly, an association does not prove that acetaminophen causes these conditions. Researchers note that factors such as maternal illness, genetics, underlying medical conditions, and other environmental influences may also affect a child's neurodevelopment.

As a result, experts say more high-quality research is needed before any causal relationship can be established.

What Do Medical Experts Recommend?

Major medical associations continue to consider acetaminophen the preferred pain reliever and fever reducer during pregnancy when used appropriately.

Doctors advise pregnant women to:

• Use the lowest effective dose for the shortest necessary duration.
• Avoid prolonged or unnecessary use without medical advice.
• Consult their healthcare provider before taking any medication during pregnancy.

Medical societies have also cautioned against avoiding acetaminophen altogether, noting that untreated high fever or severe pain during pregnancy can pose risks to both the mother and the developing baby.

Michigan health officials say that they may have identified the possible source behind one of the largest Cyclosporiasis outbreaks the state has ever recorded. Thousands of people were sickened by a parasitic infection that can cause severe, watery, or even “explosive” diarrhea.

Source Behind Cyclospora Outbreak Traced

On July 13, the Michigan Department of Health and Human Services (MDHHS) announced preliminary findings from its investigation point to lettuce or other salad greens as the possible source of Cyclospora outbreak.

However, officials stressed that the investigation is in progress, and no specific product, grower, distributor, or supplier has yet been identified for certain.

Health officials also interviewed more than 1,000 patients to identify common exposures.

Early analysis also repeatedly identified lettuce and salad greens as foods consumed before illness, prompting the state to issue precautionary guidance while the investigation continues.

"Although we do not have a definite product identified as the source of the outbreak, we want to let Michiganders know what we have learned so far so they can take steps to protect their families," said Dr. Natasha Bagdasarian, Michigan's chief medical executive, in a state statement.

Also read: As Cyclospora Cases Surge In The US, Expert Explains Why India's Monsoon Raises Risk Of The Parasitic Infection

Cyclospora Cases Continue To Surge

The outbreak has continued to expand at an extraordinary pace since late June. As of July 13, Michigan reported 2,640 cases of Cyclosporiasis, with 44 hospitalizations.

No deaths have been reported so far. The number represents a dramatic increase from the state's usual annual number, which is around 40 to 50 cases.

Preventing Cyclospora

Cyclospora is a parasite that infects people after they consume food or water contaminated with human feces containing the parasite's eggs (oocysts).

Although the illness is usually not life-threatening, it can cause prolonged diarrhea, stomach cramps, nausea, fatigue, bloating, and weight loss.

According to recent reports, fresh produce like salad greens and lettuce are being considered the most common source of infection, though contaminated water can also spread the parasite.

Also read: Explosive Diarrhea Parasite Spreads Across US: Why CDC Is Unable To Find The Source?

Health officials have advised people to avoid fresh produce. Previous Cyclospora outbreaks in the US have frequently been linked to imported fresh produce, including:

• Basil

• Cilantro

• Mesclun lettuce

• Raspberries

• Snow peas

How To Clean Fresh Produce Safely?

While washing produce cannot eliminate all risks, experts say it can reduce contamination. They advised washing fruits and vegetables thoroughly under clean running water and washing hands before and after handling fresh produce.

According to the Michigan Department of Health and Human Services, cooking produce whenever possible during an active outbreak is crucial, as heating food to at least 158°F (70°C) kills Cyclospora.

For specific produce, it suggested:

• Cilantro and basil: Separate the leaves and rinse each thoroughly under running water.

• Green onions: Trim off the roots, remove the outer layer, and rinse well.

• Snow peas: Rub the surface gently while washing under running water.

• Raspberries: Because of their delicate, uneven surface, raspberries are difficult to clean thoroughly. Cooking them in pies or jams is safer. Freezing may reduce the number of parasites but is unlikely to eliminate them completely.

• Leafy greens: If possible, choose whole heads of lettuce instead of bagged salad mixes. Discard the outer leaves and wash the remaining leaves under running water before eating.