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.

It is no news that ever since the President Donald Trump's administration has signed in, transgenders have seemed to lost their rights, with their research being removed, defunded, and now the administration has changed the name of transgender health leader on her official portrait. The new name used is her head name.

The person in question is Adm. Rachel Levine, who made history in 2021 when she was sworn in as the assistant secretary for health at the Department of Health and Human Services under former President Joe Biden. Levin was nation's highest ranking and openly transgender federal official. Her portrait hands in the HHS office, along with pictures of other federal officials who have led the US Public Health Corps. However, recently, especially after the US government went on a shutdown, HHS has removed Levine's name from her portrait and replaced it with her dead name, reported NPR.

As per the GLAAD, formerly Gay & Lesbian Alliance Against Defamation, a major LGBTQ media advocacy organization, the act of revealing or using a transgender person's birth name without their permission is known as deadnaming.

What Does Levine Say On The Act Of Deadnaming Her?

Adrian Shanker, a former deputy assistant secretary for health policy in the Biden administration and Levine's current spokesperson told the NPR that this act is of "bigotry against her".

“During the federal shutdown, the current leadership of the Office of the Assistant Secretary for Health changed Admiral Levine's photo to remove her current legal name and use a prior name," Shanker told the outlet.

As per Levine, it was a “great honor to serve in the United States Public Health Service Commissioned Corps.” In a statement to The Independent, she said, "My focus has been and continues to be on public health and health equity. I am not going to comment on this type of petty action.”

While the HHS spokesperson Andrew Nixon told that the agency's priority "is ensuring that the information presented internally and externally by HHS reflects gold standard science. We remain committed to reversing harmful policies enacted by Levine and ensuring that biological reality guides our approach to public health," in a statement to NPR.

Trump Administration Against Transgender

Over the last year, Trump administration has rolled back many rights of transgender people.

The U.S. Department of Health and Human Services (HHS) released new definitions for 'sex,' 'man,' and 'woman', an action that has provoked widespread discussion in health, scientific and policy communities. While proponents believe the revisions bring back biological truth, opponents caution that they will weaken science and harm healthcare policies. On February 19, HHS Secretary Robert F. Kennedy Jr. released new federal guidelines that strictly define sex as an unchanging biological category based on reproductive function. The memo claims that sex is genetically determined at birth and does not change throughout life, making it clear that biological sex cannot be altered by medical treatment or self-identification.

Also Read: Department of Health And Human Services Updates Its Guidance For Gender To Comply With Trump's Executive Orders

The government of the United States abruptly terminated at least 68 grants which were awarded to 46 institutions. This was a total of $40 million in funding. These grants were supporting research which was related to LGBTQ health, and included HIV prevention, youth suicide, cancer and bone health. While some of these funds have already been used, at least $1.36 million was withdrawn from future support. This figure is also an undercount, as estimates were available only for a portion of the cancelled grants.

A new law in South Dakota has restricted transgender people's use of communal facilities in public schools and state-owned buildings. This was implemented from July 1 2025.

The Centers for Disease Control and Prevention (CDC) retracted references to transgender people, gender identity, and equity from its website. This change followed the executive order and a directive from the Federal Office of Personnel Management instructing agencies to eliminate taxpayer-funded programs reflecting "gender ideology". The guidelines issues on Wednesday asked to end "all agency programs that use taxpayer money to promote or reflect gender ideology", and was signed by President Trump.

According to a latest BBC report, GPs think that many people in England are being over diagnosed with mental health problems. Being stressed does not mean an illness. As per the commonly held view by family doctors, the society tends to over medicalize normal life stresses. However, the doctors are also concerned about the difficulty for the patients who actually have a mental health condition.

Earlier this week, the Health Secretary launched an independent review to understand why more people in England are seeking mental health, ADHD and autism services, and to identify where support is currently falling short.

BBC News sent a questionnaire to more than 5,000 GPs in England to understand their experiences supporting patients with mental health concerns. The 752 responses that came back show just how complicated and emotionally heavy this workload has become for many family doctors.

Of those who took part, 442 GPs said they believed over-diagnosis was a problem. Most felt mental health issues were being slightly over-diagnosed rather than significantly. At the same time, 81 GPs felt the opposite and said under-diagnosis was still a real concern.

Concerns about Limited Support

Over-diagnosis was far from the only issue. Many GPs told us they were deeply worried about the lack of meaningful support available for patients who come to them in distress. The questionnaire included both multiple-choice questions and an open invitation to leave anonymous comments, which many used to explain their frustrations.

One of the most common sentiments was summed up by a GP who said, “Life being stressful is not an illness.” Another reflected on how much expectations have changed, noting that society seems to have forgotten that heartbreak and grief are painful but still part of normal life. Another GP argued that labels like anxiety or depression risk medicalizing everyday emotional struggles, and this could pull resources away from people facing severe and complex needs.

A small number were openly critical of certain patients, with one describing them as “dishonest and narcissistic” and taking advantage of a system that is free at the point of use.

Rising Need Across Age Groups

According to NHS England, one in five adults lives with a common mental health condition. The rate is even higher among young people, where it rises to one in four for those aged 16 to 24.

GPs who responded to the questionnaire identified young adults between 19 and 34 as the age group most in need of mental health support. Some felt young people have become less resilient since the pandemic, with a stronger focus on seeking a diagnosis instead of learning coping strategies. Others disagreed and said the real problem was that services have become increasingly hesitant to assess and diagnose people when needed.

A Growing Workload for GPs

There are nearly 40,000 fully qualified GPs in England. While the responses cannot represent every doctor across the country, they do reveal clear patterns. Almost all GPs with more than five years of experience said the amount of time they now spend on mental health has risen sharply.

They pointed to three main reasons for this increase:

• Supporting patients who are unable to access good quality mental health services elsewhere

• Helping people whose mental health is affected by practical issues like housing, employment or financial pressure

• Seeing patients who believe they have a mental health condition when they may be dealing with normal life challenges

Earlier this year, the Health Secretary said mental health conditions were being over-diagnosed and too many people were being written off. He has since acknowledged that his comments were divisive and did not reflect the full complexity of the situation.

Demand That Services Cannot Meet

It is estimated that 2.5 million people in England have ADHD, including many without a formal diagnosis. Some NHS ADHD services have already stopped accepting new patients because they cannot cope with the demand. Many individuals have told the BBC just how difficult it has become to find proper assessment and care.

Overall, most GPs agreed that the system is not keeping up. Of the 752 respondents, 508 said there was rarely or never enough good quality mental health support for adults in their area. An even larger number, 640, said they were worried about getting young patients the help they need.

One GP called the state of mental health support “a national tragedy”. Another described the situation for children starkly: “A child literally needs to be holding a knife to be taken seriously and the second that knife is put down, services disengage.”

The Pressure to Prescribe

GPs were also asked whether they prescribe medication because they worry patients will not get other types of support, like talking therapies, quickly enough. The most common answer was yes, and that they do this routinely. One GP admitted they often reach for antidepressants even though they know it may only offer short-term relief and does little to prevent future episodes.

Professor Victoria Tzortziou Brown, chair of the Royal College of GPs, said family doctors face a difficult balance. Patients increasingly expect a diagnosis, yet not every emotional difficulty meets the criteria for one. She added that society needs to be careful not to medicalize the full range of normal feelings but also must avoid dismissing genuine concerns.

Fraser Olender, known from Below Deck, recently shared that he was hospitalized with a lung injury and a heart attack linked to vaping. The 33-year-old posted photos from his hospital bed and explained that the episode began with sudden chest pain and trouble breathing. He later learned that he had developed EVALI, or E-cigarette or Vaping-Associated Lung Injury, along with a coronary artery vasospasm that reduced blood flow to his heart. His experience has renewed questions about the real risks of vaping, especially for young adults who may assume it is a safer option.

Deck’s Fraser Olender Says Vaping Triggered His Heart Attack

Olender described being rushed to the hospital after severe chest discomfort and breathlessness. Over the next week, doctors ran tests and confirmed that he had EVALI, a condition first identified in 2019. It can include several serious complications, such as bronchiolitis obliterans and acute respiratory distress syndrome. Many patients require intensive care.

During his evaluation, doctors also found that his arteries had tightened suddenly, cutting off oxygen to part of his heart. This led to an ST-elevation myocardial infarction, a type of heart attack usually caused by a blocked artery. In his case, there was no blockage. The spasm alone was enough to trigger the event.

What Is Coronary Artery Vasospasm?

A coronary artery vasospasm occurs when the vessels supplying blood to the heart contract sharply. Reduced blood flow deprives the heart muscle of oxygen. When this lasts long enough, it can cause injury similar to a traditional heart attack. Vaping can contribute to these spasms by irritating blood vessels, upsetting the balance of oxygen in the lungs, and releasing chemicals that cause inflammation.

Cardiologists note that nicotine and other compounds in vape aerosols can cause the blood vessels to narrow, raise heart rate, and place stress on the heart even in otherwise healthy adults.

Why Doctors Warn About EVALI

EVALI has been linked to a wide range of vaping products. Symptoms include shortness of breath, chest pain, gastrointestinal upset, and fatigue. The condition inflames the lungs and interferes with oxygen exchange, which increases pressure on the heart. For some people, the damage appears suddenly, even after periods of regular use without symptoms.

Olender’s Recovery and Warning to Others

Olender wrote that the pain during the episode was intense and unrelenting. Multiple rounds of morphine offered little relief. He said the incident convinced him to quit vaping immediately.

He urged others to stop as well, calling the habit a needless risk. He added that soon after quitting, he noticed improvements in his skin and overall energy, something he had not expected.

Vaping is often marketed as a cleaner alternative to smoking, yet its long-term effects on the lungs and heart remain uncertain. Olender’s story highlights the need for awareness. Sudden heart complications, vessel spasms, and lung injury can occur in people with no prior health issues. Doctors continue to study the chemicals released in aerosols and how they affect blood vessels, lung tissue, and the cardiovascular system.