The recent approval of a long-acting HIV prevention drug, Yeztugo, has triggered a global debate over access and affordability.
Health experts say the drug, while a major scientific milestone, may remain out of reach for millions unless action is taken to address pricing.
Yeztugo, a brand of injectable Lenacapavir, was approved by the United States Food and Drug Administration (FDA) as a twice-yearly medication for people at risk of HIV.
Clinical trials concluded in 2024 showed that when used as prescribed every six months, the drug nearly eliminates the chance of new infections.
Public health officials described it as a more convenient and long-lasting alternative to daily oral PrEP pills like Truvada and Descovy or GSK’s Apretude, taken every two months.
Calls for Fair Pricing Grow as Global Rollout Nears
Gilead Sciences, the drug’s manufacturer, announced a US price of $28,218 per person annually.
While the company promises free or discounted access to eligible Americans, international public health leaders have warned that such a high cost could block access to people in low-income countries who are at high risk of infection.
Winnie Byanyima, Executive Director of UNAIDS, described the FDA’s approval as a historic moment, but questioned Gilead’s pricing. “It is beyond comprehension how Gilead can justify a price of 28,218 dollars,” she said. “If this game-changing medicine remains unaffordable, it will change nothing.”
A recent study published in a medical journal estimates that generic Lenacapavir could be manufactured for just $35–$46 per person annually and even less with strong demand. Experts believe this could bring it in line with existing oral PrEP options already available in many developing countries.
In response, Gilead announced that it had licensed six generic drug manufacturers to produce and distribute low-cost versions of Lenacapavir across 120 low- and lower-middle-income countries.
The company also promised to supply doses for up to two million people at no profit while generic production scales up.
Experts Urge Africa to Build Self-Reliance in Medicine Development
In Nigeria, health professionals applauded the scientific progress but pointed to the persistent challenge of access in Africa. Virologist Prof. Oyewale Tomori warned that unless African countries invest in local research and pharmaceutical manufacturing, they will continue to depend on foreign companies for life-saving treatments.
“We must invest significantly in local research, biotechnology, and pharmaceutical development,” Tomori said. “Only through self-reliance can the continent avoid being perpetually left behind during major health breakthroughs.”
Other advocates, like Jeremiah Johnson of PrEP4All, stressed the importance of equitable access. “It’s not enough to have the science, we need it in the hands of those who need it most,” he said.
Daily oral PrEP pills have been available globally for over 10 years, but public health experts note that stigma, the burden of taking daily medication, and lack of access have made them less effective in many communities. Yeztugo’s twice-yearly injection could remove those barriers, but only if the cost does not lock out those most in need.
Gilead’s CEO, Daniel O’Day, expressed optimism. “This really will bend the arc of the epidemic as we roll this out globally,” he said. The company has stated its commitment to broad insurance coverage in the US and plans to expand the drug’s availability internationally with partnerships.
The medication is already being used for HIV treatment under the name Sunlenca, which currently sells for over $42,000 annually in the US. But unless pricing changes, Yeztugo may face the same access limitations that have affected earlier breakthrough drugs.
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