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’s RT-PCR testing system is capable of detecting the Bundibugyo strain of the Ebola virus, and the chances of missing a confirmed infection are very low when standardized protocols are followed, said health experts after the suspected Ebola case in Bengaluru involving a Ugandan woman tested negative.

The woman, who arrived in Bengaluru from Kampala, Uganda, on May 23, was suspected of Ebola infection after developing mild symptoms including body ache. She was shifted from a hotel to the state-run Epidemic Diseases Hospital on May 26, and her samples were sent to the National Institute of Virology (NIV), Pune. The tests today returned negative. India currently has no reported case of Ebola, the Health Ministry said.

Let’s take a look at how testing for Ebola takes place in India’s virology labs.

Speaking to HealthandMe, Dr. NK Ganguly, former Director General of ICMR, said that RT-PCR remains the confirmatory test for Ebola infection, while rapid diagnostic tests (RDTs) are mainly used for initial screening with limited sensitivity — of around 85-89 per cent.

According to him, the World Health Organization recommends that RT-PCR should only be carried out in specialized reference laboratories due to biosafety requirements. India currently has two designated Ebola reference laboratories — the National Institute of Virology (NIV), Pune, and the National Centre for Disease Control (NCDC).

"The Altona RT-PCR kit is the real star and is highly standardized. It rarely misses Ebola cases when proper protocols are followed,” Dr Ganguly said.

Can India Detect The Bundibugyo Strain?

Bundibugyo is one of the strains of the Ebola virus currently linked to outbreaks in parts of Africa, including Uganda and the Democratic Republic of the Congo (DRC). The rare strain has caused over 900 cases and more than 200 deaths.

Dr. Ganguly said the incubation period for the Bundibugyo strain can range from six to seven days up to 15 days or even three weeks.

“If a person tests RT-PCR negative during this period, the chances of being infectious are lower. However, isolation is still necessary because there may be a short window period during which the infection may not be detected,” he said.

The expert added that travelers arriving from outbreak-hit countries should remain under quarantine even if their initial Ebola test is negative.

Why Ebola Testing Is Complicated

Dr. Ganguly explained that Ebola belongs to the filovirus family, which includes several strains such as Bundibugyo, Sudan, Taï Forest and Zaire viruses.

He noted that Ebola has a high fatality rate, with nearly 50 per cent of infected individuals dying from the disease. He added that the virus can spread through several body fluids including tears, saliva, milk and urine.

In the early stages, Ebola symptoms can resemble flu, malaria or other viral illnesses, including fever, cough, sore throat, headache, diarrhea, skin rashes and body ache, making early diagnosis difficult.

Dr. Ishwar Gilada, a Mumbai-based infectious disease expert, told HealthandMe that the Bengaluru patient’s symptoms were similar to common viral infections, which is why epidemiological history and travel exposure become critical in suspecting Ebola infection.

“The symptoms of Ebola can be a little confusing because they are just like any other flu,” Dr. Gilada said, adding that travelers arriving from Ebola-affected countries should remain under observation for up to 21 days.

Are There Any Limitations In India’s Ebola PCR Testing?

Dr. Jatin Ahuja, Consultant, Infectious Diseases, Indraprastha Apollo Hospital, Delhi, told HealthandMe, there are no major loopholes in India’s Ebola PCR testing system, but there are certain limitations common to all diagnostic tests.

"One key limitation is the timing of testing. If RT-PCR is performed very early in the infection, there is a possibility of a false-negative result because the viral RNA levels may still be too low for detection," he said.

Dr. Ahuja also pointed out that test accuracy depends on whether the PCR targets are correctly aligned with the specific Ebola strain being tested. Improper alignment may reduce sensitivity.

He added that pre-analytical factors such as sample collection, storage, transport and RNA extraction also influence the final test outcome.

“Negative Ebola PCR substantially reduces concern, but interpretation always depends upon the clinical picture, travel history and exposure risk,” Dr. Ahuja said.

Hypertension is the “number one killer” in India, with nearly 1.6 million people dying from the condition every year, said Dr. Ambuj Roy, Professor of Cardiology at the All India Institute of Medical Sciences, New Delhi, today.

Speaking to media persons on hypertension, Dr. Roy said the deaths “linked to high blood pressure are five times higher than tuberculosis fatalities and exceed the combined toll of communicable diseases such as TB, malaria, dengue, and HIV”.

Calling hypertension a “silent but deadly disease,” he said most people remain unaware they have high blood pressure because symptoms are often absent.

“Ninety per cent of the time, hypertension does not cause symptoms. The only way to detect it is through regular screening,” he said.

Dr. Roy also cited the ICMR and NFHS-5 data showing that nearly 30 crore Indians are living with hypertension.

According to him, one in four adults in rural India and one in three adults in urban areas have the condition. However, “only one in three people know they are hypertensive, one in five receive treatment, and just one in twelve achieve proper blood pressure control below 140/90 mmHg”.

Lifestyle Changes Surging Hypertension Risk

Dr Roy said lifestyle changes are driving the growing burden of hypertension in India. Poor diet, obesity, physical inactivity, air pollution, stress, and poor sleep habits are major contributors, particularly among younger people.

He highlighted excessive salt intake as a key concern. While the recommended salt intake is less than 5 grams per day, average consumption in India is around 12 grams daily. He also stressed the importance of potassium-rich foods such as fruits and vegetables, noting that most Indians fail to consume the recommended 400 grams of fruits and vegetables per day.

Pollution: An Emerging Concern

Further, the Cardiologist linked pollution exposure to rising hypertension rates. Referring to studies conducted by AIIMS in collaboration with IIT Delhi, Dr. Roy said areas exposed to crop burning showed a 15 per cent higher prevalence of hypertension.

Another study found that every 10 microgram increase in PM2.5 levels was associated with a 5 per cent higher risk of hypertension.

How To Reduce Hypertension

Dr. Roy said reducing blood pressure by just 10 mmHg can significantly lower the risk of

• cardiovascular mortality by 20 per cent,
• stroke 28 per cent,
• heart failure by 28 per cent,
• coronary artery disease by 17 per cent,
• mortality by 13 per cent.

He also referred to the “TOPSPIN trial,” a large Indian hypertension study, which found that a single-pill combination therapy using two medicines reduced blood pressure by 30–40 mmHg and helped nearly 70 per cent of patients achieve blood pressure control.

The expert stated that around 70 per cent of patients may require long-term treatment or may need it lifelong. However, for nearly 30 per cent of people, hypertension can be reduced by stopping medication through:

• sustained lifestyle changes
• weight loss,
• low-sodium diets,
• exercise,
• better sleep.

‘Do Not Stop BP Medicines Abruptly’

Importantly, Dr Roy cautioned people against stopping blood pressure medicines abruptly once readings improve.

“Blood pressure is controlled because of the medicine. If you stop it suddenly, BP can rise sharply and may trigger a brain stroke or hemorrhage,” he said.

Dr. Roy also dismissed fears around side effects of antihypertensive medicines, calling them among the safest long-term drugs available. “The only side effect they have is benefits,” he remarked, adding that these medicines reduce the risk of heart attack, stroke, and kidney failure.

To reduce blood pressure naturally, the expert advised people to

• remain physically active for at least 150 minutes per week,
• reduce processed and salty foods,
• maintain hydration during heatwaves,
• adopt DASH-style diets rich in fruits and vegetables.

The American Cancer Society (ACS) has updated its colorectal cancer testing guidelines, which bring new screening options for colorectal cancer. This will give the Americans two new options of stool-based tests and blood-based screening tests.

The ACS recommended colorectal cancer screening for citizens as the risk of the disease starts at the age of 45 and continues through age 75 for those with a life expectancy of 10 more years. Thus, to make colorectal cancer tests more accessible to the masses, the new guideline gives nod to blood-based screening tests and FDA-approved new stool sample kits.

Blood-based screening tests must be done in a doctor's office, while one can use stool sample kits for testing at home. Notably, colonoscopy is still the most accurate option for detecting colorectal cancer.

The new guidelines acknowledged the fact that people are likely to choose the most effective colorectal cancer screening test. But still about 20 million eligible Americans remained untested, according to the ACS.

ACS mentions that 1 in 5 colorectal cancer cases is seen in young adults; the new guidelines were a direct result of this huge problem. Though the one who will choose colonoscopy would only have to go through screening every 10 years, on the other hand, the gap between screenings will be every one, three, or five years, depending on the specific method of testing selected.

Early Symptoms Of Colorectal Cancer

Some of the most commonly missed early signs include:

• Persistent changes in bowel habits, especially if they last more than a few days, must be taken seriously. Narrow or ribbon-shaped stools may indicate a tumor partially blocking the colon.
• Blood in the stool is one of the most common and concerning signs. While it might be due to hemorrhoids or fissures, it’s important not to assume. A proper evaluation is critical.
• Unexplained weight loss: Especially when unintentional.
• Abdominal cramps or bloating: Misinterpreted as common digestive issues.

Ignoring such a red flag delays diagnosis and drastically reduces treatment success rates. A timely visit to a healthcare provider can change outcomes.

How To Prevent Colorectal Cancer?

• Diet: More fibre-rich fruits, vegetables, and whole grains; less processed food and red meat.
• Physical activity: “Even 30 minutes of daily walking helps.”
• Screenings: Especially vital for those over 45 or with a family history.