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 COVID-19 pandemic did more than overwhelm global healthcare systems. It also disrupted timely care for people experiencing strokes.

Published in European Medical Journal, a global review of 107 studies has found that patients delayed hospital visits, stroke-related hospital admissions fell and treatment became harder to access during the pandemic.

The review, which examined research published between December 2019 and September 2024, looked at how the pandemic affected stroke care from the moment symptoms began through hospital treatment and recovery. Researchers initially screened 1,405 studies before including 107 in their analysis.

Stroke Patients Delayed Going To Hospital

One of the alarming patterns among stroke victims was a delay in seeking medical help. People experiencing stroke symptoms were reluctant to go to hospitals because they feared catching COVID-19 or believed healthcare facilities were already overwhelmed.

The delay was particularly noticeable among people with milder stroke symptoms; some of whom reached hospitals after critical treatment windows had passed.

The findings are a cause of concern as stroke treatment is extremely time-sensitive. Delays can prevent patients from seeking timely treatments to restore blood flow to the brain.

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Stroke Admissions Declined

Several studies included in the review reported a decline in stroke admissions during the pandemic. One study found a 31% decrease in monthly admissions for ischaemic stroke, while another reported a 44% reduction.

The drop did not mean fewer people were having strokes. Instead, researchers found evidence that some patients may simply have avoided or delayed seeking emergency care.

When patients did reach hospitals, several studies found they were more likely to have more severe strokes than patients treated before the pandemic.

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Stroke Treatment Was Delayed Inside Hospitals

The disruption was not limited to patients' decisions about when to seek help. Hospitals had to reorganise resources and reassign staff towards COVID-19 response. These changes affected stroke services and contributed to delays in treatment.

The review also identified increases in both symptom-to-door time, the period between stroke symptoms beginning and reaching hospital, and door-to-treatment time, the period between arriving at hospital and receiving treatment to restore blood flow. Ambulance services also faced additional pressure during the pandemic.

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Delays Affected Stroke Recovery

The review found evidence that the disruption was associated with poorer outcomes for some stroke patients. One study reported significantly greater disability at discharge during the pandemic, with a median modified Rankin Scale score of 4 compared with 2 before the pandemic. The difference remained at three months after the stroke.

Another analysis reported higher mortality at discharge among patients treated during the pandemic, at 7.7% compared with 2.5% in a pre-pandemic group.

Role Of Telemedicine In Stroke Care During Pandemic

Telemedicine refers to seeking healthcare remotely using technology, without the doctor and patient needing to be in the same physical location.

Telemedicine helped maintain some continuity of stroke care during the pandemic, but access was not even everywhere.

The review found that younger patients were more likely to use remote healthcare services, while older adults didn't.

This raises concerns about whether telemedicine can adequately support people who may have greater healthcare needs but face barriers to digital access.

The researchers added that said future preparedness should focus on keeping stroke services accessible, ensuring equitable access to telemedicine and educating patients about the need to seek emergency care promptly.

A few extra minutes during an upper gastrointestinal endoscopy may help doctors detect more gastric cancers and precancerous alternations, according to research recently discussed at the World Congress of Gastroenterology (WCOG) 2026 in New Delhi.

At WCOG, it was discussed that the quality and duration of an endoscopic examination can influence the chances of finding early cancer. An inspection time of an additional at least seven minutes was linked with about 3.4 times higher detection of gastric cancer and dysplasia.

The finding comes as gastrointestinal cancers continue to increase, contributing to a growing global health burden. GI cancers currently account for around one in four cancer cases and one in three cancer deaths worldwide. The overall burden of the disease is projected to nearly double by 2050.

Dr. Pramod Garg, Professor & Head, Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi; President, Indian Society of Gastroenterology and Co-Chair, Steering Committee, WCOG 2026, said, “Earlier detection depends on both identifying people at risk and ensuring that diagnostic procedures are performed to the highest possible standard. High-quality endoscopy can create an important opportunity to identify disease at a stage when intervention can make a greater difference.”

Could Endoscopy Time Affect Cancer Detection?

Also read: WCOG 2026: How Infections, Metabolic Disease Are Changing Digestive Health

An upper gastrointestinal endoscopy allows doctors to examine the lining of the oesophagus, stomach, and upper part of the small intestine using a flexible camera device.

Simply inserting the scope and looking quickly may not be enough to identify subtle abnormalities. A more systematic examination allows the endoscopist more time to examine the stomach lining, identify suspicious areas, improve mucosal visualisation and document findings accordingly.

The WCOG discussion therefore puts focus on not just whether endoscopy is performed, but also on how long and how well it is performed.

The reported 3.4 times association highlights the value of a careful, detailed examination that could help detect changes related to cancer early, prompting timely treatment.

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India's GI Cancer Burden

The changes in India's gastrointestinal cancer burden were also discussed, including growing concern around early-onset colorectal cancer. Researchers are examining whether genetics, environmental exposures and changes in the gut microbiome could be contributing to colorectal cancer appearing at younger ages.

WCOG 2026 also included concerns related gallbladder cancer, liver cancer and the rising role of metabolic risk factors. Discussions also focused on the use of AI in gastrointestinal diagnosis and the importance of validating these tools before introducing them in standard practice.

Dr. Govind Makharia, Professor, Department of Gastroenterology and Human Nutrition, AIIMS, New Delhi and Chairman, Local Organising Committee, WCOG 2026, said, “AI has the potential to strengthen diagnosis and decision-making across gastroenterology, while advanced endoscopy is expanding what can be treated through minimally invasive approaches. The next step is ensuring that these technologies are supported by robust evidence and integrated responsibly into clinical practice.”

H. pylori was also addressed as a preventable risk factor for gastric cancer.

Dr Barry Marshall, Nobel Laureate in Physiology or Medicine, said, “H. pylori is much more than an ulcer organism. If the infection persists for many years, it can cause chronic inflammation in the stomach and increase the risk of gastric cancer. That gives us an opportunity because this is a potentially preventable cause of cancer.”

Advances in minimally invasive procedures like POEM, endoscopic submucosal dissection and therapeutic EUS were also discussed, although access to advanced GI care remains uneven.

The President of the United States, Donald Trump, has revealed that he takes aspirin every day, sharing that he has been doing so for decades because he believes it helps keep his blood “thin”.

He said it while discussing his aspirin use and the bruising that was recently seen on his knuckles. He also said that doctors have advised he take a lower dose.

“I take an aspirin a day. I don’t know if it works but psychologically I need it. It thins the hell out of your blood I guess. I don’t know if it works or not but I’ve been doing it for a long time. And here I am making speeches. I like Bayer aspirin. And I take the big one. They want me to go down to the 80. I take the 386. I don’t know what the hell it is. It’s a monster. They said, ‘Sir, you don’t need that!’ I said, do me a favor, I’ve been doing okay for 35 years. Leave me alone.”

So, does taking an aspirin every day actually protect the heart? And if yes, does a higher dose necessarily provide better results?

Aspirin Reduces Blood Clot Formation

Aspirin affects platelets, which are tiny components of blood that help form clots. By making platelets less likely to clump together, aspirin can reduce the formation of blood clots that could block an artery supplying the heart or brain.

This is why doctors may prescribe daily aspirin to people who have already had a heart attack, stroke, or procedures like coronary stent placement.

But aspirin does not make the blood “thin” in a literal sense. It changes the way blood platelets clot. The US Food and Drug Administration (FDA) says daily aspirin can help people with cardiovascular disease or those who have already had a heart attack or stroke, but daily use is not suitable for everyone.

Aspirin can reduce the risk of certain blood clot formations, but it can also increase the risk of unwanted bleeding. The FDA warns that aspirin can lead to serious side effects like bleeding in the stomach and brain.

It recommends that people do not take daily aspirin without discussing it first with their healthcare professionals.

Mayo Clinic also says that daily aspirin is not right for everyone. Regular use can increase the risk of gastrointestinal bleeding and stomach ulcers, while in some people it can also increase the risk of a bleeding stroke.

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Who Should And Shouldn't Take It?

For people who have never had a heart attack or stroke or any other type of cardiovascular disease, taking aspirin routinely to prevent a cardiovascular event is generally not recommended.

The American Heart Association says routine daily aspirin is not recommended for most healthy adults without cardiovascular disease because its benefit can be offset by the risk of serious bleeding.

The FDA also says that for people without cardiovascular disease risk, the risks of long-term aspirin use may be greater than the benefits.

For someone who has already had a heart attack, stroke or any other cardiovascular event, doctors may prescribe daily aspirin because preventing another clot-related event can outweigh the bleeding risk.

According to Mayo Clinic, this is a secondary method of prevention. It says that the benefit of daily aspirin in this group is well established. This does not mean that patients should start, stop or change their aspirin dose on their own.

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Is A Bigger Aspirin Dose Better For Heart?

A higher dose does not automatically provide better protection against heart attacks. Low-dose aspirin prescribed for cardiovascular health is usually around 75 to 100 mg, with 81 mg frequently used.

Mayo Clinic says that the appropriate dose depends on the individual and should be discussed with a healthcare professional.

Taking higher doses of aspirin can increase the risk of bleeding. People with a history of stomach ulcers or gastrointestinal bleeding, bleeding disorders or aspirin allergy may also face greater risks.

The risk of bleeding also increases with age. The American Heart Association says routine aspirin for primary prevention is generally not recommended for healthy adults over 70.