Adapted from reporting by Rachel Schraer, The Independent (Rethinking Global Aid Project)
The closest thing we have to an HIV vaccine has finally arrived. Lenacapavir, a long-acting injectable medication that can prevent nearly 100% of HIV infections when administered twice yearly, is being hailed as revolutionary. Yet despite its promise, only a fraction of the people who need it will gain access.
The Numbers Behind the Breakthrough
- Current plans by Gilead and international funders will provide lenacapavir to 2 million people over three years, about 666,000 annually.
- Research by Dr. Andrew Hill (University of Liverpool) shows this rollout could avert 165,000 infections, but scaling up to 10 million people annually could prevent half a million infections and put us on track to ending HIV transmission.
- The challenge: funding cuts, particularly from the U.S. under President Donald Trump, have left prevention efforts severely under-resourced.
The Cost and Access Challenge
- In the U.S., a course of lenacapavir costs $28,000.
- Thanks to advocacy and licensing agreements, the drug will be sold at no profit in low-income countries, with costs reduced to around $40 per person per year.
- Gilead’s plan to reach 2 million people by 2028 is described as an “initial step,” with hopes that generic manufacturers will expand access further.
Why This Matters Globally
Anne Aslett, CEO of the Elton John AIDS Foundation, called the rollout “unprecedented,” noting that doses are arriving in Eswatini at the same time as in the U.S., a sharp contrast to the early AIDS crisis, when African nations waited more than a decade for antiretroviral drugs.
Still, she warns that funding gaps threaten progress. Vulnerable populations, young women, LGBTQ communities, sex workers, and people who use drugs, are often excluded from prevention services. Without reaching these groups, the epidemic cannot be contained.
Innovation in Delivery
- Foundations are experimenting with drone deliveries of drugs and testing kits.
- Digital pilots in London are making PrEP accessible directly to consumers, by passing traditional clinics.
- Sub-Saharan Africa is now pioneering models of care that are more advanced than those in parts of the Global North.
🇬🇧 The UK’s Role
Mike Podmore, CEO of STOPAIDS, emphasizes that UK contributions are not just charity, they fuel domestic research and innovation. Agencies like Unitaid have invested £250m into UK universities over the past decade, strengthening both global and local HIV responses.
The UK has set a goal to end new HIV transmissions by 2030, and expanding access to lenacapavir will be critical to achieving it.
The Call to Action
Ending HIV is within reach, but only if global leaders step up. Dr. Hill and advocates worldwide are urging wealthy nations to contribute to a proposed $400m fund to expand access without undermining existing HIV programs.
This is a pivotal moment: decades of research and advocacy have brought us closer than ever to a cure. But without adequate funding, only 7% of those who need lenacapavir will receive it.
What you can do:
- Sign petitions demanding governments protect and expand HIV funding.
- Share this story widely to raise awareness.
- Pressure policymakers to prioritize vulnerable populations in prevention programs.
Together, we can ensure that this breakthrough doesn’t stall at the starting line. Let’s end HIV and make life better for all.
Original reporting by Rachel Schraer, The Independent, as part of the “Rethinking Global Aid” project.