By Gloria Nosa
A major turning point in the global fight against HIV is on the horizon. By 2027, generic versions of the groundbreaking injectable HIV-prevention drug, lenacapavir, will be made available for as little as $40 annually in over 100 low- and middle-income countries. This development, announced jointly by Unitaid and the Bill & Melinda Gates Foundation, promises to transform the global HIV prevention landscape by making one of the most effective medical tools accessible to populations most in need.
Currently sold under the brand name Yeztugo by U.S.-based Gilead Sciences, lenacapavir is administered twice a year and has been clinically proven to reduce the risk of HIV transmission by more than 99.9 percent. However, in its present form, the therapy remains far beyond the reach of most individuals in developing countries, costing an estimated $28,000 annually in the United States. The drastic reduction to $40 per year marks a landmark achievement in both pharmaceutical licensing and equitable healthcare access.
Strategic Partnerships for Affordable Access
The breakthrough comes on the back of licensing agreements between Gilead and six generic manufacturers, followed by subsequent arrangements brokered by Unitaid and the Clinton Health Access Initiative (CHAI). Indian pharmaceutical giants such as Dr. Reddy’s Laboratories and Hetero are now positioned to take the lead in manufacturing these cost-effective generics. Production is slated to begin in India, with gradual regional expansion anticipated to strengthen supply chains across Africa, Asia, and Latin America.
The Gates Foundation reinforced this progress with a separate partnership, emphasizing that cutting-edge medical innovations must be made available not only in wealthy nations but also where the HIV epidemic continues to exert devastating social and economic costs. Trevor Mundel, head of global health at the Foundation, underscored that scientific innovation without equitable access achieves little in combating epidemics.
A Turning Point in the Global HIV Epidemic
Public health experts describe the agreement as nothing short of transformative. Carmen Perez Casas, Unitaid’s HIV strategic lead, declared: “With this product, we can end HIV.” While ambitious, her statement reflects the optimism generated by long-acting pre-exposure prophylaxis (PrEP) solutions such as lenacapavir. Unlike daily oral PrEP regimens that have faced challenges with adherence, lenacapavir’s biannual injection offers a simpler, more reliable means of preventing transmission.
UNAIDS data indicates that, despite significant progress, approximately 1.3 million new HIV infections were recorded globally in 2024. Though prevention initiatives have reduced new infections by 40 percent since 2010, campaigners stress that access to innovative, low-cost medication is essential if the world is to achieve the long-envisioned goal of ending the HIV epidemic.
Bridging the Gap Before 2027
While the generic rollout is set for 2027, interim measures are already in place to accelerate access. Gilead and the Global Fund have initiated agreements to provide lower-cost supplies to poorer countries ahead of full-scale production. Furthermore, U.S. government commitments to sustain funding, despite recent shifts in foreign aid policy, ensure the continuity of this life-saving initiative. The first doses are expected to reach at least one African country before the close of 2025, laying the foundation for broader adoption.
Looking Ahead
The prospect of a $40-a-year HIV-prevention injection is not merely a medical breakthrough; it is a potential game-changer in global health equity. By reducing economic barriers, the initiative strengthens the possibility of widespread prevention, particularly among high-risk populations in sub-Saharan Africa, where the burden of new infections remains disproportionately high.
If successfully scaled, lenacapavir could be to HIV prevention what vaccines have been to polio and smallpox eradication: a decisive tool that changes the trajectory of human history. The next two years will be critical in ensuring production, regulatory approvals, and distribution logistics align to deliver on this promise.
