Generic versions of a long-acting injectable drug for HIV prevention will be made available in over 100 low- and middle-income countries at a cost of $40 per year beginning in 2027, according to announcements by Unitaid and the Bill & Melinda Gates Foundation.
In October 2024, Gilead Sciences entered into licensing agreements with six generic manufacturers to enable broader access to lenacapavir, the world’s first long-acting pre-exposure prophylaxis (PrEP). Currently sold in the United States under the brand name Yeztugo, the twice-yearly injection is priced at approximately $28,000 annually. Clinical studies have shown lenacapavir to reduce the risk of HIV transmission by more than 99.9%, making affordability a key factor in its global adoption.
Unitaid confirmed a collaboration with Dr. Reddy’s Laboratories, the Clinton Health Access Initiative (CHAI), and South Africa’s Wits RHI to make the drug available in more than 120 countries from 2027. The initial manufacturing will be undertaken in India, with plans to expand to regional facilities in the future to strengthen supply chains.
The Gates Foundation separately announced a similar partnership with Indian drugmaker Hetero to support production and distribution. These agreements are expected to make lenacapavir accessible at scale across countries that account for the majority of global HIV cases.
Carmen Perez Casas, strategic lead for HIV at Unitaid, said the move marks a critical turning point in prevention efforts. “Far cheaper generic versions are essential for scaling up HIV prevention. With this product, we now have an opportunity to change the trajectory of the epidemic.”
For healthcare systems, the development offers the prospect of integrating cost-effective prevention into national programs, potentially reducing long-term treatment burdens and aligning with global goals to end HIV as a public health threat.
