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New ‘game-changer’ HIV drug sought for Africa

More than 300 politicians, health experts and celebrities on Thursday called for US pharmaceutical giant Gilead to allow cheap, generic versions of a promising new HIV drug to be produced so it can reach people in developing countries most affected by the deadly disease

ANALYSIS | AGENCIES | The drug lenacapavir could be a “real game-changer” in the fight against HIV, according to an open letter to Gilead CEO Daniel O’Day signed by a range of former world leaders, AIDS groups, activists, actors and others.

Gilead responded that it is in talks with governments and organisations about how to expand access to the drug.

Lenacapavir, which was approved for use in the United States and the European Union in 2022, only needs to be injected twice a year, making it particularly suited for people normally “excluded from high quality health care,” the open letter said.

“We urge Gilead to ensure that people in the Global South living with or at risk of HIV can access this groundbreaking medicine at the same time as people in the Global North can,” it added.

The signatories urged Gilead to license the drug on the United Nations-backed Medicines Patent Pool, which would allow for cheaper generic versions to be manufactured.

Two thirds of the 39 million people living with HIV were in Africa in 2022, according to the World Health Organisation. Africa also accounted for 380,000 of the 630,000 AIDS-related deaths across the world that year, the WHO figures showed.

‘Horror and shame’

The letter said the “world now recalls with horror and shame that it took 10 years and 12 million lives lost before generic versions” of the first antiretroviral drugs became available worldwide.

“This innovation could help end AIDS as a public health threat by 2030—but only if all who would benefit from it can access it.”

Because it only requires two shots a year, the drug could be particularly important for those who face stigma getting treated for HIV, including young women, LGBTQ people, sex workers and people who inject drugs, the letter said.

Among the signatories were former heads of state including Liberian ex-president Ellen Johnson Sirleaf and Malawi’s Joyce Banda.

UNAIDS executive director Winnie Byanyima and other humanitarian figures also signed on, as did actors including Gillian Anderson, Stephen Fry, Sharon Stone and Alan Cummings.

Another signatory Francoise Barre-Sinoussi—the French scientist who co-discovered the HIV virus—lamented “that inequality, not science, is the greatest barrier to fighting AIDS”.

On behalf of the scientists who paved the way for such new medicine, “I implore Gilead to erase much of that inequality and make a monumental step towards ending the AIDS pandemic,” she said in a statement.

Lenacapavir, sold under the brand name Sunlenca, has been shown to reduce “viral load in patients with infections that are resistant to other treatments,” according to the European Medicines Agency.

Gilead said in a statement it is “grateful for the advocacy of all those who share our enthusiasm for the potential of lenacapavir”.

“As we await the results of our pivotal phase 3 clinical trials which will start to read out later this year, we are in regular conversations with HIV advocates and partners, including governments and NGOs, as we work to reach our access goals,” the biotech firm said.

“We are extremely committed to developing an access model that ensures lenacapavir for PrEP reaches as many people as possible that can benefit.”

Lenacapavir belongs to a group of HIV drugs called capsid inhibitors. Capsid inhibitors interfere with HIV capsid, a protein shell that protects HIV’s genetic material and enzymes needed for replication. Capsid inhibitors can disrupt HIV capsid during multiple stages of the viral life cycle. This prevents HIV from multiplying and can reduce the amount of HIV in the body. Lenacapavir may work against HIV strains that are resistant to other HIV drugs. Lenacapavir has been shown to reduce “viral load in patients with infections that are resistant to other treatments,” according to the European Medicines Agency. Lenacapavir is also being studied as an investigational drug to prevent HIV infection.

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