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.

Pope Leo XIV recently underwent lung cancer surgery to have the lower lobe of his right lung removed. According to the Vatican, the 71-year-old pontiff's recovery is on track. But doctors are awaiting further test results to determine whether he needs further treatment. The pope has resumed eating, walking and celebrating Mass but he is not fit to take a trip just yet.

The pope underwent surgery at Rome's Gemelli Hospital on October 13 after doctors identified a suspicious lung nodule. The procedure confirmed lung adenocarcinoma, the most common type of lung cancer, and surgeons removed the lower lobe of his right lung.

In a update on October 14, the pope's personal physician, Dr Luigi Carbone, and thoracic surgeon Professor Stefano Margaritora said, "The Holy Father underwent respiratory physiotherapy and has begun walking in his room. He resumed his regular diet and had breakfast and lunch." They added, "Recovery is proceeding as planned."

Blood tests and a chest X-ray indicated that the pope was recovering normally after the operation. He also celebrated Mass with his secretaries in a private hospital chapel.

However, doctors have not yet disclosed whether the cancer has spread to the lymph nodes or other parts of the body. That will help determine if further treatment is needed.

Surgery For Lung Lobe

The lungs are divided into sections called lobes. The right lung has three lobes, while the left lung has two. When cancer is confined to a particular area, surgeons may remove the affected lobe in an operation called a lobectomy.

The procedure aims to remove the tumour along with surrounding tissue to reduce the likelihood of cancer remaining in the lung. Nearby lymph nodes may also be removed and examined to check whether cancer cells have spread.

Pope Leo underwent surgery assisted by video, a minimally invasive technique that uses a camera and small surgical incisions to operate inside the chest.

Dr PierCarlo Gentile, head of radiation oncology at Rome's San Pietro Fatebenefratelli Hospital, told The Associated Press that this type of surgery typically requires around 15 to 20 days of recovery. He also said that in this case postoperative complications, including infections, is rare.

Also read: Pope Leo XIV, Diagnosed With Lung Cancer, Undergoes Surgery As His Brother Battles Relapsed Multiple Myeloma

Recovery After Lung Lobe Removal

After a lobectomy, the remaining lung tissue can help compensate for some of the lost lung capacity. However, recovery varies depending on a person's age, overall health, lung function before surgery and the extent of the operation.

In the initial days, patients are encouraged to get out of bed and walk as soon as medically appropriate. Early movement helps reduce the risk of blood clots and other complications associated with prolonged bed rest.

Respiratory physiotherapy is also a part of recovery. Breathing exercises help patients expand their remaining lung tissue, improve ventilation and clear secretions from the airways. Some patients may also need oxygen support temporarily.

Pain management, proper nutrition and slow and gradual increases in physical activity are important. Breathlessness and fatigue can persist for weeks, and full recovery may take longer than the initial hospital stay.

Although the remaining lung tissue can adapt, it does not mean lung capacity automatically returns to its previous level. The extent of recovery depends on the individual's baseline respiratory health and how much functioning lung tissue remains.

Also read: Pope Leo XIV’s Lung Cancer Diagnosis: When Should You Worry About Lung Nodules?

Additional Cancer Treatment

The need for additional treatment for Pope Leo will depend on the final results, including the tumour's size and whether cancer cells are present in the lymph nodes.

If the cancer is localised and has been completely removed, surgery may be sufficient in some cases. If tests show that the disease has spread or carries features associated with a higher risk of recurrence, doctors may consider chemotherapy, immunotherapy or targeted therapy, depending on the tumour's characteristics.

Dr Stephen Liu, a lung cancer expert at Georgetown University's Lombardi Comprehensive Cancer Center who is not involved in the pope's care, told The Associated Press, "While we know the diagnosis, we now need to know the stage."

The US Food and Drug Administration (FDA) recently expanded the approval of Anktiva (nogapendekin alfa inbakicept-pmln), a bladder cancer treatment, to include adults with high-grade papillary bladder cancer that has not responded to Bacillus Calmette-Guérin (BCG) therapy.

The decision provides a new treatment option for patients whose cancer persists or returns despite standard immunotherapy.

The approval specifically covers BCG-unresponsive, high-grade papillary-only non-muscle-invasive bladder cancer (NMIBC). Anktiva was already approved in April 2024 for certain patients with BCG-unresponsive NMIBC involving carcinoma in situ, with or without papillary tumours.

The latest development is significant because patients with high-grade papillary-only disease previously had fewer approved bladder-preserving treatment options after BCG failed.

The FDA based its decision on evidence supporting Anktiva's earlier approval, alongside scientific similarities between the two forms of bladder cancer.

“We listen to patients, clinicians, and researchers, and we act when the science supports a new approach,” said R. Angelo de Claro, MD, director of the FDA's Oncology Center of Excellence.

“For Anktiva, our review of the similarities between these cancers allowed us to build on the results in patients with CIS and expand treatment options for people with high-grade papillary tumors alone. This approach may also help guide the development of future treatments.”

What Is BCG-Unresponsive Bladder Cancer?

Also read: Pope Leo XIV’s Lung Cancer Diagnosis: When Should You Worry About Lung Nodules?

BCG is a form of immunotherapy used to treat high-risk non-muscle-invasive bladder cancer. Although the name comes from a bacterium originally used in tuberculosis vaccination, BCG is administered directly into the bladder to initiate an immune response against cancer cells.

NMIBC refers to bladder cancer that has not grown into the muscle layer of the bladder wall. Treatment often involves removing visible tumours through a procedure called transurethral resection of bladder tumour (TURBT), followed by BCG therapy to destroy remaining cancer cells and reduce the risk of recurrence.

However, some cancers return despite treatment. These are described as BCG-unresponsive, and patients may need alternative therapies or surgery to remove the bladder.

More About Anktiva

Also read: Can A Blood Test Predict Childhood Cancer Years Before Diagnosis? Study Gives Clues

Anktiva is an interleukin-15 receptor agonist, a type of immunotherapy designed to strengthen the body's immune response against cancer.

It activates and expands immune cells, including natural killer cells and T cells, which help recognise and attack abnormal cells. When administered with BCG, Anktiva provides an additional immune stimulus to help the body fight cancer within the bladder.

The medicine is delivered directly into the bladder through a catheter, a procedure known as intravesical instillation. This allows treatment to act locally rather than being administered through an intravenous infusion.

Treatment begins with weekly doses for six weeks. Depending on the patient's response, additional induction and maintenance treatment may be given, with the overall treatment period extending up to 37 months.

FDA's Approval For Anktiva

The FDA's original approval was supported by the QUILT-3.032 clinical trial, which included 77 adults with BCG-unresponsive, high-risk NMIBC involving CIS, with or without papillary tumours.

The study found a complete response rate of 62%. This means that no high-grade cancer was detected during the relevant assessments. Among patients who achieved a complete response, 58% maintained it for at least 12 months, while 40% maintained it for at least 24 months.

For the expanded approval, the FDA considered these findings alongside laboratory evidence indicating that CIS and high-grade papillary-only tumours share key biological features. Both can recur or progress when BCG treatment fails.

The agency concluded that the earlier evidence of effectiveness could be applied to patients with high-grade papillary-only disease.

The United States shelved the decision to vaccinate poultry as a bird flu prevention measure due to HHS Secretary Robert F. Kennedy Jr.’s skeptical vaccine views

According to a Politico report, the move came as highly pathogenic avian influenza, especially the H5N1 strain, continues to affect poultry farms, threatening bird populations, disrupting egg supplies and raising concerns about transmission to humans.

According to Politico's findings, five people who were involved in the decision-making said that Agriculture Secretary Brooke Rollins pulled back an internal strategy for vaccinating poultry and hens that lay eggs.

The plan was initially intended to be shared with governments of other countries, industry leaders and other stakeholders to help boost bird flu response.

However, it remains unclear whether Kennedy directly asked Rollins to halt the strategy. However, concerns about how poultry vaccination would be received by the health secretary reportedly influenced the decision to keep the document away from wider circulation.

Why Was The Poultry Vaccination Plan Shelved?

Also read: Pope Leo XIV’s Lung Cancer Diagnosis: When Should You Worry About Lung Nodules?

The US Department of Agriculture (USDA) announced a $1 billion bird flu response strategy in February 2025. The plan included $500 million for farm biosecurity, $400 million in financial relief for farmers and $100 million for vaccine research.

Despite the resources, an internal poultry vaccination strategy reportedly failed to be executed as planned. One person familiar with the process told Politico that the technical and communication components were already in place by the summer of 2025, but the final document was circulated among fewer than a dozen people.

Kennedy has publicly opposed vaccinating poultry against bird flu, arguing that vaccines that do not completely prevent infection could allow the virus to continue evolving.

In a March 2025 interview with Fox News host Sean Hannity, Kennedy warned that using vaccines that do not provide complete protection could turn poultry flocks into “mutation factories”.

He argued that allowing the virus to circulate among birds could help identify animals with natural immunity. The proposal attracted criticism from veterinary and vaccine experts, who warned that permitting uncontrolled infections could, in turn, increase viral replication and create opportunities for mutations.

Dr Gail Hansen, a former state veterinarian for Kansas, criticised the idea of allowing bird flu to spread through poultry populations, calling it a “really terrible idea, for any one of a number of reasons”. She warned that a virus circulating through a flock containing millions of birds would have many opportunities to evolve or mutate, which increases the risk to other animals and farm workers.

Also read: US Health Secretary Wants To Expand Vaccine Injury Reporting: Benefits And Risks Explained

Can Vaccinating Poultry Help Control Bird Flu?

Vaccination is one the effective tools for reducing bird flu infections and containing transmission. However, vaccines do not always provide sterilising immunity, meaning vaccinated animals may still become infected even if they are protected against severe disease.

So, if vaccination reduces visible symptoms without fully preventing infection, infected birds may be harder to identify unless monitoring systems are efficient.

However, this does not mean vaccination inevitably creates dangerous mutations. The evolution of viruses occur naturally, and vaccination can reduce the number of opportunities for viral replication. The overall effect depends on the vaccine effectiveness, surveillance, biosecurity and how the nature of the virus.

Countries including France, China, Egypt and Mexico have used poultry vaccination against avian influenza. In the US, the USDA granted conditional approval for an avian influenza vaccine in 2025, but poultry vaccination has not been adopted yet.

H5N1 has infected people following exposure to infected animals, but sustained human-to-human transmission has not been established yet. Hence, preventing infections in poultry remains important for reducing opportunities for the virus to spread and evolve.