3 October, 2025

A breakthrough in HIV prevention is taking shape. From 2027, lenacapavir, a twice-yearly injectable that protects against HIV with more than 99% effectiveness, will be available in 120 low- and middle-income countries for just $40 a year. It’s a major step forward from the drug’s US launch last year, where Gilead Sciences introduced it as Yeztugo at a list price of more than $28,000. 

What makes the new agreement so significant is the way different players have come together. Gilead Sciences granted licences to six manufacturers to make generic copies of the drug to ensure wider access, and Unitaid, the Clinton Health Access Initiative (CHAI), and Wits RHI worked with Dr. Reddy’s Laboratories in India to lock in affordable production. At the same time, the Gates Foundation partnered with Hetero, the world’s largest HIV medicines producer, to expand supply. The organisations coordinated their efforts, from timing to terms, creating the foundations for scale. With backing from the Global Fund and PEPFAR, the plan is to reach two million people with lenacapavir by 2028. 

Access to long-acting ways to prevent HIV matters because although current treatments can suppress HIV, there is no cure, and 1.3 million people still contract the virus each year. Daily oral pills are effective but come with challenges, especially for women in low-income settings, where stigma, safety concerns and the burden of adherence create barriers.  

The deal shows what’s possible when pharmaceutical innovation meets philanthropic leverage. It’s a template for how partnership can turn cutting-edge science into life-saving access. 

By Charlotte Pounder