Dose of hope
To really help, new HIV vax has to be made cheap
A pill to treat multidrug-resistant HIV, lenacapavir, has been approved by US drug regulator FDA as a preventive vaccine. This is a huge deal – incidence of HIV may have declined since 1990s but even today about 13L people globally are infected by the virus every year. But its price is an obstacle. Sold for $28,218 per year in US, it's prohibitive even for high-income nations. Pharma company Gilead that manufactures lenacapavir has reportedly tied up with over 100 middle- and low-income countries for manufacture of generics pending approvals. But access likely will still be tricky for poorer African countries that bear the HIV burden.
Drugs to prevent HIV transmission have been around almost a decade, but a daily dosage regimen makes these unreliable. People forget and there's the stigma/doubt in partners that a daily dose is preventive. Lenacapavir needs to be taken just twice a year. Its long-lasting effect in preventing infection – almost 100% in adults and adolescents – is thus the best bet today. Also because HIV research in US bears the additional burden of Trump administration's slashed funds.
An effective vaccine for HIV has been elusive for decades because of its rapid mutations. Several mRNA vaccines, like those developed for Covid and considered the most promising, are in clinical trials. But since Jan, under Trump's health secretary Bob Kennedy Jr, NIH stopped funding hundreds of such HIV vaccine-related research. This is what makes repurposed lenacapavir a lifeline, provided it's made affordable.
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This piece appeared as an editorial opinion in the print edition of The Times of India.
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