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.

A commonly prescribed class of blood-thinning medicines may do more than prevent strokes in patients with both Alzheimer’s disease and atrial fibrillation (AFib). A new Swedish study suggests newer blood thinners may also be linked with a slower rate of cognitive decline.

The findings, published in the European Heart Journal, come from a large analysis of 7,308 people with Alzheimer’s disease and AFib.

Researchers compared patients who were on newer oral anticoagulants, known as NOACs, to those taking the older drug warfarin and people who were not receiving anticoagulant treatment.

What Did The Study Find?

Patients taking NOACs experienced a slower decline in cognitive function compared to those taking warfarin or no anticoagulant.

Cognitive function was assessed using the Mini-Mental State Examination (MMSE), a commonly used test that evaluates areas including memory, attention and orientation.

The researchers also found that NOAC treatment was associated with more favourable outcomes for stroke and death compared to no anticoagulation.

The study included patients from Sweden's national dementia registry and followed their outcomes over many years.

“This finding suggests that NOAC may offer benefits beyond their established role in preventing stroke and blood clots in people with atrial fibrillation,” said Maria Eriksdotter, professor at Karolinska Institutet and senior author of the study. She noted that the effect on cognition was modest, but even a small delay in cognitive deterioration could be meaningful over several years.

Also read: Limiting Sugar Before Age 2 May Lower Alzheimer’s Risk By 46%, Study Suggests

How Could A Blood Thinner Affect Alzheimer’s?

Researchers believe that the connection may stem from the relationship between AFib, blood clots and the brain. AFib causes the heart to beat irregularly, which can allow blood clots to form. These clots can travel to the brain and cause a stroke.

But researchers are also investigating whether smaller blockages in blood vessels, including so-called silent strokes, may contribute to cognitive damage.

Blood thinners reduce the formation of these clots, potentially protecting the brain from some additional vascular injury. Researchers have also proposed that the body's blood-clotting system could interact with biological processes involved in Alzheimer’s disease.

Also read: Alzheimer's Sleep Loss May Be Reversible; Study Sparks Hope For New Treatments

Why Did Newer Blood Thinners Prove Better Than Warfarin?

The researchers noted that differences in how consistently patients took their medicines may partly explain why NOACs appeared to perform better than warfarin. However, the study cannot determine exactly why the difference occurred.

Blood Thinners And Alzheimer’s

As this study was observational, it does not mean that blood thinners can treat Alzheimer’s successfully. Researchers analysed existing medical records rather than randomly assigning patients to receive a particular blood thinner. Therefore, it can identify an association but cannot prove that NOACs themselves caused the slower cognitive decline.

Anticoagulants are prescribed primarily to reduce the risk of stroke associated with AFib, and they can also cause serious bleeding. But this study raises the possibility that treating cardiovascular risk aggressively in people with Alzheimer’s could potentially have benefits for the brain as well.

Toronto Public Health is investigating a Legionnaires’ disease outbreak near the downtown core after six confirmed cases were identified among people who live, work or recently visited the area.

The cases are clustered within roughly a one-kilometre radius of Bathurst Street and Dupont Street, with patients developing symptoms between July 2 and July 26, according to Toronto Public Health. Officials are now carrying out environmental inspections and collecting samples to determine where the Legionella bacteria may have come from.

The source has not been identified yet, and Toronto Public Health said the overall risk to the public remains low because Legionnaires’ disease generally does not spread from person to person.

Did A Cooling Tower Cause Toronto's Legionnaires' Outbreak?

Also read: Legionnaire’s Disease NYC Outbreak: 3 Dead, 67 Sick; Health Authorities Have Identified ZIP Codes Linked With Cluster

Investigators believe this could be one of the possibilities but no source has been confirmed yet. Toronto Public Health is conducting on-site inspections to identify potential sources. Precautionary control measures have already been implemented.

Officials are also investigating whether the current cluster could be connected to an earlier outbreak at Castleview Wychwood Towers, a nearby long-term care facility where five cases were confirmed in July.

The possibility of a building water system is particularly relevant because Legionella grows more easily in warm, stagnant water, especially when disinfectant levels are inadequate or systems contain biofilm and sediment.

Toronto Has Already Seen A Rise In Legionella Cases

The current investigation comes against a broader increase in legionellosis in Ontario. Public Health Ontario reported 94 laboratory-confirmed cases between January 1 and June 16, 2026. Of these, 35 were linked to a cluster or outbreak, compared with an average of just 3.6 outbreak-associated cases during the same period from 2021 to 2025.

The province also recorded an earlier-than-expected increase in cases in April, when the rate was 1.8 times higher than the average for the previous five years.

For Toronto residents, however, health officials are stressing that the current investigation does not mean there is a widespread public health emergency.

What Is Legionnaires’ Disease?

Also read: Legionnaire’s Disease Outbreak Kills 2 And Sickens 58 In New York City- Know Symptoms And Risk

The bacteria become a health concern when they multiply in human-made water systems. These can include cooling towers, large plumbing systems, hot tubs, showers, humidifiers and decorative fountains.

People can become infected by breathing in tiny droplets or vapour containing the bacteria. Drinking contaminated water is not considered the usual route of infection, and people generally do not catch Legionnaires’ disease simply by being around someone who has it.

Who Is Most At Risk?

Most healthy people exposed to Legionella do not develop severe disease. However, the risk of serious illness is higher among:

• Older adults
• People who smoke
• People with chronic lung disease or other underlying health conditions
• People with weakened immune systems

Symptoms can include fever, cough, shortness of breath and muscle aches, and the infection can become severe enough to require hospitalisation. Legionnaires’ disease can also be fatal, particularly in vulnerable people.

Amid increasing uptake of GLP-1 weight-loss drugs such as Ozempic and Wegovy, FMCG major Nestlé has realigned its nutritional drinks to meet the changing nutritional needs of users.

The company has announced plans to roll out new protein drinks designed for people taking GLP-1 weight-loss medications such as Ozempic and Wegovy in the US, Asia and Australia. Since these drugs curb appetite and can contribute to issues such as muscle loss and “Ozempic face,” Nestlé wants to help users stay healthy while their eating habits change, Reuters reported.

To better understand their nutritional needs, Nestlé is using AI to study clinical research and real-world consumer needs. It is also expanding its high-protein offerings to support muscle health, along with collagen-added products in its Vital Proteins line for skin and hair.

What Are the Protein and Nutrition Needs of GLP-1 Users?

Also read: World Prediabetes Day: Can ‘Food Noise’ Affect Blood Sugar And Weight?

The number of people using GLP-1 drugs is growing rapidly, with about 16 million Americans currently taking the medications for weight loss. Globally, use remains much smaller than the potential eligible population, with access and affordability still major barriers.

But do GLP-1 users need more protein?

Dr. Navin Gnanasekaran, Longevity Physician, Apollo Hospitals, told HealthandMe that for individuals on GLP-1 receptor agonists, rapid weight loss can lead to a significant reduction in both fat and lean muscle mass. Alarmingly, up to 30-40% of the total weight lost can be muscle.

“Prioritizing protein intake and structured resistance training is absolutely critical to counteract this muscle depletion,” he said.

How Much Protein Do GLP-1 Users Need?

Read More:GLP-1 Weight Loss Drugs Ozempic, Wegovy, Mounjaro Tied To Over 60 Reported Deaths In Australia

Dr. Navin said that a daily intake of at least 1.0 to 1.5 grams of high-quality protein per kilogram of body weight is recommended. Lean meats, eggs, dairy and plant-based proteins can help meet these needs.

He also recommended strength training to preserve muscle tissue. Together, adequate protein and resistance training can help support muscle mass and maintain the basal metabolic rate (BMR), which may help prevent weight regain.

Dr. Praveen Gupta, Chairman, Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals, told HealthandMe that a large number of people in India eat vegetarian diets that are already low in B12, iron and vitamin D. These nutritional gaps can quietly widen when food intake is reduced with GLP-1 drugs.

For people following vegetarian diets, familiar kitchen staples such as paneer, dal, soya chunks, hung curd, sprouts and eggs, spread across the day, can help meet protein targets without animal meat.

How Do GLP-1 Drugs Work?

Dr. Praveen said these drugs work by slowing digestion and dialing down “food noise” — the constant mental chatter around eating — which naturally cuts how much a person consumes, sometimes by half.

GLP-1 receptors are located not just in the gut but throughout the central nervous system, including regions such as the hypothalamus and hippocampus that receive direct input from GLP-1-producing neurons in the hindbrain. This is part of why appetite suppression can be so powerful: the drugs act on the brain’s hunger circuitry, in addition to slowing digestion.

Do GLP-1 Drugs Increase the Risk of Nutritional Deficiencies?

The overall appetite suppression caused by these medications can increase the risk of vitamin deficiencies. Constipation is also a common GLP-1 side effect due to decreased dietary fiber intake.

Good hydration, planned nutrient-dense meals and adequate fiber can help offset these effects.

Routine monitoring of essential micronutrients, particularly vitamin D, B12 and iron, is highly advised to ensure patients achieve sustainable, healthy weight loss without compromising their long-term nutritional well-being.

Why Protein Matters

• Reduced food intake: Appetite suppression from GLP-1 drugs can create nutritional gaps, with potential neurological consequences.
• Vitamin B12: Deficiency can cause irreversible nerve damage, including peripheral neuropathy and cognitive impairment.
• Warning signs: Unaddressed deficiencies can cause tingling, numbness, brain fog and unexplained fatigue.
• Muscle loss: A significant share of weight lost on GLP-1 medications can be lean muscle rather than fat if adequate protein intake and physical activity are not prioritised.
• Nutrition matters: Inadequate nutrition can affect both muscle and nerve tissue, making adequate protein and essential micronutrients important during weight loss.