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HIV prevention drug access threatened by USAID cuts, experts warn

Created at 31 Jul · 5:06 PM1 source↑ Market-relevant
IN SHORT

Experts at the Aids 2026 Conference expressed concern that cuts to USAID funding will limit global access to lenacapavir, a new injectable HIV prevention drug. The medication, recommended by the WHO, could significantly reduce new infections but is becoming inaccessible to those who need it most.

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Key Numbers

99%effectiveness of PrEP in preventing sexually transmitted HIV
twolenacapavir injections required annually
41%estimated reduction in new HIV infections with lenacapavir availability in key r
73%donor-funded resources for HIV prevention globally provided by USAID

Who's Involved

World Health Organization
recommended expanded access to lenacapavir
Beatriz Grinsztejn
President of the International Aids Society and researcher at Fiocruz
Ailish Brennan
Policy analyst at Harm Reduction International
USAID
US foreign aid agency facing funding cuts
Gilead Sciences
Provider of generic lenacapavir versions

↳ Why This Matters

Cuts to US foreign aid and pharmaceutical pricing strategies threaten to limit access to a groundbreaking HIV prevention drug, potentially reversing progress made in combating the global AIDS epidemic and leaving vulnerable populations without crucial medical interventions.

Key facts

  • New injectable HIV prevention drug lenacapavir could significantly reduce global cases.
  • The WHO recommended prioritizing lenacapavir access globally.
  • USAID funding cuts are hindering access to the drug, especially for vulnerable populations.
  • Outreach services and harm reduction organizations are also impacted by funding reductions.
  • Several Latin American countries are excluded from affordable generic versions of the drug.

Experts at the Aids 2026 Conference in Rio de Janeiro have warned that significant cuts to USAID funding are jeopardizing global access to lenacapavir, a highly effective injectable HIV prevention medication.

The World Health Organization had previously recommended that governments worldwide prioritize the rollout of lenacapavir, which requires only two injections per year. This innovation is seen as particularly crucial for individuals facing barriers such as poverty, stigma, or remote locations, for whom daily pills or bimonthly injections are difficult to maintain.

A modeling study suggested that widespread availability of lenacapavir could prevent up to 41% of new HIV infections in South Africa, Zimbabwe, and western Kenya. However, these advancements are being undermined by substantial funding cuts, particularly the dissolution of USAID, which historically provided a significant portion of global donor-funded HIV prevention resources.

Beatriz Grinsztejn, president of the International Aids Society, highlighted that the funding reductions not only affect medication availability but also the capacity of organizations to reach vulnerable populations, including people who inject drugs. Ailish Brennan of Harm Reduction International noted that outreach workers, vital for building trust and engaging at-risk individuals, have been particularly impacted, leading some organizations to close locations and clients to lose their local points of contact.

Furthermore, even before the recent funding cuts, many Latin American countries were excluded from affordable access agreements for lenacapavir, with Gilead Sciences classifying them as 'upper middle-income' despite their significant role in clinical trials. Experts expressed pessimism about achieving the UNAIDS goal of eliminating AIDS as a public health threat by 2030 under the current circumstances.

Frequently asked questions

Lenacapavir is an injectable version of the HIV prevention medication PrEP that requires only two injections annually, offering a more accessible option for many individuals.

It is crucial for populations facing barriers to consistent daily medication, such as those experiencing poverty, stigma, or living in remote areas, and is highly effective in preventing HIV.

The cuts have dramatically reduced investment in HIV prevention, affecting the availability of new technologies like lenacapavir and hindering outreach services that connect people to care.

Countries like Brazil, Colombia, Mexico, Peru, and Argentina are classified as 'upper middle-income' by Gilead, excluding them from lower-cost generic versions of the drug.

What Happens Next

01Continued monitoring of USAID funding levels and their impact on global HIV prevention programs.
02Advocacy efforts by international organizations and HIV advocates to ensure broader access to lenacapavir.
03Potential re-evaluation of Gilead Sciences' pricing and access strategies for middle-income countries.

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Cadence

How It Developed

The WHO recommended prioritizing expanded access to lenacapavir, an injectable HIV prevention medication, one year ago.
Lenacapavir requires only two injections annually, offering a game-changing solution for populations facing barriers to daily pills or bimonthly injections.
A modeling study estimated widespread lenacapavir availability could prevent 41% of new HIV infections in South Africa, Zimbabwe, and western Kenya.
The Trump administration was dissolving USAID, which provided 73% of donor-funded HIV prevention resources globally, when the WHO made its recommendation.
Investment in HIV prevention has dramatically declined globally as of July 2026.
Experts noted that funding cuts impact not only medication availability but also outreach services crucial for engaging high-risk populations.
Many harm reduction and HIV prevention organizations are closing locations due to funding loss, impacting client trust and access.
Even before USAID dissolution, much of Latin America was excluded from affordable innovative HIV prevention agreements.

Sources

T1
HIV prevention drug could reduce cases globally but USAID cuts prevent access, say expertsThe Guardian

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