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 Trump administration has asked the US Supreme Court to allow federal prisons to restrict gender-affirming medical care for transgender inmates. This has escalated a legal battle over what healthcare transgender inmates in federal custody are entitled to receive.

The Justice Department filed an emergency request on September 28, asking the court to lift a lower-court order that currently prevents the Bureau of Prisons from enforcing its restrictions.

The case concerns a policy introduced by the Bureau of Prisons in February 2026. Under the policy, federal prisons would stop providing surgeries and hormone therapy for transgender inmates and would also remove certain cosmetic accommodations like wigs and other clothing-related provisions. Mental health and psychiatric care would remain available.

Here's a wider look at its implications on prison healthcare for transgenders.

Why Is The Policy Being Challenged?

Also read: Why Is The Trump Administration Stopping Obamacare Health Plans For 760,000 Enrollees?

Three transgender inmates in federal prisons in New Jersey, Florida and Minnesota filed a class-action lawsuit challenging the restrictions.

A federal judge, Royce Lamberth, ordered the government to continue providing gender-affirming medical care like hormone therapy to affected inmates. He found that the Bureau of Prisons was likely to have acted unlawfully.

The US Court of Appeals for the District of Columbia Circuit declined to lift that order on September 18, leaving the restrictions blocked while the legal challenge continues.

The administration has now taken the dispute to the Supreme Court, asking the justices to allow the restrictions to be enforced while the wider case proceeds.

The administration argues that an executive order required the Bureau of Prisons to revise its medical care policies so that federal funds aren’t spent “for the purpose of conforming an inmate’s appearance to that of the opposite sex." It also argues that security and prison-management concerns support the policy.

The government is seeking permission to enforce the policy before the courts reach a final decision on whether the restrictions themselves are lawful. It says that the Bureau of Prisons had “determined that sex-trait-modification surgeries, hormone interventions in general, and social accommodations could no longer be justified as treatment for gender dysphoria.”

What Do The Inmates Say?

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Attorneys representing the transgender inmates argue that withholding medically necessary treatment because a person is transgender could violate their constitutional rights. They have also raised the Eighth Amendment, which prohibits cruel and unusual punishment. Their argument is that prison officials have a constitutional obligation to provide necessary medical care for serious health conditions and that gender dysphoria can require personalised treatment.

The legal dispute therefore involves two questions: whether the Bureau of Prisons can change its medical policy in this way, and whether denying gender-affirming treatment to transgender inmates can amount to unconstitutional refusal of medical care.

What Is Gender Dysphoria?

Gender dysphoria is a clinical diagnosis that identifies significant emotional distress that someone experiences when their gender identity and their sex assigned at birth do not match.

Treatment for gender dysphoria can vary from person to person. Depending on an individual's circumstances and clinical assessment, gender-affirming care may include mental health support, hormone therapy or surgery.

Having gender dysphoria does not automatically mean that every person diagnosed with it will receive every form of gender-affirming treatment.

How Does This Affect Healthcare For Transgender Inmates?

Inmates cannot simply choose another doctor if a certain kind of treatment is restricted. Medical treatments are largely controlled by the correctional authorities. The Bureau of Prisons previously allowed inmates with gender dysphoria to receive gender-affirming treatment when clinicians determined that it was medically appropriate. The new policy would make that approach invalid.

The Bureau said in 2025 that it was providing hormone therapy to more than 600 inmates, highlighting the number of people affected.

The case could ultimately affect other areas besides federal prisons, as it challenges medical necessity, prison healthcare and transgender rights directly before the nation's highest court.

A blood pressure medicine manufactured in India has been recalled in the US for the second time in three months after a few batches failed a test designed to ensure that the drug dissolves properly in the body.

The medicine is chlorthalidone 25 mg, a commonly used diuretic, or 'water pill', manufactured by Inventia Healthcare Limited in India. The latest recall involves more than 13,500 bottles, while the earlier recall included 11,460 bottles. Both recalls have been classified by the US Food and Drug Administration (FDA) as Class II recalls.

India-Made BP Drug Recalled In The US For The Second Time

The US Food and Drug Administration recalled chlorthalidone due to “failed dissolution specifications.” It means that when the tablet is swallowed, its active ingredient needs to dissolve at the right rate so the body can absorb the medicine.

If a tablet does not dissolve properly in the body, less of the active ingredient may become available for absorption, making the medicine less effective that it should be.

For someone taking chlorthalidone to control high blood pressure, inadequate drug absorption could mean that blood pressure is not controlled as effectively as intended. The FDA has not reported contamination or a toxic ingredient as the reason for this particular recall.

Also read: Chlorthalidone Recall: FDA Flags Second India-Made Blood Pressure Drug

Why Was The Drug Recalled Again?

The first recall was made by Inventia Healthcare on June 5, 2026, involving 11,460 bottles. A second, separate recall was initiated on September 3, involving another 13,567 bottles. The FDA classified this second recall as Class II on September 17. Together, the two recalls affect more than 25,000 bottles of the medication.

The second recall has raised eyebrows as both issues were linked to the same type of manufacturing quality problem, which is failure to meet dissolution specifications.

The earlier recall involved batches RISA24001 and RISB24002. The latest recall involves 25 mg chlorthalidone tablets. Patients must check their medicine packaging for:

• Manufacturer: Inventia Healthcare Limited
• Strength: Chlorthalidone 25 mg
• Batch: RISA24002
• Expiry: April 2027
• NDC: 64980-599-01

Also read: Thyroid Medicine Recall Gets US FDA’s Highest Risk Rating: What To Know

More About Chlorthalidone & Class II Recall

Chlorthalidone is a diuretic used to treat high blood pressure. It works mainly by helping the kidneys remove excess sodium and water from the body. This reduces the amount of fluid circulating through the blood vessels and helps lower blood pressure.

Keeping blood pressure under control is essential as untreated hypertension increases the risk of heart attack, stroke, heart failure and kidney disease.

A Class II recall does not mean the medicine will cause serious harm in everyone who takes it. The FDA defines Class II recalls in which the affected product could cause temporary or medically reversible adverse health consequences, or where the probability of serious harm is remote.

In this case, the concern is primarily that the affected tablets may not work as intended because of inadequate dissolution.

What Should Patients Who Take This Medicine Do?

Patients should not stop the medication abruptly without speaking to a doctor or pharmacist. The FDA advises that people generally should not stop a recalled medicine without medical guidance, as suddenly stopping treatment for high blood pressure could be risky.

If you take chlorthalidone, check the batch number on your bottle and contact your pharmacist or healthcare provider if it matches one of the recalled ones.

Low-dose CT (LDCT) screening of people at high risk based on age and smoking history can reduce lung cancer deaths and advanced-stage disease, according to an International Agency for Research on Cancer (IARC) working group.

Speaking to HealthandMe, Dr Abhishek Shankar of AIIMS New Delhi, the only Indian author among the 23 experts from 17 countries involved in the IARC review, said India needs to generate its own screening evidence.

The review was published in The New England Journal of Medicine as part of IARC WHO Handbook 21.

India Should Not Wait For A Perfect Model

Dr Shankar, a lung cancer specialist, said India needs to generate its own screening evidence while ensuring high-risk people have access to screening and follow-up care.

“India should not wait for a perfect screening model and there is a need to generate Indian evidence while ensuring that those at highest risk have access to lung cancer screening and care pathways for screen positive cases,” he said.

Dr Shankar is leading the Indian Lung Screening Trial (ILST), which is assessing risk-based lung cancer screening across 10 centers in India.

Also read: Never Smoked, Still Got Lung Cancer? Rare Gene Mutation Linked To Over 60x Risk

Who Should Undergo LDCT Screening?

The evidence mainly covers people aged 50 to 80 with a substantial smoking history, typically 20–30 pack-years or more. Studies involving former smokers generally included those who had quit within the previous 10–15 years.

In India, people aged 50 to 80 who have smoked at least 20 pack-years and are current smokers or quit within the past 15 years can contact ILST about screening under the trial.

“High-risk smokers should be encouraged to participate in organized screening rather than opportunistic CT scanning, with appropriate nodule management, follow-up and smoking-cessation support,” Dr Shankar said.

What Did The Trials Show?

Read More: World Lung Day: Dry Cough, Breathlessness May Not Always Be Asthma — Could It Be ILD?

In the US National Lung Screening Trial, LDCT was linked to a 16% lower relative risk of lung cancer death at seven years compared with chest X-rays. The European NELSON trial also found lower lung cancer mortality among men screened with LDCT at 10 years.

IARC classified LDCT as Group A, indicating established evidence that it reduces lung cancer mortality and stage III or IV disease. Chest X-rays, with or without sputum examination, were classified as Group C, as a mortality benefit could not be established.

What Are The Risks Of LDCT Screening?

LDCT is not meant for everyone. Across studies, false-positive rates ranged from 1% to 42%. Among those with false-positive results, 5% to 32% underwent an invasive procedure, with complications reported in 10% to 22% of those procedures.

The review also estimated that 3% to 26% of lung cancers detected in randomized trials could represent over-diagnosis.

The IARC group stressed that screening requires more than CT scans, including risk assessment, nodule management, follow-up, smoking-cessation support and adequate healthcare capacity.

“India has an opportunity to build an equitable, affordable, locally relevant lung cancer screening pathway and ILST can provide the evidence needed to guide that future,” Dr Shankar said.