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 UK coroner's court is currently examining whether a popular weight loss medication is linked to the death of a 73-year-old woman. She developed severe abdominal pain shortly after increasing her dose of Mounjaro (tirzepatide).

The incident has highlighted the importance of recognizing warning signs that go beyond the drug's common side effects and seeking immediate medical help.

What Happened?

Caroline Savage, a resident of Wortwell in Norfolk, had been using Mounjaro through a private prescription for around four months to manage obesity.

According to evidence presented during the inquest, she had recently been advised to increase her dose from 7.5 mg to 10 mg after losing about 14 kg.

On October 18, 2024, Savage developed sudden, severe abdominal pain and was taken to Norfolk and Norwich University Hospital.

Doctors evaluated her for pancreatitis, a known but uncommon complication of GLP-1 weight loss medications, and ruled out an abdominal aortic aneurysm before discharging her with pain relief.

Hours later, she collapsed at home and died despite emergency efforts. A post-mortem found the cause of death to be faecal peritonitis, a life-threatening infection caused by a perforation in the intestine.

Also read: After ‘Ozempic Face’, Experts Warn of ‘Ozempic Hair’; Why Are GLP-1 Users Facing Hair Loss?

No Proof Of Direct Cause

Medical experts told the inquest that there is currently no established evidence linking Mounjaro directly to faecal peritonitis.

However, they discussed the possibility that in people with an underlying bowel condition, like diverticular disease, the medication's gastrointestinal effects could theoretically increase pressure within the intestine and contribute to a perforation.

Savage, although, had not been diagnosed with diverticular disease.

The coroner has not reached a final conclusion, and the inquest has been adjourned pending a narrative verdict later this month.

Also read: Using Compounded GLP-1 Drugs? Here's What Doctors Want You to Know

Family's Concerns Over Hospital Assessment

Representing the family, barrister Jasmine Leng argued that Savage's symptoms may have been attributed to expected side effects of Mounjaro rather than prompting further investigations.

She also questioned whether repeated pain assessments conducted after morphine administration may have underestimated the severity of her condition.

Lawyers representing the NHS trust acknowledged that documentation "wasn't as good as it could have been" but maintained that clinicians followed appropriate assessment methods and denied medical negligence.

Also read: Novo Nordisk Sues Eli Lilly Over Weight-Loss Drug Ads: Should GLP-1 Users Be Concerned?

Mounjaro Side Effects

Mounjaro belongs to the GLP-1 receptor agonist class of medicines, which slows stomach emptying and helps reduce appetite. As a result, nausea, vomiting, constipation, diarrhoea and abdominal discomfort are among some of its most common side effects.

However, experts say persistent, severe or worsening abdominal pain, especially when accompanied with vomiting, fever, bloating or an inability to pass stools, should never be dismissed as common side effects.

Such symptoms can indicate serious complications, including pancreatitis, bowel obstruction or, in rare cases, intestinal perforation, all of which require urgent medical attention.

The case comes after another UK death drew focus on the safety of GLP-1 weight loss drugs.

In 2024, Scottish nurse Susan McGowan's death certificate showed prescribed tirzepatide as a contributing factor alongside pancreatitis, septic shock and multiple organ failure.

Regulators have maintained that the overall benefits of these medicines outweigh their risks when used as prescribed.

Chipotle has gotten rid of jalapeño peppers from some of its restaurants after health officials identified them as a possible source of a Salmonella outbreak that has sickened at least 110 people, mostly in Minnesota.

The investigation is ongoing, and authorities say the contaminated ingredient may also have reached other Mexican-style restaurants.

About The Salmonella Outbreak

The Salmonella outbreak is being investigated by the Minnesota Department of Health, the U.S. Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC).

At least 75 of the 84 people interviewed reported that they ate at Chipotle between June 14 and July 14. This has prompted health officials to look into all the ingredients served in those meals.

In response, Chipotle said it used its ingredient traceability system to identify a common lot of jalapeños that may be linked to the illnesses. It also said that it has replaced those peppers with stocks from different vendors.

"We immediately activated our traceability systems, identified the common lot of jalapeños and removed them from our restaurants," the company said, adding that it is cooperating with public health authorities in order to contain the outbreak.

Carlota Medus, senior epidemiologist supervisor at the Minnesota Department of Health, said investigators believe the contaminated peppers may have been supplied to more than one restaurant chain.

"It's not just Chipotle," Medus said, noting that other Mexican-style restaurants could also have received the same batch of peppers. She added that additional cases are expected because it can take weeks for infections to be diagnosed and reported.

Also read: US FDA Identifies New Cyclospora Outbreak As Michigan Cases Top 7,000: Why Is The Source So Hard To Trace?

What Is Salmonella?

Most healthy people recover within a week, but young children, older adults and those with weak immune systems face a higher risk of severe illness who often end up requiring hospitalization.

Also read: FDA Launches An Online Tool That Can Check Contaminant Levels In Foods

Not The First Time Jalapeños Have Come Under Scrutiny

Fresh produce like peppers can get contaminated anywhere along the supply chain, including during growing, harvesting, processing or distribution.

As jalapeños are eaten raw in foods like salsa, burrito bowls and tacos, any contamination may survive and end up infecting people.

This is not the first time jalapeño peppers have been linked to a major Salmonella outbreak.

In 2008, U.S. investigators traced an outbreak in multiple states that involved more than 1,400 illnesses linked primarily to contaminated jalapeño and serrano peppers imported from Mexico.

Also read: Is Unpasteurized Apple Cider Making You Sick? Here's What You Should Know

Chipotle's Previous Health Controversies

The latest investigation comes more than a decade after Chipotle faced a series of high-profile food safety incidents involving E. coli, norovirus and Salmonella between 2015 and 2018.

Those outbreaks prompted the restaurant chain to overhaul its food safety protocols, strengthen ingredient traceability and establish stricter food handling practices.

Officials stress that the current investigation is still underway, and no final determination has been made linking the outbreak exclusively to jalapeños.

The FDA is currently conducting an investigation to determine where the suspected peppers originated and whether they were distributed to other restaurants or states.

Eli Lilly has launched an early access program that will allow a limited number of patients with severe obesity to receive its experimental weight loss drug retatrutide before it receives approval. The program is only open to a limited number of eligible patients.

According to the company, adults aged 18 years and older may qualify if they have refractory obesity, meaning they have not achieved adequate weight loss despite receiving the highest approved doses of currently available obesity medications.

Patients must also have at least two obesity-related health conditions, like type 2 diabetes, cardiovascular disease, or obstructive sleep apnea.

They must also be patients who were unable to enroll in an ongoing clinical trial related to retatrutide or a similar investigational medicine.

The expanded access, also known as a 'compassionate use' program, is intended for patients with serious medical conditions who have exhausted approved or existing treatment options.

"Retatrutide is currently an investigational medicine and has not yet been approved by regulatory authorities," Eli Lilly said, adding that the drug should only be accessed through authorised clinical trials or its expanded access program.

Also read: UK Woman Spends £4,000 On Wegovy, Mounjaro, But Loses Less Than 14 Pounds In 15 Months

What Is Retatrutide?

Retatrutide is one of Eli Lilly's next-generation obesity treatments which is currently under development.

Unlike its currently approved GLP-1 drugs, retatrutide activates three hormone receptors: GLP-1, GIP and glucagon.

Researchers believe that this triple-action approach could help people lose shed excess weight by reducing appetite as well as increasing their energy expenditure at the same time.

Also read: Johnson & Johnson Talc-Cancer Row: Pharma Co To Pay 5.5 Billion To Settle Its Decade-Long Controversial Lawsuits

Promising Results

The drug has piqued significant interests from patients after its late-stage clinical trials showed some of the highest weight loss outcomes seen with an obesity medication.

In the drug's Phase 3 studies, adults without diabetes who received the highest dose lost more than 28% of their body weight over 80 weeks.

More recently, Eli Lilly reported that overweight or obese adults living with type 2 diabetes achieved an average weight loss of 20.8%, further proving the drug's efficacy in different patient groups.

Also read: Using Compounded GLP-1 Drugs? Here's What Doctors Want You to Know

The company plans to submit retatrutide for approval to the US Food and Drug Administration (FDA) in the first quarter of 2027.

The early access announcement comes as Eli Lilly continues to build its portfolio of weight loss medications.

The company recently released additional Phase 3 data on retatrutide while announcing its plans to obtain regulatory approval in 2027.

Beyond retatrutide, Lilly is also advancing orforglipron, an investigational oral GLP-1 pill, alongside expanding access to its approved obesity medicine Zepbound.

What Patients Should Know

Health experts note that expanded access programs are not the same as regulatory approval. They are meant for select patients who could not participate in the clinical trials and thus have limited treatment options.

Patients are also advised not to seek investigational medicines through unofficial online sellers or unregulated sources, as retatrutide has not yet been approved by the FDA.

The drug's safety and quality can only be ensured through authorised clinical studies or Eli Lilly's official expanded access program.