UNAIDS urges Gilead to help end the AIDS pandemic with Lenacapavir

Gilead could help bring the AIDS pandemic to an end if the US pharmaceutical group expands access to its potentially transformative HIV medicine, the head of UNAIDS has told AFP.

Winnie Byanyima called on Gilead to "make history" by permitting generic production of Lenacapavir, a long-acting antiretroviral injection administered twice a year to treat people with HIV.

She asked the company to make Lenacapavir available through the UN-supported Medicines Patent Pool, an international body that licenses lower-cost generic versions for sale in low- and middle-income countries.

Byanyima said that, however substantial the financial gains from developing Lenacapavir may be, Gilead's reputation as the company that defeated the AIDS pandemic would be worth even more.

"Gilead has an opportunity to take us closer to ending AIDS as a public health threat," Byanyima told AFP during an interview at UNAIDS headquarters in Geneva.

"Gilead has an opportunity to save the world. To save the world, literally," from the pandemic.

"They can be the company that wins a Nobel Prize, for example. Reward doesn't come just through money. There is also recognition… imagine how great it would be."

Lenacapavir in a different league

About 30 million people are receiving antiretroviral treatment for HIV, but roughly 10 million others still need to be reached with that therapy.

Byanyima, executive director of the Joint United Nations Programme on HIV and AIDS, said this progress had only been achievable because of pharmaceutical innovations from firms including Gilead.

Yet Lenacapavir is "so highly effective, it's in a different category of preventive medicines", she said.

According to Byanyima, the drug could reach people who are most difficult to access.

"Those people hiding from the law – gay men, trans women – who could come out just twice a year to get their injection and be safe", she said, as well as young women in Africa who fear stigma and domestic violence.

Lenacapavir received approval for use by HIV patients in the United States and European Union in 2022. In the US, it is available at about $40,000 per year.

The medicine is also undergoing trials as a possible pre-exposure prophylaxis (PrEP), designed to stop people without HIV from acquiring the virus, and interim findings have been highly encouraging.

Byanyima argued that Gilead could remain profitable through tiered pricing, with, for instance, a person in Nepal paying only a fraction of what someone in Britain would pay for Lenacapavir.

"We could come close to ending this disease," she insisted.

Gilead has previously said it is holding discussions with governments and organisations "as we work to reach our access goals".

The 2030 target for HIV

In general, advances in HIV treatment are delivering prevention and treatment products that are more effective and cause fewer side effects, Byanyima said.

However, "a vaccine is very, very difficult to make. Same as a cure. But we have everything in between now for people to live long, healthy lives."

Around 1.3 million people acquired HIV last year.

UNAIDS says HIV can be eliminated as a public health threat by 2030, provided leaders take appropriate decisions on funding, resources and rights.

"We do see countries making progress towards that, which also proves that it is possible," Byanyima said.

Since 2010, she said, several sub-Saharan African countries have cut new HIV infections by more than half and reduced deaths by as much as 60 percent.

But "we also have regions such as Eastern Europe, Central Asia and Latin America where we see new infections moving in the wrong direction and rising," as stigma deters people from using services.

Fulfil the promise

Byanyima also cautioned against a "well-coordinated, well-resourced pushback" targeting LGBTQ rights, reproductive rights and gender equality.

She pointed to Uganda's tougher Anti-Homosexuality Act, introduced in her home country; efforts in The Gambia to decriminalise female genital mutilation; and the US Supreme Court's removal of constitutional abortion protections.

The 25th International AIDS Conference will be held in Munich from Monday to Friday, convening governments, civil society, academics, scientists and people living with HIV to exchange knowledge.

Byanyima said she hoped the event would strengthen political determination to defeat the AIDS pandemic.

"Fulfil the promise that this disease will end. No-one should suffer, living with HIV," she said.

"We have all the possibilities for people to live healthy lives. And we should do it."

© Agence France-Presse