The NGO Unitaid and the Gates Foundation have announced two parallel agreements aimed at enabling access, in 120 low- and middle-income countries, to the revolutionary preventive treatment against HIV infection.
The injectable PrEP revolution is coming to fruition. A generic of lenacapavir, a preventive treatment that protects against HIV infection, will be able to be distributed in 120 low- and middle-income countries at a price of $40 (€34), they announced on Wednesday, September 24, the NGO Unitaid and the Gates Foundation. This immense progress is based on protection by an injection twice a year, instead of the current oral daily pre-exposure prophylaxis (PrEP); a turning point especially in countries where daily access to treatment is difficult.
Unitaid – supported by the Clinton Health Access Initiative as well as the Wits RHI research institute – and the Gates Foundation have concluded two parallel agreements, negotiated very quickly, with Indian laboratories so that they can produce these generics. Currently the molecule, developed by the American laboratory Gilead, has been marketed in the United States since June at the astronomical price of $28,128 per year, under the name Yeztugo.
“This is a revolutionary and essential breakthrough to broaden HIV prevention. With this product, we can end the virus, it’s within reach“, said Carmen Perez Casas, HIV strategic lead at Unitaid, in an interview with Agence France-Presse (AFP). The treatment will initially be manufactured in India, by the Dr. Reddy’s laboratory, before regional production. “This shows that the most advanced tools can be made affordable from the outset”, notes Philippe Duneton, executive director of Unitaid, quoted by Le Monde.
“Turning off the tap” for HIV infections
In parallel, the Gates Foundation announced a similar partnership with another Indian pharmaceutical group, Hetero. “What is essential with lenacapavir is that it essentially allows us to turn off the faucet right now, so that the problem we will have to face in five to ten years does not become dramatically worse”, argues Trevor Mundel, President of Global Health at the Gates Foundation, in the daily Le Monde. Another agreement is expected to be signed between the Global Fund and Gilead to deliver the treatment to the concerned countries, with U.S. support.
If oral PrEP has demonstrated its effectiveness, supply difficulties and regular access to care prevent in vulnerable countries from effectively covering the population in need. The semestrial injection of lenacapavir helps address this challenge with a nearly 100% reduction in transmission risk. Unitaid’s agreement aligns the price of the injectable treatment with that of oral PrEP, “a critical condition for adoption in low- and middle-income countries”, the organization notes. UNAIDS data show that in 2024 there were 1.3 million new infections (-40% since 2010), half of which occurred in African countries.
The molecule has also received clearance from European health authorities. However, before it can be distributed, each Union country must still negotiate its price with the manufacturer. A tedious step that can take, in France, 12 to 18 months. This is why injectable PrEP is not yet possible to prescribe to patients by their doctor.
Illustration: Romain Lamy for têtu·
