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.

34-year-old ABC News correspondent Will Reeve, the son of late actor Christopher Reeve, recently revealed his testicular cancer diagnosis. He said that first noticed a tender lump that seemed like nothing but it turned out to be the first sign of cancer.

Reeve recently opened up about his diagnosis and treatment journey, revealing that he first noticed something unusual in his left testicle while showering in April. He initially thought it would go away.

“I assumed it was nothing or would go away,” He told People.

But his wife, Amanda Dubin Reeve, encouraged him to get it checked. He got an ultrasound and found out later that it was a mass. “It’s probably nothing,” she told him, “but what if it’s something?”

Reeve's story highlights the importance of catching signs of testicular cancer. Any change that seems minor should not automatically be dismissed, particularly if it persists.

Will Reeve's Testicular Cancer Diagnosis

After the ultrasound showed a mass, Reeve underwent surgery to remove the affected testicle, a procedure called an orchiectomy.

Testing showed that most of his cancer was embryonal carcinoma, an aggressive type of testicular cancer. Doctors subsequently found cancer in three lymph nodes in his abdomen, leading to another surgery and two rounds of chemotherapy.

“I hadn’t had surgery since I got my tonsils out at 5,” said Reeve. “So I was more nervous about the unknown of the surgery rather than the overwhelming realization that I would be losing an essential part of my body forever.”

He took a few days off work to recover and was declared cancer-free on September 8.

Also read: H. pylori, HPV Among Five Infections Behind 1 In 8 Cancers Worldwide: Lancet

Early Signs Of Testicular Cancer

A lump on the testicle is one of the most common first signs of testicular cancer. The lump may or may not always be painful. Other possible changes include:

• Swelling or enlargement of a testicle
• A feeling of heaviness in the scrotum
• An ache or discomfort in the testicle or lower abdomen
• A change in the size or consistency of a testicle
• Breast enlargement or tenderness in some cases

The American Cancer Society notes that many of these symptoms can also be caused by other conditions that are not cancer, including infections or injuries. However, any unexplained lump or persistent change should be evaluated by a doctor.

This is one reason a new lump can be easy to overlook. Most testicular cancers do not cause pain, although some tumours can cause aching or discomfort. In Reeve's case, the lump was tender, but he initially assumed it was nothing serious.

Also read: IARC Says Low-Dose CT Can Cut Lung Cancer Deaths: AIIMS Expert Explains Why India Needs Its Own Screening Evidence

Who Is At Risk?

Testicular cancer is generally uncommon overall, but it is the most common cancer in young men, particularly those in their teens and 20s.

Certain factors can increase risk, including having had an undescended testicle, a previous testicular tumour or a family history of testicular cancer.

If you notice a lump or a tender swelling on your testicles, get evaluated by a medical professional immediately.

A doctor can examine the testicle and may recommend an ultrasound, which can help determine whether a mass is present and whether further evaluation is needed.

Before jumping to conclusions, remember that conditions like infections, fluid accumulation or enlarged veins can also cause swelling or changes in the testicle. But the only way to know what is causing the new change is to get it checked.

Amid rising demand for surgical care, the US is expected to face a significant shortage of surgeons by 2038, according to the first unified assessment of the country’s surgical workforce.

The study, presented at the American College of Surgeons (ACS) Clinical Congress 2026, projects that the US will face a shortfall of 27,940 surgeons nationally.

This comes as demand for surgeons is projected to increase by 12.8%, while the overall surgeon workforce is expected to decline by 4.2% between 2023 and 2038. The workforce would meet just 84.3% of projected national need.

“Studies usually look at one specialty at a time, so a shortage looks like that specialty’s problem,” said lead author Fernando Ribeiro Duraes, a medical student at Case Western Reserve University School of Medicine.

“When you put all 10 specialties together, you can see supply is projected to fall while demand keeps rising, and that the gaps are worse in rural areas. The fixes have to be targeted by specialty and by geography, not incremental.”

Which Specialties Will Face The Biggest Shortages?

Researchers used the Health Workforce Simulation Model (HWSM), a federal model from the US Department of Health and Human Services, to analyze surgeon supply and demand across 10 surgical specialties from 2023 to 2038.

The analysis found that overall surgeon supply is projected to decline 4.2% from 2023 to 2038, while demand is expected to rise 12.8%.

The specialties projected to face the most critical shortages include:

• Vascular surgery — 65.8% of need met
• Ophthalmology — 71.8%
• Thoracic surgery — 73.1%
• Plastic surgery — 74.1%
• Urology — 84.4%
• Otolaryngology — 87.5%
• Orthopedics — 87.9%
• Neurosurgery — 88.7%

Only general surgery, at 91.3% and colorectal surgery, at 98.3%, are projected to remain close to meeting demand.

At the same time, the gaps between surgeon supply and demand are also projected to be greater in rural areas.

What Could This Mean For Patients?

For patients, surgical shortages could mean longer waits for procedures.

Patients may also need to travel farther for medical care, particularly in rural areas where some people may have to drive hours to access treatment.

The researchers said the findings point to the need for targeted workforce policies and geography-focused strategies rather than incremental changes.

Duraes pointed to a proposed bill, H.R. 3890, the Resident Physician Shortage Reduction Act, as one potential response.

The bill would increase the number of residency positions, which the ACS says has not changed since 1997. It also proposes addressing federal student loan limits and expanding loan-forgiveness programmes to encourage physicians to practise in rural areas.

“The fixes have to be targeted by specialty and by geography” if they are expected to work, Duraes said.

Global Health Workforce Crisis

The US shortage projection comes amid broader concerns about health workforce shortages worldwide.

Nearly one in four doctors globally is older than 55 and could retire within the next decade, according to the World Health Organization’s National Health Workforce Accounts: Health Workforce Levels and Trends 2026.

The report, the first in an annual series providing a global picture of health workforce levels and trends, said ageing among health workers is intensifying shortages in some countries, while population ageing is simultaneously increasing demand for healthcare services.

The global health worker shortage has fallen from 20 million in 2013 to 15 million in 2020. However, newer analysis has revised the projected shortage for 2030 upward to 11.1 million, compared with an earlier estimate of about 10 million.

The Ebola outbreak, declared an emergency in May, continues to spread in the Democratic Republic of the Congo (DRC). According to the latest update from DRC health authorities, confirmed cases have surpassed 8,000, while the death toll is nearing 4,000.

The World Health Organization (WHO) warned that the outbreak remains large, geographically expanding and marked by sustained transmission.

The DRC “had recorded 8,067 confirmed cases, including 3,901 deaths, with a case fatality rate of 48.4 per cent,” according to the latest government situation report. It has spread to seven health zones.

“The continuously high case fatality ratio, and especially the continuous high rate of deaths occurring in communities, highlights the seriousness of the disease and the persistent challenges in timely case detection and access to early and adequate patient care,” the WHO said in its latest Disease Outbreak News.

However, Dr Janet Diaz of the WHO’s Health Emergencies Program told reporters in Geneva that “we are beginning to see a reduction in transmission in some areas, the number of cases remains high for this outbreak”.

Treatment Delays Remain A Concern

Dr Diaz said that although it is known that “early access to care can significantly improve chances of survival,” “Yet in this outbreak, many people are still dying at home or in their communities because they are unable to reach health facilities on time.”

“Delays in seeking care, together with challenges in access and referral, continue to complicate the response,” she said, adding that WHO and its partners have focused on improving early recognition of illness, rapid referral systems and early supportive care.

“Every patient bed requires a skilled workforce to provide safe, quality care around the clock,” Dr Diaz said.

Oxygen Access A Key Challenge

A key component of supportive care for patients with Ebola, particularly those with severe illness, is oxygen. Yet this life-saving medicine remains “unavailable or unreliable in many health facilities, especially in emergency settings”.

Ensuring access to oxygen requires functioning health systems, reliable infrastructure, trained health workers and sustainable delivery systems “that reach patients wherever they are”.

“Without previous oxygen scale-up efforts in Ebola and Marburg [virus disease] responses, we would not be where we are today in terms of more positive outcomes for patients,” she noted.

Vaccine Trials Underway

While there is currently no approved vaccine against Ebola Bundibugyo virus, vaccine trials are underway.

Clinical trials of specific vaccines and treatments against the Bundibugyo virus are also ongoing. The DRC also received more than 70,000 doses of the Ervebo vaccine last month. Ervebo is approved for protection against the more common Zaire Ebola virus.

DRC’s 17th Ebola Outbreak

The outbreak, caused by the rare Bundibugyo virus, was declared by the WHO on May 15. It is the DRC’s 17th Ebola outbreak since the virus was first identified in 1976.

It is also the second-deadliest Ebola outbreak on record, behind the West African outbreak that lasted from 2014 to 2016.