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.

X-Men actor Tyler Mane has revealed that he has been diagnosed with a "super-rare" form of breast cancer.

In a post on Instagram, Mane, a former professional wrestler, shared that he has been diagnosed with the condition, which is predominantly associated with women. He noted that only about 1 per cent of breast cancer cases occur in men.

The 59-year-old actor said he initially considered keeping his diagnosis private, but ultimately decided to speak publicly about it because men are often diagnosed at more advanced stages of the disease due to a lack of awareness.

“I have some bad news: I start chemo today. One in 750 men will be diagnosed with breast cancer in their lifetime and I’m one of them,” he said in a video posted on Instagram.

Mane revealed that doctors initially dismissed the lump he discovered.

“My doctors initially dismissed it and it was only because my wife pushed me to get the lump removed that I got in early,” he said.

The actor admitted that his first instinct was to keep the diagnosis secret.

“I’ll be honest, my first reaction was to keep it secret. I mean it’s kind of embarrassing,” he said.

However, after learning more about male breast cancer and the importance of early detection, he decided to share his experience publicly to help raise awareness.

While Mane did not reveal the stage of his cancer, he informed of undergoing chemotherapy and urged his followers to spread awareness about the disease.

“I’m gonna kick cancer’s ass. Thank you for coming along for the journey. We need to spread the awareness. Cancer sucks but if you catch it quick enough, you can win this battle,” he wrote.

Breast Cancer in Men

According to the CDC, about one in every 100 breast cancer cases diagnosed in the United States occurs in men. The situation is similar globally, with the World Health Organization estimating that between 0.5 and 1 per cent of breast cancers occur in men.

The lifetime risk of breast cancer in men is currently less than one in 1,000. However, the incidence of the disease is increasing, particularly with advancing age.

The average age at diagnosis for men is about 67 years, roughly five years later than the average age of diagnosis in women.

Because breast cancer is often not suspected in men, the condition can be overlooked or misdiagnosed, resulting in many cases being detected at later stages.

What Are the Risk Factors in Men?

Several factors can increase a man's likelihood of developing breast cancer. These include:

• Advancing age
• Genetics
• Family history
• Lifestyle and hormonal factors, including excess weight, alcohol consumption, liver disease and hormonal imbalances
• Medical conditions such as gynecomastia and Klinefelter syndrome
• Radiation exposure, particularly previous radiation treatment to the chest area

Symptoms to Watch For

The symptoms of breast cancer in men are similar to those in women, but men may overlook them because they are less aware of the disease.

Common signs include:

• A lump in the breast, usually painless
• Nipple discharge
• Dimpling, redness or inversion of the skin or nipple

Why Early Detection Matters

Routine mammography is not generally recommended for men because of the low prevalence of the disease. However, men considered to be at high risk, including those with a strong family history or genetic predisposition, may benefit from periodic screening and should discuss appropriate options with their healthcare providers.

An indigenous low-cost point-of-care (PoC) testing approach has shown promise in making screening for Human Papillomavirus (HPV) more affordable and accessible, potentially improving the early detection of cervical cancer, according to a joint study led by researchers from AIIMS, ICMR, and the WHO's International Agency for Research on Cancer (IARC).

The study, published in the International Journal of Cancer, found that PoC tests have the potential to become scalable, low-cost screening tools in India and other low- and middle-income countries (LMICs).

The objective of the study was to evaluate indigenous HPV DNA testing platforms for use in primary cervical cancer screening.

Four Indigenous Tests Evaluated

While several Indian HPV tests have been developed, many had not yet been validated against the international standards laid down by the WHO.

The study evaluated four point-of-care tests developed by 3 Indian companies:

• Genes2Me – HPV-Q
• Mylabs India – PathoDetect HPV-7 and PathoDetect HPV-14
• Molbio Diagnostics – Truenat HR-HPV-Plus

Each test was developed by repurposing existing COVID-19 RT-PCR platforms. HPV-Q and PathoDetect HPV-14 can detect all 14 high-risk HPV types, while PathoDetect HPV-7 detects seven high-risk types: 16, 18, 31, 33, 45, 52, and 58.

How the Tests Performed

Also read: PM Modi Launches Nationwide Free HPV Vaccination Drive; A Landmark Step, Says WHO

To assess performance, researchers analyzed 1,159 cervical samples collected from studies conducted in Argentina and Costa Rica.

The results showed:

• Truenat HR-HPV-Plus: Sensitivity 80.4%, specificity 91.5% — met IARC validation criteria.
• PathoDetect HPV-7: Sensitivity 68.1%, specificity 89.0% — lower sensitivity.
• HPV-Q and PathoDetect HPV-14: Did not meet validation criteria.

Indigenous Platforms Can Be Game-Changers

"This study demonstrates that indigenous platforms can achieve clinical validation, quality standards, and accuracy comparable to global gold-standard tests. It will be a game-changer for cervical cancer prevention and early detection in India," said lead author Dr Neerja Bhatla, Professor Emeritus, NCI and former Head of the Department of Obstetrics & Gynecology at AIIMS New Delhi.

Dr Shalini Singh, Director of ICMR-NICPR, added that HPV DNA testing at age 35 and again at age 45 is central to WHO's cervical cancer elimination strategy, but high costs remain a major barrier in LMICs.

"Affordable indigenous solutions are essential to expand screening coverage and reduce disease burden," she said.

High Burden Of Cervical Cancer: Why HPV Testing Matters

Read More: HPV Vaccine Can Help Curb Rising Head And Neck Cancers, Says Top US Doctor

Cervical cancer continues to be a major public health challenge in India, with around 127,000 new cases and 80,000 deaths reported annually.

Globally, cervical cancer is the fourth most common cancer in women. According to WHO data for 2022, there were approximately 662,000 new cases and 348,000 deaths worldwide.

Regular screening of women over 30 years of age every 3-5 years can help detect precancerous and cancerous lesions early. However, screening coverage in India has remained low despite the inclusion of visual inspection with acetic acid (VIA) in the national screening program for breast, oral, and cervical cancers.

Persistent infection with carcinogenic HPV types is the necessary cause of cervical cancer. WHO recommends a transition to HPV testing as the preferred strategy for cervical cancer elimination.

Using validated HPV tests, only two rounds of screening — at ages 35 and 45 — may be sufficient to help achieve elimination targets. However, most existing HPV tests are expensive, require sophisticated laboratory infrastructure, and are not easily available at last-mile health facilities.

The researchers said that the point-of-care HPV testing approach, thus, could be a major breakthrough, enabling affordable diagnostics and even same-day treatment for women who test positive.

Potential for Nationwide Rollout

The researchers noted that while the recently introduced national HPV vaccination campaign will benefit younger generations, there remains an urgent need to expand HPV testing for women over 30 who are currently at risk of cervical cancer.

Dr Showket Hussain of the ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, said the validated platform has strong potential for integration into national screening programs because district-level healthcare personnel are already familiar with similar testing systems.

"Future advancements such as self-sampling and high-throughput adaptations could further enhance accessibility," he said.

The findings are expected to support India's cervical cancer elimination goals while offering a scalable model for other low-resource settings globally.

Cancer patients in India, already affected by shortages of critical chemotherapy drugs, are now set to face higher costs after the government approved a price hike.

Facing significant shortages are Cisplatin and Carboplatin — the two platinum-based drugs that form the backbone of treatment for common cancers such as oral cancer, breast cancer, ovarian cancer, cervical cancer, esophageal cancer, and testicular cancer.

Shortages Disrupt Cancer Treatment

The shortage of these essential chemotherapy medicines is disrupting care across hospitals and cancer centers, with several doctors pointing out that a substantial proportion of chemotherapy protocols for solid tumors rely on one of these platinum-based agents.

The drugs have been facing shortages as companies find it difficult to sustain production amid rising manufacturing costs linked to the ongoing conflict in the Middle East.

The two drugs, often prescribed in combination and with no alternatives, are derived from platinum, a precious metal whose cost has surged due to the Middle East conflict and the closure of the Strait of Hormuz.

Rising Production Costs Hit Manufacturers

Also read: India Revises Folic Acid Measurement Unit to Prevent Dosage Errors

"The production cost has increased because the API, or active pharmaceutical ingredient, which is imported from abroad, has become more expensive. As a result, manufacturing costs have gone up, but the MRP has not increased," Dr Shyam Agarwal, Senior Consultant, Medical Oncology at Sir Ganga Ram Hospital, told HealthandMe.

As companies have struggled to sustain production amid rising manufacturing costs, they approached the government seeking a revision of the price cap.

Drugmakers reportedly sought price revisions for 82 medicines, citing substantial increases in production costs due to the US-Iran conflict linked to the Hormuz crisis and other factors.

Government Approves Higher Prices

In response, the National Pharmaceutical Pricing Authority (NPPA), following permission from the Union government's Department of Pharmaceuticals (DoP), has increased maximum retail prices for four drugs, including the life-saving cancer medicines Cisplatin and Carboplatin, and two anti-tetanus injections.

While the move is aimed at restoring supplies, it has also raised concerns about affordability for patients already battling a costly disease.

The NPPA is the country's drug price regulator and functions under the DoP, Ministry of Chemicals and Fertilizers.

NPPA Asked to Review Cost Increases

Read More: India's Maternal Mortality Ratio Drops From 130 To 87 In Last 10 Years: Govt

The ministry directed the pricing authority to determine how much prices could be increased.

The formula suggested: "The Standing Committee recommended a 10 per cent increase per year from the last fixation with a ceiling of 50 per cent, which could also be a guide, but the primary principle should be cost increase," News18 reported.

The DoP has further advised the NPPA to examine increases in raw material costs for these drugs while determining any price revisions. It has also asked the regulator to assess similar requests from the pharmaceutical industry, where price hikes have been sought due to higher raw material costs.