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.

In a landmark judgement, the Supreme Court today allowed passive euthanasia for a 32-year-old man, living in a vegetative state for the last 13 years.

A bench comprising Justice JB Pardiwala and Justice KV Viswanathan allowed the withdrawal of life support for Harish Rana, a resident of Ghaziabad, who has been in a coma and kept alive on tubes for breathing and nutrition after sustaining severe head injuries following a fall from a building in 2013 in Chandigarh.

It is the first known case of a court-ordered passive euthanasia in India, since it was legalised in 2018 and modified in 2023, recognizing the fundamental right to die with dignity.

"Harish Rana, presently aged 32 years, was once a young, bright boy. He met with a tragic life-altering accident after a fall from the fourth floor of his paying guest accommodation. His brain injury left him in a condition of Persistent Vegetative State (PSV) with 100 percent quadraplegia... Medical reports show that his medical condition has not improved in the past 13 years," LiveLaw quoted the bench as saying.

The Court noted that the continuation of his treatment -- Clinically Administered Nutrition (CAN) via surgically installed PEG tubes -- can just prolong his biological existence but will not lead to any therapeutic improvement.

What Is The Case Of Harish Rana?

Harish was a BTech student in Chandigarh who suffered severe traumatic brain injury after falling from the fourth floor of his paying guest accommodation in August 2013.

Since then, he has remained bedridden and dependent on others for all activities of daily life.

Harish's father, the petitioner, first approached the Delhi High Court in 2024, seeking permission for passive euthanasia, but was rejected as the patient was not terminally ill.

The same year, the petitioner knocked on the doors of the Supreme Court, which, though it refused to entertain the plea, directed the Uttar Pradesh government to bear the treatment expenses.

In 2025, the petitioner filed a miscellaneous application in the Supreme Court, noting that Harish's condition had no scope for improvement.

The Court then directed the constitution of a Primary Medical Board led by the District Hospital in Noida to examine his health, as well as a Secondary Medical Board constituted by the All India Institute of Medical Sciences (AIIMS).

After perusing the report, Justice Pardiwala remarked that it's a "sad report" and the man can't continue to live like this. Before passing the final order, the Court met the parents, LiveLaw reported.

The Court has asked AIIMS to provide palliative care, so that the withdrawal of CAN can be given effect to.

To maintain the dignity of death, the apex Court said that the life support must be withdrawn with a tailored plan.

1st Passive Euthanasia: What's New From The 2018 Judgment

In 2018, a five-judge Constitution Bench had recognized and given sanction for passive euthanasia, and living will/advance directives.

Later in 2023, the SC modified the guidelines, noting that withdrawal of life support is permissible only after the approval of the Primary and Secondary Medical Boards.

With the Harish Rana judgment, the apex Court today clarified how passive euthanasia should be applied in cases where a patient’s life is being supported by feeding tubes.

The top Court waived off the reconsideration period of 30 days and noted that the medical treatment, including the CAN administered to the patient, can be withdrawn or withheld.

What is Passive Euthanasia

Passive Euthanasia allows a terminally ill or irreversibly comatose patient to die naturally. It involves deliberately withholding or withdrawing life-sustaining treatments (like ventilators, feeding tubes, or medication). It has been legal since 2018, but under strict guidelines.

In Active Euthanasia, patients are administered a lethal injection to cause death. It is illegal in India and considered an offence.

The Aruna Shanbaug case in 2011 opened the door for passive euthanasia in India for the first time.

The top Court rejected euthanasia in the case of Shanbaug, a nurse at Mumbai's KEM hospital who was in a vegetative state for 42 years after an assault in 1973, as the hospital staff who cared for her for decades did not support stopping treatment.

Shanbaug continued to be under care and passed away naturally in 2015

However, in her case, the court made the judgment allowing for passive euthanasia in certain rare situations under strict conditions.

In the wake of a shocking incident in Uttar Pradesh’s Kanpur, where two engineers allegedly died within 48 hours of undergoing hair transplant surgery by a dentist, the Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) and the Association of Plastic Surgeons of India (APSI) have pressed the need for stricter rules for aesthetic and hair restoration procedures.

The doctors raised concerns about patient safety and called for ramping up training standards, even as many such cases where unqualified medical practitioners performed aesthetic procedures leading to severe infections, loss of sight, and many complications have been documented from across the country.

Traditionally, these procedures were performed by specialists such as dermatologists and plastic surgeons trained under the regulatory framework of the National Medical Commission (NMC).

However, experts said the issue has become more complicated after the Dental Council of India (DCI) allowed MDS dental surgeons, under provisions of the Dentists Act, 1948, to perform certain aesthetic procedures and hair transplantation.

“Aesthetic procedures and dermatology demand additional training. In addition to the MBBS degree, a dermatologist training program requires three years of residency at a postgraduate level in dermatology at certain accredited medical schools,” Dr Vinay Singh, President IADVL said.

He added that the training also includes a condensed curriculum of various skin ailments, hair problems, and advanced procedures in dermatology.

“Allowing professionals without comprehensive medical training in skin diseases, hair disorders, and surgical complication management to perform such procedures could dilute training standards and increase risks for patients,” warned Dr. Rajat Gupta, Senior Consultant Plastic Surgeon, Delhi.

The experts also pointed out that hair transplant is a modern medical procedure and should only be conducted by Registered Medical Practitioners (RMPs) who are specialized in that area.

Also read: Fact Check: Popular Hair Loss Treatment Ingredient Could Trigger Chest Pain

Dr. Aditya Aggarwal, Senior Consultant Plastic Surgery, Medicity Medanta Hospital, shared that the surgery requires knowledge regarding the biology of the skin, the disorders of the hair, how to manage infections, and how to manage complications.

The associations urged the government to issue comprehensive guidelines and ensure strict implementation of existing regulations to curb quackery and safeguard public health.

Further, they advised the patients to verify the doctor’s qualifications and registration with the state medical council before undergoing any skin, hair, or cosmetic treatment.

The public must remain alert and avoid falling prey to misleading advertisements or treatments offered by unlicensed practitioners, the experts said.

About 6 million people in India's capital city are living with several vision problems, such as poor distance vision or near vision, according to a recent study by doctors at All India Institute of Medical Sciences (AIIMS), New Delhi.

The study, Dr. Rajendra Prasad Centre for Ophthalmic Sciences at AIIMS, and submitted to the World Health Organization (WHO), also flagged major gaps in eye care services in Delhi, the Times of India reported.

An estimated one-third of the population in the national capital was identified with refractive errors or presbyopia -- conditions that can usually be corrected with a pair of glasses. Globally, 826 million people suffer from presbyopia.

About 70 percent of older adults in the capital city were identified with the problem.

Alarmingly, about 13.1 percent school-going children had refractive errors, Dr. Praveen Vashist, professor and head of community ophthalmology at AIIMS, was quoted as saying.

Gaps In Eye Care

The study showed a lack of access to vision correction. While just 60 percent of people needing distance vision correction could access care, those with near vision correction could access care in over 47 percent of cases.

Further, the doctors found:

• women had the lowest access to spectacles compared to men
• lack of trained eye care workers,
• the affordability of spectacles,
• limited outreach to vulnerable groups -- elderly patients, rural women, and economically weaker populations.

But Dr. Vashisth noted that Delhi currently has only 1,085 ophthalmologists and approximately 489 optometrists.

Further, only 50 community-level vision centers, out of the has 249 eye care institutions in the city were found to be functioning. Moreover, only about 25 percent of children were receiving free spectacles through public health initiatives.

Global Eye Burden

According to the World Health Organization (WHO), at least 2.2 billion people worldwide have near or distance vision impairment. Of these, at least 1 billion cases could be prevented with increased access to eyeglasses and cataract surgeries

The WHO identifies refractive errors and cataracts as the leading causes of vision impairment and blindness.

Vision loss can affect people of all ages; however, most people with vision impairment and blindness are over the age of 50.

Here's how to maintain a healthy vision:

• Eat fruits and veggies, especially leafy greens like spinach, kale, and fish like salmon and tuna, to protect your sight.
• Be physically active, as being overweight or obese can increase risk for diabetes and other conditions that can lead to vision problems.
• If your vision gets blurry, use glasses to help you see better.
• Always wash your hands before putting them close to your eyes, especially if you’re putting in or taking out contact lenses.
• Use protective eyewear while playing a favorite sport or mowing the lawn
• Wear your shades to prevent the sun’s rays from hurting your eyes.
• Give your eyes a break with the 20-20-20 rule: Every 20 minutes, look about 20 feet away for 20 seconds.
• Quit smoking as it can put you at risk of serious eye issues, leading to blindness.