Experts say that a promising drug that offers complete protection against HIV and requires only two shots a year isn't getting to enough people MBARARA, Uganda -- In the red light district in Mbarara, a city in western Uganda known in part for sex tourism, a sex worker named Lisa Mutoni insists on using condoms when men enter her room, to protect her against HIV and other infections. The problem: Some try to remove or tear the condom while having sex. She takes HIV-prevention medication called PrEP, or preexposure prophylaxis, which can come in the form of daily pills or periodic injections.
But there’s a new option for her and millions like her — if they could only get it. It’s a drug called lenacapavir that studies have shown can offer nearly complete protection from HIV with just two shots a year. Mutoni said access to lenacapavir would benefit sex workers who sometimes shift elsewhere for months at a time.
Such is the promise and the frustration with lenacapavir, a drug developed by Gilead Sciences. Other PrEP options, including pills and an every-other-month shot of the drug cabotegravir, are very effective and widely available. But health experts say lenacapavir has the power not just to protect individuals but potentially even turn the tide of the HIV epidemic globally because of its long-lasting effects.
But there are not nearly enough doses, in this East African country or the rest of the world. We need to be getting to the millions pretty soon,” said Andrew Hill, an expert in HIV treatment who is a senior visiting research fellow at the University of Liverpool in northwest England. That may start to change in the coming months.
Food and Drug Administration has just tentatively approved a generic version of lenacapavir that could help speed the production and distribution of the drug to 120 low-income countries at a price of roughly $40 a year, far below the U.S. list price of $28,218. The approval was announced Monday. The hope, according to the Global Fund, is to get it to 3 million people by the end of 2028.
Some, including Doctors Without Borders, known by its French initials MSF, say this isn't nearly enough. The group is calling on Gilead to make cheap doses available to more countries and to sell it directly to MSF so it can help protect more people faster. For now, people in Mbarara, where an estimated 10% of the adult population has HIV — double the rate of Uganda as a whole — have to settle for inferior choices.
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