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.

A parliamentary committee in Canada has recommended that the country's assisted dying laws continue to exclude people whose sole underlying condition is a mental illness.

According to the committee's report, Canada's assisted dying framework should "indefinitely exclude" individuals whose only medical condition is a mental illness.

Canada first passed its assisted dying legislation, known as Bill C-14, in 2016, marking a significant development in healthcare and personal autonomy.

Officially known as Medical Assistance in Dying (MAID), the law initially applied only to adults who were terminally ill. However, eligibility for MAID has remained one of the country's most contentious healthcare issues over the past decade, with plans to expand access delayed twice.

Committee Recommends Permanent Exclusion

The 98-page report by the joint House and Senate committee on Medical Assistance in Dying contains a single recommendation: that Canada "indefinitely exclude persons whose sole underlying medical condition is a mental illness from eligibility for medical assistance in dying", according to the BBC.

The report noted a "divergence of perspectives" on the issue and highlighted concerns raised during testimony about the "pressing need for increased and more equitable access to adequate mental health services".

However, some committee members disagreed with the findings and published a dissenting report, arguing that the process was "fundamentally flawed", "biased", and favored testimony from those opposed to expanding MAID. Canada's government must respond to the report by July 11.

Also read: Noelia Castillo: 25-year-old Spanish Woman Dies By Euthanasia After Long Legal Battle

What Does Canada's MAID Law Say?

When MAID was introduced in 2016, it was available only to adults who were terminally ill.

The eligibility criteria were strict. Individuals had to be suffering from a "serious and incurable illness", be in an "advanced state of irreversible decline", experience "intolerable suffering", and have a natural death that was "reasonably foreseeable".

This legal pathway became known as Track 1. Modelled on end-of-life care, it primarily served people with terminal cancer or other severe illnesses who wanted greater control over the dying process. Track 1 remains a relatively swift procedure, with some patients receiving MAID within a day of applying.

Expansion Beyond Terminal Illness

Read More: Passive Euthanasia: Harish Rana’s Case May Reshape End-of-life Protocols, Say Experts

However, many Canadians living with severe non-terminal conditions argued that they were excluded from the law. These included people with degenerative diseases, chronic pain, or spinal injuries who experienced significant suffering but were not nearing death. Many requested MAID but were routinely denied.

In 2019, the country introduced Bill C-7 in 2021, creating Track 2 and extending MAID eligibility to people with serious, incurable conditions causing enduring suffering even when death was not foreseeable.

Track 2 includes additional safeguards, including a 90-day assessment period, evaluation by two independent clinicians, and consultation with specialists when necessary.

Ongoing Debate Over Mental Illness Eligibility

Despite its stricter safeguards and ethical complexities, Track 2 MAID has steadily gained use. In 2023, there were 622 deaths under Track 2 compared with 14,721 under Track 1.

Supporters view Track 2 as a compassionate option for people living with severe, non-terminal suffering, while critics argue it risks exposing vulnerable populations to premature death.

In 2023, Canada first delayed eligibility for MAID for people whose sole condition was a mental illness by one year, citing concerns that the healthcare system was not ready for the expansion. The government later delayed implementation again until March 17, 2027.

Along with the second delay, the government recommended that a parliamentary committee undertake a comprehensive review of the proposal.

MAID Accounts For About 5% of Deaths in Canada

According to the latest available figures from 2024, MAID accounts for around 5 per cent of all deaths in Canada. About 96 per cent of MAID cases involved people whose deaths were reasonably foreseeable, most of them terminal cancer patients.

The remaining 4 per cent involved patients whose deaths were not imminent but who had a "grievous and irremediable medical condition".

The United States is witnessing a rise in cases of Powassan virus disease, a rare but potentially deadly illness transmitted through tick bites. Unlike many other tick-borne diseases, Powassan virus can be transmitted within 15 minutes of a tick attaching to the skin, making prevention and awareness especially important.

According to the US Centers for Disease Control and Prevention (CDC), tick exposure can occur throughout the year, although ticks are most active during the warmer months between April and September.

Emergency physician Dr. Rick Pescatore recently highlighted the growing threat in a TikTok video post, warning that many people remain unaware of the virus despite its severe health consequences.

"There's a new and deadly tick virus that's spreading across the United States, and you probably haven't heard about it," he said.

Pescatore emphasized the seriousness of the infection, noting that "about one in 10 people with severe disease die, while around half of survivors may experience permanent neurological damage". He also claimed that reported cases have increased steadily over the past decade.

Several state health departments have urged residents to take precautions after reporting cases of the rare disease.

In one recent case, a 66-year-old man from New Hampshire was hospitalized for several weeks after contracting the virus. After initially being admitted to Concord Hospital, he was later transferred to Massachusetts General Hospital for specialized care.

What Is Powassan Virus?

Also read: Taking Duloxetine? US FDA Warns of Cancer-Causing Impurity in Antidepressant

The Powassan virus is named after the town of Powassan in Ontario, Canada, where it was first identified in 1958. It belongs to the flavivirus family, which also includes viruses that cause Zika, dengue, and West Nile fever.

The virus is primarily spread by the black-legged tick (Ixodes scapularis), also known as the deer tick, which is also responsible for transmitting Lyme disease.

However, unlike Lyme disease—which generally requires a tick to remain attached for more than 24 hours before transmission—Powassan virus can be transmitted in as little as 15 minutes, according to the Massachusetts Department of Public Health.

Symptoms of Powassan Virus Infection

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Symptoms typically develop between seven and 30 days after a tick bite and may include:

• Fever
• Headache
• Vomiting
• Weakness
• Confusion
• Loss of coordination
• Seizures
• Difficulty speaking

These complications can lead to long-term neurological damage. According to Yale Medicine, approximately 10 per cent of severe cases are fatal, while nearly 50 per cent of survivors experience lasting neurological problems.

No Vaccine or Treatment Available

One of the most concerning aspects of the Powassan virus is that there is currently no vaccine or antiviral treatment available.

Unlike Lyme disease, which can be treated with antibiotics, Powassan virus has no specific cure. Medical care focuses on managing symptoms and supporting patients with severe disease.

As a result, prevention remains the most effective defense against infection.

How to Prevent Tick Bites

The CDC and the National Institutes of Health (NIH) recommend the following measures to reduce the risk of tick bites:

• Wear long-sleeved shirts and long pants when outdoors
• Choose light-colored clothing to make ticks easier to spot
• Tuck pants into socks or seal gaps in clothing
• Use insect repellents containing DEET, picaridin, or permethrin
• Stay in the center of hiking trails and avoid brushing against vegetation
• Check your body, clothing, pets, and outdoor gear for ticks after spending time outside
• Shower and wash clothing in hot water soon after returning indoors

If you find a tick attached to your skin, remove it promptly using fine-tipped tweezers.

Amid the ongoing Ebola outbreak caused by the Bundibugyo virus in the Democratic Republic of the Congo (DRC), the World Health Organization (WHO) has released its first comprehensive guidelines for the clinical management of filovirus diseases, a group that includes all Ebola and Marburg virus infections.

Ebola and Marburg diseases are severe, often fatal illnesses that have caused repeated outbreaks across Africa. Since the discovery of the Marburg virus in 1967, there have been 72 documented outbreaks of Ebola and Marburg diseases.

There are currently no licensed vaccines and treatments for Marburg virus disease, as well as Bundibugyo and Sudan virus diseases. Thus, the WHO emphasized that early supportive care remains one of the most effective ways to improve survival.

"The current Bundibugyo virus outbreak is a stark reminder of the need for diligent, holistic and person-focused medical care to save lives and preserve human dignity. We encourage governments and authorities to integrate these new recommendations into preparedness and outbreak response to ensure high-quality care for everyone," said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.

Also read: Ebola Bundibugyo Outbreak: UK Scientists Identify 23 Unique Mutations

What Do The New Guidelines Recommend?

The WHO has previously published disease-specific guidance on Ebola care and therapeutics. However, the newly released guidelines are the first to provide a comprehensive framework covering all filovirus diseases, including Ebola and Marburg.

Developed through consultations with global experts and based on the latest scientific evidence, the guidelines contain 16 evidence-based recommendations focused on improving supportive care and reducing mortality.

The recommendations are designed to help frontline healthcare workers:

• Identify clinical deterioration early
• Manage dehydration and shock effectively
• Improve patient monitoring
• Deliver critical supportive interventions safely
• Provide structured follow-up care for survivors

Key Recommendations include:

• Prioritizing Laboratory Testing
• Rapid Treatment of Dehydration
• Early Management of Shock
• Treatment should be guided by continuous monitoring of vital signs and indicators of tissue perfusion.
• Treat Secondary Bacterial Infections
• Provide Long-Term Follow-Up Care

The WHO also recommended structured after-care programs for survivors to support recovery, improve long-term well-being, and reduce the risk of infections linked to viral persistence after recovery.

Supportive Care Remains Critical

For Bundibugyo virus disease and other filovirus infections, WHO stressed that early recognition, rapid referral, and optimized supportive care remain the foundation of patient management.

Effective supportive care can reduce complications, improve survival, and provide the basis for evaluating potential antiviral treatments through future clinical research.

Ebola Outbreak Faced Major Contact-Tracing Gaps

Meanwhile, the Africa Centers for Disease Control and Prevention (Africa CDC) has raised concerns about significant weaknesses in contact-tracing efforts during the ongoing outbreak.

According to Africa CDC Director-General Dr. Jean Kaseya, more than 28,000 people who have been in contact with confirmed Ebola patients are currently not being monitored.

Responders should be tracking approximately 33,080 contacts, but only 4,112 are being actively followed, he said during a high-level meeting.

The agency warned that the outbreak is spreading at a pace that surveillance systems are struggling to keep up with.

Read More: Ebola Survivors May Face COVID-Like Memory Loss and Brain Issues For Over 7 Years: NIH Study

Ebola: More Than 800 Confirmed Cases

As per latest update till June 15, there are 827 confirmed Ebola cases linked to the outbreak in the Congo and 196 confirmed death.

Health officials estimate that each infected person may have come into contact with around 40 other individuals, creating a large pool of people at risk of infection.

Because Ebola can take up to 21 days for symptoms to appear, all identified contacts should ideally be monitored throughout the incubation period.

Africa CDC officials cautioned that without stronger surveillance and contact-tracing efforts, controlling the outbreak will become increasingly difficult, despite advances in clinical care and patient management.