At the 80th United Nations General Assembly in New York, the Nigerian government—through the National Agency for the Control of AIDS (NACA) joined global actors in announcing a landmark agreement: the cost of lenacapavir, a long-acting HIV prevention injection, will be slashed from USD 28,000 to just USD 40 per person per year.
The announcement was made during the Clinton Global Initiative (CGI) 2025 Annual Meeting. Former U.S. President Bill Clinton described lenacapavir as “a revolutionary injection that provides six months of protection in one shot,” and emphasized that affordable access is critical, especially in light of potential shortfalls in donor funding.
Delivering Nigeria’s statement, NACA’s Director General, Dr. Temitope Ilori, called the agreement “a milestone in the fight against HIV in Nigeria and globally,” and said it signals a shift toward pairing innovation with equity and offering hope to millions at risk.
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Key Details & Context
1. How the price cut was enabled
The agreement involves multiple partners, including UNITAID, the Clinton Health Access Initiative (CHAI), Wits RHI, Dr. Reddy’s Laboratories, and the Gates Foundation.
Under the deal, the injection itself will cost USD 40/year, while the initial oral regimen (two tablets on day one + two tablets the next day) required to achieve protective drug levels will cost no more than USD 17.
This move builds on voluntary licensing agreements: Gilead (the original developer) granted royalty-free licenses in 2024 to six generic manufacturers to produce lenacapavir in 120 low- and middle-income countries.
The strategy also includes commitments from major funders: PEPFAR and the Global Fund will help procure the medication for up to 2 million people in LMICs (low- and middle-income countries).
2. Effectiveness and advantages
Clinical trial data (the PURPOSE 2 trial) indicate that lenacapavir offers between 96% and 100% efficacy in preventing HIV infection.
Compared to daily oral PrEP, a twice-yearly injection dramatically reduces adherence burden, stigma, and the risk of “pill fatigue.”
The long-acting formulation can be game-changing especially for populations with difficulty maintaining daily regimens.
3. Timeline and limitations
The generic versions under this deal are expected to become available around 2027, following regulatory approvals and manufacturing scale-up.
Not all countries are covered by Gilead’s licensing scheme; some upper-middle income nations may be excluded.
There is still urgency to expand access before 2027. During the interim, early procurement via global funds may help bridge gaps.
Experts caution that sustaining donor support is key: withdrawal or reduction of funding could provoke setbacks in HIV prevention gains. Bill Clinton himself flagged this risk in his remarks.
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Implications & Challenges for Nigeria
This deal carries profound implications for Nigeria, which bears a heavy HIV burden:
Wider access: With the cost barrier drastically lowered, more Nigerians, especially key and vulnerable populations, may gain access to this powerful prevention tool.
Health system readiness: Nigeria will need to ensure that peripheral health facilities, supply chains, and community outreach programs are prepared to deliver injections every six months.
Equitable rollout: The authorities must guard against unequal distribution, ensuring rural, marginalized, or high-risk groups are not left behind.
Sustained financing: While the price is dramatically lower, financing the procurement, distribution, monitoring, and follow-up (e.g. side-effect surveillance) remains a challenge.
Regulatory & patent constraints: Nigeria will have to manage intellectual property, regulatory approvals, and possibly negotiate to include itself or ensure favorable conditions under licensing.
Integration with existing strategies: The new tool must complement, not displace, existing prevention strategies (condoms, daily PrEP, behavior change, HIV testing, etc.).
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