Imagine failing 1.3 million times in a year: Failure to ensure that everyone has access to prevention options to protect oneself from HIV acquisition, has resulted in at least 1.3 million new HIV infections in 2023. The pace of progress towards ending AIDS is out of step if we are to end AIDS by 2030.

Scientific research has thankfully added new HIV prevention tools over the years. The range of options to protect one from HIV is expanding. But the growing range of HIV prevention options has failed to translate into more choices for people. We need to deliver new HIV prevention tools with speed, scale and equity, rightly says Mitchell Warren, Executive Director of AVAC.

“It is so wonderful to see a product do so well in clinical studies, but we have to remember too that this is not the first time we have seen an amazing prevention product (lenacapavir),” he said.

Lenacapavir is an antiretroviral medicine that is taken as Pre-Exposure Prophylaxis (PrEP) which reduces one’s risk of getting infected with HIV to zero or almost zero (one injection every six months). The study (PURPOSE-1) showed 100% protection for women and girls in June this year. Later, another study (PURPOSE-2) showed that lenacapavir reduced HIV infections by 96% compared to background HIV incidence among transgender men, transgender women and gender non-binary people. There were 2 incident cases among 2,180 participants, corresponding to 99.9% of participants not acquiring HIV infection in the lenacapavir group.

“These studies are spectacular but clinical studies do not prevent infections by themselves. We have to ensure these translate into real choices for people with equity and rights,” said Warren.

In July 2024 there was a global outrage when lenacapavir’s price was cited to be over US$ 40,000 per person per year. At such an astronomical price, a prevention option that is almost 100% effective in protecting people from HIV would be 0% used among those who need it most.

Owing to mounting pressure worldwide, makers of lenacapavir announced that six generic companies will be given voluntary licenses to make it at a much cheaper price to make it more affordable in 120 countries.

But why is lenacapavir not being made available at affordable prices to all nations worldwide? Countries whose people participated in its studies, such........

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