A new twice-yearly injection has shown unprecedented effectiveness in preventing HIV infections, with a 96% success rate in men, but experts warn that the key challenge now is ensuring access to those who need it most.
The injection, called lenacapavir, has been hailed as one of the closest advancements the world has seen to an HIV vaccine. It was found to be significantly more effective than the daily oral pill PrEP (pre-exposure prophylaxis), which has long been a primary HIV prevention method. Lenacapavir is already approved in several countries, including the US, Canada, and Europe, under the brand name Sunlenca for the treatment of existing HIV infections. It was previously shown to be 100% effective in preventing HIV in a study involving women.
“This is so far superior to any other prevention method we have, that it’s unprecedented,” said Winnie Byanyima, executive director of UNAIDS, praising drugmaker Gilead for developing the medication. However, she emphasized that the fight to end AIDS hinges on how the drug is distributed, particularly in at-risk countries.
Gilead has agreed to allow generic versions of the drug to be sold in 120 poor countries with high HIV rates, primarily in Africa, Southeast Asia, and the Caribbean. However, Latin America, where HIV rates are lower but rising, has been excluded from this deal. This has raised concerns among health experts and activists that the region may be missing a crucial opportunity to curb the spread of HIV.
In a report issued for World AIDS Day on Sunday, UNAIDS noted that the number of AIDS-related deaths dropped to an estimated 630,000 last year, the lowest since the peak in 2004. The report suggested that the world is at a “historic crossroads” in the battle against the epidemic, with a real chance to end it.
Lenacapavir’s potential benefits are particularly significant for marginalized groups, such as gay men, sex workers, and young women, who often face stigma or fear seeking regular HIV prevention care. UNAIDS’ Byanyima called the drug a “miracle” for these groups, as it only requires a visit to a clinic twice a year for protection.
Luis Ruvalcaba, a 32-year-old man from Guadalajara, Mexico, who participated in the recent study, explained that he had avoided requesting daily pills due to fears of discrimination. Now, as a study participant, he will continue receiving the injection for at least another year.
Despite these advancements, access to lenacapavir in countries like Mexico remains uncertain. Health officials in Mexico have not commented on whether the drug will be available through the public health system, although daily HIV prevention pills were made available for free in 2021.
In response to growing concerns, advocacy groups in Latin America, including countries like Peru, Argentina, and Chile, have written to Gilead requesting access to generic versions of Sunlenca. They argue that as infection rates rise, the need for new, more effective HIV prevention tools is critical.
AIDS expert Dr. Salim Abdool Karim from South Africa’s University of KwaZulu-Natal stressed that while lenacapavir is one of the most effective prevention tools ever seen, the real challenge now lies in ensuring it reaches everyone who needs it.
