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.

India has seen a significant rise in the cancer burden, with the cases rising to 1,569,793 in 2025, the government has informed the Parliament.

From more than 1.4 million in 2021, the cancer cases in the country rose to over 144,000 in the last five years, revealed Prataprao Jadhav, Union Minister of State for Health, in a written reply in the Rajya Sabha.

The increase in cases has been consistent:

• 1,426,447 cases in 2021
• 1,461,427 cases in 2022
• 1,496,972 cases in 2023
• 1,533,055 cases in 2024
• 1,569,793 cases in 2025

Similarly, cancer deaths also increased in the country -- 868,588 in 2025 from 789,202 in 2021.

The country reported about 15,000 cancer -related deaths each year:

• 789,202 deaths in 2021
• 808,558 deaths in 2022
• 828,252 deaths in 2023
• 848,266 deaths in 2024
• 868,588 deaths in 2025

Worst-Affected States And Key Reasons

Jadhav informed that bigger states with large populations have seen a major increase in cancer cases and deaths consistently in the last five years.

States with the highest estimated cancer cases in 2025 include:

Uttar Pradesh - 226,125

Bihar - 118,136 cases

West Bengal - 121,639 cases

Maharashtra - 130,465 cases

Rajasthan - 80,628 cases

States with the highest estimated cancer deaths in 2025 include:

Uttar Pradesh - 125,184 deaths

Bihar - 65,571 deaths

West Bengal - 67,093 deaths

Maharashtra - 71,696 deaths

Rajasthan - 44,402 deaths

Major reasons for the rise in cancer burden include:

• environmental factors such as industrial pollution, pesticide exposure,
• contaminated water sources, by pollutants like industrial waste, pesticides, heavy metals, and pharmaceuticals.

“The review provides a critical analysis of the current evidence, summarizing the association of water contamination, including industrial waste, pesticides, and heavy metals, with rectal and colorectal cancer,” Jadhav stated in the Upper House of the Parliament.

Cancer Care Facilities In India

Jadhav further informed that the government is tackling the growing burden by expanding cancer care infrastructure across the country.

The Ministry of Health and Family Welfare has implemented the Strengthening of Tertiary Care Cancer Facilities Scheme, which has approved:

• 19 State Cancer Institutes (SCI)
• 20 Tertiary Care Cancer Centers (TCCC)

Other high-quality comprehensive cancer care facilities in the country include:

• Tata Memorial Centre’s (TMC) six hospitals in Varanasi, Visakhapatnam, New Chandigarh, Guwahati, Sangrur, and Muzaffarpur
• Cancer treatment facilities in all 22 new AIIMS
• Advanced diagnostic and treatment facilities at the National Cancer Institute (NCI) at Jhajjar
• A second campus of Chittaranjan National Cancer Institute in Kolkata
• 297 Day Care Cancer Centers (DCCCs) as promised in the Union Budget 2025-26
• Free essential medicines and diagnostics at public health facilities
• Anti-cancer drugs in the Essential Drugs List at District and Sub-Divisional Hospitals
• Health insurance of Rs. 5 lakh per family annually for secondary and tertiary care under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB PMJAY)
• Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacies providing access to affordable cancer medicines.

A new vaccine that targets the mosquito-borne dengue has proven to be over 80 percent effective in preventing the risk of severe disease for up to five years, according to a recent study conducted by Brazilian researchers.

The study, published in the journal Nature Medicine, confirmed that the tetravalent dengue vaccine -- Butantan-DV -- developed by the Butantan Institute in São Paulo, prevents hospitalizations and offers broader protection against all four dengue serotypes.

“This vaccine is establishing itself as a very important tool in the fight against dengue in Brazil, with the potential to contribute to reducing the circulation of the virus, in addition to individual protection,” said Fernanda Boulos, the institute’s medical director of clinical trials.

The Phase 3 Clinical Trial

The phase 3 clinical trial, conducted from February 2016 to July 2019, involved 16,235 participants between the ages of 2 and 59.

The researchers compared individuals who received a single dose of the vaccine (10,259) with those who were administered a placebo (5,976).

• The results showed
• 80.5 percent effectiveness against severe dengue cases
• no hospitalization in the vaccinated group vs 8 cases in the placebo group
• 65 percent effective in preventing symptomatic dengue

The Butantan-DV Vaccine

The Butantan-DV vaccine is tetravalent and offers protection against the four known serotypes: DENV-1, DENV-2, DENV-3, and DENV-4.

The vaccine uses live viruses that have been “weakened” (attenuated) in a laboratory.

Once administered, the vaccine controls replication of these attenuated viruses in the body -- a process which induces the immune system to produce neutralizing antibodies specific to each of the four serotypes.

The vaccines create immunity specific to each serotype to enable the body to recognize and neutralize each variant individually.

The Butantan-DV vaccine was approved by the Brazilian Health Regulatory Agency (ANVISA) on November 26, 2025, for use by the Brazilian population aged 12 to 59.

The country's Ministry of Health has

• incorporated the vaccine into the national immunization program in January
• launched a pilot project to immunize 90 percent of the target population in states with high burden
• rolled out vaccination of primary care health professionals in February

Also read: Why Is Dengue Fever on the Rise Despite Vaccines?

Global Dengue Burden

Dengue is transmitted through infected mosquitoes, primarily the species Aedes aegypti.

Common Symptoms include:

• Sudden onset of high-grade fever.
• Intense headache
• Severe muscle, joint, or bone pain.
• Skin Rash that often appears 2–5 days after the fever starts
• Nausea and Vomiting
• Fatigue

According to the World Health Organization (WHO), about half of the world's population is now at risk of dengue.

It estimates that:

• about 390 million dengue infections occur annually worldwide
• nearly 100 million people develop symptoms each year

The two main authorized vaccines in the world against dengue are Dengvaxia and Qdenga.

These vaccines are designed to protect against all four serotypes of the virus, with a focus on reducing severe disease and hospitalizations.

The recent decision by the Supreme Court of India allowing withdrawal of life support for a 32-year-old man in an irreversible permanent vegetative state is an important development in patient-centered healthcare.

The order follows the principles established in the landmark Common Cause v. Union of India, which recognized passive euthanasia and affirmed that individuals have the right to die with dignity. From the perspective of a critical care specialist, this decision supports ethical medical practice while protecting the dignity and rights of patients.

In modern intensive care units (ICUs), doctors use advanced technologies such as ventilators, feeding tubes, dialysis machines, and strong medications to sustain life during serious illness. These treatments are extremely valuable when there is a reasonable chance of recovery.

However, in some medical conditions—particularly severe brain injuries—patients may enter a permanent vegetative state. In this condition, the patient’s body may continue functioning with medical support, but the brain has lost the ability to produce consciousness or awareness. The patient cannot communicate, recognize loved ones, or interact with the environment, and medical science currently has no effective treatment to reverse this condition.

From a medical standpoint, continuing life support in such cases may only prolong biological survival without any possibility of recovery or meaningful quality of life. The Supreme Court’s decision acknowledges this difficult reality and allows withdrawal of life-sustaining treatment when doctors confirm that recovery is medically impossible. This approach respects the patient’s dignity and avoids unnecessary prolongation of suffering.

Harish Rana Case: Key benefits

One of the key benefits of this judgment is the recognition of dignity at the end of life. The Court has interpreted the right to life under the Constitution of India to include the right to die with dignity. In practical terms, this means that patients should not be forced to remain on life-support machines when such treatment no longer benefits them.

Medicine should focus not only on prolonging life but also on ensuring that patients are treated with respect, comfort, and compassion during their final stages of life.

The decision also supports patient autonomy, which is a core principle of ethical medical care. Individuals have the right to make decisions about their own bodies and medical treatment. The recognition of living wills or advance directives allows patients to express their wishes in advance regarding life-prolonging treatments. This ensures that medical decisions align with the patient’s values and preferences, even if the patient is no longer able to communicate.

Also read: Harish Rana Case Highlights Why Planning For A Living Will Is Important

Another important benefit is the support it provides to families. Families often experience deep emotional stress when a loved one remains in a permanent vegetative state for a long period. They may struggle with uncertainty about whether continuing life support is truly helping the patient.

The Supreme Court’s framework provides a clear and compassionate process for decision-making involving medical boards and proper documentation. This helps families make informed choices in consultation with doctors while ensuring that the decision is ethically and legally sound.

Harish Rana Case: Offers Clarity For Healthcare Workers

The ruling also offers legal clarity for doctors and hospitals. In the past, physicians sometimes feared legal consequences if life support was withdrawn, even in medically futile situations.

The guidelines established under the Common Cause judgment create a structured and transparent process for making such decisions. This allows doctors to practice responsible and ethical medicine without unnecessary legal concerns.

Also read: Passive Euthanasia: Harish Rana’s Case May Reshape End-of-life Protocols, Say Experts

Passive Euthanasia: A Compassionate Step

In conclusion, the Supreme Court’s order is a compassionate step forward in Indian healthcare. From a critical care perspective, it respects patient dignity, supports family decision-making, provides legal clarity for doctors, and encourages thoughtful end-of-life care.

Most importantly, it reminds us that the true goal of medicine is not merely to extend life at all costs, but to ensure that every patient is treated with dignity, humanity, and respect throughout all stages of life.

Also read: Harish Rana Case Brings Spotlight On How Passive Euthanasia Has Evolved Over The Years