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 US Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Centers and has classified the hantavirus outbreak as "Level 3" emergency.

Level 3 is the lowest level of emergency activation and is typical for this stage, ABC News reported.

It also signifies that the risk of the rat-borne virus to the general public remains low. However, the public health agency is actively monitoring the situation.

As per the media report, activating the Emergency Operation Centers signals that an emergency team, consisting of epidemiologists, scientists, and physicians, may have been set up to assist with the response.

No Immediate Public Health Threat To India, says ICMR

After reports of two Indian nationals infected with hantavirus aboard MV Hondius cruise ship, Dr Naveen Kumar, director of the ICMR’s National Institute of Virology (NIV), said that there is "no immediate public health threat” to India.

Dr Kumar said the outbreak appears to be isolated, and that there is currently no evidence of community spread. He stressed that, unlike COVID-19, hantavirus does not spread easily between humans.

“The reported hantavirus cases appear to be isolated ones, and there is no immediate public health threat to India,” he was quoted as saying by news agency PTI.

According to the World Health Organization, the Indian passengers were among a small cluster of suspected infections identified aboard the ship, with health authorities monitoring contacts and taking precautionary measures.

Surveillance Capacity Adequate In India

Kumar said India has sufficient laboratory infrastructure to detect suspected hantavirus cases through the ICMR-NIV and the nationwide Viral Research and Diagnostic Laboratory Network.

“India has diagnostic capacity for hantavirus infection through the ICMR-National Institute of Virology and the nationwide Viral Research and Diagnostic Laboratory Network of 165 labs,” he said.

He said symptoms generally appear one to five weeks after exposure. It includes

fever,

• severe body ache,
• headache,
• fatigue,
• nausea,
• abdominal pain,
• dry cough.

2 Indians Among Crew On MV Hondius Cruise Ship

Two Indians are among 149 people aboard MV Hondius, the expedition cruise ship hit by a deadly hantavirus outbreak that has so far left three passengers dead and eight others infected, according to a BBC report.

The vessel, operated by Oceanwide Expeditions, began its journey from Ushuaia, Argentina, on April 1 and is currently travelling to Spain's Canary Islands on May 10.

According to the World Health Organization, eight people onboard the cruise ship MV Hondius have been infected with hantavirus. Of these, three have died, and five have been confirmed to have the virus. However, more people are likely to be infected, as the disease can take a long time to show symptoms.

The luxury cruise ship was carrying around 150 passengers and crew members from 28 countries.

The nationalities included 38 people from the Philippines, 31 from the United Kingdom, 23 from the United States, 16 from the Netherlands, 14 from Spain, nine from Germany, six from Canada and two crew members from India, BBC reported.

While it is yet not known whether they're infected or not, Dr Puneet Misra, Professor of Community Medicine, AIIMS Delhi, told ANI News Agency that it is likely that the two passengers "might have been exposed to the infection".

He added that "there is no pandemic or epidemic threat" with hantavirus. "The public should not worry. There is no need for panic..."

Follow this page for all latest updates.

US President Donald Trump is hopeful that the deadly hantavirus outbreak is very much under control. However, questions are mounting as his administration cut funding to study the rat-borne virus last year.

According to the World Health Organization, eight people onboard the cruise ship MV Hondius have been infected with hantavirus. Of these, three have died, and five have been confirmed to have the virus. However, more people are likely to be infected, as the disease can take a long time to show symptoms.

Speaking to reporters Thursday, Donald Trump sought to reassure Americans that the situation appeared contained.

“It’s very much, we hope, under control,” Trump said during an impromptu appearance near the Lincoln Memorial Reflecting Pool in Washington, DC. The President added that the administration planned to release “a full report” on the incident and said health officials were continuing to study the outbreak closely.

“We’re doing the best we can,” Trump told reporters when asked whether Americans should worry about the wider spread of the virus.

Notably, at least 23 passengers from the hantavirus-affected MV Hondius cruise ship returned home, including several to the United States — and one of them has already fallen ill.

Hantavirus Cases In The US?

The travelers reportedly did not know they had been exposed to the deadly virus when they disembarked during the ship’s stop at Saint Helena, a remote island in the South Atlantic, on April 23.

People in at least five US states — Georgia, Arizona, California, Texas, and Virginia — are reportedly being monitored for possible hantavirus exposure, though none have shown symptoms.

According to Dr. Jay Bhattacharya, Director of the US National Institutes of Health (NIH), “Hantavirus is not spread by people without symptoms, transmission requires close contact, and the risk to the American public is very low.”

CDC Cuts On Hantavirus Research

Behind the public reassurance, however, health authorities are confronting a situation that remains poorly understood — particularly because the Trump administration last year cut funding to study the virus behind the deadly cruise ship outbreak, and also fired scientists in key positions who were tracking viruses.

The Centers for Research in Emerging Infectious Diseases were designed to study viruses that could jump from animals to people, including hantavirus, but in 2025, the National Institutes of Health said the work would not continue.

Further, in its 2026 budget request, on one hand, the Trump administration said it planned to refocus the CDC on outbreak investigations and preparedness; on the other hand, it proposed eliminating about $750 million in preparedness grants that states rely on to cope with natural and man-made disasters, including outbreaks.

It also zeroed funding for the Hospital Preparedness Program, which strengthens healthcare systems to respond to emergencies, saying the program “has been wasteful and unfocused”, the New York Times reported.

Notably, the effects of the Trump administration’s cuts to infectious disease research are also being felt globally. South Africa has the capacity to sequence the hantavirus partly because of investments made by previous US administrations through the President’s Emergency Fund for AIDS Relief (PEPFAR), Dr. Carlos del Rio, an infectious disease expert at Emory University, told reporters.

However, the Trump administration has significantly reduced support for South Africa’s research system and is pulling back funding for PEPFAR.

“I worry that as we disinvest in global health, we’re losing our capacity — our global capacity — to deal with diseases,” Dr. Del Rio said.

The six-week-long incubation period of Hantavirus is a matter of concern, but the rat-borne disease is certainly not a large epidemic, said the World Health Organization today.

At a media briefing, the WHO Director General Dr Tedros Adhanom Ghebreyesus, expressed concerns about the time taken for the symptoms of the disease to appear.

He noted that so far the disease has been limited to the 150 people who traveled on board the MV Hondius ship. Of these, only 8 people have been infected - 3 have died, and 5 have been confirmed.

A case has been reported in a person who disembarked from the ship, without having the symptoms, and some have self-isolated to prevent the risk of spreading.

Among those on board the ship, now travelling to the Canary Islands, "currently no one is symptomatic".

However, "with a six-week incubation period, more cases are expected to be reported".

Countries involved in the contact tracing efforts of people who disembarked at St. Helena Islands include Canada, the Netherlands, Singapore, Turkey, the UK, and the US, the WHO chief said.

WHO infectious disease epidemiologist Maria Van Kerkhove reiterated that the disease spreads only among close, prolonged contacts or those providing care, as seen in the case of the doctor who got infected on board.

The WHO also noted that the disease is unlikely to become a large epidemic, as it's an isolated case occurring in a closed environment. However, public health measures like contact tracing and testing are key to preventing any further spread.

According to the WHO, the outbreak of the rat-borne disease among people aboard the MV Hondius ship after it left Argentina on April 1 was caused by the Andes strain.

Speaking to HealthandMe, Dr. Gautam Menon, Epidemiologist and Professor of Physics and Biology, Ashoka University, Delhi-NCR, said that the long incubation period is likely to complicate the spread of the hantavirus.

"What complicates matters is that incubation periods - the time between getting infected and symptoms showing - are large, up to several weeks, so passengers and their contacts will have to be quarantined for a long period before they can be declared safe." The expert said.

Is Hantavirus Similar To COVID-19?

Ven Kerkhove said that hantavirus causes severe respiratory issues, but it is still not the same as SARS-CoV-2.

This is not a new virus and is completely different from SARS-COV-2. It has caused similar outbreaks in Argentina in 2018, where contact tracing and other public health measures contained the spread.

"The outbreak of Hantavirus on a cruise ship has generated significant anxiety around the world, evoking memories of cruise ships affected by COVID-19 in the first phase of the pandemic. However, this is a different virus that is not known to spread efficiently from person to person. Its characteristics are already well-documented, unlike the SARS-CoV-2 virus, which was an unknown organism until then," Dr. Rajeev Jayadevan, Ex-President of IMA Cochin and Convener of the Research Cell, Kerala, told HealthandMe.

"The current cases do not indicate a pandemic threat, but they underline the growing importance of surveillance of zoonotic diseases. Strengthening rodent control, environmental hygiene, and early detection systems remains essential to prevent localized outbreaks and public panic. There is neither a proven treatment for its cure nor is there any vaccine," added Dr.Ishwar Gilada, Mumbai-based infectious disease expert.

How does The Hantavirus Affect The Human Body?

Hantavirus infection is caused by the hantavirus, which belongs to the Hantaviridae family. It is is rare but can be life-threatening.

The infection presents with initial symptoms resembling the flu and has a relatively high mortality of about 40%.

Also read: Hantavirus Sparks Global Alert As Countries Race To Trace Contacts; WHO Says Risk Low

Even though this virus is not believed to spread very efficiently, it would have done so far more easily in the enclosed environment that the ship provided, the experts said.

Dr Neha Rastogi, Senior Consultant, Infectious Diseases, Fortis Memorial Research Institute, Gurugram, told HealthandMe that it can be contracted by coming into contact with rodent saliva, urine, and feces.

Hantavirus can cause infection - 2 syndromes: hantavirus pulmonary syndrome and haemorrhagic fever that may quickly develop into severe respiratory illness, as flu-like symptoms (fever, muscle aches, and fatigue) occur before developing serious respiratory symptoms (dyspnea) that may require respiratory assistance.

"On rare occasions, it can also spread from person to person through close contact. Rapid diagnosis and intensive medical treatment are critical for a successful outcome," Dr Rastogi said.

"Preventative measures include proper personal hygiene, avoiding contact with rodents or rodent-inhabited areas; using PPE when cleaning; and ensuring the area is well-ventilated," she added.

Although hantavirus infections can cause severe respiratory illness with high mortality, confirmed human cases globally remain relatively uncommon, Dr Gilada told HealthandMe

"The pneumonia syndrome caused by the virus is due to excessive permeability of blood vessels, resulting in fluid accumulation. It is managed with expert supportive care while the lungs recover, as there are currently no known antivirals or vaccines available for the Andes virus. By carefully tracking contacts and isolating those who might be infected, the virus can be stopped in its tracks, bringing this outbreak under control," Dr Jaydevan said.