Health activists are urging pharmaceutical manufacturer Gilead Sciences to make larger volumes of its twice-yearly HIV shot available to African countries, saying the quantities planned won’t do enough to slow the epidemic.
Earlier this week the US government and the Global Fund to Fight HIV/Aids, Tuberculosis and Malaria announced the first donations of Gilead’s lenacapavir, which allocated 500 doses each to Eswatini and Zambia.
South Africa is slated to receive just fewer than 975,000 doses over two years starting in April, financed with part of an existing grant from the Global Fund.
The US state department and the Global Fund had reserved Gilead’s total available volume of lenacapavir for 2026, which runs to 600,000 doses, the US Bureau of Global Health Security & Diplomacy’s senior adviser, Brad Smith, told reporters on Tuesday. The US had committed to purchasing 325,000 doses, he said.
But achieving the global goal of a 90% reduction in new HIV infections by 2030 will require providing the shots to at least 10-million people in Africa alone, according to an international coalition of health activists that includes South Africa’s Health Justice Initiative (HJI) and Treatment Action Campaign.
“By procuring a minuscule number of doses, Gilead can claim that lenacapavir is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” said HJI director Fatima Hassan.
Africa bears the brunt of the world’s HIV/Aids epidemic, with 60% of all new HIV infections taking place in Sub-Saharan Africa.
“Instead of crumbs, the US should be providing millions of doses to alter the course of the HIV pandemic and to repair the harm caused by their illegal and deadly cuts to HIV programmes since January,” said Bellinda Thibela, international policy and advocacy co-ordinator for Health GAP, a member of the coalition.
The activists criticised the US government’s announcement earlier this week that it had excluded South Africa from its plans to roll out lenacapavir, noting that 14% of the world’s HIV infections occurred in South Africa.
South Africa’s allocation of lenacapavir will enable it to initiate more than 450,000 people on the shot, though Wits researchers estimate more than 2-million people a year need lenacapavir to change the trajectory of the country’s HIV epidemic.
“Gilead and the US government are thwarting efforts to increase lencapacavir volumes and use cheaper generic versions sooner. Their profit-seeking and at times deeply exclusionary and racist ‘market shaping’ efforts will unnecessarily prolong the pandemic,” said Hassan.
Gilead has awarded voluntary licences to several generic drug manufacturers, but these doses are only expected to be available in 2027, said Gilead CEO Daniel O’Day.
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