MEXICO CITY (AP) — A groundbreaking new HIV prevention treatment is being hailed as the closest the world has ever come to an AIDS vaccine. The twice-yearly shot has shown exceptional effectiveness, offering 100% protection against HIV infections in a study of women, with nearly identical results for men. Published results on Wednesday highlight the potential of this treatment, yet concerns persist over its accessibility to those in need.
The pharmaceutical company Gilead has committed to making affordable generic versions of the treatment available in 120 countries with high HIV rates, primarily in Africa, Southeast Asia, and the Caribbean. However, Latin America, where infection rates are lower but on the rise, is excluded from this deal, sparking concerns that a critical opportunity to combat the disease could be missed.
“This is so far superior to any other prevention method we have, that it’s unprecedented,” said Winnie Byanyima, executive director of UNAIDS. She praised Gilead for developing the drug but stressed that the success of ending AIDS depends on widespread use in countries most at risk.
UNAIDS’ World AIDS Day report revealed that AIDS-related deaths hit their lowest point in nearly two decades, dropping to 630,000 in 2023. This marks a historic turning point, offering hope that the global fight against the epidemic could soon reach its end. The drug, known as lenacapavir and marketed under the name Sunlenca in the U.S., Europe, and Canada, has already been approved for treating HIV and will soon seek authorization for prevention use.
Unlike existing prevention methods, such as condoms, daily pills, and bi-monthly shots, the twice-yearly Sunlenca injection is seen as a game-changer for marginalized groups like gay men, sex workers, and young women who often hesitate to seek care due to stigma. Byanyima emphasized that the convenience of a twice-yearly shot could be life-changing for these vulnerable populations.
Luis Ruvalcaba, a 32-year-old man from Guadalajara, Mexico, participated in the study and shared his fears of discrimination for requesting daily prevention pills as a gay man. Thanks to the study, he will continue to receive the injections for at least another year.
“In Latin American countries, there’s a lot of stigma. Patients are ashamed to ask for the pills,” said Dr. Alma Minerva Pérez, who enrolled study participants in Guadalajara.
The availability of the shots in Mexico through the public health system remains uncertain, as government officials have not yet commented on the plans to purchase Sunlenca for citizens. However, Pérez remains hopeful that the potential for generics could enable Mexico to make this treatment accessible.
Byanyima noted that several other Latin American countries, such as Brazil, Peru, and Argentina, are also excluded from the generics deal, calling the exclusion “unconscionable.”
In response, Gilead emphasized its commitment to improving access to HIV prevention and treatment, particularly in the hardest-hit regions. The company noted that 18 African nations, representing 70% of the world’s HIV burden, will have access to the generic version of Sunlenca.
Meanwhile, 15 advocacy groups from Latin America have written to Gilead, urging the company to extend access to generics in the region, where HIV rates are rising, particularly among high-risk groups.
Though the cost of Sunlenca in wealthier nations like the U.S. and Europe can exceed $40,000 per year, experts estimate that generics could bring the cost down to just $40 per treatment for 10 million people, making it more accessible to those in need.
Dr. Chris Beyrer of Duke University’s Global Health Institute called the development of Sunlenca a crucial step forward for countries in Africa and Asia but highlighted the rising HIV rates in Latin America as a public health emergency.
Hannya Danielle Torres, a 30-year-old trans woman and artist who participated in the Sunlenca study in Mexico, expressed hope that the government would find a way to provide the shots. “Mexico has some of the wealthiest people in the world, but it also has some of the most vulnerable populations living in extreme poverty and violence,” she said.
Similarly, the drugmaker Viiv Healthcare, which produces a bi-monthly HIV prevention shot known as Apretude, has also excluded most Latin American countries from its generics program. These shots, though effective, remain out of reach for many due to their $1,500 annual cost.
Asia Russell, executive director of Health Gap, argued that established HIV prevention methods are no longer sufficient in the face of over 1 million new HIV infections annually. She urged Latin American countries like Brazil and Mexico to issue “compulsory licenses” to bypass patents during health crises, as Colombia did earlier this year for a key HIV treatment.
Dr. Salim Abdool Karim, an expert in AIDS research, acknowledged that Sunlenca could be the missing piece in the global fight against HIV. “The question now is how we get it to everyone who needs it,” he said.
As the world edges closer to a potential breakthrough in AIDS prevention, the challenge remains: ensuring that life-saving treatments reach every person, regardless of geography, income, or status.