Generic Production Agreements Poised to Expand HIV Prevention Access in Africa & Beyond
New agreements aimed at producing generic versions of the revolutionary HIV prevention drug Lenacapavir offer the potential to protect individuals in low and middle-income countries for as little as 34 euros per person per year. These developments come at a critical juncture, as funding cuts threaten to reverse progress in the global fight against HIV.
Experts warn that reduced financial support, particularly from major financier the United States, could lead to a surge in new infections. Projections indicate that without sustained funding, 6.6 million new HIV infections could occur by 2029, a meaningful increase from the 1.3 million new cases recorded in 2024.”Let us follow at the same level of new annual infections, which will not be the case because the situation will get worse due to the cuts,” stated López casas, highlighting the escalating costs – the treatment of the 1.3 million newly infected in 2024 alone exceeded $50 million.
The current moment presents a “unique opportunity” to eradicate AIDS,according to experts,due to the availability of effective medicines like Lenacapavir at potentially affordable prices. “That is why it is important to get the financing that allows the Lenacapavir to take all the people who need it,” López Casas emphasized, advocating for a rapid expansion of preventative treatment. He estimates that the number of people receiving preventative treatment needs to be “duplicated or tripled, in a narrow margin of time” to effectively control the epidemic.
While agreements on generic production represent “a basic step” towards accessibility, particularly for vulnerable populations, Beatriz Grinsztejn, president of the International AIDS Society, cautioned that 2027 – the anticipated timeframe for generic availability – remains distant. She stressed the need for “urgent additional investment to avoid delays or access problems,” as some countries are already making “difficult concessions” due to funding shortfalls.
unitaid is also advocating for the future local manufacture of Lenacapavir to further reduce it’s price and for an expansion of the current voluntary license agreement, which currently benefits 120 countries. Currently, 22 middle and low-income countries experiencing rising HIV rates – including brazil, Argentina, Peru, and nations in Asia and Eastern Europe – are excluded from this agreement, according to López Casas.
In the interim, initiatives are underway to improve access to lenacapavir. The US President’s Emergency Plan for AIDS Relief (Pepfar) and the World Fund have reached an agreement with Gilead to supply the medicine to up to two million people in low and medium-income countries at an undisclosed price. Pepfar, which has operated for over 20 years providing prevention, treatment, and support, claims to have contributed to saving 26 million lives. the World Fund anticipates delivering the first shipments of Lenacapavir to an African country by the end of 2025.
