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.

Health officials in the Democratic Republic of the Congo (DRC) have stated that the Ebola outbreak has reached its peak, with the number of new cases slowing for the first time since May.

However, the UN has warned that the epidemic remains “massive” and is still growing in some areas, while the World Health Organization (WHO) said it is too early to confidently conclude that the outbreak has passed its peak.

The outbreak, caused by the rare Bundibugyo virus, was declared by the WHO on May 15. It is the DRC’s 17th Ebola outbreak since the virus was first identified in 1976.

It is also the second-deadliest Ebola outbreak on record, behind the West African outbreak that lasted from 2014 to 2016.

While clinical trials are ongoing for vaccines and treatments against Bundibugyo virus, the DRC received more than 70,000 doses of the Ervebo vaccine last month. Ervebo is approved for protection against the more common Zaire Ebola virus.

Are Ebola Cases Slowing?

Also read: Ebola Bundibugyo Virus: American Health Worker Had 10x Higher Viral Load In Throat Than Blood

According to the latest data from the Congolese health ministry, more than 7,200 confirmed cases and over 3,475 deaths had been reported as of September 14.

Congolese Health Minister Samuel Roger Kamba said transmission of the Bundibugyo virus had declined, with daily cases falling from about 120 at the peak in mid-August to around 80.

“We are fighting a very dangerous virus that is killing many of our people. Today, we can say that the outbreak is under control,” he said.

“At one point, we were recording about 120 cases per day; today, we’re seeing about 80 per day. So the number of new cases is decreasing every day.”

Kamba said 10 of the 62 affected health zones had reported no new cases for more than 22 days. Six health zones had gone more than 42 days without a new case, while four had gone more than 21 days without one.

He said the figures were “encouraging” but stressed that people must remain fully mobilized and not lower their guard.

Concerns Over Government Claim

Read More: Chile Eliminates Dog-Transmitted Rabies: What Other Countries Can Learn

Last week, Sud-Ubangi province, which borders Congo-Brazzaville and the Central African Republic, became the sixth province to report Ebola cases.

While welcoming the progress, Iracan Gratien de Saint-Nicolas, an MP for Bunia, warned against “triumphalism” and called for greater transparency over the outbreak data, The Guardian reported.

“Claims that an epidemic is under control must be supported by objective indicators. If the indicators show that the epidemic is indeed under control, let’s make them public. Transparency in the data will strengthen public confidence,” he said.

He also called for lessons to be learned from failures in epidemiological surveillance that contributed to the rapid spread of the disease.

What Is The UN Saying?

UN officials acknowledged that response efforts were showing results but warned that the epidemic remained “massive” and could take months to bring under control.

“It remains a deadly and a massive epidemic. There are some areas of progress, but nonetheless, in other areas, we continue to see growth in cases,” Julien Harneis, the UN special Ebola coordinator, told a Geneva press briefing.

Asked about reports that the epidemic had reached a turning point, WHO's Olivier le Polain said: “It's too early to confidently say we have passed a peak”, Reuters reported.

A team of US researchers has developed an unconventional surveillance tool: a 3D-printed “mosquito toilet” that collects mosquito waste for genetic analysis.

The approach detected a complete West Nile virus genome and the first known evidence of a Hedwig-like virus in the Americas, along with several viruses that may be new to science and parasites.

Researchers from the Rutgers University adapted an approach used to track genetic evidence in wastewater, including during the COVID-19 pandemic and for polio surveillance, to mosquitoes.

How Does The Mosquito ‘Toilet’ Work?

Also read: ICMR Study Shows Pune Dengue Mosquitoes Resistant To Insecticides: What It Means for Public Health

The team built what it called “a mosquito toilet” — a 3D-printed funnel coated with a superhydrophobic (water-repelling) material that causes liquid to bead up and slide into a collection tube, explained lead author and entomologist Dana Price from the School of Environmental and Biological Sciences.

The researchers collected two groups of 50 wild Culex mosquitoes from a yard in New Brunswick, New Jersey, in 2021 and 2022. They placed each group in a screened container over the funnel and fed them a sugar solution. The mosquitoes produced drops of waste, which slid into a tube.

The scientists used shotgun metagenomic sequencing, which sequences all genetic material present in a mixed sample. Computers then assembled the millions of fragments generated and compared them with known sequences in scientific databases.

What Did The Mosquito Waste Reveal?

The team captured tiny traces of mosquito waste and conducted genetic sequencing.

The findings, published in the journal Microbiology Spectrum, revealed:

• A complete West Nile virus genome
• The first known evidence of a Hedwig-like virus in the Americas
• Several viruses that may be new to science
• Parasites
• The mosquito species that deposited the waste droplets

The study suggests mosquito waste could become a surveillance tool, allowing scientists to search broadly for familiar pathogens as well as threats they don't yet know exist, Price said.

Mosquitoes excrete small amounts of liquid containing genetic traces of viruses and other organisms. Because the waste contains far less mosquito tissue, and therefore less mosquito DNA, than a crushed insect, the scientists reasoned that viral material might be easier to find.

A Full West Nile Virus Genome

The 2022 sample contained a complete, high-quality genome of West Nile virus, which can cause serious neurological illness in people.

The researchers identified the virus as belonging to the NY07 genetic variant previously found in the region. Such detail could help scientists track how genetic variants of a virus emerge, spread and change.

"What came out was an entire viral genome," Price said. "Rather than just positive or negative, we have genetic data."

An Unexpected Virus In The Americas

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The researchers were even more intrigued by evidence of a Hedwig-like virus, which hadn't previously been reported in the Americas.

Hedwig virus was first identified in Europe in snowy owl tissue, prompting scientists to name it after Harry Potter's famous white owl. Some of the infected birds also had West Nile virus.

Scientists don't know whether Hedwig-like viruses make birds sick, facilitate West Nile infections or simply coexist with other viruses.

The finding doesn't establish that the virus is a threat, Price said. It shows that it has been circulating where no one knew to search for it.

"We didn't even look for it specifically," Price said. "We just looked for everything, and we found Hedwig in there."

A virus found for the first time in a region may have recently arrived or may have gone unnoticed for years. Because few broad mosquito-virus studies have been conducted in North America, organisms that seem geographically restricted may prove widespread.

Price is currently working with health officials at the New Jersey Department of Environmental Protection to screen organ and tissue samples for the virus. The samples are collected from deceased birds during a postmortem examination.

Chile has become the first country in South America to eliminate dog-transmitted rabies as a public health problem, marking a major milestone in the fight against a disease that is almost always fatal once symptoms appear.

The achievement follows more than five decades without a human case of rabies transmitted by dogs, supported by sustained dog vaccination, disease surveillance and timely access to post-exposure treatment.

“I congratulate the government and people of Chile on this historic achievement,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“This validation reflects decades of commitment to protecting communities from rabies and demonstrates the impact of sustained investment in public health. Chile’s success offers valuable lessons for countries working to end human deaths from this preventable disease,” he added.

How Chile Eliminated Dog-Transmitted Rabies

Also read: Bhutan Eliminates Rabies While India Battles Persistent Deaths: What Can India Learn From Its Neighbor?'

WHO recognizes elimination when transmission among dogs has stopped, no human deaths from dog-mediated rabies have occurred for at least two years, and the country can prevent the disease from returning.

Chile’s last reported case of human rabies transmitted by dogs occurred in 1972.

Since then, the country has sustained efforts including timely vaccination for people exposed to the virus through bites, scratches or contact with saliva from infected or suspected rabid dogs.

These efforts were supported by:

• Door-to-door dog vaccination campaigns
• Targeted dog population management
• Community awareness and education
• Free mass vaccination for dogs and cats
• Epidemiological surveillance
• Strengthened laboratory diagnosis
• Monitoring of rabies virus in animals
• Timely access to post-exposure prophylaxis.

More recently, Chile has expanded preventive vaccination and surveillance to border areas at higher risk of rabies reintroduction.

What Chile’s Success Teaches

Chile’s achievement builds on decades of coordinated action across the Americas, where human cases of dog-mediated rabies have fallen by more than 98% since 1983.

It also contributes to the Pan American Health Organization’s (PAHO) Disease Elimination Initiative, which aims to eliminate more than 30 communicable diseases and related conditions in the Americas by 2030.

While the Americas has made significant progress, dog-transmitted rabies still causes tens of thousands of deaths globally each year, primarily in Asia and Africa.

Chile’s success shows how sustained investment in prevention, surveillance and access to care can bring this deadly but preventable disease to the point of elimination.

It also highlights the value of the One Health approach, bringing together human, animal and environmental health sectors to prevent and control diseases that spread between animals and people.

Read More: US CDC Warns Of Rising Human Rabies Exposure Risk: How To Stay Safe

What Is Rabies?

Rabies is a vaccine-preventable zoonotic disease that is almost invariably fatal once symptoms appear. However, deaths can be prevented through timely post-exposure prophylaxis, including wound care and vaccination.

Dogs account for up to 99% of human rabies transmissions globally.

Public education on dog behavior, bite prevention, appropriate action after a bite or scratch, and responsible pet ownership is also essential to rabies prevention.

Rabies is also one of 21 neglected tropical diseases (NTDs), which affect one billion people globally. As of September 2026, 65 countries had eliminated at least one NTD, including seven in the Americas.

Chile’s validation for rabies marks its second NTD elimination achievement; earlier this year, it was verified by WHO for the elimination of leprosy, becoming the first country in the Americas to achieve this target.