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.

Public health officials in Alaska have reported three cases of Clade I mpox in people with no recent travel history, raising concerns about local transmission of the virus in the US.

The cases were confirmed in Anchorage in October 2026, shortly after California's Stanislaus County reported four cases of Clade I mpox, the strain responsible for the 2024 global outbreak.

While the cases point to possible community transmission, health officials said the risk to the general public remains low.

Three Clade I Mpox Cases Reported In Alaska

Three cases of mpox (monkeypox) were confirmed in Anchorage in October 2026, according to the Alaska Public Health Alert Network.

All three patients are male. An epidemiological link has been identified between the first two cases, while no link has been established for the third.

None of the patients reported out-of-state travel.

The first two cases were caused by Clade Ib mpox, marking the first reported Clade I infections in Alaska. Clade determination for the third case is pending.

One patient was briefly hospitalised. All three are currently isolating and recovering, while investigations continue.

The global mpox outbreak that began in 2022 was caused by Clade IIb. Since March 2026, imported Clade I cases have increased in the US, with presumed local transmission reported in 15 jurisdictions since August 2026.

Also read: 1,370 Mpox Cases, 7 Deaths Reported In July: WHO Says Risk Remains Moderate

California Reports Four Clade I Mpox Cases

Public health officials in California's Stanislaus County have reported four mpox cases. Two have been confirmed as Clade I, while testing is underway for the other two.

Three individuals had no recent international travel history, raising concerns about local transmission. The travel history of the fourth person is still being assessed.

The cases suggest possible community transmission. However, county officials have said the risk to the general public remains low.

US Reports Sustained Clade I Mpox Transmission

The Center for Outbreak Response Innovation (CORI), supported by the Johns Hopkins Bloomberg School of Public Health and the CDC's Center for Forecasting and Outbreak Analytics, has classified the US as being in Scenario 4: Sustained Transmission for Clade I mpox.

This indicates ongoing person-to-person transmission chains in some jurisdictions, primarily among adults with multiple sexual partners, including sex workers and men who have sex with men (MSM).

The CDC reported more than 90 Clade I cases across at least 23 states and Puerto Rico as of October 14, 2026. Domestic transmission had been reported in 10 jurisdictions, with additional cases involving people without recent international travel.

Read More: Mpox Spreads in Guinea-Bissau, Half Of Suspected Cases Are Children

Why Is Clade I Mpox A Concern?

Clade I has historically been associated with more severe illness and higher case-fatality rates than Clade II.

Its historical case-fatality rate has been estimated at 1% to 10%, compared with approximately 1% to 4% or lower for Clade II. However, recent Clade I outbreaks have recorded substantially lower mortality, particularly where appropriate medical care is available.

The 2024 global outbreak was driven largely by Clade I, particularly the Clade Ib sub-lineage. On August 14, 2024, the World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC).

What Is Mpox?

Mpox is a viral zoonotic disease caused by the monkeypox virus, which belongs to the Orthopoxvirus genus, the same family of viruses as smallpox.

It spreads through close contact with an infected person, including skin-to-skin and sexual contact, exposure to sores or bodily fluids, and contact with contaminated items such as bedding and towels. Transmission can also occur through contact with infected animals.

What Are The Symptoms Of Mpox?

Symptoms generally appear 5 to 21 days after exposure and include:

• Skin rash
• Fever
• Sore throat
• Headache
• Muscle and body aches
• Fatigue
• Swollen lymph nodes

Most people recover within two to four weeks. However, severe illness can occur, particularly in children, pregnant women and immunocompromised people.

GLP-1 drugs such as Ozempic and Wegovy can reduce cardiovascular events and deaths in people with type 2 diabetes (T2D) and some people with obesity. However, stopping treatment may affect these benefits.

Around 20–50% of patients discontinue GLP-1 therapy within the first year. Previous studies have linked discontinuation to weight regain and worsening blood sugar, blood pressure and cholesterol levels.

Now, a study published in The Lancet Regional Health has found that people with type 2 diabetes and no previous cardiovascular disease who stopped GLP-1 treatment had nearly twice the risk of heart attack, stroke or death from any cause compared with those who continued.

"In people with T2D and without previous cardiovascular disease, interrupting a therapy with GLP-1RA was associated with a higher risk of a composite of myocardial infarction, stroke, or death from any cause compared to those continuing the treatment," said researchers from IRCCS MultiMedica in Milan, Italy.

However, the observational study cannot establish that stopping GLP-1 drugs directly caused the increased risk. Researchers also did not know why patients discontinued treatment, which could have been due to side effects, cost or underlying illnesses such as frailty or cancer.

What Did The Study Find?

Also read: After Ozempic, Wegovy And Other GLP-1 Drugs, More US Men Opt for Cosmetic Treatments

Researchers analysed electronic medical records from more than 300 diabetes clinics in the Italian Association of Clinical Diabetologists (AMD) database, covering 2004–2024.

They identified more than 80,000 people with type 2 diabetes and no established cardiovascular disease who had started GLP-1 treatment.

Those who continued treatment took the medication for nearly three years on average, compared with just over one year among those who stopped.

The combined risk of non-fatal heart attack, non-fatal stroke or death from any cause was nearly twice as high among those who discontinued treatment.

• Those who stopped: About 4 events per 100 people per year.
• Those who continued: About 2 events per 100 people per year.

People With Obesity Had Higher Risks

Read More: Ozempic, Zepbound: US FDA Orders New Warning Over Rare Eye Risk

Among those who discontinued treatment, the risks of adverse outcomes were higher in people with obesity (body mass index of 30 or above) than in those without obesity.

Interestingly, changes in weight, blood sugar and blood pressure after stopping treatment were modest and similar among those who subsequently experienced a heart attack, stroke or death and those who did not.

This suggests that changes in these risk factors may not fully explain the higher rates of adverse outcomes.

Should You Stop Ozempic Or Wegovy?

Lead author Antonio Ceriello, head of diabetes research at IRCCS MultiMedica, said the association between stopping GLP-1 receptor agonists and poorer cardiovascular outcomes was "not a complete surprise". However, he noted that the scale of the association was significant, ABC News reported.

The researchers said long-term GLP-1 use may be important for maintaining health benefits in people with type 2 diabetes, but further studies are needed to establish whether stopping treatment directly increases cardiovascular risk or reflects worsening underlying health.

People taking Ozempic, Wegovy or other GLP-1 medications should discuss any decision to stop treatment with their doctor.

Eli Lilly's oral weight-loss drug Foundayo, that received FDA approval in April 2026, has shown promise in reducing the severity of obstructive sleep apnoea (OSA) in a recent trial.

OSA is a condition in which breathing repeatedly gets interrupted during sleep. In a late-stage clinical trial, the medicine reduced the repeated starting and stopping of breathing by up to 44% over 52 weeks in adults with moderate-to-severe sleep apnoea and overweight or obesity.

The findings from the phase 3 ATTAIN-OSA clinical programme were presented at the American Heart Association's Scientific Sessions 2026 on November 9 and published simultaneously in JAMA. The study included 712 participants, divided into two groups based on whether they were using positive airway pressure (PAP) therapy.

Eli Lilly plans to submit the findings to the US Food and Drug Administration (FDA) by the end of 2026 to seek approval for Foundayo as a treatment for moderate-to-severe obstructive sleep apnoea in adults with overweight or obesity.

Foundayo Reduces Sleep Apnoea Episodes

Also read: Lancet Study Says Obesity Drug Mazdutide Shows 18% Weight Loss In 32 Weeks: How Does It Compare To Wegovy?

The trial evaluated Foundayo, also known by its generic name orforglipron, in two separate studies. One involved 363 adults who were not using PAP therapy, while the other included 349 participants who continued using it.

After 52 weeks, the drug reduced the number of breathing interruptions per hour, measured using the apnoea-hypopnoea index (AHI).

The findings included:

• Participants not using PAP therapy: Breathing interruptions fell by 43.8% compared to a 6.3% reduction in the placebo group.
• Participants using PAP therapy: Breathing interruptions fell by 27.5% compared to a 3% reduction in the placebo group.
• Better oxygen levels: Sleep apnoea-related oxygen deprivation, measured through hypoxic burden, fell by 55.9% in the group not using PAP and 45.8% in the group using PAP.

The drug also helped some participants reach remission or mild disease. According to Lilly's reported efficacy analysis, this included 31.5% of participants not using PAP therapy and 19.6% of those using it.

Can Foundayo Replace CPAP Therapy?

Also read: Ozempic, Mounjaro Users Report Burning Skin Sensation: What Is Allodynia?

Continuous positive airway pressure (CPAP), a form of PAP therapy, remains a standard treatment for obstructive sleep apnoea. It uses a machine to deliver a steady flow of air through a mask, keeping the airway open during sleep.

The ATTAIN-OSA programme included participants who were not using PAP therapy as well as those who continued using it. The results suggest that Foundayo could benefit both groups, but they do not establish that patients can stop using CPAP.

Vaishnavi Kundel, the study's presenting author and Associate Professor of Medicine at the Icahn School of Medicine at Mount Sinai, said, “If approved to treat obstructive sleep apnea, orforglipron could be a promising oral pharmacologic option for people with overweight or obesity and this condition. A convenient daily pill may help expand access to treatment for sleep apnea, and it could potentially be used with CPAP or other therapies to better meet individual patient’s needs.”

More About Foundayo

Also read: Ozempic, Zepbound: US FDA Orders New Warning Over Rare Eye Risk

Foundayo is an oral glucagon-like peptide-1 (GLP-1) receptor agonist. It is taken once daily and works by mimicking the GLP-1 hormone, which helps regulate appetite, calorie intake and blood glucose levels.

By reducing appetite and supporting weight loss, the drug may help address one of the important risk factors of obstructive sleep apnoea.

Excess weight, especially around the neck and upper airway, can increase the likelihood of airway narrowing or collapse during sleep. When the airway repeatedly becomes blocked, breathing interruptions occur and blood oxygen levels can fall.

Participants taking Foundayo lost an average of 11.5% of their body weight in the study group not using PAP therapy and 11.2% in the group using it.

Why Is Obstructive Sleep Apnoea A Concern?

Obstructive sleep apnoea is a breathing disorder related to sleep in which the muscles and soft tissues of the upper airway relax during sleep, causing the airway to narrow or become temporarily blocked.

This results in repeated pauses in breathing or episodes of shallow breathing, disrupting sleep and reducing oxygen levels. Common symptoms include:

• Loud and constant snoring
• Episodes of gasping or choking during sleep
• Waking up frequently during the night
• Morning headaches
• Excessive daytime sleepiness
• Difficulty concentrating and irritability