Editor's Note: The 2025 Asia-Pacific AIDS & Co-Infections Conference (APACC 2025) recently concluded successfully in Tokyo, Japan. The conference centered on advances, key issues, and practical needs in HIV and co-infection control across the Asia-Pacific region. As one of the conference chairs, Dr. Junko Tanuma from the International University of Health and Welfare (Japan) granted an exclusive interview to Infectious Disease Frontier during the event. Dr. Tanuma provided an in-depth analysis of critical challenges in global HIV/AIDS control, highlighted the alarming resurgence of syphilis (including neurosyphilis and congenital syphilis) worldwide, and advocated for regulatory reforms addressing Japan's delayed policy responses.IDF: As the Conference Chair, could you highlight key agenda innovations? How will Japan facilitate multinational collaboration on HIV and co-infection management across the Asia-Pacific region?
Dr. Tanuma: Firstly, I would like to emphasize that this conference was held at a critical time. We have significant innovations to help end HIV/AIDS, such as long-acting injectable medicines for PrEP and HIV self-testing, and these are being expanded through implementation science. However, due to decreased investment in HIV-specific programs, we are now facing a crisis of underfunding.
Therefore, during this conference, I drafted a petition letter to the government to initiate discussions with the authorities on how to sustain investment from these countries. By gathering voices from abroad, this effort proved effective. We successfully submitted the petition to both the Minister of Foreign Affairs and the Minister of Health. I will watch their response closely and hope that Japan will continue to contribute to global HIV control.
IDF: Your report indicates a surge in cases of neurosyphilis among pregnant women. What are the primary contributing factors to this trend?
Dr. Tanuma: As I addressed in my presentations, there is an underlying syphilis epidemic affecting not only women of reproductive age but also men. This trend is evident not only in Japan but globally. Therefore, the surge in neurosyphilis may be linked to this global pattern. Additionally, congenital syphilis is re-emerging, as I previously described. Consequently, we must first recognize the critical importance of testing during pregnancy and being vigilant for clinical manifestations to enable early diagnosis. This awareness will be a key factor not only in addressing the syphilis surge but also in mitigating the rising burden of congenital syphilis.
IDF: To further optimise the management of sexually transmitted infections (STIs) such as syphilis, what key areas do you believe need to be improved by regulatory authorities, healthcare institutions, and communities?
Dr. Tanuma: My comments primarily concern the regulatory authorities in Japan. HIV self-testing has not yet been sufficiently promoted. The delay in its expansion is largely attributable to the delayed regulatory process for HIV self-testing kits, or what I would refer to as HIV mailing testing kits. We aim to overcome this delay and expand the utilization of such testing in the future.
