Lenacapavir is a long-acting injectable form of PrEP that blocks HIV entry and replication. It is administered at six-month intervals and is the longest-acting injectable produced to date. In late-stage trials the drug cut infections by 96% among diverse groups, and in the PURPOSE 2 study only two people out of more than 2,000 became infected. The earlier PURPOSE 1 study found no cisgender women contracted HIV while using the drug.
Gilead is seeking regulatory approval in several African countries and plans to begin processes by the end of 2024 in 18 low- and middle-income countries. Experts including Hasina Subedar and Colleen Kelley say affordability and the ability to reach people who struggle with daily pills will shape impact.
Gilead has licensing agreements with six generic manufacturers to make generic versions for 120 resource-limited countries and says it will supply the product at no profit until generics can meet demand. Advocates warn of practical challenges such as building reliable supply chains, ensuring people return for injections every six months, and offering community choices. Countries like Zambia and Kenya are expected to be early adopters and tests of real-world impact.
Difficult words
- administer — to give a drug or treatment to someoneadministered
- replication — process of a virus making more copies
- trial — a test of a drug with peopletrials
- affordability — whether people can pay for a medicine
- agreement — a formal deal between two organisationsagreements
- generic — a product not made by the original company
- supply chain — system that moves goods to where neededsupply chains
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Discussion questions
- How could six-month injections help people who have trouble taking daily pills?
- What problems might health systems face when they build reliable supply chains for injections?
- If you lived in a country starting this program, what reasons would make you try or refuse the injection?
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