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.

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

Amid increasing reports of a rare form of sudden vision loss called nonarteritic anterior ischemic optic neuropathy (NAION) following the use of drugs such as Ozempic, Wegovy and Mounjaro, the U.S. Food and Drug Administration (FDA) has ordered GLP-1 drugmakers Novo Nordisk and Eli Lilly to add warnings about the potential eye risk to their drug labels.

NAION can cause sudden, painless vision loss in one eye and, in some cases, permanent impairment.

In a Drug Safety Communication, the FDA informed patients and healthcare providers about the potential increased risk associated with these medicines. It is requiring manufacturers to include information about NAION in the Warnings and Precautions section of their drug labels.

The agency said it evaluated clinical trial data, animal studies and post-marketing evidence, including observational studies and case reports.

GLP-1 Users File Lawsuits Over Vision Loss

Also read: Hundreds Of American GLP-1 Users Sue Novo Nordisk, Eli Lilly Over Vision Loss: What Is NAION?

The FDA action comes amid lawsuits filed by people who allege they developed NAION after taking GLP-1 drugs such as Ozempic and Wegovy.

According to The Wall Street Journal, US law firm Weitz & Luxenberg has filed more than 90 lawsuits in New Jersey state court since 2025 on behalf of people who say they developed the condition while taking these medicines.

Separate federal lawsuits in Philadelphia accuse Novo Nordisk and Eli Lilly of failing to provide adequate warnings about the potential eye risk. The cases are pending. The allegations do not establish that the medicines caused the condition.

Regulators in Europe and Australia have also required warnings about a possible increased risk of NAION with some GLP-1 medicines.

In the US, vision problems are listed as possible side effects, but NAION had not previously been included as a specific risk in FDA-required labelling. The FDA's Sentinel Initiative is also reviewing the possible safety signal.

What Is NAION?

NAION is the most common acute optic neuropathy in people over 50, according to the Mayo Clinic. It occurs when blood flow to the optic nerve is reduced, damaging the nerve that carries visual information from the eye to the brain.

The condition typically causes sudden, painless vision loss in one eye. While some patients may experience partial improvement, the damage can be permanent. There is currently no proven treatment to reverse the vision loss.

Diabetes itself increases the risk of NAION, independent of GLP-1 use. Other risk factors include low blood pressure during sleep and having a small optic nerve cup.

What Does Research Say About The Risk?

Read More: Wegovy More Likely To Cause Rare Blindness Than Ozempic And Other Similar Drugs, Recent Study Finds

The potential association between GLP-1 medicines and NAION has been under regulatory review internationally.

Last year, the European Medicines Agency's safety committee said NAION may affect up to one in 10,000 people taking semaglutide for at least one year. Semaglutide is the active ingredient in Ozempic, Wegovy and Rybelsus.

The Danish Patient Compensation Association also granted compensation to four patients who experienced vision loss after using Novo Nordisk's GLP-1 medicines.

A large study published in 2025 tracked nearly 175,000 people with diabetes taking semaglutide and an equal number taking non-GLP-1 medicines. It found that the risk of NAION was more than twice as high after two years of treatment with semaglutide compared with other diabetes medicines.

However, an observed association does not establish that the medicines directly caused the condition.

The FDA routinely monitors medicines after they enter the market, evaluates potential safety signals and takes regulatory action when appropriate.

The developing El Niño event could intensify heatwaves, droughts and extreme rainfall into 2027, increasing health risks worldwide, including heat-related illnesses and infectious diseases such as dengue, malaria and cholera, according to a new World Meteorological Organization (WMO) report.

The State of the Climate in 2026 report, released during COP31 in Türkiye, warned that El Niño will amplify the health impacts of climate change.

In view of this, the World Health Organization (WHO) has, for the first time, classified the anticipated health impacts as a health emergency.

The report warns of increased heat-related deaths, wildfire smoke exposure, poor air quality, malnutrition, injuries and changing risks of water- and vector-borne diseases.

"We have entered a new age of climate extremes. A supersized El Niño is colliding with a planet already superheated by manmade climate change," UN Secretary-General António Guterres said.

How Could El Niño Affect Health?

Read More: Climate Change Is Already Harming Health: WHO Chief Pushes Antalya Initiative At COP31

El Niño is a natural climate phenomenon involving warmer-than-average sea-surface temperatures in the central and eastern equatorial Pacific. It influences weather patterns worldwide and can raise global temperatures. The current event is expected to continue into early 2027.

According to the WMO, its health impacts could include:

• Extreme heat: More intense heatwaves, heat-related illnesses and deaths.
• Poor air quality: Increased wildfire smoke and pollution exposure.
• Infectious diseases: Changing risks of dengue, malaria and cholera.
• Food insecurity: Disrupted agriculture, malnutrition and water shortages.
• Extreme weather injuries: Greater risks from floods, storms and other disasters.

Vulnerable communities with limited healthcare access and high dependence on rain-fed agriculture could face the greatest risks.

2026 Among Four Warmest Years On Record

Further, the report noted that the past 12 years have individually been the warmest on record, with 2023–2026 ranking as the four warmest.

Global average temperatures from January to September 2026 were 1.47°C above the 1850–1900 pre-industrial average. The figure could rise further by year-end as El Niño strengthens. The event has been intensifying since August and is forecast to continue into early 2027.

WMO Secretary-General Celeste Saulo said El Niño was releasing heat from already warming oceans.

"El Niño doesn't add new heat to the planet. It releases heat from the ocean, which is the warmest ever measured. There is simply more heat available to release," she said.

Extreme Weather Is Already Taking A Toll

The report highlights the human cost of climate extremes across several regions.

• Europe: Heatwaves, droughts and wildfires contributed to more than 30,000 excess deaths, according to preliminary estimates.
• India: An estimated 146.5 million people were exposed to extreme heat during an April 2026 heatwave.
• Nepal: A glacier collapse and downstream flash floods in August killed more than 1,300 people and severely affected the country's economy.

Oceans Continue To Warm As Glaciers Melt

Also read: Global Temperatures Likely To Stay Near Record Levels For Next Five Years: WMO

Earth's energy imbalance reached its highest level since monitoring began in 1960, as greenhouse gases trap more heat in the climate system.

The oceans absorb around 90% of this excess heat. Ocean heat content in the upper 2,000 metres reached a record high in 2025 and continued rising in 2026.

Global sea levels also reached a record high in 2026, driven by melting glaciers and ice sheets and the expansion of warming seawater.

Early Warning Systems Show Progress

The number of countries reporting multi-hazard early warning systems increased from 56 in 2015 to 136 in 2025.

These systems help communities prepare for extreme weather and reduce risks to lives and livelihoods.

The WMO stressed that sustained climate monitoring and reliable forecasts are increasingly important as extreme weather intensifies.