HIV Prevention Partnerships: Expanding Access to Lenacapavir for Global Impact

By João L. Carapinha

April 17, 2026

HIV Prevention Partnerships between PEPFAR, The Global Fund, and Gilead Sciences are accelerating access to twice-yearly injectable lenacapavir for HIV pre-exposure prophylaxis (PrEP) in high-burden countries.

Unprecedented Speed to Sub-Saharan Africa

This additional investment by Gilead will provide lenacapavir to up to one million more people over the next three years, bringing the total commitment to three million individuals through 2028. Lenacapavir has become the first HIV prevention therapy to reach communities in sub-Saharan Africa in the same calendar year it received U.S. approval, with initial shipments expected by the end of 2025.

No-Profit Supply Meets Generic Scale-Up

HIV Prevention Partnerships are combining Gilead’s no-profit pricing for PEPFAR and The Global Fund in priority countries with accelerated voluntary licensing to six generic manufacturers. This dual approach enables immediate access through established distribution networks while preparing for large-scale generic availability beginning in 2027. Many countries have already begun engaging with these manufacturers, demonstrating strong market readiness.

By bridging branded supply in 2025–2026 with generic rollout from 2027, these efforts dramatically shorten the traditional lag between regulatory approval in high-income markets and widespread use in low- and middle-income countries. This strategy directly addresses the persistent 1.3 million annual new HIV infections globally and the urgent need for long-acting options that overcome adherence challenges of daily pills.

A Model for Sustainable HIV Prevention

From a health economics perspective, the initiative offers a replicable framework for accelerating adoption of innovative PrEP technologies. The combination of early stakeholder collaboration, voluntary licensing, and results-based financing is expected to lower lifetime treatment costs and support more sustainable funding models for ending the HIV epidemic.

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