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HIV

South Africa's HIV Prevention Efforts Hinge on Lenacapavir Jab Pricing Transparency

Strategic Insights

— 2 min read

As South Africa prepares to roll out the HIV prevention jab, lenacapavir, scientists and policymakers warn that the country's limited funds and health system capacity may hinder the ambitious plan to put two to four million people on the medication per year. The Global Fund has offered a grant of $29.2 million, but this amount is far from sufficient to cover the costs, and even if it were, the country's health system would struggle to distribute the medication quickly enough.

Key Takeaways:

  • The Global Fund has offered a grant of $29.2 million to South Africa to purchase lenacapavir, but this amount is insufficient to cover the costs of putting two to four million people on the medication per year.
  • The country's health system capacity is a major concern, as the roll-out period is expected to be in early 2026, and the essential medicines list committee has yet to review and recommend lenacapavir.
  • Two studies released in 2024 showed that lenacapavir can prevent HIV infection in 88.8% of participants, including women, adolescents, and transgender individuals.
  • The US government's Aids fund, Pepfar, will need to commit to paying for the roll-out of lenacapavir in poorer countries, and some activists believe it's still possible for the US administration to come on board.
  • Gilead, the maker of lenacapavir, has not disclosed the price of the medication, citing a "not-for-profit" price, but this has led to concerns that the company is trying to obscure the true cost of the medication.
  • Activists argue that Gilead's secrecy will obstruct civil society activism for lower drug prices and keep prices high in middle-income countries, where Gilead negotiates prices directly.
  • The rumoured not-for-profit price negotiation between Gilead and the Global Fund is unclear, but activists are calling for transparency on the price of lenacapavir.

Statistics:

  • The grant of $29.2 million from the Global Fund translates to putting and keeping about 400,000 people on lenacapavir over three years.
  • The country's HIV prevention program in 2024 had 13% of the 1.3 million new HIV infections around the world.
  • 56% of survey participants in Tshwane, Mthatha, and Gqeberha said they would take a lenacapavir shot.

Sources:

  • Bhekisisa
  • The Global Fund to Fight Aids, TB and Malaria
  • Gilead Sciences
  • The US Department of Health and Human Services
  • The South African Department of Health
  • The Food and Drug Administration
  • Avac
  • The World Health Organization
  • The South African Health Products Regulatory Authority

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