By Ashok Ramsarup :: The international humanitarian medical non-governmental organization, Médecins Sans Frontières (MSF), also known as Doctors Without Borders, has welcomed the World Health Organization’s (WHO) release of guidelines for lenacapavir, a potentially “game-changing” HIV prevention drug. However, MSF has expressed deep concern about access, citing licensing limitations.

At the International AIDS Society Conference in Kigali, Rwanda, MSF highlighted lenacapavir’s potential to transform the HIV prevention landscape. According to WHO, lenacapavir is a long-acting injectable that needs to be administered only twice a year. The drug has shown remarkable efficacy: 100% effectiveness in preventing HIV among cisgender women and girls, 96% risk reduction among cis and trans men and non-binary individuals, and 89% more effectiveness than daily oral HIV prevention pills.

Current HIV prevention options, including oral pre-exposure prophylaxis (PrEP), the dapivirine vaginal ring, and cabotegravir (an injection every two months), have limitations. MSF notes that oral PrEP, which requires frequent pill-taking, can be challenging to adhere to, potentially leading to reduced effectiveness.

While MSF acknowledges lenacapavir’s potential, the organization stresses that accessibility is crucial. High pricing and limited licensing make it out of reach for millions in low- and middle-income countries. Antonio Flores, Senior HIV/TB Advisor for MSF Southern Africa Medical Unit (SAMU), emphasized that lenacapavir’s impact will depend on its accessibility to communities that need it most.

MSF welcomes the strategic partnership between Gilead, the American pharmaceutical company behind lenacapavir, and the Global Fund to Fight AIDS, TB, and Malaria. However, the organization calls for transparent pricing and supply agreements to facilitate negotiations for affordable access outside of the Global Fund agreement.

Dr. Tom Ellman, MSF SAMU Director, urged Gilead to remove licensing roadblocks and ensure lenacapavir reaches its full potential in reversing the HIV epidemic. Additionally, Dr. Ellman emphasized the need for governments and global health donors to commit further funding to enable the development of affordable and sustainable generic markets for lenacapavir.