A revolutionary new HIV prevention drug, Yeztugo, is being celebrated as a potential game-changer in the global fight against HIV. But healthcare experts warn that its high cost could prevent millions from accessing the lifesaving treatment.
The injectable medication, known scientifically as Lenacapavir, has been approved by the U.S. Food and Drug Administration (FDA) for use as a long-acting PrEP solution. It only requires two doses per year and was shown in 2024 trials to be highly effective in preventing HIV transmission.
Unlike daily oral medications or even bimonthly injectables, Yeztugo’s twice-yearly dosing offers a more discreet and user-friendly alternative, especially in communities where HIV-related stigma and poor adherence have posed challenges.
However, Gilead’s announcement of a U.S. price tag of $28,218 per person per year has prompted outrage. A recent analysis published in The Lancet HIV suggests the drug could be produced for under $50 per year if manufactured generically—raising concerns that pricing, rather than science, may determine who benefits from this innovation.
Winnie Byanyima, Executive Director of UNAIDS, described the approval as a “breakthrough moment,” but added: “If it’s not affordable, it won’t save lives. We must ensure equitable access to such critical innovations.”
Professor Oyewale Tomori, a leading Nigerian virologist, echoed those concerns. “Africa must start producing its own treatments. As long as we rely on imports, we’ll always be last in line when it matters most,” he said.
In the U.S., Gilead has committed to reducing out-of-pocket costs for insured patients and offering the drug free to eligible uninsured individuals. Globally, the company has signed deals with six generic producers to ensure access in 120 low- and lower-middle-income nations. It has also promised to supply two million doses at no profit in the interim.
Still, civil society groups remain sceptical. Jeremiah Johnson, Executive Director of PrEP4All, said: “Science without access is meaningless. We must do more to ensure this drug reaches those most at risk.”
While daily PrEP pills have long been available, their uptake has remained uneven—especially outside high-income countries and among marginalised populations.
As Yeztugo enters the global market, activists argue that this innovation must not become another symbol of disparity. Instead, they urge governments, global health agencies, and pharmaceutical companies to work together to make HIV prevention truly universal.
