A New HIV Prevention Strategy Sparks Excitement - and Protests Over Cost

"Lenacapavir is not a new drug," reports NPR. "It's been approved by the FDA in the United States for multi-drug resistant HIV treatment since 2022." But instead of treating HIV, what if it were used for preventing infections?The treatment consists of a twice-yearly injection... Early trial results were released in June and generated great excitement, indicating 100% efficacy. On Wednesday, July 24, the full peer-reviewed results were released at the AIDS 2024 conference, confirming the preliminary data... This treatment offers an alternative to the current standard of core for HIV prevention efforts for over a decade: taking a pill like Truvada every day... Any eventual approval and widespread use would come with challenges... Lenacapavir's cost as HIV treatment in the United States in 2023 was $42,250 per new patient per year. Oral PrEP options, on the other hand, can cost less than $4 a month. "The biggest gap in prevention isn't medication, it's accessing medications," says Dr. Philip Grant, clinical associate professor and director of the HIV clinic at Stanford University School of Medicine. Activists across Uganda and South Africa have urged Gilead Sciences to license lenacapavir to the Medicines Patent Pool - a United Nations-backed organization that partners with governments, industry and other organizations to license medications. This would allow for manufacturing of generic versions of the drug at a fraction of the cost... [A] group of Medecins Sans Frontieres activists gathered at AIDS 2024 and called for an "immediate global action to break Gilead's monopoly on lenacapavir." In a statement Gilead said they couldn't set a price because the drug had not yet been approved - but that Gilead "is committed to access pricing for high-incidence, resource-limited countries."Gilead will ensure dedicated supply of lenacapavir for HIV prevention in the countries where the need is greatest until voluntary licensing partners are able to supply high-quality, low-cost versions of lenacapavir.a Gilead is developing a robust direct voluntary licensing program to expedite access to those versions of lenacapavir in high-incidence, resource-limited countries. We are moving with urgency to negotiate these contracts.

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