What’s new
- From 2027, Indian generics companies Hetero Labs and Dr. Reddy’s will supply lenacapavir, a twice-yearly injectable PrEP with ~96–100% efficacy, for US$40 (R698) per person per year across 120 low- and middle-income countries.
- South Africa, home to the world’s largest HIV epidemic, is included in the agreement, making the country one of the first able to procure affordable long-acting PrEP.
Why it matters
- Daily oral PrEP uptake in South Africa has lagged. Adherence challenges, stigma, and supply disruptions limit impact.
- This marks a dramatic price drop compared to current U.S. list prices (~US$28,000/year) for the Gilead developed version of lenacapavir.
- Lenacapavir’s six-month dosing schedule could dramatically improve consistency and reduce barriers for high-risk populations.
- At $40/year, the injectable is a potential game changer for scaling prevention.
The catch
- The current PEPFAR / Global Fund programme aims for 2 million people by 2028 . UNAIDS modelling suggests this will prevent just 50,000 infections out of a potential 3.8 million.
- Many high-HIV countries are left out of the licensing deal, raising concerns about regional inequity.
- Even at a low price, reaching millions requires budget allocations, procurement plans, and political will.
- Some licensing agreements limit which manufacturers can produce and which countries can use the generics. These restrictions reduce competition and may delay access in excluded territories.
What they’re saying
“This scenario of opaque pricing, restrictive licensing and inadequate global targets will leave far too many people at continued risk of preventable HIV infections,” says Antonio Flores, Senior HIV/TB Advisor at MSF’s Southern Africa Medical Unit.”
“Generic manufacture of lenacapavir is essential to ensure this breakthrough HIV prevention option is not limited to a privileged few,” says Professor Saiqa Mullick, Director of Implementation Science at Wits RHI, University of the Witwatersrand. “By driving prices down and securing sustainable supply, generics will make six-monthly PrEP a real choice for the millions of people in great need in low- and middle-income countries.”-Health-e News
