MSF Warns of HIV Prevention Medicine Access Conundrum Amid Global Funding Cuts

Strategic Insights -

Washington-based non-profit medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is sounding the alarm over the limited access to the HIV prevention medicine lenacapavir, partly due to restrictive patent licensing agreements imposed by the developer, Gilead Sciences. The organization welcomes the World Health Organization's (WHO) recommendation to use lenacapavir more widely, but concerns arise from the patent restrictions that hinder generic competition, subsequently limiting access to affordable versions of the medicine in low- and middle-income countries. Amidst global funding cuts, MSF emphasizes the need for governments and donors to commit further funding to ensure large-scale procurement and distribution of lenacapavir, fostering the development of sustainable generic markets.

Key Takeaways:

  • Lenacapavir, a game-changing HIV prevention medicine, requires only twice-yearly injections and has been proven to be 100% effective in preventing HIV infection among cisgender women and girls and reduced HIV risk by 96% in a gender-diverse group.
  • The current patent licensing agreement signed by Gilead Sciences includes restrictive conditions that hinder access to generic lenacapavir in countries excluded from the license, limiting broader generic competition.
  • MSF is already supporting the rollout of long-acting cabotegravir (CAB-LA) for PrEP in several African countries and offers other forms of PrEP, but expansion is needed to increase access to HIV prevention tools.
  • MSF estimates that with sufficient demand and additional competition, generic versions of lenacapavir could be produced at about $40 per year, comparable to current prices for oral PrEP.
  • Gilead Sciences has not made price information for low- and middle-income countries publicly available, and the price for PrEP in the US is $28,218 per year.
  • Global health funding cuts substantially impact HIV prevention services, leaving fewer programs that will be able to afford lenacapavir.
  • MSF calls on Gilead to remove licensing roadblocks and for governments and donors to commit further funding for affordable and sustainable generic markets to increase access to lenacapavir.
  • The WHO aims to reach 2 million people with lenacapavir through the Global Fund, but this represents only a fraction of the UNAIDS target of 21 million by 2025, underscoring the need for drastic measures to increase access to the drug.
  • MSF supports the development of a price-transparent partnership agreement between Gilead and the Global Fund to facilitate negotiations for affordable and sustainable access to lenacapavir.

Statistics:

  • 100% effective in preventing HIV infection among cisgender women and girls
  • Reduced HIV risk by 96% in a gender-diverse group
  • $40 per year estimated cost of generic versions of lenacapavir
  • $28,218 per year price for PrEP in the US
  • 21 million UNAIDS target for HIV prevention coverage by 2025
  • 2 million Global Fund target for lenacapavir coverage through the Global Fund

Sources:

  • Doctors Without Borders/Médecins Sans Frontières (MSF)