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.

The Saudi Arabian Food and Drug Authority has cleared Anktiva, an IL-15–based immunotherapy created by billionaire physician-scientist Patrick Soon-Shiong and his biotech firm ImmunityBio, for the treatment of bladder cancer and lung cancer. This marks the first time the therapy has received national regulatory approval outside the United States.

The move signals an important global step for Anktiva, which currently holds a limited approval from the U.S. Food and Drug Administration. In the U.S., the drug is authorised only for patients with BCG-unresponsive, non–muscle-invasive bladder cancer (NMIBC) that includes carcinoma in situ. American regulators have so far resisted expanding its use to other bladder cancer subtypes. Saudi regulators, however, have adopted a broader stance, approving Anktiva for two cancer types under their domestic regulatory system.

What Is Anktiva?

Anktiva is an interleukin-15 receptor agonist designed to stimulate the body’s own immune defences. It works by activating and expanding natural killer (NK) cells and memory CD8⁺ T cells, which play a key role in immune surveillance. Unlike chemotherapy or gene-based treatments, Anktiva does not attack tumour cells directly. Instead, it boosts existing immune pathways to help the body recognise and destroy cancer cells.

ImmunityBio describes Anktiva as “the first FDA-approved immunotherapy that activates what’s called a natural killer cell to target and kill non-muscle-invasive bladder cancer cells.” In clinical practice, the drug is used alongside BCG (Bacillus Calmette-Guérin) in patients whose NMIBC has not responded to BCG alone. It is administered directly into the bladder through a catheter, followed by a structured maintenance schedule

Clinical Evidence Supporting FDA Approval in NMIBC

The FDA’s approval, issued on April 22, 2024, was based on results from a single-arm clinical study involving 77 patients with BCG-unresponsive stage 0 NMIBC. Participants received intravesical Anktiva combined with BCG, with maintenance therapy continuing for as long as 37 months.

The main efficacy results were as follows:

• Complete response rate: 62%

Durability:

• 58% of patients who responded remained disease-free for at least 12 months
• 40% stayed disease-free for 24 months or longer

For patients facing the prospect of radical cystectomy as the only curative option, these results were considered clinically significant. Still, the absence of a randomised control group has remained a point of contention among regulators and experts.

Regulatory Tension in the United States

Although the FDA approved Anktiva for NMIBC cases involving carcinoma in situ, it declined to extend the indication to patients with papillary-only disease. ImmunityBio pushed back against the decision, arguing that the same clinical data had already been deemed sufficient to support approval in a closely related patient group.

Rachel Sherman, MD, former principal deputy commissioner of the FDA, publicly criticised the agency’s stance, saying: “it is incomprehensible to me that the FDA refuses to file a supplemental BLA, stating the study is not sufficient to support a regulatory review, when it has already approved a product based on that very same study in essentially the same indication and population.”

The FDA has also expressed concerns about how the drug has been marketed. It issued a warning letter to ImmunityBio over promotional materials that cited survival benefits and cystectomy-avoidance rates not supported by robust evidence.

Saudi regulators, by contrast, have taken a more permissive view, approving Anktiva for both bladder and lung cancer and highlighting a willingness to act in areas of high unmet medical need.

With this decision, Saudi Arabia becomes the first country to approve Anktiva beyond NMIBC, potentially placing itself at the forefront of evaluating the therapy’s wider role across multiple cancer types.

Once a rare condition, non-alcoholic fatty liver disease (NAFLD) now affects one in three Indians, scientists say.

NAFLD, now called as metabolic dysfunction-associated steatotic liver disease (MASLD), is when excess fat builds up in the liver, unrelated to heavy alcohol use, due to obesity, Type 2 diabetes, high blood pressure and cholesterol.

It ranges from simple fat accumulation to inflammation and damage, which can progress to fibrosis, cirrhosis or liver cancer, The disease often has no symptoms and is managed with lifestyle changes such as diet and weight loss.

A JAMA study has now found that about 40 percent of the global population is now suffering from NAFLD, with abdominal obesity identified as its single biggest risk factor. Between 2010 and 2021, India recorded a 13.2 percent increase in age-standardized prevalence, ranking just behind China at 16.9 percent and Sudan at 13.3 percent.

What Did The Study Find?

Researchers found that nearly 70 percent of people with Type 2 diabetes and about 80 percent of those with obesity are affected by NAFLD. They also discovered that NAFLD prevalence is higher in men than in women, with rates of 15,731 per 100,000 population in men compared with 14,310 in women.

Additionally, the disease peaks earlier in men, between 45 and 49 years of age, while women show the highest prevalence between 50 and 54 years.

Why Is NAFLD on the rise?

Experts also note that working long hours at desks without any proper physical activity can lead to weight gain and fat accumulation in the liver.

According to the Union health ministry, the prevalence of the condition could be in the range of 9-53 percent. Multiple other health studies also suggest nearly 40 percent of urban Indians may have some form of fatty liver disease

Hepatologist Dr Cyriac Abby Philips, popularly known as LiverDoc on social media, noted on X that many patients do not realize that timely lifestyle changes can completely reverse the condition. “All it takes is being in charge of your body and health. No shortcuts—go slow and steady,” he wrote.

If left untreated, NAFLD can progress to Non-Alcoholic Steatohepatitis (NASH), where liver inflammation begins. Over time, this inflammation can lead to scarring of the liver, known as fibrosis. Advanced fibrosis results in cirrhosis, which severely affects liver function.

NAFLD can also increase the risk of chronic liver disease, liver failure and hepatocellular carcinoma. Many patients diagnosed with liver cancer have a history of untreated fatty liver.

NHS expanded access of a life-extending prostate cancer drug after a campaign ran by a patient and a charity. This drug is abiraterone, which had been available on the NHS in Scotland and Wales since 2023, but now in England and Northern Ireland, except in the most severe cases.

In the UK, the cancer drug is prescribed for patients with prostate cancer at a very advanced stage. However, now, the drug will be available to prostate cancer patients in England on the NHS, even for those where cancer has not metastasized or spread. This could save hundreds of lives.

The assistant director of health improvement at charity Prostate Cancer UK, Amy Rylance said that the decision was "a momentous, life-saving victory for the thousands of men whose lives will not be saved".

The charity estimated that this will enable 7,000 men a year to start their treatment, with around 1,470 cancers being avoided rom getting worse. This could save somewhere around 560 lives.

The drug is soon to be available on NHS England in weeks.

What Is Abiraterone?

As per the Cancer Research UK, abiraterone is a hormone therapy drug. The Prostate Cancer UK notes that this is most commonly offered to men whose cancer has stopped responding to other types of cancer drugs.

As per Mayo Clinic, it is used in combination with prednisone to treat patients with metastatic castration-resistant prostate cancer and metastatic high risk castration-sensitive prostate cancer. This medicine is only available on doctor's prescription and is available as a tablet.

What Is Prostate Cancer?

The prostate is a small walnut-shaped gland in men that produces seminal fluid that nourishes and transports sperm. It occurs when abnormal cells form and grow in that gland.

Experts say that not all prostate cancer is deadly. There are cancers that are slow-growing and will not affect a man's lifespan, which is found in 1 in 3 men over 50. Then there is a small number of very aggressive prostate cancers which move quickly and cause harm, this is why regular screening is important.

Read: Olympic Cyclist Sir Chris Hoy Shares His Diagnosis Of Prostate Cancer From A Common Shoulder Pain

Are There Any Tests For Prostate Cancer?

In the UK, there is no prostate cancer screening programme like those for breast, bowel and cervical cancer. The onus is therefore on men to request a blood test from their general practitioner once they are over 50. When not aware, it can become life-threatening as it did for Sir Chris Hoy, the six-time Olympic cyclist, who opened up on his diagnosis of the same through a shoulder pain last year.

Despite more men dying from prostate cancer than women from breast cancer, as per BBC, there are no reliable tests for this. The blood test that men over 50 request from their general practitioner measure prostate-specific antigen (PSA), released by the prostate, a small gland located below the bladder involved in the production of semen.

However, experts say that PSA levels can be high for many other reasons too, including enlarged prostate, inflammation, infection, recent vigorous exercise or sex.