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 deadly case of hantavirus has been confirmed in Israel, while health authorities in the UK and Spain are investigating suspected infections in three individuals, raising fresh concerns over the spread of the rare rat-borne disease.

Hantavirus is primarily transmitted through contact with infected rodents or exposure to their urine, droppings, and saliva, though rare cases of person-to-person transmission have also been reported.

According to the World Health Organization (WHO), eight cases — including three deaths — have been confirmed so far. However, additional suspected and confirmed cases are continuing to emerge across countries.

Despite growing concern, the WHO, the US Centers for Disease Control and Prevention (CDC), and other health agencies have stated that the overall public health risk remains low.

Here’s a look at the countries reporting confirmed and suspected hantavirus cases.

Israel

The case in Israel, reported by the local newspaper Maariv, is believed to have been infected during a stay in Eastern Europe several months ago. It is reportedly not linked to the ongoing outbreak linked to the MV Hondius cruise ship in the Atlantic Ocean.

The patient underwent an antibody test after the symptoms appeared, which showed exposure to hantavirus, the report said. A PCR (polymerase chain reaction) test was then conducted to detect the virus’s genetic material, confirming the infection, it added.

The patient was said to be in stable condition, not in need of intensive care or strict isolation, and was being kept under medical observation.

Details about the patient and the medical center where the diagnosis was made could not yet be published, but have been reported to the country's Health Ministry.

UK

The UK Health Security Agency had confirmed two British cases connected to the outbreak on board the MV Hondius.

One remains in a stable condition in the Netherlands after being evacuated from the ship, the other remains in intensive care after being flown to South Africa last month.

A third case is also being suspected on the remote South Atlantic island of Tristan da Cunha, where the ship stopped in mid-April, the UK HSA said.

In addition, the agency said that two British nationals are self-isolating at home after potential exposure to hantavirus on the cruise ship. The pair had disembarked earlier in the voyage and currently shows no symptoms.

They were part of a group of 30 people from a dozen nations - including seven Britons - who disembarked from the ship at St Helena in the south Atlantic on 24 April, according to operator Oceanwide Expeditions. Four Britons who disembarked on St Helena remain there, BBC reported.

They do not have symptoms but are in contact with health officials. It is understood that medical staff will be sent to the islands to provide support.

Also read: Donald Trump Says Hantavirus Is 'Under Control'; Questions Grow Over CDC Research Cuts

Spain

A 32-year-old woman who shared an airplane with a MV Hondius cruise ship passenger who later died of hantavirus is now showing symptoms consistent with the disease, Secretary of State for Health Javier Padilla said while speaking to the media.

The woman ⁠has been taken to a hospital in Alicante, where she ⁠remains in isolation, he added. Her symptoms included coughing and "general malaise".

She is being transferred to a hospital in the city of Alicante where she will be tested ‌for ⁠the virus, with results expected 24 to 48 hours later, according to a statement on the regional health department's website.

Padilla said the woman, a resident of Alicante in the Valencia region, ⁠was sitting two rows behind the cruise ship passenger, but the contact between them "was brief" since the passenger had only been "on ⁠board for a short time" during the flight.

Netherlands

The World Health Organization confirmed that a KLM flight attendant, who was isolating in an Amsterdam hospital with mild symptoms after being in brief contact with a hantavirus patient, has tested negative for the virus.

Her case supports the WHO experts’ theory that the rat-borne disease can only be transmitted person-to-person through prolonged, close contact.

Singapore

Two Singaporean residents who were onboard the MV Hondius cruise ship have tested negative for the virus, the Communicable Diseases Agency (CDA) said today.

The 67-year-old and a 65-year-old had been tested and isolated in the city state. The CDA's National Public Health Laboratory conducted testing on multiple samples collected from the individuals and confirmed that hantavirus, including the Andes virus, was not detected, it said.

“The risk to the general public in Singapore is currently low,” the CDA said.

Hantavirus: The Common Symptoms And How To Reduce Your Risk

According to the CDC, symptoms can appear one to eight weeks after exposure, initially presenting fatigue, fever, and muscle aches. As the disease progresses, it can cause coughing, shortness of breath, and chest tightness as fluid accumulates in the lungs.

The CDC reports that about one-third of individuals who develop respiratory symptoms from the disease may not survive.

You can reduce your risk by eliminating and minimizing your contact with rodents in your home, workplace, or campsite. The best way is to seal holes and gaps in your home or garage and keep the rodents from entering your home. You can also place traps in and around your home to decrease rodent infestation. Clean up any easy-to-get food that could attract rodents.

A deadly case of hantavirus has been confirmed in Israel, while health authorities in the UK and Spain are investigating suspected infections in three individuals, raising fresh concerns over the spread of the rare rat-borne disease.

The case reported from is unlikely to be linked with the ongoing outbreak linked to the MV Hondius cruise ship, currently sailing to the Canary lslands.

The UK is suspecting its third case from a remote South Atlantic island of Tristan da Cunha. Spain is suspecting its first case in a 32-year-old woman who shared an airplane with a MV Hondius cruise ship passenger who later died of hantavirus.

In a good news, suspected cases from Singapore and the Netherlands have reportedly turned negative.

The health officials across 12 countries have joined the WHO in contact tracing efforts. They are:

• Canada
• Denmark
• Germany
• The Netherlands
• New Zealand
• Saint Kitts and Nevis
• Singapore
• Sweden
• Switzerland
• Türkiye
• The United Kingdom
• The United States of America

US CDC Classifies Outbreak As 'Level 3' Emergency

The US Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Centers and has classified the hantavirus outbreak as "Level 3" emergency.

Level 3 is the lowest level of emergency activation and is typical for this stage, ABC News reported.

It also signifies that the risk of the rat-borne virus to the general public remains low. However, the public health agency is actively monitoring the situation.

As per the media report, activating the Emergency Operation Centers signals that an emergency team, consisting of epidemiologists, scientists, and physicians, may have been set up to assist with the response.

No Immediate Public Health Threat To India, says ICMR

After reports of two Indian nationals infected with hantavirus aboard MV Hondius cruise ship, Dr Naveen Kumar, director of the ICMR’s National Institute of Virology (NIV), said that there is "no immediate public health threat” to India.

Dr Kumar said the outbreak appears to be isolated, and that there is currently no evidence of community spread. He stressed that, unlike COVID-19, hantavirus does not spread easily between humans.

“The reported hantavirus cases appear to be isolated ones, and there is no immediate public health threat to India,” he was quoted as saying by news agency PTI.

According to the World Health Organization, the Indian passengers were among a small cluster of suspected infections identified aboard the ship, with health authorities monitoring contacts and taking precautionary measures.

Surveillance Capacity Adequate In India

Kumar said India has sufficient laboratory infrastructure to detect suspected hantavirus cases through the ICMR-NIV and the nationwide Viral Research and Diagnostic Laboratory Network.

“India has diagnostic capacity for hantavirus infection through the ICMR-National Institute of Virology and the nationwide Viral Research and Diagnostic Laboratory Network of 165 labs,” he said.

He said symptoms generally appear one to five weeks after exposure. It includes

fever,

• severe body ache,
• headache,
• fatigue,
• nausea,
• abdominal pain,
• dry cough.

2 Indians Among Crew On MV Hondius Cruise Ship

Two Indians are among 149 people aboard MV Hondius, the expedition cruise ship hit by a deadly hantavirus outbreak that has so far left three passengers dead and eight others infected, according to a BBC report.

The vessel, operated by Oceanwide Expeditions, began its journey from Ushuaia, Argentina, on April 1 and is currently travelling to Spain's Canary Islands on May 10.

According to the World Health Organization, eight people onboard the cruise ship MV Hondius have been infected with hantavirus. Of these, three have died, and five have been confirmed to have the virus. However, more people are likely to be infected, as the disease can take a long time to show symptoms.

The luxury cruise ship was carrying around 150 passengers and crew members from 28 countries.

The nationalities included 38 people from the Philippines, 31 from the United Kingdom, 23 from the United States, 16 from the Netherlands, 14 from Spain, nine from Germany, six from Canada and two crew members from India, BBC reported.

While it is yet not known whether they're infected or not, Dr Puneet Misra, Professor of Community Medicine, AIIMS Delhi, told ANI News Agency that it is likely that the two passengers "might have been exposed to the infection".

He added that "there is no pandemic or epidemic threat" with hantavirus. "The public should not worry. There is no need for panic..."

Follow this page for all latest updates.

US President Donald Trump is hopeful that the deadly hantavirus outbreak is very much under control. However, questions are mounting as his administration cut funding to study the rat-borne virus last year.

According to the World Health Organization, eight people onboard the cruise ship MV Hondius have been infected with hantavirus. Of these, three have died, and five have been confirmed to have the virus. However, more people are likely to be infected, as the disease can take a long time to show symptoms.

Speaking to reporters Thursday, Donald Trump sought to reassure Americans that the situation appeared contained.

“It’s very much, we hope, under control,” Trump said during an impromptu appearance near the Lincoln Memorial Reflecting Pool in Washington, DC. The President added that the administration planned to release “a full report” on the incident and said health officials were continuing to study the outbreak closely.

“We’re doing the best we can,” Trump told reporters when asked whether Americans should worry about the wider spread of the virus.

Notably, at least 23 passengers from the hantavirus-affected MV Hondius cruise ship returned home, including several to the United States — and one of them has already fallen ill.

Hantavirus Cases In The US?

The travelers reportedly did not know they had been exposed to the deadly virus when they disembarked during the ship’s stop at Saint Helena, a remote island in the South Atlantic, on April 23.

People in at least five US states — Georgia, Arizona, California, Texas, and Virginia — are reportedly being monitored for possible hantavirus exposure, though none have shown symptoms.

According to Dr. Jay Bhattacharya, Director of the US National Institutes of Health (NIH), “Hantavirus is not spread by people without symptoms, transmission requires close contact, and the risk to the American public is very low.”

CDC Cuts On Hantavirus Research

Behind the public reassurance, however, health authorities are confronting a situation that remains poorly understood — particularly because the Trump administration last year cut funding to study the virus behind the deadly cruise ship outbreak, and also fired scientists in key positions who were tracking viruses.

The Centers for Research in Emerging Infectious Diseases were designed to study viruses that could jump from animals to people, including hantavirus, but in 2025, the National Institutes of Health said the work would not continue.

Further, in its 2026 budget request, on one hand, the Trump administration said it planned to refocus the CDC on outbreak investigations and preparedness; on the other hand, it proposed eliminating about $750 million in preparedness grants that states rely on to cope with natural and man-made disasters, including outbreaks.

It also zeroed funding for the Hospital Preparedness Program, which strengthens healthcare systems to respond to emergencies, saying the program “has been wasteful and unfocused”, the New York Times reported.

Notably, the effects of the Trump administration’s cuts to infectious disease research are also being felt globally. South Africa has the capacity to sequence the hantavirus partly because of investments made by previous US administrations through the President’s Emergency Fund for AIDS Relief (PEPFAR), Dr. Carlos del Rio, an infectious disease expert at Emory University, told reporters.

However, the Trump administration has significantly reduced support for South Africa’s research system and is pulling back funding for PEPFAR.

“I worry that as we disinvest in global health, we’re losing our capacity — our global capacity — to deal with diseases,” Dr. Del Rio said.