HIV prevention drug could reduce cases globally but USAID cuts prevent access, say experts

Lead

New innovations in HIV prevention could dramatically reduce the number of new HIV cases worldwide, but cuts to US foreign aid will leave many of those most in need unable to access the medication, according to experts at the AIDS 2026 Conference in Rio de Janeiro, Brazil.

At the center of the discussion is lenacapavir, an injectable form of pre-exposure prophylaxis (PrEP) that requires only two injections a year. The drug has shown near-complete protection against HIV in clinical trials and is being rolled out in some countries, including South Africa. However, the same experts warn that funding cuts and delays in generic production could prevent the drug from reaching its full potential.

Coverage Comparison

Coverage of the story spans two distinct angles. Reports from AllAfrica focus on the promise of lenacapavir, highlighting its clinical efficacy and South Africa's rollout as a major step forward in HIV prevention. One AllAfrica piece describes the drug as a potential "transformative" advance, emphasizing the science and government commitment behind the rollout. Another AllAfrica report underscores the drug's "exceptional" protection and its potential to "fundamentally transform" the global response to HIV.

In contrast, The Guardian's coverage centers on the threat posed by US foreign aid cuts. While acknowledging the drug's effectiveness, The Guardian frames the story around the risk that those who need lenacapavir most will be "unable" to access it, pointing to the dissolution of USAID and a reported decline in HIV prevention funding.

Both perspectives agree on the science: lenacapavir is a highly effective, long-acting prevention tool. The divergence lies in whether the world can deliver it equitably.

Key Claims

Clinical Efficacy and Rollout

Lenacapavir has demonstrated almost complete protection against HIV infection in clinical trials, according to AllAfrica. The drug requires only two injections a year, making it a potentially powerful alternative to daily oral PrEP, which many people struggle to take consistently.

Updated data from the PURPOSE-1 and PURPOSE-2 studies, presented at the AIDS 2026 conference, show continued high efficacy and safety with extended follow-up, as reported by AllAfrica. The PURPOSE-1 trial enrolled cisgender women in South Africa and Uganda, and during the earlier randomized phase, twice-yearly lenacapavir demonstrated superior protection compared with daily oral PrEP.

South Africa, which has the largest HIV treatment program in the world, became the ninth African country to introduce lenacapavir into public HIV prevention services in June, according to AllAfrica. The rollout covers six provinces and is part of an effort to expand prevention choices. AllAfrica notes that adolescent girls and young women are at particularly high risk of infection, making the new option especially important.

Global Impact and WHO Recommendation

The World Health Organization recommended that governments prioritize expanded access to lenacapavir in 2025, according to The Guardian. The recommendation came with a caveat: access to the drug is currently limited outside clinical trials.

A mathematical modeling study from the WHO and the United Nations estimated that widespread availability of lenacapavir could prevent 41% of new HIV infections in South Africa, Zimbabwe, and western Kenya, as reported by The Guardian. The Guardian also notes that PrEP, in its various forms, is 99% effective in preventing sexually transmitted HIV when taken consistently.

Funding Threats

The Guardian reports that US foreign aid cuts could limit access to lenacapavir. When the WHO made its recommendation in 2025, the Trump administration was already in the process of dissolving USAID, which provided 73% of donor-funded resources for HIV prevention globally, according to a study in the Lancet Global Health cited by The Guardian. As of July 2026, multiple reports indicate that investment in HIV prevention has declined dramatically.

AllAfrica's coverage of the South African rollout also acknowledges the funding pressure, noting that international HIV funding is under strain, civil society organizations are warning of the impact of cuts to US-backed programs, and generic versions of the medicine are still at least a year away.

Perspectives

Scientific and Public Health Advocates

Researchers and public health officials at the AIDS 2026 conference expressed optimism about lenacapavir's potential. Beatriz Grinsztejn, President of the International AIDS Society and International Co-Chair of the conference, called the drug a "breakthrough advance" with the potential to accelerate global prevention progress if delivered rapidly and equitably. She also serves as director of the HIV/AIDS Clinical Research Unit at Fiocruz in Brazil and is a member of the PURPOSE-2 study team. Scientists emphasize that the science has moved faster than anyone imagined, and the question now is whether access can keep pace.

Funding and Policy Concerns

Experts and civil society organizations warn that US foreign aid cuts are undermining HIV prevention efforts. The Guardian's reporting highlights that those who most need the new medication may be unable to access it, despite the WHO's recommendation. AllAfrica's coverage of the South African rollout similarly notes that the launch comes at a difficult moment, with funding pressures and delays in generic versions threatening to slow progress.