ViiV Healthcare Licensing: Expanding Access to Long-Acting HIV Treatment in Low-Income Countries

ViiV Healthcare has expanded its voluntary licensing agreement with the Medicines Patent Pool. The update now includes access to long-acting injectable cabotegravir (CAB LA) for HIV treatment. This allows generic manufacturers to supply the therapy in 133 low- and middle-income countries (LMICs). The move follows WHO’s updated guidelines recommending CAB LA with rilpivirine as a treatment option. It builds on a prior agreement focused on HIV prevention via pre-exposure prophylaxis (PrEP). The extension aims to address global disparities in access to innovative HIV therapies.

Key Insights

The agreement shifts from covering only prevention (PrEP) to now including HIV/AIDS treatment. This addresses a critical gap in available therapies. Existing generic licensees, like Aurobindo, Cipla, and Viatris, can produce CAB LA for LMICs and Sub-Saharan Africa, pending regulatory approvals. The collaboration aligns with WHO recommendations to prioritize equitable access to effective therapies, especially in high-burden regions with limited healthcare infrastructure.

The WHO’s 2025 update endorsed long-acting CAB LA + rilpivirine as an HIV treatment regimen. It highlighted its potential to reduce pill burden and improve viral suppression when given every two months. The Medicines Patent Pool (MPP) is a UN-backed organization, and it has a strong record in negotiating voluntary licenses for essential medicines, including HIV antiretrovirals and COVID-19 treatments. Previously, CAB LA was only licensed for PrEP through this platform, however with this expansion, now treatment needs are addressed.

Implications

ViiV Healthcare’s licensing model could reshape HIV treatment economics in LMICs. Lower drug costs through generic production may reduce patient expenses. However, challenges remain, like refrigeration needs and healthcare provider training for injectables. Research may explore if injectables improve adherence over daily pills, especially in strained healthcare systems. Partnerships like ViiV-MPP could accelerate access to novel therapies. Yet, scalability and sustainability will need ongoing public-private investment.