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A groundbreaking deal is set to make a highly effective HIV prevention drug, Lenacapavir, available at a fraction of its current cost in more than 120 low- and middle-income countries. Health experts say the move could dramatically widen access to life-saving treatment and push the world closer to the long-term goal of ending the HIV/AIDS epidemic.
From $28,000 to Just $40
Currently, the injectable treatment, approved for use in both the United States and Europe, costs about $28,000 per person annually. However, under the newly announced agreement, the price is expected to be reduced to $40 per year, with rollout anticipated from 2027. That is less than 0.1% of the current cost, making the medicine accessible to millions who would otherwise be unable to afford it.
The deal was brokered through a collaboration between the Clinton Health Access Initiative, the Bill & Melinda Gates Foundation, and South Africa’s Wits Reproductive Health and HIV Institute (Wits RHI), among other partners.
“For many countries with limited resources, affordable HIV prevention is not a luxury but a necessity,” explained Professor Saiqa Mullick of Wits RHI. She emphasized that Lenacapavir has “the potential to transform HIV prevention strategies, especially among young people and marginalized groups who often face barriers to consistent healthcare access.”
How Lenacapavir Works
Lenacapavir is a long-acting injection given just twice a year, offering six months of protection against HIV infection per dose. By stopping the virus from replicating inside human cells, it has shown impressive clinical trial results, including a 100% success rate in a 2023 Gilead Sciences trial.
The World Health Organization (WHO) endorsed the drug earlier this year, citing its potential to significantly reduce new infections among high-risk groups such as adolescent girls, young women, men who have sex with men, sex workers, and people who inject drugs.
Unlike oral PrEP (pre-exposure prophylaxis), a daily pill costing around the same $40 annually, Lenacapavir removes the need for daily adherence, which can be difficult for many due to stigma, accessibility challenges, or forgetfulness. According to the Gates Foundation, only 18% of people eligible for PrEP currently have access, highlighting the need for alternatives.
Potential Global Impact
Modeling studies suggest that increasing access to Lenacapavir to just 4% of the global population could prevent up to 20% of new HIV infections. Beyond prevention, researchers note that the drug can also be used in treatment regimens for people already living with HIV.
The wider distribution of Lenacapavir is particularly significant for South Africa, the country with the highest number of HIV cases worldwide, with nearly eight million people living with the virus. The country’s health ministry has already welcomed the agreement, saying it supports efforts to ensure “life-saving treatments are available and affordable for all who need them.”
Challenges Ahead
While the promise of a low-cost injection is historic, the path to implementation will require strong coordination. Regulatory approvals for the generic version are still pending, and governments will need to prepare healthcare systems to manage rollout, distribution, and uptake.
Professor Mullick stressed that the next phase involves “working hand-in-hand with governments, civil society, and communities to build demand, secure commitments, and ensure readiness for rapid scale-up.”
A Step Toward Ending the Epidemic
Globally, about 40 million people live with HIV, according to UNAIDS. Despite remarkable progress since the early 2000s, the world still saw 1.3 million new infections and more than 600,000 AIDS-related deaths last year.
This development comes at a critical moment, as international funding for HIV programs faces cuts, including reductions in U.S. foreign aid under the Trump administration. Advocates say the affordability of Lenacapavir could offset some of those gaps by giving vulnerable populations access to prevention methods once available only in wealthier countries.
If rolled out successfully, Lenacapavir could become a game-changing tool in global health, offering hope that the goal of drastically reducing HIV infections, and ultimately ending the epidemic, is within reach.
Credit: BBC Africa