Context:

The World Health Organization (WHO) has recommended the inclusion of lenacapavir, a new HIV drug approved for prevention, in global HIV prevention efforts, emphasizing its suitability for high-risk groups and regions with significant HIV burdens. This recommendation aligns with the recent FDA approval of lenacapavir as a biannual injection to prevent HIV, following its success in dramatically reducing infection risk during trials. Despite this advancement, there is a growing concern about funding for global HIV prevention, as the U.S. has recently reduced its foreign assistance, including dismantling USAID and cutting PEPFAR funding. Gilead Sciences has responded by agreeing to supply lenacapavir at no profit in low- and lower-middle-income countries through an agreement with the Global Fund. The United Nations warns that without adequate funding, millions more could die from HIV-related causes by 2029, highlighting the urgency for international collaboration and resources to ensure lifesaving treatments reach those in need.

Dive Deeper:

• Lenacapavir, recently approved by the FDA as a twice-yearly injection for HIV prevention, is recommended by WHO as a key tool for preventing HIV, especially in high-risk groups and areas with high HIV prevalence.

• The drug, previously approved for treating certain HIV infections, has shown in trials to significantly reduce the risk of HIV infection, offering near-total protection against the virus.

• Concerns about global HIV funding have intensified as the U.S. has withdrawn significant foreign assistance, including the dismantling of USAID and reduction of PEPFAR funding, which has historically supported HIV prevention programs in low- and middle-income countries.

• Gilead Sciences has partnered with the Global Fund to supply lenacapavir at no profit, aiming to reach two million people in low- and lower-middle-income countries as an interim measure before generic versions become available.

• The United Nations report warns of potential increases in HIV-related deaths and infections if current funding gaps are not addressed, with expectations of millions of additional deaths and infections between 2025 and 2029 if funding is not restored.

• The reduction in international funding has already affected countries like Nigeria and Kenya, where significant drops in HIV prevention services have been reported, including reduced access to PrEP and maternal HIV medications.

• UNAIDS emphasizes the need for global solidarity and increased domestic funding to transform the current crisis into an opportunity, ensuring that effective HIV prevention and treatment reach all populations in need.