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 Type 2 diabetes diagnosis increases the risk of developing chronic kidney disease (CKD) or heart failure (HF), or dying, by 55% within 10 years, according to analysis of data from more than 1.6 million patients across the US.

Within the first five years of a Type 2 diabetes diagnosis, the study found that the combined risk of developing CKD or heart failure, or dying, was 33% on average. By year 10, that combined risk rises to 55%.

Key Findings

The study shows within five years of a first diabetes diagnosis, the risk of developing CKD first was more than twice that of developing heart failure first (19.0% vs. 8.3%).

However, among people who developed heart failure first, there was a 42% risk of developing CKD within the following five years.

Conversely, among those who developed CKD first, there was a 23% risk of developing heart failure within the following five years.

"Our findings clearly show how the serious complications associated with type 2 diabetes rise sharply over time as the common combination of obesity, abnormal blood fats, high blood pressure and higher blood sugar damages blood vessels and vital organs," said Professor Naveed Sattar of the University of Glasgow in Scotland, UK.

Why The Findings Matter

Type 2 diabetes is projected to become the world's most prevalent epidemic disease, affecting an estimated 1.3 billion people by 2050.

It frequently occurs alongside obesity, high blood pressure, heart failure, CKD and depression, contributing substantially to the global burden of multi-morbidity.

The researchers say the findings highlight the importance of early, proactive and holistic management of Type 2 diabetes to help reduce the risk of serious complications.

"Our results emphasize the critical importance of detecting and treating type 2 diabetes thoroughly at the earliest opportunity to help reduce the risk of serious complications," Sattar added.

How Was The Study Conducted?

The team included 1,617,508 patients newly diagnosed with diabetes between January 1, 2010, and March 31, 2024, from across the US.

The average age of participants at enrollment was 59, and 51% were female. Among the 13% of patients who had a body mass index (BMI) recorded, the median was 30.9 kg/m².

Almost three-quarters (72%) of participants were living with dyslipidemia, or high levels of cholesterol and other fats in the blood, while more than two-thirds (68%) had high blood pressure.

How Are Diabetes, Kidney Disease And Heart Failure Linked?

The US Centers for Disease Control and Prevention (CDC) explains that diabetes, CKD and heart disease are interconnected.

High blood sugar can gradually damage the kidneys, reducing their ability to filter blood and potentially leading to CKD. When kidney function declines, it can also put additional stress on the heart.

Common Risk Factors

Risk factors that can overlap across diabetes, CKD and heart disease include:

• High blood sugar
• High blood pressure
• Family history
• Obesity
• Unhealthy diet
• Physical inactivity

Tips To Prevent

The CDC recommends lifestyle measures that can help reduce the risk of these conditions and their complications:

• Get active
• Choose healthy foods and drinks
• Quit smoking

A widely used supplement for joint health has been linked to a faster Alzheimer's progression, raising questions about whether glucosamine could turn mild cognitive impairment into dementia.

The study, published in Nature Metabolism, combined an analysis of health records of experiments involving human brain tissue and genetically modified mice. It showed that the supplement affected the brain in people already showing early signs of cognitive decline.

The findings, however, do not prove that glucosamine increases the progression of Alzheimer’s disease faster in humans.

What Is Glucosamine?

Glucosamine is a sugar-related compound widely sold as an over-the-counter supplement for joint discomfort and joint health. It is also found naturally in cartilage. It is used by older adults, the same age group in which cognitive impairment and dementia become more common.

Researchers at the University of Florida analysed health records collected between 2012 and 2024 to investigate whether glucosamine use was linked with Alzheimer's disease and related dementias.

"In the United States, there are about 7 million people living with Alzheimer's and millions more with related dementias such as Lewy body or frontotemporal dementia," said senior author Ramon Sun, Ph.D., Director of the Center for Advanced Spatial Biomolecule Research and associate director for innovation of UF's McKnight Brain Institute. "A lot of these people actively take an over-the-counter supplement that could be making their disease progression worse."

Also read: Muscle Loss In Middle Age May Signal Dementia Risk, Study Finds

What Were The Study's Findings?

About 8% of patients in both groups were using glucosamine supplement. This included 2,750 people with mild cognitive impairment and 1,896 people who already had Alzheimer's disease or a related dementia.

After accounting for age, sex and demographic factors, researchers found that people with mild cognitive impairment who used glucosamine had a 25% higher likelihood of progressing to dementia compared with those without documented use.

Among people who already had Alzheimer's disease or a related dementia, glucosamine use was also associated with a 25% higher risk of death during the study period. However, these were findings were based on collective health records, not a controlled clinical trial.

“The electronic health record data are very provocative,” said Matt Gentry, Ph.D., a study co-author. “While it's an association and not proof of causality, it does raise an important clinical question that now deserves much more attention.”

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Glucosamine's Effects On Brain

The researchers identified a possible biological explanation involving a process called glycosylation. In simple terms, glycosylation involves attaching sugar structures to proteins. This is a normal process that helps proteins fold correctly, move around cells and perform their functions.

But the researchers found evidence that this process becomes excessively active in Alzheimer's disease. Their analysis suggested that glucosamine may intensify this abnormal “sugar-tagging” process in the brain.

The researchers tested the idea in genetically modified mice. Glucosamine increased the attachment of sugar molecules to proteins inside brain cells. The subjected mice's ability to recognise familiar animals also worsened.

When researchers used a chemical treatment to suppress the sugar-attachment process, the mice showed improved memory performance.

This does not prove the same mechanism occurs in humans, but it gave researchers a possible biological explanation for the association seen in the health records.

The researchers also examined brain tissue from people who had Alzheimer's disease. They found significantly more sugar attachment to proteins in Alzheimer's brain tissue compared to tissue from people without the disease. Taken together, the health-record analysis, mouse experiments and human brain-tissue findings point toward a connection between altered metabolism and Alzheimer's progression.

Despite the observation, a controlled clinical trial is needed to determine whether glucosamine itself accelerates Alzheimer's progression and whether certain patients are vulnerable.

Fighting cancer is “brutal and unrelenting,” said White House Chief of Staff Susie Wiles, who is now cancer-free after undergoing treatment for early-stage breast cancer.

In an op-ed published Sunday in USA Today, Wiles described undergoing chemotherapy while continuing to lead the White House staff for President Donald Trump.

She said some days, simply getting out of bed and going to work took all her strength. The disease, treatment, test results and uncertainty about what came next occupied her thoughts from the moment she woke up and sometimes even while she slept.

‘Even The Strongest Mind Can Be Overtaken’

“Even the strongest mind can be overtaken by it. At times, mine was,” Wiles wrote.

“Fighting for your health while remaining fully committed to your work can feel impossible,” she said, adding that determination and “perhaps some measure of mind over matter” helped her maintain that balance.

Wiles acknowledged that continuing to work during cancer treatment may not be possible or right for everyone. For her, she said, work provided “a mission larger than myself.”

“Maintaining that balance was not easy,” Wiles wrote, saying the experience gave her “profound respect and empathy” for everyone undergoing cancer treatment.

“It drains you physically, mentally, emotionally and spiritually,” she added.

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Wiles said cancer can shrink a person’s world to chemotherapy appointments, blood tests, scans, medications and side effects.

“There is a temptation to measure each day by how sick you feel,” she wrote. She said she worked hard not to let breast cancer become the center of everything.

“I directed as much of my energy as I could toward doing my job,” Wiles wrote. “People depended on me to be strong and clear-eyed, and I was determined not to let them down.”

Her Team Helped Carry The Burden

Wiles said cancer affected her stamina, mobility and focus, making the support of her colleagues crucial.

“People stepped forward without hesitation, filled every gap, carried additional weight and never allowed me to feel that I was carrying this burden alone. I will never be able to repay them,” she wrote.

She also credited her family and two daughters, who “traveled every step of this road with me.”

After surgery, pathology showed no residual cancer. Wiles announced on September 16 that she was cancer-free after receiving clear pathology results at the Mayo Clinic. She had disclosed her early-stage breast cancer diagnosis in March.

She said chemotherapy tested her in ways she could never have anticipated. Her next stage, she added, will involve rebuilding what treatment took from her.

“Cancer does not have to take away who you are,” she wrote.

Wiles Thanks Trump And Her Family

Wiles thanked Trump “for the kindness and compassion” he showed while she was undergoing treatment.

Trump had publicly praised Wiles during her cancer battle, saying in a prerecorded message in May that she was winning her fight.

Wiles also credited her family, friends, colleagues and doctors for helping her through the ordeal.

In a post on X, she said she rarely writes about herself but wanted to share what it was like to fight cancer while continuing to do a job she loves.

“Cancer tried to make my world smaller. I was determined not to let it,” she wrote. She said she hoped her account could offer strength to someone still fighting the disease.