New Medicines May Help End AIDS, but High Prices Lock Out the Poor

Matthew Kavanagh and Eamonn Murphy - IPS
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May 22, 2022

Here’s the good news: there are a new set of breakthrough medicines to prevent and treat HIV, known as “long actings” because they can be taken every few months instead of every day, and they are coming on-stream. If, as they are rolled out, they are made available at scale, they could help save many lives and help end the AIDS pandemic.

But here’s the bad news: on the current trajectory, most people who need them will not be able to get them any time soon, because high prices and monopolies will keep people in low- and middle-income countries locked out. That’s where we are heading – again.

UNAIDS has been convening some of the world’s leading scientists and researchers. They have emphasized to us that long-acting drugs for prevention are available now – an injection every few months that very effectively protects against HIV transmission. It has been approved in the U.S. and the World Health Organization (WHO) is reviewing it now.

And in the near term, there are in addition exciting medicines in development for long-acting treatment – which could make it far easier for people to stay on life-long HIV treatment, even when their lives make getting pills every day difficult.

New HIV prevention tools like long-acting pre-exposure prophylactic (PrEP) are particularly needed to fight the ongoing pandemic. In 2020, a year for which the world had set a collective goal of reducing new infections below 500,000, there were, in fact, 1.5 million; and in too many communities new HIV infections are rising.

Long-acting injectable PrEP could help fill critical HIV prevention needs for those facing the worlds’ highest HIV risks – particularly those whose lives, logistics, and legal contexts make accessing and taking oral prep challenging.

This includes people facing discrimination, including gay men, transgender people, sex workers, and people who use drugs in Africa, Asia, Latin America and the Caribbean, and Eastern Europe. Young African women, facing far higher risks than young men of their age, also need new HIV prevention options.

Studies have shown many people want a long-acting option, and indeed an estimated 74 million people around the world use long-acting injections to prevent pregnancy. Carefully done studies presented at the Conference on Retroviruses and Opportunistic Infections (CROI) showed long-acting PrEP can prevent more new infections than taking a pill every day.

If and when WHO endorses its use, the world should move fast to make it available at scale. The best way to ensure this breakthrough science translates into a global game-changer it is to make it available free to all who choose it.

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