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 January 2025, Los Angeles was ravaged by wildfires, which reportedly exposed an estimated 7 million people to lead concentrations more than 80 times higher than normal levels. The findings were published in Science Advances.

Researchers from the California Institute of Technology (Caltech) found that smoke from the Eaton Fire contained excessive concentrations of toxic metals and other chemicals than smoke from a wildfire that burned mainly vegetation. The findings highlight the health risks caused when fires spread through populated areas and burnt homes, vehicles and electronic equipment.

The lead exposure for an estimated 24-hour period across the Los Angeles metropolitan area was more than 80 times typical levels. The researchers also found that the fire plume contained 50 times more lead, three times more arsenic and seven times more chlorine and bromine than the smoke.

LA Wildfire Smoke Was Highly Toxic

Wildfire smoke is releases particulate matter from the burning of trees, grass and other vegetation. However, when fires spread deeper into cities, they can also burn building materials, paint, vehicles, plastics and electronic devices, releasing more toxic pollutants.

The Eaton Fire began on January 7, 2025, and ravaged communities in and around Altadena, California. As the fire burned homes and vehicles, concentrations of toxic metals in the atmosphere increased drastically.

The researchers compared the chemical composition of the Eaton Fire plume to measurements from the 2024 Airport Fire in Southern California, which predominantly burned vegetation. They found that the urban fire plume had a completely different chemical composition.

“Urban fire plumes are chemically distinct from those of wildfires. Now that we have these observational data about how they differ, we can go back and adjust our models to more accurately estimate how smoke might affect people,” said Haroula Baliaka, the study’s lead author, in a statement released by Caltech.

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Health Risks Of Lead And Arsenic Exposure

Lead is a toxic metal that can damage the nervous system. In children, exposure can impair brain development and lower IQ. In adults, it can cause high blood pressure and other health problems.

Arsenic exposure is also connected to several cancers. Chlorine and bromine are halogens that can be released when certain materials burn.

However, scientists have not established the full health consequences of the short-term, high-concentration lead exposure estimated in the study. The findings establish that millions of people may have encountered elevated levels of toxic pollutants, but they do not show how many developed health problems as a result.

Urban Fire Smoke Needs Stricter Monitoring

Wildfire smoke threatens populated areas. Smoke can travel beyond the fire zone, exposing people who may not face an immediate risk from flames.

Researchers and outside experts have called for better monitoring of smoke composition, better public alerts and emergency responses that account for toxic pollutants as well as fire danger.

The study also points to a gap in current understanding of air quality models that are based on wildfire emissions. They may not be fully be able capture the chemical hazards from fires that burn buildings and vehicles.

“Smoke travels; it's not just about the burn area. What does a plume mean for people who are miles away from a fire but receive the smoke? We evacuate for fire, but we don't evacuate for smoke exposure,” Baliaka said according to CBS Los Angeles.

Tuberculosis (TB) remains the world’s leading cause of death from a single infectious agent. Treatment typically involves daily oral medicines that is taken for over weeks or months, making adherence a challenge for many patients.

To tackle this, the World Health Organization (WHO) has now released target regimen profiles for long-acting injectables (LAIs), which may soon replace pills with injections for TB preventive treatment and TB disease.

The new treatment regimen for tuberculosis with LAIs targets three or fewer injections in just four months.

These treatments are not yet commercially available for routine clinical use, but several candidates are entering clinical development.

“Long-acting injectables could make TB prevention and treatment much simpler for the people who need them. These profiles tell developers, early, what a new regimen must achieve to make that difference in practice, without trading away efficacy, safety or patient choice,” said Dr. Tereza Kasaeva, director of the WHO Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections.

What Are the WHO’s Targets for Long-Acting TB Injections?

Also read: 94% Of TB Patients Report Anxiety, 77% Depression: Study Highlights Mental Health Toll Of India's TB Burden

The WHO’s target regimen profiles (TRPs) define the minimum and optimal requirements for developing LAIs for TB prevention and treatment, guiding pharmaceutical companies, researchers, product developers, donors and TB-affected communities.

"The profile for TB preventive treatment aims for a complete course delivered through a single injection during one healthcare encounter. For TB disease, the target is a regimen lasting no more than four months, delivered in three or fewer dosing encounters," the WHO said.

Both profiles call for injections administered by trained health workers at the lowest feasible level of the health system. They also specify small injection volumes, no requirement for a cold chain, and efficacy and safety at least comparable to those of existing oral regimens. The profiles also address clinical trial design, scalability, equitable access and affordability.

How Could Long-Acting Injections Help People With TB?

Read More: ICMR's Advanced Blood Test to Predict Risk of TB 1.5 Years Before Symptoms Appear

LAIs are sustained-release medicines administered through intramuscular or subcutaneous injections. They have shown previously shown potential in managing conditions including HIV, schizophrenia, opioid dependence and contraception.

For HIV prevention, long-acting cabotegravir is administered every two months, while lenacapavir is administered twice yearly. WHO recommended lenacapavir for HIV prevention in 2025.

For people affected by TB, potential benefits include:

• Simpler adherence: Fewer doses could make it easier to complete treatment.
• Lower risk of drug resistance: Better adherence could reduce the risk of resistance developing during treatment.
• Reduced treatment burden: Fewer pills and healthcare visits could mean less time away from work and lower travel costs.
• Less stigma: Less frequent medication-taking and fewer healthcare visits could ease some of the burden associated with treatment.

However, LAIs address medication-taking frequency and adherence, not every challenge in TB care. Effective implementation would still require timely diagnosis, appropriate testing, management of comorbidities and drug interactions, contact investigation, and adequate healthcare resources.

Will Long-Acting TB Injections Be Affordable?

The WHO expects LAIs for TB prevention and treatment to enter the market at higher prices than existing oral formulations, based on anticipated development and production costs. International collaboration and support may be needed to ensure affordability, particularly during the initial rollout.

The WHO also emphasized that research into improved oral regimens should continue. Treatment programmes must preserve patient choice, allowing people who prefer oral medicines to continue using them.

Why Does This Matter for India?

According to the WHO’s Global Tuberculosis Report 2025, more than 10 million people developed TB worldwide in 2024, while more than 1.2 million died from the disease.

India bears the largest share of the global TB burden. Prolonged treatment, financial hardship, stigma and uneven access to drug-resistant TB care can make treatment more challenging.

If successfully developed and made accessible, long-acting injections could reduce some of the practical and economic barriers associated with TB treatment. Their impact will depend on safety, efficacy, affordability and equitable access.

Australian actor and stuntman Richard Norton died in 2025 after an injection of unapproved peptides triggered a fatal anaphylactic reaction, according to a coroner’s findings. The coroner has recommended tighter restrictions on the substances.

The findings come as US Health Secretary Robert F. Kennedy Jr. moves to ease restrictions on six unapproved peptides despite opposition from US Food and Drug Administration (FDA) scientists.

What Happened to Richard Norton?

Norton, 75, died on March 30, 2025, after suffering cardiac arrest following an injection of CJC-1295 and Ipamorelin, according to ABC News. A coroner found that the peptides triggered a fatal anaphylactic reaction.

Norton sought peptide therapy to address fatigue, slow physical recovery, shoulder pain and muscle loss. Doctor Jerzy Muchnicki prescribed the injectable peptides, which were compounded by a licensed pharmacy in Queensland.

Norton told a clinic nurse he had been taking double his prescribed dose. The nurse advised him to return to the prescribed dose the following week. Hours later, he became unresponsive after injecting the peptides and died at Melbourne’s Alfred Hospital.

Coroner David Ryan recommended that Australia’s Therapeutic Goods Administration (TGA) review the peptides’ safety and benefits and consider tighter restrictions. Norton’s death is believed to be Australia’s first confirmed fatality linked to unapproved peptide use.

RFK Jr. Eases Restrictions on Six Unapproved Peptides

The Trump administration has outlined a policy allowing the limited compounding of six unapproved peptides under specified safeguards, despite opposition from FDA scientists.

In a draft policy released Wednesday, Kennedy said compounding pharmacies could prepare BPC-157, Epitalon, KPV, MOTS-c, Semax and TB-500, none of which are approved by the FDA as a medicine.

The policy states that the Department of Health and Human Services (HHS) does not intend to take action against licensed pharmacies or physicians that compound products using certain peptide ingredients not found in FDA-approved drugs.

“By allowing limited compounding of the substances addressed in this guidance under appropriate safeguards, the policy provides patients with a more controlled alternative,” Kennedy wrote in the draft policy.

Kennedy has previously expressed support for peptides, including the so-called “Wolverine stack,” a combination of BPC-157 and TB-500 marketed online for healing and recovery. Both substances are included in the proposed policy.

The draft policy will be open for public comment from Friday through November 13. It will remain in effect until the FDA finalizes a rule on compounded peptides. The FDA has not yet proposed such a rule.

What Are Peptides?

Peptides are short chains of amino acids that perform various functions in the body, including regulating hormones and processes involved in growth, metabolism and healing.

Some peptide-based medicines are approved to treat conditions such as diabetes and obesity. However, other peptides promoted online have not been adequately studied or approved as medicines.

What Are the Safety Concerns?

The FDA has raised concerns about limited human safety data, potential immune reactions and impurities associated with certain peptides, including BPC-157. The agency has also cited potential risks from compounded peptides, including contamination, allergic reactions and tumor growth.

The FDA’s adverse-event database includes reports of injection-site reactions, shortness of breath and changes in skin or gum pigmentation among people who used BPC-157. However, these reports do not establish that the peptide caused the events.

Compounded medicines can meet specific patient needs, but they are not FDA-approved. The agency does not verify their safety, effectiveness and quality through the same premarket approval process used for approved drugs.

Allowing pharmacies to compound certain peptides would not mean the substances had received FDA approval or that their safety and effectiveness had been established.