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.

Triple-negative breast cancer is notorious as it can respond to chemotherapy initially, only for some cancer cells to adapt, survive and eventually become resistant to treatment. Researchers at the Medical University of South Carolina’s Hollings Cancer Center may have found a way to turn that against the tumour's nature.

In a new study published in Cell Reports Medicine, scientists used a two-step drug strategy that first weakened drug-resistant cancer cells and then blocked the backup system they turned to for survival.

Marking a breakthrough, the combination significantly slowed tumour growth in several models of triple-negative breast cancer, including the ones made from patients whose tumours had stopped responding to chemotherapy treatment.

An important thing to note is that this is still laboratory and preclinical research and not a treatment that is readily available to patients.

How Does The Two-Step Drug Strategy Work?

Also read: Mystery Behind Rare Cancer Cluster In California Community Deepens After 20-YO Warning Emerges: What Is Ewing Sarcoma?

First Step:

The researchers mainly focused on a protein called lysyl oxidase, or LOX. LOX has always been studied for its role outside cancer cells, where it can make it easier for cancer to spread by altering the tissue around the tumour.

But the research team found that LOX has another job inside triple-negative breast cancer cells. It helps them produce energy, maintain healthy mitochondria and cope with cellular stress. Blocking LOX therefore cancer cells from spreading.

Burge Ulukan, PhD, a postdoctoral fellow and co-first author of the study, “LOX helps cancer cells keep multiple survival systems running. When we blocked LOX, the cancer cells lost that advantage." He added, “When we inhibit it, we are inhibiting multiple arms. We're disrupting cells' energy production and making them much more vulnerable to treatment.”

But the researchers observed that the instead of simply dying, the cancer cells adapted again after LOX was blocked.

Second Step:

Also read:

The next step in the strategy is blocking the cancer's backup route. Once LOX was blocked, the cancer cells became increasingly dependent on another protein called DHODH, which gave the scientists with an even better second target.

They paired an experimental drug used to block LOX with leflunomide, an FDA-approved drug that blocks DHODH. Together, the drugs pushed the cancer cells towards ferroptosis, a form of cell death caused by damaging molecules building up inside the cell.

The combination significantly blocked tumour growth across several models and performed better than the LOX inhibitor combined with standard chemotherapy. The researchers reported no major weight loss or signs of kidney or liver toxicity in the models tested.

Ozgur Sahin, PhD, co-leader of the Hollings Cancer Biology and Immunology Research Program, described the strategy as, “It's a one-two-punch approach. First, we block LOX, which weakens the cancer cells. As they adapt and become dependent on a backup survival pathway, we deliver the second punch by blocking that pathway, too.”

Why Triple-Negative Breast Cancers Are Challenging To Treat?

Triple-negative breast cancer gets its name as its cells lack three common treatment targets: oestrogen receptors, progesterone receptors and HER2. This leaves doctors with fewer targeted treatment options than they have for some other breast cancers.

Chemotherapy remains an important treatment, but resistance can develop quickly. Sahin said, “Triple-negative breast cancer is one of the most aggressive, deadliest versions of breast cancer. Chemotherapy is really the mainstay, and interestingly, this subtype is sensitive to chemotherapy compared to others, but resistance develops quite quickly.”

Till now, the findings have been demonstrated in labs and preclinical models. The researchers are now developing a newer version of their drug to trap LOX to prepare for human testing.

India is moving closer to its goal of eliminating malaria by 2030. Between 2022 to 2025, 160 districts across the country reported zero indigenous malaria cases, according to the Union Health Ministry.

The country has also saw nearly 80% decline in malaria cases and deaths between 2015 and 2025. The number of districts with high malaria burden also went down from 155 to 33.

The latest figures were discussed at a review meeting chaired by Aradhana Patnaik, Additional Secretary and Mission Director, National Health Mission, with officials from the Ministry of Health and Family Welfare, National Centre for Vector Borne Diseases Control (NCVBDC), states and affected districts.

160 Districts Reported Zero Malaria Cases In Last 3 Years

160 districts reported zero indigenous malaria cases from 2022 to 2025. This is significant as it suggests that local transmission was successfully interrupted in these regions.

But zero reported cases does not mean the risk has vanished completely. Malaria can return when mosquitoes, infected people or favourable environmental conditions fuel transmission. To avoid this, health authorities are vigilantly continuing surveillance even in areas that have made substantial progress.

The government said the reduction in numbers reflects the positive impact of focused malaria control and elimination initiatives and strategies. According to PIB, It including surveillance, early diagnosis, treatment and control measures for vector-borne infections.

Also read: Malaria Alert in Germany: Frankfurt Airport Worker Dies After ‘Mosquito Arrives On Plane’; 5 Infected

Strategies Needed For Malaria Elimination

Patnaik stressed that India cannot rely on a one-size-fits-all approach as it moves towards elimination. He said, “Focused, area-specific strategies and strengthened surveillance are essential to accelerate India’s progress towards malaria elimination by 2030.”

The Health Ministry has identified 33 high-burden districts across nine states and Union Territories for particularly intensive action. These districts accounted for 64% of India's malaria cases and 54% of malaria deaths in 2025.

The states and UTs reviewed included Mizoram, Odisha, Tripura, Assam, Andhra Pradesh, Andaman and Nicobar Islands, Chhattisgarh, Jharkhand and Maharashtra.

Despite the overall decline, malaria deaths continue to occur, and authorities highlighted that delays in diagnosis and treatment are the primary driving factors.

The government has asked states to strengthen the “Test, Treat and Track” strategy, improve active surveillance and ensure that diagnostic tests and anti-malarial medicines remain available, particularly in remote areas.

Also read: World Mosquito Day: How Dengue Can Damage Your Kidneys

The Real Challenge For India

Malaria is transmitted through the bite of infected Anopheles mosquitoes. The parasite enters the bloodstream and can cause fever, chills, headache and body aches. In severe cases, it can affect the brain and other organs and become life-threatening.

The challenge for India now is not simply reducing cases, but preventing malaria from coming back in districts where transmission has become zero.

Patnaik stressed, “Health interventions alone cannot address several factors contributing to malaria transmission, including water-logging, source reduction and environmental management.”

The government has therefore called for greater coordination with rural and urban development departments, Panchayati Raj institutions and local communities to identify breeding sites and report suspected cases early.

Myocardial infarction (MI) is one of the most common cardiovascular disorders, with an estimated prevalence of 3.8% in individuals aged less than 60 years and 9.5% in those aged over 60 years. MI remains a leading cause of death and is a significant public health concern worldwide.

But a heart attack isn't one single disease with one single mechanism. Being able to classify the type of myocardial infarction quickly can improve diagnosis and treatment.

In view of this, four major cardiac societies—the European Society of Cardiology (ESC), the American College of Cardiology (ACC), the American Heart Association (AHA) and the World Heart Federation (WHF)—have jointly launched the Fifth Universal Definition of Myocardial Infarction.

The Fifth Universal Definition of Myocardial Infarction replaces numerical labels with three clinically meaningful categories.

The new approach aims to help healthcare professionals make more consistent diagnoses and enable patients to understand their condition better.

The new definition also aligns with the International Classification of Diseases (ICD) coding, which captures statistics on the extent, causes and consequences of different diseases.

“People may think of an MI as a heart attack caused by a blocked coronary artery but there are many different causes of MI,” explained ESC Chair, Professor Nicholas Mills from the University of Edinburgh, UK.

“The previous universal definition used a numerical system to categorize the different types of MI but this was not always easy to apply in clinical practice, leading to inconsistencies in diagnosis and treatment. The ESC, ACC, AHA and WHF have worked together to devise an updated and simplified classification system for MI, which aims to address these limitations.”

What Does the Fifth UDMI Mean?

The Fifth Universal Definition of Myocardial Infarction updates the classification to better reflect underlying pathophysiology, align with the clinical evaluation of patients, and incorporate objective diagnostic criteria.

Notably, it could facilitate wider study of less common mechanisms of primary MI, such as spontaneous coronary artery dissection (SCAD), a condition occurring predominantly in women that is currently underdiagnosed.

What Are the 3 New Heart Attack Categories?

The new system considers the underlying cause of MI and aligns the diagnosis with established approaches to clinical evaluation. It recognises that MI occurs in three clinical settings: primary MI, secondary MI and procedure-related MI.

In this updated approach to MI classification, all MIs fit into one of these three clinical categories, and the new document outlines the diagnostic tests and investigations required for each.

1. Primary MI

Primary MI arises spontaneously due to an acute problem in a coronary artery. It is most commonly caused by a rupture of an atherosclerotic plaque, but there are other causes, such as a tear in the coronary wall (spontaneous coronary artery dissection [SCAD]), spasm or a clot.

2. Secondary MI

Secondary MI arises from an imbalance in oxygen supply and demand in the heart caused by another condition, such as very high or very low blood pressure or a very fast heartbeat.

3. Procedure-Related MI

The third setting—procedure-related MI—is one that occurs within 30 days of a cardiac procedure, such as coronary stenting, or a heart operation, such as coronary artery bypass surgery.

“Clinicians often do not use the previous numerical terminology—e.g. type 2 or type 4c—in patient discussions as it is rather complex. With the new approach, we can now talk with patients about the cause of their MI so that they can understand their condition and recognize why the next steps, such as further tests and treatments, are needed,” said ACC/AHA Chair, Professor Kristin Newby from Duke University Medical Center, Durham, US.