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.

President Donald Trump on Monday signed an executive order calling for fewer routine childhood vaccinations and directing the Justice Department to challenge state vaccine laws, a move swiftly rejected by physicians and vaccine makers.

The order, signed on August 10, calls for childhood vaccines to be administered at separate medical visits whenever possible and narrows federal recommendations to vaccines against 11 core diseases.

"For too long, America recommended more childhood vaccines than any peer nation. No longer," the White House share in a post on X.

It also directs federal health agencies to develop a plan for separate measles, mumps and rubella vaccines, which are currently not available as individual shots in the US.

What Does the Executive Order Say?

The executive order, titled “Delivering Gold Standard Childhood Vaccine Recommendations for Americans,” cuts the number of vaccines recommended for all children from 18 to 11.

• Immunizations recommended for all children: Measles, mumps, rubella, diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and varicella (chickenpox).

• Immunizations recommended for certain high-risk groups or populations: Respiratory syncytial virus (RSV) monoclonal antibodies, hepatitis A, hepatitis B, meningococcal B, meningococcal ACWY, and dengue for children with certain underlying conditions or specific exposure risks.

• Immunizations based on shared clinical decision-making: Hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19 are to be considered in consultation with a doctor based on the child’s individual circumstances.

Splitting the MMR Vaccine

Also read: Donald Trump Signs Order To Split MMR Vaccine: Is It Safe For Children?

The order calls for the combined MMR vaccine to be replaced by separate measles, mumps, and rubella shots.

The MMR vaccine currently protects children against all three diseases with a combination shot. Under existing CDC guidance, children receive two doses, generally at 12 to 15 months and again at 4 to 6 years.

Trump claimed that “there could be a possibility” the MMR vaccine is “quite lethal,” but said that when separated, the vaccines are “not at all lethal, but just very effective.”

Trump also suggested that vaccines cause autism, despite a lack of scientific evidence showing a link.

The CDC and many major medical groups have long recommended the combined vaccine because it reduces the number of injections and lowers the risk that children will miss protection against one of the three diseases.

When Will the Order Be Implemented?

The new executive order does not immediately replace the current CDC childhood immunization schedule. It, instead, directs the HHS Task Force on Safer Childhood Vaccines to develop plans within 90 days to assess vaccine timing and sequencing and adjust the federal schedule as appropriate and consistent with applicable law.

There are also logistical hurdles. Individual measles, mumps and rubella vaccines are not currently licensed in the US. The combined MMR vaccine is manufactured by Merck and GSK for the US market. Merck stopped making single-disease shots for measles, mumps and rubella in 2008, and such vaccines are not routinely used in most other countries.

Merck and GSK said there is no published scientific evidence supporting separation of the vaccines and that decades of evidence support the safety of the combined MMR vaccine.

“Even under current expedited review pathways, it could take years — potentially as many as 10 — to meet the safety and efficacy requirements to obtain FDA approval and then begin manufacturing and commercialization” of single-disease shots, Merck said.

Dr. Andrew Racine, president of the American Academy of Pediatrics, said that although it is possible to separate the MMR vaccine into its individual components, each component would need to be manufactured and tested.

“They wouldn't be able to do that probably for another 10 years, and there's no indication that they have any interest in doing that,” Racine was quoted by Reuters as saying.

Read More: Amid Cyclospora, Salmonella Outbreaks, US FDA Issues Guidance on Ready-to-Eat Produce

WHO expresses Concern

Taking to social media platform X, WHO Director-General Dr. Tedros Adhanom Ghebreyesus said that “vaccines are among the most powerful tools” for keeping children safe and “making deadly diseases preventable.”

Expressing concern about the changes to US immunization policy, the WHO said they “are not aligned with decades of evidence that show when children are most vulnerable to disease, when vaccines provide the strongest protection, how many doses are needed, and which vaccines can be given together safely.”

“The current evidence is unequivocal: vaccines — including the MMR vaccine — are safe and do not cause autism,” he said, adding that “delaying vaccines or separating doses unnecessarily does not make vaccination safer and can leave children unprotected.”

Dr. Andrew Racine, president of the American Academy of Pediatrics, said the announcement could create unnecessary uncertainty for families.

“Science about vaccines and their efficacy has not changed,” Racine said.

People working night shifts were nearly twice as likely to develop long COVID, according to a new study.

Researchers at Spain’s ISGlobal said no previous study had examined whether disruption of the body’s biological clock could increase the risk of developing long COVID.

“Our findings suggest that circadian disruption plays a role in the transition from acute infection to persistent symptoms,” said Manolis Kogevinas, an ISGlobal researcher.

Published in the Scandinavian Journal of Work, Environment and Health, the study also found that chronic insomnia further increased the risk, highlighting the potential importance of healthy sleep habits in preventing long COVID and other post-acute infectious syndromes.

Night Shift Raises Long COVID Risk

Also read: Long COVID Patients May Face Brain Fog & Fatigue Due To Reduction In Dopamine? New Study Explains

The research team followed 2,941 adults in Catalonia between 2021 and 2023. Among the 1,899 participants who became infected with SARS-CoV-2, 284 developed long COVID during the two-year follow-up.

Long COVID was defined as persistent symptoms lasting more than three months after infection.

Compared with day workers, people who worked night shifts had an 88% higher risk of developing long COVID. This was after accounting for other factors, including vaccination history and chronic diseases.

The association was stronger among night workers with obesity.

Importantly, the increased risk was seen in both current and former night workers, suggesting that it may reflect longer-term effects of circadian disruption rather than short-term changes.

However, night-shift work was not associated with a higher risk of infection. This suggests that disruption of the biological clock may influence how the body recovers from infection rather than the likelihood of catching the virus.

Chronic Insomnia Further Raises Risk

Read More: Amid Cyclospora, Salmonella Outbreaks, US FDA Issues Guidance on Ready-to-Eat Produce

The researchers found that chronic insomnia independently increased the risk of long COVID by 42%, regardless of night shift work.

The two factors also appeared to have a synergistic effect. Night shift workers with chronic insomnia were 2.7 times more likely to develop long COVID than day workers without insomnia.

The biological mechanisms behind the association are not yet fully understood. Researchers noted that the time of day when the body encounters a pathogen may influence the immune response. Disruption of the biological clock may also impair the immune system’s ability to clear an infection.

Could Better Sleep Help Prevent Long COVID?

With insomnia becoming increasingly common, the researchers highlighted the need to better understand the short- and long-term effects of disturbed sleep on infection-related outcomes.

The findings suggest that sleep may be a potentially modifiable factor in reducing the risk of long COVID and other post-infectious conditions.

“Promoting healthy sleep habits and minimizing circadian disruption could represent simple, low-cost strategies to reduce the long-term consequences of viral infections, particularly among people who work night shifts,” Kogevinas said.

What is Long COVID?

Long COVID is a debilitating condition that can persist for months or even years after a SARS-CoV-2 infection. Long COVID is an infection-associated chronic condition marked by fatigue, cognitive impairment, exercise intolerance, and multisystem dysfunction.

It has affected an estimated 400 million people worldwide and continues to have significant health, social, and economic consequences. Despite the ongoing risk, prevention strategies have received relatively little attention.

Indian scientists have developed tiny, light-responsive nanobots that could pave the way for more precise breast cancer treatment. The findings indicate that this approach could potentially reduce damage to healthy tissues during therapy.

Researchers from the Institute of Nano Science and Technology (INST), Mohali, in collaboration with scientists from the Bhabha Atomic Research Centre (BARC), Mumbai, have developed multifunctional nanobots that can move towards a light source and destroy cancer cells using a combination of heat and reactive oxygen species. The findings were published in ACS Applied Materials & Interfaces.

How Do The Nanobots Work?

The experimental nanobots are made of upconversion nanoparticles, which can respond to near-infrared (NIR) light. Unlike conventional light-driven systems that may require ultraviolet, NIR light has greater potential to penetrate tissue.

When exposed to a 980-nanometre NIR laser, the nanobots generate heat and show directional movements towards the light source. This is called phototaxis.

The researchers reported that the nanobots reached speeds of around 27 ± 7 micrometres per second under the tested conditions.

The team also coated the nanobots with folic acid. This helps them recognise breast cancer cells that have higher levels of folate receptors, improving their ability to target tumour cells.

At the tumour site, the nanobots use two mechanisms to attack cancer cells. Photothermal therapy generates localised heat, while photodynamic therapy produces reactive oxygen species that can damage and kill cancer cells.

“The field of fuel-free light-powered nanobots and microbots with stimulus-responsive behaviour can have crucial implications for biomedical research,” the researchers said in the study.

Also read: The Office Actress Lucy Davis Reveals Incurable Stage 4 Breast Cancer: 'It’s Too Late For Chemo'

Why Is This Important For Breast Cancer?

Chemotherapy remains an important part of breast cancer treatment, but its effects go beyond targeting tumour cells. Drugs circulating through the body can also affect healthy tissues, leading to side effects. Tumours may also develop resistance to the treatment.

The researchers say conventional nanomedicines often depend on passive accumulation inside tumours, which can limit penetration and control over exactly where treatment acts. The new method attempts to work with a navigation system managed externally by light.

Also read: Breastfeeding Can Help Reduce Mothers' Risk of Type 2 Diabetes, Breast Cancer and More

What Did The Study Find?

The technology has so far been tested in laboratory cancer-cell models and in mice carrying breast tumours. The researchers reported significant inhibition of tumour-growth when the nanobots with folic acid function were combined with 980 nm laser irradiation.

Researchers say that this is still preclinical research and may need further examination and clinical trials.

The nanobots have not been established as a treatment for breast cancer patients, and a lot more research will be needed to gauge their safety, effectiveness, dosing and ability to successfully work in humans.

Also read: Don't Fear The Biopsy, Fear The Delay

Global Breast Cancer Burden

Breast cancer is the most common cancer worldwide, with steady increases in incidence over the last few decades. It accounts for around one in four cases of cancer and 15 per cent of cancer deaths in women, and is one of the leading causes of death in women under 50.

Breast cancer is the most common cancer in the UK, with around 59,400 new cases diagnosed annually and roughly 11,200 deaths each year. About one in seven women in the UK develops the disease in their lifetime, though survival rates are high, with nearly 90% surviving for five years or more.