By Michael Gwarisa in RIO DE JANEIRO
An estimated 600,000 people are expected to be receiving the groundbreaking twice-yearly HIV prevention injection lenacapavir by the end of 2026, with the number projected to surpass one million early next year, as global efforts to rapidly expand access to long-acting HIV prevention gather pace.
The milestone was revealed on Tuesday during an industry media briefing at the 26th International AIDS Conference (AIDS 2026), where pharmaceutical companies, scientists, implementation experts and community advocates agreed that while science has delivered unprecedented HIV prevention tools, the world’s greatest challenge is now ensuring equitable access.
Speaking during the briefing, Dr Jared Baeten, Senior Vice President of Clinical Development and Therapeutic Area Head for Virology at Gilead Sciences, said partnerships with the Global Fund and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) are helping accelerate the rollout of lenacapavir while generic manufacturers prepare to enter the market.
“Our target is that 600,000 people will be on lenacapavir by the end of this year through that collaboration,” Baeten said.
“To put that into context, 600,000 people is approximately the number of people currently using all forms of PrEP in the United States. That number is expected to exceed one million at the beginning of next year.”
Baeten said lenacapavir is currently available in 10 African countries, with availability expected to expand to 24 countries before the end of 2026. He added that Gilead has increased its commitment from supplying enough medicine for two million people to three million people during the transition period before lower-cost generic versions become available.
The company has also signed voluntary licensing agreements with six generic manufacturers covering 120 countries, a move intended to accelerate affordable production and long-term access to the injectable HIV prevention medicine.
Innovation Means Little Without Access
Despite celebrating what many described as a historic moment in HIV prevention, conference leaders repeatedly stressed that scientific breakthroughs alone will not end the epidemic.
Opening the briefing, Prof. Beatriz Grinsztejn, President of the International AIDS Society (IAS), said the conversation must now shift from scientific innovation to ensuring that lifesaving medicines reach those who need them most.
“Many of us believe we are entering a new era for HIV prevention,” she said. “We now have scientific tools with the potential to fundamentally change the course of the epidemic. But scientific progress alone is not enough.”
Quoting Brazil’s Ministry of Health, Grinsztejn added: “Innovation without access is not innovation. It is injustice.”
She warned that uncertainty surrounding global health financing threatens the rollout of new prevention technologies, including lenacapavir and other long-acting HIV prevention options currently under development.
Industry Calls for Faster Implementation
Other pharmaceutical leaders echoed the message that expanding access, not developing new medicines, is now the defining challenge.
Dr Jean van Wyk, Chief Medical Officer at ViiV Healthcare, said the HIV community had learned that innovation only has value if it reaches the people most at risk.
“Our mission is to leave nobody behind,” Van Wyk said. “As we’ve heard very clearly, innovation is meaningless unless there is access and unless we can provide it to the people who need it most.”
Van Wyk said ViiV had already transferred patents and manufacturing know-how for long-acting cabotegravir to the Medicines Patent Pool, enabling generic manufacturers to begin preparing production while the company continues supplying injectable PrEP at a non-profit price in low- and middle-income countries.
Communities Must Drive Demand
Community organisations attending the conference cautioned that access depends on far more than medicine supplies.
Adaobi Lisa Olisa, a Pharmacist and passionate advocate for HIV prevention from Nigeria, said communities must remain at the centre of HIV prevention if the promise of long-acting medicines is to be realised.
“The science is not failing. The science is progressing,” she said. “But where we have the risk is in implementation. Are we going to get it right? Are we going to deliver these products to the people who need them most equitably, at scale and sustainably?”
Olisa said community-led awareness campaigns, trust-building and demand generation will determine whether countries successfully introduce new HIV prevention technologies.
“A product will not be impactful if it doesn’t get to the people who need it the most,” she said. “If it just sits on the shelf collecting dust, it will not deliver on its promise.”
A Defining Moment for HIV Prevention
Lenacapavir has been hailed as one of the biggest advances in HIV prevention since the introduction of oral pre-exposure prophylaxis (PrEP), requiring just two injections each year to provide protection against HIV.
For countries such as Zimbabwe, which have already begun introducing lenacapavir into national HIV prevention programmes, the discussions in Rio underscored that the next phase of the HIV response will depend not only on scientific innovation, but also on political commitment, sustainable financing and community leadership.
