Injecting this drug twice a year can help end AIDS

the shot twice a year was 100% effective in preventing HIV infection in a study of women, and results published Wednesday showed it worked almost as well in men.

Drug manufacturer Gilead said it would allow the sale of low-cost generic drugs in 120 poor countries with high HIV rates – mainly in Africa, Southeast Asia and the Caribbean. But it ruled out almost all of them Latin Americawhere rates are much lower but rising, raising concerns that the world is missing a crucial opportunity to stop the disease.

“This approach is far superior to any other prevention method we have and is unprecedented,” said Winnie Byanyima, executive director of UNAIDS. She credited Gilead with developing the drug, but said the world’s ability to stop AIDS depends on its use in at-risk countries.

in one report Issued to mark World AIDS Day on Sunday, UNAIDS said the number of AIDS deaths last year – estimated at 630,000 – was at its lowest since peaking in 2004, showing how The world is currently at a “historic crossroads” and has a chance to end. epidemic.

The drug called lenacapavir has been sold under the brand name Sunlenca to treat HIV infection in the US, Canada, Europe and elsewhere. The company plans to soon apply for a license for Sunlenca to be used for HIV prevention.

Although there are other ways to protect against infection, like condoms, daily medicine, vaginal ring and vaccination every two months, experts say Gilead vaccination twice a year will be especially helpful for marginalized people who are often afraid to seek care, including gay men, prostitutes prostitutes and young women.

“This will be a miracle for these groups because it means they only need to show up twice a year at a clinic and then they will be protected,” said Byanyima of UNAIDS.

That was the case for Luis Ruvalcaba, a 32-year-old man from Guadalajara, Mexico, who participated in the latest published study. He said he was afraid to ask for daily preventive medicine provided by the government, fearing discrimination because he was gay. Because he participated in the study, he will continue to receive the vaccine for at least another year.

“In Latin American countries, there is still a lot of stigma,” said Dr. Alma Minerva Pérez, who has recruited and enrolled dozens of research volunteers at a private research center in Guadalajara. People are embarrassed to ask for medicine.”

It remains unclear how widely these shots will be available in Mexico through the country’s health care system. Health officials declined to comment on any plans to buy Sunlenca for its residents; Daily medication to prevent HIV was made available for free through the country’s public health system in 2021.

“If the possibility of using generics is opened up, I believe Mexico could participate,” Pérez said.

Byanyima said other countries besides Mexico participating in the study were also excluded from the generics agreement, including Brazil, Peru and Argentina. “To now deny them that drugs is unconscionable.” she said.

In a statement, Gilead said it has an “ongoing commitment to supporting access to HIV treatment and prevention options where the need is greatest.” Of the 120 countries eligible to use the original version, 18 are mainly in Africa, which accounts for 70% of the world’s HIV burden.

The drugmaker said it is also working to establish “a rapid, effective pathway to reach all people who need or want lenacapavir for HIV prevention.”

On Thursday, 15 advocacy groups in Peru, Argentina, Ecuador, Chile, Guatemala and Colombia wrote to Gilead, demanding the supply of generic drug Sunlenca in Latin America, citing “alarming” inequities in access to new HIV prevention tools while infection rates are rising.

While countries including Norway, France, Spain and the US already pay more than $40,000 per year for Sunlenca, experts have calculated that it could be produced for as little as $40 per treatment. as generic drug production expands to 10 million people.

Dr. Chris Beyrer, director of the Institute for Global Health at Duke University, said it would be extremely helpful if Sunlenca was available in the hardest-hit countries in Africa and Asia. However, he said rising HIV rates among groups including gay and transgender people constituted a “public health emergency” in Latin America.

Hannya Danielle Torres, a 30-year-old transgender woman and artist participating in the Sunlenca study in Mexico, said she hopes the government will find a way to make the shots available. “Mexico may have some of the richest people in the world, but it also has some of the most vulnerable people living in extreme poverty and violence,” Torres said.

Another drugmaker, Viiv Healthcare, has also outpaced most of Latin America by allowing generic HIV shots in about 90 countries. Sold under the name Apretude, the bimonthly shots are about 80% to 90% effective in preventing HIV. They cost about $1,500 a year in middle-income countries, more than most people can afford.

Asia Russell, executive director of the advocacy group Health Distancesaid that with more than 1 million new HIV infections globally each year, established prevention methods are insufficient. She called on countries like Brazil and Mexico to issue “compulsory licenses,” a mechanism by which countries suspend patents during a health crisis.

That’s a strategy some countries have used in previous HIV treatments, including in the late 1990s and 2000s when AIDS drugs were first discovered. More recently, Colombia issued the first mandatory license for its main HIV drug Tivicay in April without the permission of the drugmaker Viiv.

Dr. Salim Abdool Karim, an AIDS expert at South Africa’s University of KwaZulu-Natal, said he had never seen a drug that appeared to be as effective as Sunlenca in preventing HIV.

“The missing piece in the puzzle now is how can we get it into the hands of the people who need it,” he said.