NEW DRUG PROVEN TO PREVENT AIDS, BUT U.S. CUTS FUNDING TO DELIVER IT. Stephanie Nolan reports.
A new drug that gives almost complete protection against the virus was to be administered across Africa this year. Now, much of the funding for that effort is gone.
EXCERPTS FROM THE NY TIMES
This was supposed to be a breakthrough year in the 44-year-long struggle against H.I.V. A breakthrough preventive drug, lenacapavir, a twice-yearly injection that offers total protection from H.I.V., was to be rapidly rolled out across eastern and southern Africa. The main target: young women. About 300,000 of them were newly infected with the virus last year — half of all new infections worldwide…
There is more potential than ever before to end the H.I.V. epidemic, scientists and public health experts say. But now, H.I.V. programs across Africa are scrambling to procure drugs that the United States once supplied, replace lost nurses and lab technicians, and restart shuttered programs to prevent new infections.
“We imagined we would be in a different world right now,” said Dr. Leila Mansoor, a senior research scientist at the Centre for the AIDS Program of Research in Durban, South Africa. She had planned to spend 2025 analyzing data from one H.I.V. prevention trial, preparing for another and tracking how lenacapavir was transforming the epidemic — alongside colleagues testing new vaccines and cure strategies.
“And instead we’re moving backwards at warp speed,” she said…
Already, there are fears that H.I.V. infection rates are rising in the hardest-hit countries, but there is no clear way to measure the damage because data collection was mostly reliant on the terminated U.S. funding. Stocks of prevention drugs once supplied by the U.S. are running out across Africa.
The Trump administration says that too much foreign aid is wasted by corrupt governments and bloated programs. The president and his allies have repeatedly said that the United States has shouldered an unfair share of responsibility for global health support and that other countries must do more…
Among the prevention programs cut is U.S. support for an ambitious plan to distribute lenacapavir, which the U.S. Food and Drug Administration approved this week. Rapid rollout of the new injection is seen by many public health experts as the best opportunity the world has yet had to stop the spread of H.I.V. in the United States and abroad.
Lenacapavir was supposed to be the product that showed that the world was finally doing things differently, said Dr. Linda-Gail Bekker, director of the Desmond Tutu H.I.V. Centre at the University of Cape Town, who was a principal investigator in the trial that proved the drug’s extraordinary effectiveness.
The company that makes the drug, Gilead Sciences, applied for regulatory approval in African countries where it was tested at the same time as in the United States. The company also issued a voluntary license to makers of generics, including companies in India and Egypt, so that an affordable product would be available in a few years.
To bridge the gap until that time, Gilead committed to producing enough of the drug to protect two million people over three years, to be sold at “a no-profit price.”
However, about half of those doses from Gilead were supposed to be purchased by the President’s Emergency Fund for AIDS Relief, known as PEPFAR. But the Trump administration has decided that PEPFAR should no longer support H.I.V. prevention for anyone except pregnant and breastfeeding women, and will most likely fund only a sliver of the planned Gilead purchase. The other half of the doses were meant to be bought by the Global Fund to Fight AIDS, Tuberculosis and Malaria, a multilateral donor agency to which the United States has historically been the largest funder. But the Trump administration is also cutting deeply into its support to the Global Fund…
“The promise of lenacapavir for prevention was — everybody thought this is the last stage to bring the H.I.V. epidemic down to its knees, and there was such enthusiasm for what we would see,” said Dr. Ntobeko Ntusi, the chief executive of the South African Medical Research Council. “That’s now all up in the air.”