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According to the WHO, an estimated 39.9 million people were living with HIV at the end of 2023. Almost a million people die because of the virus each year. Recently though, there has been a huge breakthrough in the global fight against HIV. A new drug, claiming to be 99% effective in preventing HIV has received the green light by The Food and Drug Authority (FDA). The federal agency in the United States approved Lenacapavir, an injectable drug, to be administered twice a year for near perfect protection against the deadly virus. Lenacapavir, part of a class of drugs known as capsid inhibitors, proved 99.9% effective at preventing HIV in large trials last year, raising new hope of interrupting transmission of the virus that infects 1.3 million people a year. However, health activists in India are raising concerns over its cost and affordability.
Why Lenacapvir Is Inaccessible In India
Among the activists, Lenacapvir’s price remains the main concern. The injection costs around ₹24 lakh ($28,218) for two doses administered six months apart. A figure unimaginable for most of the people in the country. To add to that Lenacapavir belongs to the class of HIV prevention drugs known as pre-exposure prophylaxis (PrEP), which India’s National AIDS Control Organisation (NACO) has not included in public programmes so far.
"Our govt distributes condoms to break HIV transmission, it provides antiretroviral therapy drugs to prevent parent-to-child transmission of HIV, but it has never given PrEP to youngsters who are likely to indulge in high-risk behaviour," health activist Ganesh Acharya said in a social media post. The twice TB survivor added that NACO had made it mandatory for its counselling centres to provide information on PrEP a couple of years ago. PrEP has existed for over a decade and is widely used in developed countries. In India, public health discussions around PrEP only began recently. Experts said a successful launch of a long-acting HIV prevention drug could help stall the epidemic. Until recently, the only pre-exposure prophylaxis (PrEP) options for people at high risk of infection were daily pills, requiring careful adherence to be effective.
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UNAIDS Urges Gilead to Drop Price
Responding to news of Lenacapavir’s FDA approval, Winnie Byanyima, Executive Director of UNAIDS and United Nations Undersecretary-General, said: “This is a breakthrough moment. The approval of lenacapavir is a testament to decades of public investment, scientific excellence, and the contributions of trial participants and communities.” He also congratulated Gilead and US partners for advancing this important innovation. “Lenacapavir could be the tool we need to bring new infections under control – but only if it is priced affordably and made available to everyone who could benefit,” he added.
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Conclusion
In a research paper published in The Lancet HIV this week, experts found that generic lenacapavir could cost $35-$46 per person-year. This could fall to $25 per person-year for a committed demand of five to ten million people within the first year, bringing pricing in line with or lower than current oral PrEP. It is to be seen whether the prices do actually come down in the near future, as predicted by the experts. However for now, its access remains limited to only those who could afford it.