Health and Healthcare Systems

4 ways new HIV medicines could help usher in the end of AIDS

Global collaboration could help make new HIV medicines available throughout the world.

Global collaboration could help make new HIV medicines available throughout the world. Image: Getty Images/SeventyFour

Winnie Byanyima
Undersecretary-General of the United Nations and Executive Director, Joint United Nations Programme on HIV/AIDS (UNAIDS)
This article is part of: World Economic Forum Annual Meeting
  • Innovative long-acting medicines could usher in a new era of HIV prevention and treatment for millions of people around the world.
  • Current options work well for some in the global North but are not yet reaching lower-resourced settings, particularly the large numbers of people at high risk in Africa, Asia and Latin America.
  • Collaboration by business, governments and civil society to expand production, knowledge sharing and financial commitments could help millions more people access these new HIV medicines.

The world could be on the cusp of a revolution in the global AIDS response. In December 2024, Science Magazine named a new long-acting HIV drug — lenacapavir — its Breakthrough of the Year. It can prevent new HIV infections with just two shots per year and can also keep people already living with HIV alive and well.

This is just one of several exciting, long-acting prevention medicines that are now available. A two-monthly injection and a monthly vaginal ring are already available. A three-month vaginal ring and once-a-month pill are also in promising clinical trials. And just as that Breakthrough of the Year award was named, trials were announced for a once-a-year injectable version of lenacapavir.

This is scientific innovation at its best. And it could usher in a new era of HIV treatment and prevention.

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For this remarkable science to actually end the AIDS pandemic, we need a global public-private effort by companies, governments and communities that goes beyond anything we have seen to date. If this opportunity can be seized, we could do something the world has never done before: We could end a pandemic with no cure and no vaccine, and with the people most affected still alive to tell the tale.

We could consign AIDS to the history books – and 2025 could be the pivotal year for doing so.

The benefits of new HIV medicines

A decade ago, the world adopted a bold goal to end the AIDS pandemic by 2030. But we are not on track to do this. In 2023, new HIV infections were still at around 1.3 million – far higher than the 370,000 target for 2025 – and, on average, a person died of AIDS somewhere in the world every minute.

But now, these new HIV medicines could replace daily pills with methods people only have to deal with a few times a year. These innovations are not pipe dreams, some are already being used in high-income countries. But for those who need them most – people at high risk in Africa, Asia, and Latin America – these treatments are not available or affordable.

This new class of HIV medicines could introduce a style of prevention similar to an injectable contraceptive or seasonal vaccine. Anyone who has struggled to swallow tablets every day can understand the difference. And when taking HIV medicine is tied up in deeply unjust stigma and discrimination, the potential for these tools to be game-changing is crystal clear.

Jumpstarting a new era in the HIV response

With business, government and civil society leaders gathering at the World Economic Forum's 2025 Annual Meeting in Davos, this could be the opportunity that helps to jumpstart the global AIDS response. Here’s how:

1. Make HIV medicine affordable

Medicines should be global public goods, not treated like luxury products. Drug companies can still make a healthy profit while ensuring that HIV medicines are affordable to those who need them. In the US, HIV medicines cost as much as $40,000 per person per year. There is no way low- and middle-income countries can pay this.

Gilead Sciences and ViiV, makers of the long-acting injectables lenacapavir and cabotegravir, have announced they will reduce prices for some countries – although Gilead's price for lenacapavir has yet to be confirmed.

2. Expand production

We need many producers for these drugs, not just one. This means bringing in the innovation of generic drug companies in countries like South Africa, India, Brazil, Egypt and Thailand. Researchers have already calculated that, if demand is high enough, lenacapavir can be produced and sold for around $40 per person per year while still making a profit for the drug company.

Gilead and ViiV have licensed the HIV medicines for companies to make affordable generics in many lower-income countries, but not all. Some countries, particularly in Latin America, have been left out. Even Brazil, Argentina, Mexico and Peru, which participated in clinical trials of lenacapavir, have been excluded.

We need to expand public-private collaboration in this area. The United Nations is working with partner organizations Unitaid, the US President's Emergency Plan for AIDS Relief, AIDS Vaccine Advocacy Coalition, and the Global Fund to Fight AIDS, TB and Malaria (The Global Fund) to shape a sizeable global market. For this to be transformative, more producers of drugs, as well as medical equipment and those with expertise in supply chains and beyond, must get involved. The private sector has a big part to play.

3. Encourage innovation

By doubling down on innovation, producers can create treatment options that revolutionize life for people living with HIV in the global South. African adolescents who have grown up with HIV tell us they yearn to be free of taking a pill every day. People facing criminalization, like gay men in some parts of the world, need options they can take at the clinic instead of bringing home with them.

Right now, the long-acting treatment options available work well for some in the global North, which creates less urgency to try new combinations. Current combinations are not ideal for lower-resourced settings, creating the need for trials combining drugs from different companies.

4. Boost global collaboration

The Global Fund will be the single most important source for supplying these new medicines in Africa, but it does not currently have enough money to support a global roll out.

In 2025, the fund is scheduled for a three-year replenishment. Governments will be making pledges in a deeply challenging political and economic environment. We need private sector leaders to lend their voices and their resources to ensure the fund can grow.

Choosing the right path

The history of the AIDS pandemic shows two paths can be taken. Between 1997 and 2006, 12 million people died in Africa waiting for the first generation of HIV treatments to become affordable. After years of public pressure, business, governments and civil society came together to push for lower prices and build the institutions that have brought HIV medicines to millions through widespread generic production, knowledge sharing and financial commitment.

Leaders gathered at the World Economic Forum's Annual Meeting must take this second path if we are to end the AIDS pandemic once and for all. Scientists are providing the opportunity for long-acting medicines to achieve remarkable things in the HIV response. If business, governments and civil society can follow suit, this could be the beginning of the end of AIDS.

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