Price new HIV prevention drug affordably, UNAIDS urges manufacturer

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News of the United States Food and Drug Administration (FDA) approving long-acting injectable lenacapavir for HIV prevention has been met with great expectations of new infections being reduced by huge margins. 

However, there is a catch: The drug's cost (about shillings 102 million per person per year), which is out of reach for the majority of populations in greater need of it, especially those from sub-Saharan Africa, which Uganda is part of.

The new medicine, which will be sold under the name Yeztugo, is administered by injection once every six months and is a significant step in improving prevention options for people at risk of HIV infection around the world.

In an interview with the New York Times, drug manufacturer Gilead Sciences said the drug would cost $28,218 (about shillings 102 million) per person per year.

However, UNAIDS says in a research paper published in The Lancet HIV, experts found that generic lenacapavir could cost $35 (about sh126,000)-$46 (about sh162,000) per person per year if its demand rises to above 10 million people within the first year.

This development would bring lenacapavir's pricing in line with or lower than current oral PrEP (pre-exposure prophylaxis), medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use.

Responding to news of Lenacapavir’s FDA approval, UNAIDS executive director Winnie Byanyima, also United Nations undersecretary-general, said:  “This is a breakthrough moment. The approval of lenacapavir is a testament to decades of public investment, scientific excellence, and the contributions of trial participants and communities".

"I congratulate Gilead and US partners for advancing this important innovation. Lenacapavir could be the tool we need to bring new infections under control – but only if it is priced affordably and made available to everyone who could benefit".

According to Byanyima, UNAIDS has seen research that lenacapavir can be produced for just $40 (about shillings 144,000) per person per year, falling to $25 (about shillings 90,000) within a year of rollout.

"It is beyond comprehension how Gilead can justify a price of $28,218. If this game-changing medicine remains unaffordable, it will change nothing. I urge Gilead to do the right thing. Drop the price, expand production, and ensure the world has a shot at ending AIDS.”

HIV burden 

Uganda has made significant progress in the fight against HIV/AIDS, and is committed to ending HIV as a public health concern by 2030.

HIV prevalence among the adult population (15-49 years) stands at 5.1%. The prevalence is still higher among women (15 to 49 years) at 6.6% compared to the men in the same age bracket at 3.6%, according to the annual Joint AIDS Review report 2023/2024.

About 2,000 people died of AIDS-related illnesses by June 2024 in Uganda, which was a slight decline from 2,100 deaths in 2023.

The majority were men (8,700) and the rest were women (8,200) and children (3,200). This is against the 2025 target of 10,800.

An estimated 1,492,410 people were living with HIV as of December 2023, and of those, there are more women than men living with HIV.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organisations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals.  

Story by MSD