Landmark deal paves way for cheaper HIV protection jab

A landmark deal will lower the cost of Lenacapavir, a long-acting HIV prevention injection, to about $40 per person per year in more than 120 low- and middle-income countries by 2027. The agreement, brokered by the Clinton Foundation in partnership with the Gates Foundation and South Africa's Wits Reproductive Health and HIV Institute (Wits RHI), aims to expand access to the breakthrough drug as part of a broader effort to curb new infections. The arrangement reflects a public-private effort to move a high-cost, long-acting preventative therapy into wide use in settings where HIV remains most prevalent.

Under the terms, a higher-cost version could begin rolling out as early as the end of this year at roughly $28,000 per person annually in some markets, before the price is lowered at scale. The cheaper version is planned for rollout in 2027 across the 120 low- and middle-income countries, aligning with a broader push to reach populations with the greatest risk and the most barriers to daily oral regimens. The dual-timeline approach underscores core goals: provide immediate leverage where possible, and deliver long-term affordability to sustain protection at scale.

Lenacapavir is administered by injection twice a year and provides six months of protection against HIV infection at a time. The drug has already earned approval from the U.S. Food and Drug Administration and the European Commission this year, and in July the World Health Organization formally backed its use for HIV prevention. The injections’ infrequent dosing could help address adherence challenges seen with daily oral regimens, which currently dominate pre-exposure prophylaxis (PrEP).

Despite a robust portfolio of prevention options, access remains limited. The Gates Foundation notes that only about 18% of those who could benefit from PrEP currently have access, a gap this deal intends to begin narrowing. Proponents say a long-acting injectable could be especially impactful for groups most at risk, including adolescent girls and young women, lesbian, gay, bisexual and transgender people, sex workers, and people who use drugs, who often face barriers to daily pill regimens and stigma.

The proposed price reduction is likewise aimed at widening equity in HIV prevention. At present, PrEP pills cost roughly $40 per person per year in many settings, but the daily or near-daily adherence required in some regimens can be burdensome and stigmatizing. Advocates say Lenacapavir could complement or even supplant certain PrEP approaches in contexts where consistent daily dosing remains challenging, while also serving as a treatment option for people living with HIV who need ongoing protection against drug resistance.

Modeling cited by public health researchers suggests that expanding access to the injection—even at modest coverage—could yield meaningful declines in new infections. One study estimated that providing the injection to as little as 4% of a population could avert up to 20% of new infections, underscoring the potential impact of a scalable, long-acting prevention tool in high-burden settings.

The deal arrives amid a turbulent year for global health funding, including shifts in U.S. foreign aid programs. UNAIDS continues to report that more than 40 million people are living with HIV worldwide, with about 1.3 million new infections and more than 600,000 AIDS-related deaths last year. South Africa, which has the largest HIV-positive population, is expected to be among the first countries to access the new, lower-cost regimen.

Officials emphasize that the initiative is meant to expand access and equity, not to replace existing prevention and treatment strategies. Lenacapavir’s approval by major regulators and endorsement by WHO provide a regulatory pathway for its use in prevention, while the philanthropic-led framework seeks to resolve affordability barriers that have limited uptake in resource-limited settings. The collaboration includes the Clinton Foundation, the Gates Foundation, and Wits RHI, among others, signaling a coordinated effort to align pharmaceutical innovation with global health needs.

As the world continues to confront HIV and AIDS, health experts caution that success will depend on delivery systems, supply chains, and sustained funding. Access at the scale envisioned by the deal will require ongoing cooperation among governments, international organizations, industry, and civil society to ensure that prices stay affordable, distribution is reliable, and education accompanies rollout to maximize impact. The coming years will be critical in determining whether the Lenacapavir initiative can accelerate progress toward ending the HIV/AIDS epidemic in the world's most affected regions.