NHS Gets Lenacapavir, But Global HIV Justice Demands More
England's National Health Service (NHS) has approved lenacapavir, a twice-yearly injectable HIV treatment, for hundreds of people living with multidrug-resistant HIV. This is a life-saving development for those who have exhausted other options. However, as this breakthrough is rolled out in the UK, activists and global health experts are asking a critical question: why do the communities who helped make this drug possible remain locked out of access?
What is lenacapavir and why is it a breakthrough?
Lenacapavir is a significant advancement in both HIV treatment and prevention. For people with rare, drug-resistant strains of HIV, it can be a lifesaver. As a preventative tool, it is administered via injection just twice a year, eliminating the need for daily pills. This is crucial for individuals facing barriers like stigma, criminalisation, financial insecurity, and geographic isolation, which make daily medication regimes difficult or impossible to maintain. The potential to prevent new HIV cases on a large scale is immense.
The bitter irony of clinical trial exclusion
The drug's high cost in wealthy nations, ranging from $28,000 to $40,000 per person annually, starkly contrasts with the $40 per year price secured for some low-income countries once generics are available. Yet, middle-income countries such as Brazil, Mexico, and Peru, which hosted clinical trials and contributed to the drug's viability, are forced to pay the full price. This creates an unjust scenario where the very communities that enabled this medical progress cannot access it.
The HIV movement has spent decades fighting the idea that where you live or what you earn should determine whether you get lifesaving treatment.
What are the demands for global access?
Médecins Sans Frontières (MSF) has launched the campaign Lenacapavir: Two Shots. $40. Everywhere, with three clear demands:
- Bring the price of lenacapavir below $40 per person per year in all low- and middle-income countries.
- Increase global supply to meet actual demand.
- Allow community-based organisations to purchase lenacapavir directly.
These steps are viewed as the minimum requirement to make this breakthrough universally available and to meet the 2030 goal of ending AIDS as a public health threat.
What role should the UK play in HIV justice?
The UK, now benefiting from this scientific progress, is urged to leverage its financial and diplomatic influence. This includes supporting organisations like Unitaid and the Global Fund, which are working to secure affordable generics and deliver the drug where needed. Activists argue the UK must also use its diplomatic leverage with Gilead, the manufacturer, to ensure licensing arrangements prioritise people over profit.
However, this leadership is undermined by the UK's cuts to aid spending and reductions in global health resources. As Molly Thompson, senior advocacy advisor at STOPAIDS, notes, the UK cannot claim to want to end AIDS while reducing support for the partners that make such progress possible. With just four years to 2030, the UK's new leadership faces a choice about the kind of global health leader it wants to be.
Will lenacapavir end the epidemic or deepen inequality?
If lenacapavir is not made accessible to all who need it, it risks becoming another medical breakthrough reserved for the wealthy. The opportunity to finally end a decades-long epidemic hinges on equitable access. The UK has a chance to build on its history of global HIV leadership by investing in organisations that can scale these innovations and fighting for fair access for all.
This is not just a matter of public health; it is a matter of global justice. The communities most impacted by HIV, including LGBTQIA+ people, BIPOC communities, migrants, and those living in poverty, must be at the centre of the solution, not excluded from it. The fight for lenacapavir access is a fight against the systemic inequalities that allow profit to trump human life. #GlobalHealthJustice #HIVAwareness #LenacapavirForAll