The Global Fund and Gilead have announced that Lenacapavir, the new 6-month PrEP treatment for HIV, will be made available in 120 countries at no profit. Gilead originally agreed to license Lenacapavir, royalty-free, to local manufacturers, but have now also agreed to directly supply doses until those manufacturers reach capacity, likely for up to 2 million at-risk people. The Global Fund will direct resourcing and deliver doses.
Extremely good news, and a possible silver lining after potentially losing PEPFAR.
Thanks this is indeed amazing news and I’m actually a bit surprised at the commitment, would love to hear the full story and how much it will actually cost, it could still be quite expensive. Super cool as well that eventually it will actually be manufactured in many of the countries that will use the drugs
Although good news, I don’t think its the best ever news on HIV treatments. I would rate both the invention of the first antiretroviral (AZT) and PEPFAR probably 10x-100x more important than this news. Not to diminish this at all, as it will definitely reduce HIV infections and likely reduce HIV treatment cost in future, I don’t think its going to lead to huge population level reductions in HIV burden like AZT and PEPFAR did.
Why do you think this might be the best ever news?
Obviously Global Fund are gonna emphasise the importance of this, but this quote stood out:
For the first time, we have a tool that can fundamentally change the trajectory of the HIV epidemic — but only if we get it to the people who need it most
I don’t really have any knowledge on HIV, but my assumption is that if it’s cheap to deliver high volumes of 6-month protection, you can essentially end the spread of the virus, and if it can be widely funded and generically manufactured, we might be able to permanently end it within a generation. (Would be happy to stand corrected!)
Yeah his statement is incorrect (unless maybe quoted out of context). ARVs have already fundamentally changed the trajectory of the HIV epidemic in incredible ways—even if this drug did as well, it would not be a first.
In terms of whether this can “change the trajectory of the HIV pandemic”, it depends on how we interpret that. I would say its also a misleading statement. Spread of HIV has already been plummeting over the last 30 years due to ARVs—at best Lenacapavir could continue the current trajectory (see graphs below) which I think it has great potential to do.
There’s no way a non-cure non-vaccine drug can “end the epidemic in a generation.” The nature of HIV is that if its treated well, people stay alive with fairly normal life expectancies. This means even if there’s very little spread, prevalence doesn’t change much and it is VERY difficult to end the epidemic within a short time. Its a little paradoxical that when HIV is well tracked and controlled, prevalence drops very slowly.
Most HIV is spread through unprotected sex between regular people in the community. Obviously we’re not going to give the whole population the injection, only high risk groups so many will still catch HIV that way. Even if we target vulnerable populations like transporters, sex workers and those in discordant couples, that won’t come close to “ending the spread of the virus” completely, there will likely always be low level spread.
So yes the drug is a big deal, but I think the Global Fund head is hyping it with a little dishonesty. Not the biggest deal though.
The Global Fund and Gilead have announced that Lenacapavir, the new 6-month PrEP treatment for HIV, will be made available in 120 countries at no profit. Gilead originally agreed to license Lenacapavir, royalty-free, to local manufacturers, but have now also agreed to directly supply doses until those manufacturers reach capacity, likely for up to 2 million at-risk people. The Global Fund will direct resourcing and deliver doses.
Extremely good news, and a possible silver lining after potentially losing PEPFAR.
Thanks this is indeed amazing news and I’m actually a bit surprised at the commitment, would love to hear the full story and how much it will actually cost, it could still be quite expensive. Super cool as well that eventually it will actually be manufactured in many of the countries that will use the drugs
Although good news, I don’t think its the best ever news on HIV treatments. I would rate both the invention of the first antiretroviral (AZT) and PEPFAR probably 10x-100x more important than this news. Not to diminish this at all, as it will definitely reduce HIV infections and likely reduce HIV treatment cost in future, I don’t think its going to lead to huge population level reductions in HIV burden like AZT and PEPFAR did.
Why do you think this might be the best ever news?
Obviously Global Fund are gonna emphasise the importance of this, but this quote stood out:
I don’t really have any knowledge on HIV, but my assumption is that if it’s cheap to deliver high volumes of 6-month protection, you can essentially end the spread of the virus, and if it can be widely funded and generically manufactured, we might be able to permanently end it within a generation. (Would be happy to stand corrected!)
Yeah his statement is incorrect (unless maybe quoted out of context). ARVs have already fundamentally changed the trajectory of the HIV epidemic in incredible ways—even if this drug did as well, it would not be a first.
In terms of whether this can “change the trajectory of the HIV pandemic”, it depends on how we interpret that. I would say its also a misleading statement. Spread of HIV has already been plummeting over the last 30 years due to ARVs—at best Lenacapavir could continue the current trajectory (see graphs below) which I think it has great potential to do.
There’s no way a non-cure non-vaccine drug can “end the epidemic in a generation.” The nature of HIV is that if its treated well, people stay alive with fairly normal life expectancies. This means even if there’s very little spread, prevalence doesn’t change much and it is VERY difficult to end the epidemic within a short time. Its a little paradoxical that when HIV is well tracked and controlled, prevalence drops very slowly.
Most HIV is spread through unprotected sex between regular people in the community. Obviously we’re not going to give the whole population the injection, only high risk groups so many will still catch HIV that way. Even if we target vulnerable populations like transporters, sex workers and those in discordant couples, that won’t come close to “ending the spread of the virus” completely, there will likely always be low level spread.
So yes the drug is a big deal, but I think the Global Fund head is hyping it with a little dishonesty. Not the biggest deal though.