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 wearable device developed by Zomato founder Deepinder Goyal has sparked a massive social media debate among doctors over its scientific claims and validity.

Called Temple, the gadget, worn on the forehead, is designed to track physiological signals linked with blood flow in the brain and generate a metric called 'Entropy', which, according to Goyal, is a measure of the body's real-time energy expenditure.

Priced at Rs 85,000, one of the factors that has sparked arguments, the device is now available pre-orders in India. However, medical experts have questioned whether the technology can accurately measure what it claims to and whether its readings offer meaningful insights into brain health, ageing or longevity.

The controversy intensified after Goyal defended the project against criticism from doctors. In a post on X, he said the development had cost $30 million, including $20 million of his personal money. He also said further research was underway.

“We have a number of new research breakthroughs coming up (especially Entropy), and are validating them as we speak,” Goyal wrote on November 6.

Can Temple Actually Measure Blood Flow To The Brain?

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One of the main concerns is the device's sensor placement. Temple uses optical sensors based on photoplethysmography (PPG), positioned near the temple. These detect changes in blood flow through superficial blood vessels.

However, the superficial temporal artery supplies blood to the scalp and face. The brain receives its blood supply primarily through the internal carotid and vertebral arteries. A signal detected from a superficial vessel cannot automatically be interpreted as a measurement of blood circulation inside the brain.

Dr. Cyriac Abby Philips, widely known online as The Liver Doc, is one of the many doctors who challenged Goyal's claims about Temple on social media post.

He wrote, "Deepinder's Temple device is very much like Baba Ramdev's Coronil. Only one difference. Former is scienceploitation, latter is pseudoscience and both are harmful in their own ways. Learn to identify a scam and fraud when you see one."

Dr Jason Philip, in an X post, called the research behind the device "pseudoscience". He said that the gravity ageing hypothesis is a flawed concept. Ageing is a result of many factors like metabolic factors, genomic instability, mitochondrial dysfunction, chronic inflammation and more.

Many also slammed Goyal for selling the device without solid research or clinical outcomes.

Dr Rishabh Jain responded to Goyal's post, saying that doctors asking for scientific evidence is a legitimate demand. He also said that Goyal's response to clinical questions are mostly commerce-based and does not "constitute scientific validation".

Dr Kapil Singhal, Director of Neurology at the Institute of Neurosciences, Medanta, Noida, told Mint, “Temple appears to be measuring blood flow in the superficial temporal artery, which supplies blood to the scalp, not the brain. The brain receives blood through the internal carotid and vertebral arteries. These are not the same.”

Dr Praveen Gupta, Chairman of Marengo Asia International Institute of Neuro & Spine, Gurugram, also cautioned against treating a reading from one location as representative of the entire brain.

A device may detect physiological changes near the forehead but establishing that these reflect cerebral blood flow requires comparison with established clinical measurements and independent validation.

What Is Entropy And Why Are Doctors Questioning It?

Also read: Mental Health And Longevity: The Mind-Body Connection To Aging Gracefully

Goyal has described Entropy as a new biomarker that measures how hard the body is working to sustain itself. The score is influenced by factors like sleep, exercise, stress, food and meditation.

However, doctors say that a metric responding to changes in activity does not establish what biological function it measures.

Neurologist Dr Sudhir Kumar told India Today that the idea was interesting but required stronger evidence.

“The idea of developing a novel physiological metric from signals recorded over the temple region is certainly intriguing, and advances in wearable technology have the potential to improve our understanding of human physiology. However, extraordinary claims require extraordinary evidence,” he said.

He added, “The key questions are not whether the signal changes with exercise, stress, or meditation, but whether it reliably measures what it claims to measure, whether it adds information beyond existing metrics, and whether acting on it improves health outcomes.”

In other words, doctors want to know how Entropy is calculated, what it represents biologically and whether it has been independently shown to improve health outcomes.

Gravity Ageing Hypothesis

Temple is also associated with Goyal's Gravity Ageing Hypothesis which proposes that gravity and prolonged periods spent upright may affect blood circulation to the brain and contribute to ageing.

However, the brain has a mechanism called cerebral autoregulation that helps maintain relatively stable blood flow despite changes in posture and blood pressure.

Dr Gupta told The Indian Express, “The brain automatically adjusts the size of its blood vessels and regulates blood supply to ensure that it continues to receive enough oxygen and nutrients, even when we change positions, stand up or exercise.”

He added that there is no established scientific evidence that everyday exposure to gravity progressively damages the brain or accelerates ageing.

More About Temple

Goyal has said that Temple is a wellness and research product rather than a medical device. He has also argued that its claims will be independently verifiable and that more research will be shared soon.

However, doctors say the difference between detecting a physiological signal and demonstrating its clinical significance is crucial. Temple's ability to track certain readings would not, by itself, establish that it can diagnose neurological conditions, predict cognitive decline or measure longevity.

Kidney cancer, often considered as a disease associated with older adults, has been increasing in people under 50, according to latest data released by NHS England. The data shows that diagnoses in people under 50 have increased in one year as the number of cases in this age group increased by 12% between 2023 and 2024, prompting experts to highlight symptoms that can easily be mistaken for less serious health problems.

According to the figures, 1,227 people under 50 were diagnosed with kidney cancer in 2024, compared to 1,095 in 2023. Although kidney cancer remains more common in older adults, the increase sparks concerns about recognising early warning signs in younger people.

A study published in BJC Reports, which analysed more than 200,000 kidney cancer cases in England between 1985 and 2020, found that incidence among people under 50 had increased substantially. The rise was 157% among men and 133% among women.

Researchers said some of the increase may be linked to certain changing risk factors, including rising obesity rates, but other explanations still remain unclear.

Kidney Cancer May Be Difficult To Recognise In Younger Adults

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One challenge is that kidney cancer may not cause obvious symptoms in its early stages. When symptoms do appear, they can resemble common conditions like muscle strain, urinary infections or other causes of back pain.

Andrew Greaves, general manager of Kidney Cancer UK, told the Daily Mail, “It’s very easy to miss, notoriously so.”

Back or side pain, chronic fatigue and night sweats are among the symptoms that can be overlooked. Greaves said around a third of patients report pain in the back, side or flank before diagnosis, while approximately one in four experience persistent fatigue and one in six report night sweats.

Blood in the urine, also known as haematuria, is one of the key warning signs. Greaves said that these symptoms are not limited to cancer. “Even if you said, I’ve got all four of those symptoms, it could still be highly unlikely that it’s kidney cancer, but it might be.”

Warning Signs Of Kidney Cancer

According to the NHS, kidney cancer may cause:

• Blood in the urine, even if it occurs only once
• Constant pain between the ribs and waist
• A lump or swelling in the back, beneath the ribs or in the neck
• Unexplained weight loss and loss of appetite
• Chronic fatigue
• High body temperature that does not go down
• Excessive sweating especially at night

Early Detection Of Kidney Cancer

Kidney cancer can sometimes be discovered incidentally when a person undergoes screening for another health problem. This can make diagnosis challenging because early-stage disease may present few or no symptoms.

Greaves said that more than half of kidney cancers are now found during scans conducted for other reasons.

He also explained that kidney cancer is often diagnosed late as symptoms are initially attributed to other medical conditions. Around a quarter of patients surveyed by Kidney Cancer UK said they had initially been treated for another condition before getting diagnosed with kidney cancer.

An experimental bird flu vaccine designed by researchers using artificial intelligence (AI) has shown significant promise. It provided complete protection against multiple virus variants in animal-based trials. It outperformed existing vaccines stockpiled by governments for a human outbreak.

Developed by researchers at the University of Cambridge and its spin-off company DIOSynVax, the broad-spectrum vaccine protected mice and ferrets against various variants of bird flu virus that were genetically diverse. In comparison, the existing vaccine used in the study protected only around 50% of the animals exposed to the same variants.

The findings were published in the journal Cell Reports Medicine recently. The researchers say the findings could help improve preparedness for future influenza outbreaks. The vaccine is yet to be tested in humans.

“Rather than providing immunity to a single variant of bird flu, our new broad-spectrum vaccine is protective against a huge range of variants. It’s designed to counteract viral evolution, rather than reacting to it,” said Professor Jonathan Heeney, who led the research at the University of Cambridge's Department of Veterinary Medicine.

Bird Flu Vaccine Designed Using AI

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Traditional vaccines often target specific virus strains that have already emerged and infected humans. However, influenza viruses can mutate rapidly, which could reduce the effectiveness of vaccines made for earlier variants.

The researchers collected genetic sequence data from bird flu viruses recorded through global surveillance programmes to tackle this challenge. These included samples from wildlife, livestock and infected humans.

They then used AI to analyse the large datasets and identify antigen features shared across different viruses. Antigens are the components of a vaccine that stimulate the immune system to identify and respond to a pathogen.

The researchers then used this information to design synthetic antigens, which were screened in laboratory tests before the most promising candidate was selected for animal trials.

“Using AI vastly speeds up the process of vaccine design, and then we can test the vaccine candidates in the lab to make sure they’re robust and safe,” Heeney said.

Dr Sneha Vishwanath, a member of the research team, explained that the vaccine's antigens were designed to target multiple stages of the virus's lifecycle. “By instructing the immune system to target different stages of the viral lifecycle, we can induce an immune response blocking several crucial steps in its replication,” she said.

What Did The Animal Study Find?

Also read: AI-Created Virus Injected Into A Human For The First Time To Fight Antibiotic Resistance

The experimental bird flu vaccine provided complete protection to mice and ferrets that were exposed to various genetically diverse bird flu variants. These variants have all been linked with human infections and are considered major pandemic threats.

By comparison, only around 50% of the animals survived exposure when they were given the World Health Organization's existing bird flu vaccine.

The researchers said the findings suggest that a vaccine designed to target features shared across multiple virus variants could offer better protection than one developed against a particular strain.

Human Trials Remain

The vaccine has only been tested in animal trials. Human clinical trials are the next step in the protocol. Its safety and effectiveness in people will need to be established before it can be considered for use.

Bird flu, also known as avian influenza, is an infectious disease caused by influenza viruses that primarily affect birds but can sometimes infect mammals, including humans. Some human infections can be mild while other variants have caused severe illness and deaths.

The researchers believe developing vaccines that protect against a wider range of variants could help reduce the risks posed by emerging infections.

“It’s when bird flu adapts to live in the airways of mammals that we start to get really nervous,” Heeney said. “If we can make better animal vaccines, then we can better protect human health as well.”