Global Fund plans for lenacapavir PrEP in selected countries

Simon Collins, HIV i-Base

On 9 July 2025, the Global Fund announced details of plans to make lenacapavir available as a six-monthly injection in selected low- and middle-income countries (LMICs). [1]

The Global Fund plans for their programme to reach two million people with long-acting PrEP. The first stage of this goal include having signed a licensing contract woth the manufacturer Gilead to provide lenacapavir until generic companies are able to produce lower priced versions.

Although early access will be decided both on a countries needs and the available resources, these essential details are not reported. However, the timeline includes providing lenacapavir to at least one African country before the end of 2025.

The press release also refers to working with private donors to roll out this programme including UNITAID, the Elton John AIDS Foundation (EJAF), AVAC and the Children’s Investment Fund Foundation (CIFF).

Last month, Bill Gates also publicly committed to support lenacapavir PrEP. [2]

It also suggests that much has still to be done to ensure appropriate funding will be available and that the Global Fund itself is not able to guarantee this:

“Without urgent and sustained investments the ambition to reach 2 million people with long-acting PrEP risks falling short — just as the world stands at the brink of a decisive step toward ending AIDS for good”.

comment

This is good news but funding commitments and more details is essential in order to balance realistic expectations.

Access will also depend on Gilead registering lenacapavir widely in all countries and previous announcement on access have not included many high-incidence countries in Central and South America, including those where registration studies for lenacapavir were held.

Since 20 January 2025, the withdrawal of US international funding led to the closure of thousands of clinics in LMICs that provided sexual helath services for key populations

This meant that mens basic services like condoms, lube and oral PrEP disappeared over night, showing the urgency of restoring even these basic services will be essential to provide the framework for programmes for injectable PrEP.

The importance ofr re-establishing HIV prevention as an urgent priority is also stressed in the recent Kigali Call to Action, launched to coincide with the upcoming IAS conference in Rwanda next week. [3]

References

  1. The Global Fund to Fight AIDS Tuberculosis and Malaria (the Global Fund). Global Fund Secures Access to Breakthrough HIV Prevention Drug Lenacapavir for Low- and Middle-Income Countries. (9 July 2025).
    https://www.theglobalfund.org/en/news/2025/2025-07-09-global-fund-secures-access-breakthrough-hiv-prevention-drug-lenacapavir/
  2. Gates Foundation commits to providing lenacapavir as PrEP next year. HTB 3 June 2025).
    https://i-base.info/htb/51222
  3. Kigali Call to Action: sign-on for IAS 2025 conference, HTB (1 July 2025).
    https://i-base.info/htb/51418
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Simon Collins (he, him)
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