The NHS in England has announced that hundreds of people living with multidrug-resistant HIV will soon have access to lenacapavir, a breakthrough HIV treatment. This decision has been welcomed by HIV campaigners, as lenacapavir will be life-saving for many people in the UK who have run out of other treatment options. The treatment can be given as an injection just twice a year and can prevent HIV without requiring people to take a pill every day, making it a major breakthrough in HIV prevention.
However, while lenacapavir is being rolled out in England, many people around the world do not have access to this treatment, including communities that hosted clinical trials and helped make the drug possible. The drug is expensive, selling for $28,000 to $40,000 per person per year in rich countries, although some low-income countries will have access to the drug for $40 per person per year when generics become available. Countries such as Brazil, Mexico, and Peru, which hosted clinical trials, still have to pay the full price and are unable to do so.
The HIV movement has long fought against the idea that where you live or what you earn should determine whether you get lifesaving treatment. Médecins Sans Frontières (MSF) has launched a campaign, ‘Lenacapavir: Two Shots. $40. Everywhere’, which demands that the price of lenacapavir be brought below US$40 per person per year in all low- and middle-income countries, that global supply be increased to meet actual demand, and that organizations working directly with communities be allowed to purchase lenacapavir directly.
The UK should support organizations such as Unitaid, which has already helped secure the US$40-a-year price for generic lenacapavir, and the Global Fund, which is also helping countries introduce and deliver lenacapavir. However, given the demand, the UK must also use its diplomatic leverage with Gilead to demand that licensing arrangements prioritize people and communities first, ensuring lenacapavir is affordable and available in every country where it is needed. Molly Thompson, senior advocacy advisor at STOPAIDS, a HIV, health and human rights advocacy network of 50 UK international development agencies working globally to end AIDS and realize all people’s right to health and wellbeing, emphasizes that the UK’s aid spending cuts and reduction in resources available for global health make it harder to deliver this kind of leadership.
The UK cannot say it wants to end AIDS while reducing support to partners like Unitaid and the Global Fund, who help make that possible. With just four years to 2030, the UK’s new leadership has a choice about what kind of global health leader it wants to be. If it is serious about ending AIDS as a public health threat, it must be willing to fight for equitable access to innovations like lenacapavir and put the political and financial investment behind that commitment.
