A watershed agreement struck in September 2025 promises to change the face of HIV prevention for millions living in low- and middle-income countries (LMICs). The partnership between Gilead Sciences, the Medicines Patent Pool, Dr. Reddy’s Laboratories, Unitaid, the Clinton Health Access Initiative (CHAI), Wits Reproductive Health and HIV Institute (Wits RHI), and Hetero, ensures the injectable drug lenacapavir becomes available at just $40 a year from 2027.
This transformative long-acting pre-exposure prophylaxis (PrEP) injection, taken only twice per year, has shown nearly complete protection against HIV in clinical trials. Stakeholders, including public health officials and advocates, have praised the move for its unprecedented scale and urgency, aiming to close the persistent gap in global HIV prevention access.
Proud to announce that we have received a royalty-free non-exclusive voluntary licence from Gilead to make the latest generation HIV drug lenacapavir accessible to patients in 120 countries! This marks an important milestone for us in patient access and affordability for pre and… pic.twitter.com/daQvTUN1ey
— Dr. Reddy’s Laboratories Ltd (@drreddys) October 3, 2024
How the Twice-Yearly Jab Works
Lenacapavir offers a compelling advantage over daily oral PrEP, especially for people who struggle with daily adherence. Following a brief oral lead-in, two tablets taken on two consecutive days, the individual receives a single injection providing six months of protection against HIV. Experts say this is particularly impactful for young people, women, and key populations in regions with high HIV incidence, who often face barriers to daily medication routines.
Indian pharmaceutical giants Dr. Reddy’s and Hetero will manufacture and distribute the generics in 120 countries, backed by technical, financial, and regulatory support from the agreement’s global partners.
Building a Foundation for Equitable Access
Previously, LMICs have waited years, sometimes over a decade, for access to breakthrough medicines. With lenacapavir, regulatory approvals have been fast-tracked by the US Food and Drug Administration, European Medicines Agency, and the World Health Organization. This approach has drastically reduced the timeline, enabling most LMICs to access affordable generics less than two years after the drug’s initial approval in high-income countries.
The deal also creates a competitive landscape with multiple suppliers, keeping prices low and allowing governments flexibility in procurement. Financial commitments from organisations like PEPFAR, the Global Fund, and the Children’s Investment Fund Foundation (CIFF) aim to support large-scale procurement and equitable roll-out. However, experts emphasise that continued investment in policy, health systems, and real-world research. such as ongoing studies in South Africa and Brazil, remains vital for successful community-based delivery and addressing access barriers in countries still excluded from existing licences.
Expert Insights and Next Steps
Specialists from Wits RHI and CHAI stress that the next challenge is ensuring national regulatory approvals and a robust supply chain throughout the rollout.
In an article by The Lancet, professor Saiqa Mullick, Director of Implementation Science at Wits RHI, explained, “Generic manufacture of lenacapavir is essential to ensure this breakthrough HIV prevention option is not limited to a privileged few. By driving prices down and securing sustainable supply, generics will make six-monthly PrEP a real choice for the millions of people in great need in LMICs.”
The Logical Indian’s Perspective
The Logical Indian welcomes the global collaboration that makes lenacapavir, an innovative, twice-yearly HIV prevention jab, affordable in low- and middle-income nations, viewing it as a triumph for humanity and public health.
While applauding the rapid rollout and negotiated pricing, there remains a collective responsibility to ensure no one is left behind, especially marginalised groups such as sex workers, transgender persons, and migrant communities who often face barriers to accessing healthcare. This breakthrough should be celebrated not only as a scientific milestone but as a call to foster greater equity, inclusion, and dialogue around HIV prevention.
Empathy, partnership, and transparent governance must guide distribution going forward, with civil society, government, and industry working in concert to tackle stigma, support timely access, and advocate for broader license coverage to reach presently excluded regions.
As India and other high-incidence nations gear up to deploy lenacapavir, The Logical Indian encourages the public to demand accountability, offer community support, and nurture an environment of kindness and coexistence for all affected by or vulnerable to HIV.
💥This is a blueprint for how we can do better and move faster to make sure no one dies from a preventable condition – @CHAI @NeilBuddyShah on the US$40 lenacapavir deal announced today.https://t.co/9eHZYJ1tev #CGI2025 @UNITAID @WitsRHI @drreddys @ClintonGlobal pic.twitter.com/LkS8R0DB6E
— CHAI (@CHAI_health) September 24, 2025
