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 Ebola outbreak in the Democratic Republic of Congo (DRC) has become the deadliest one in the country’s history, with the death toll reaching 2,325, according to the latest reports.

The number has now surpassed the 2,299 deaths recorded during the 2018–2020 Ebola outbreak, which had previously been the country’s worst. The current outbreak has also become the largest in the DRC by number of confirmed cases, with 4,945 infections recorded so far.

The latest figures indicate that the outbreak has reached another grim milestone just three months after it was officially declared on May 15.

Ebola Is Spreading Rapidly

The DRC’s National Public Health Institute reported 101 new confirmed cases in the 24 hours leading up to its latest update, highlighting how quickly transmission is continuing.

The outbreak was first detected in Ituri province, but the virus has since spread to six provinces, including North Kivu, South Kivu, Haut-Uele, Tshopo and Bas-Uele. More than 3,400 cases have been reported in Ituri alone.

The United Nations has described the outbreak as the fastest-growing Ebola epidemic on record.

“Ebola is winning in the Democratic Republic of the Congo. We cannot let the virus outrun our response,” UN humanitarian chief Tom Fletcher said, calling for “speed, scale, and solidarity” before the outbreak gets even further ahead of containment efforts.

Also read: Ebola Outbreak Is Claiming 1 Life Every 30 Minutes In DR Congo: UN Humanitarian Official

The Most Deadly Outbreak

One of the biggest reasons behind rapid transmission is that people are still being diagnosed too late. Thomas Parisch, a public health specialist with Médecins Sans Frontières, said that normally the proportion of people dying should fall as outbreaks progress because contact tracing improves and patients receive treatment earlier.

“Instead, we're still seeing many cases detected very late,” he said, with some infections only being identified after patients have died in their communities.

The case-fatality ratio has climbed from around 20% in early June to approximately 46%, according to Reuters.

That does not mean the virus itself has become more lethal. Rather, the increase is a warning that many patients are reaching healthcare facilities too late for treatment to be effective.

Also read: Ebola 2026 Outbreak Spreading Faster Than Any Before, On Track To Become Deadliest: WHO Chief

No Approved Vaccine

The current outbreak is being caused by the Bundibugyo species of Ebola, a relatively rare strain.

Unlike the Zaire species responsible for several previous major Ebola outbreaks, Bundibugyo currently has no approved vaccine or specific treatment. WHO says experimental vaccines and treatments are being investigated, but they remain under evaluation.

This makes early diagnosis, isolation, contact tracing and supportive medical care particularly important.

The outbreak is also unfolding in an extremely difficult environment. Conflict, population movement, weak healthcare infrastructure, misinformation and shortages of resources are making it harder for health teams to identify and isolate infections quickly. Health workers have also demonstrated strikes due to unpaid wages.

Also read: Amid Rapidly Expanding Ebola Outbreak, DR Congo Is Seeing An Alarming Increase In Maternal Deaths; Here's Why

Efforts Towards Containing The Outbreak

Despite the challenges, WHO chief Dr Tedros Adhanom Ghebreyesus said significant progress has been made towards containing and eradicating the virus. It includes:

• More than 21,000 community health workers have been trained.
• Treatment centres, safe burial teams, laboratories and community engagement teams are operating across the affected provinces, reaching hundreds of thousands of people.
• A total of 886 patients have recovered, even without specific therapeutics and vaccines, which are progressing through trials.
• For the first time, two vaccines specifically designed against Bundibugyo virus have entered Phase 1 safety trials in humans.
• Two new animal studies of a vaccine against Zaire ebolavirus — the more common species — have shown promising evidence of cross-protection in animals, Tedros said.

In an early trial, scientists are testing the possibility if a vaccine could intercept pancreatic cancer, one of the deadliest cancers in the US, at an early stage and prevent it from becoming invasive.

The trial involves people who were considered at high risk of pancreatic cancer and already had small abnormalities, like cysts, in their pancreas.

The experimental vaccine, called mKRAS-VAX, is designed to train the immune system to recognise mutated KRAS proteins, which are found in most pancreatic ductal adenocarcinomas, the most common type of pancreatic cancer.

The findings, published in Cancer Discovery, offer an intriguing new approach in which instead of waiting for pancreatic cancer to appear and then treating it, researchers are attempting to intercept the disease at its earliest stages.

How Does The Vaccine Work?

Also read: UK Set To Implement Stricter Protocol For Prostate Cancer Testing; Who Is Eligible To Get Tested?

Pancreatic cancer often develops gradually from precursor lesions. Some of these lesions can contain mutations in the KRAS gene, which can drive the development of the disease.

The mKRAS-VAX vaccine contains synthetic peptides targeting six common KRAS mutations. The goal is to teach T cells to recognise cells carrying these abnormal proteins and destroy them before they progress into cancer.

Unlike traditional vaccines against infections, this is a therapeutic cancer vaccine, meaning it is designed to stimulate the patient's immune system against targets related to cancer.

Findings From The Early Trial

Also read: Following A Western Diet? Changes In Your Gut Bacteria Could Increase Colon Cancer Risk

The Phase 1 study involved 20 people who had either a family history or genetic predisposition to pancreatic cancer and had a pancreatic abnormality detected on imaging.

The vaccine produced mutant-KRAS-specific T-cell responses in 18 of the 20 participants, or 90%. These immune responses persisted for as long as two years. Researchers also saw an intriguing change in pancreatic cysts.

At a median follow-up of 16.5 months, 37.5% of participants experienced cyst reduction or complete resolution. Among a comparable group of unvaccinated people, the figure was 6.8%.

None of the vaccinated participants had developed pancreatic ductal adenocarcinoma during the study follow-up. However, this does not prove that the vaccine prevents pancreatic cancer.

The study was small, early-stage and primarily designed to examine safety and whether the vaccine could generate an immune response.

“We are very excited about these results,” pancreatic cancer vaccine researcher Elizabeth Jaffee said.

More About Pancreatic Cysts

The researchers are interested in whether vaccination could intervene during this window, before malignant cells are formed.

That is particularly significant because pancreatic cancer is notoriously difficult to detect early and remains one of the deadliest cancers.

The long-term ambition is to develop a vaccine to prevent pancreatic cancer but researchers are not there yet.

Jaffee described the field as “nascent” and said she is “cautiously optimistic,” while emphasising that these small Phase 1 studies are not designed to establish whether the vaccines improve survival or prevent cancer.

Larger Phase 2 studies will be needed to determine whether the early immune responses translate into meaningful clinical benefits.

Endometriosis is usually characterised by painful periods, chronic pelvic pain and fertility issues. But a new study suggests the condition may also be linked to a significantly higher risk of developing type 2 diabetes.

Researchers found that women with endometriosis had a 46% higher risk of type 2 diabetes compared with women without the condition.

The findings come from one of the largest studies to examine the relationship between the two conditions, adding a new dimension to the adverse effects of endometriosis.

What Did The Study Find?

Also read: 'My Periods Are Painful' Is Not Always Normal: When Could It Be A Sign of Endometriosis?

Researchers studied health records from nearly 3 million women in the Utah Population Database, covering the period from 1996 to 2021. Almost 100,000 women were diagnosed with endometriosis.

After accounting for factors including age, race and body mass index, women with endometriosis were found to have a 46% greater risk of developing type 2 diabetes than women without the condition. The researchers also found that the association differed depending on the type of endometriosis.

Additionally, the risk of type 2 diabetes was higher across several subtypes, including superficial peritoneal, ovarian and deep infiltrating endometriosis.

The strongest association was seen in women with endometriosis outside the usual pelvic sites, where the risk was about twice as high. Adenomyosis was also associated with an increased risk.

Why Could The Two Disorders Be Connected?

Also read: Maternal Anemia: Why It’s A Major Pregnancy Risk For Indian Women And How to Prevent It

Chronic inflammation could be the reason why the two disorders could be connected. Endometriosis is an inflammatory disease in which tissue resembling the lining of the uterus grows outside the uterus.

Persistent inflammation can affect several systems in the body, while inflammation and poor insulin sensitivity could lead to type 2 diabetes.

“Previous studies largely evaluated endometriosis as a single condition and generally reported little or no overall association with type 2 diabetes,” said Fuzak Nunziato, lead author of the study. “Our findings add to a growing understanding that endometriosis may affect more than reproductive health alone.”

Despite the strong observation, it is to be noted that study found an association, meaning women with endometriosis were more likely to develop type 2 diabetes. It does not prove that endometriosis directly causes type 2 diabetes.

The study was also retrospective, meaning researchers looked back at archival health records rather than assigning participants to groups and studying them prospectively.

A large prospective research published in 2021 found no overall significant increase in type 2 diabetes among women with laparoscopically confirmed endometriosis, although it did find modestly higher risks among certain groups, including women who were not obese.

The association was particularly notable among premenopausal women and women without obesity - groups that are not normally not considered to be at the highest risk for type 2 diabetes.

If further research solidifies the the link, researchers say women with endometriosis could potentially benefit from greater awareness of metabolic health and earlier identification of diabetes risk.