There is renewed hope in the fight against HIV in low-income countries like Malawi, following a major breakthrough that could improve access to advanced prevention tools.

This comes as the Global Fund and Gilead Sciences, the manufacturer of the twice-yearly injectable HIV drug Lenacapavir (LEN), have reached an agreement to procure the drug for developing and middle-income nations.

Under this agreement, countries supported by the Global Fund will be able to access Lenacapavir for pre-exposure prophylaxis (PrEP), targeting individuals at high risk of contracting HIV.

Reacting to the development, National AIDS Commission (NAC) Chief Executive Officer, Dr. Beatrice Matanje, welcomed the agreement, describing it as a promising opportunity for expanding HIV prevention. However, she noted that discussions are still underway to explore how Malawi can benefit from the new procurement deal.

"What this means is that even those who could not previously afford Lenacapavir will now have a chance to access it—provided the country can tap into Global Fund resources," said Dr. Matanje.

She disclosed that the current implementation cycle of Global Fund-supported activities in Malawi runs until 2027 and that NAC is awaiting guidance on whether they can apply for access to Lenacapavir during the ongoing cycle or at its conclusion.

“We are planning to engage key stakeholders to clarify this and strategize on the best way forward,” she added.

Nonetheless, Dr. Matanje expressed concern over the high cost of Lenacapavir, currently reported at around \$28,000 per year. She emphasized that NAC continues to lobby Gilead Sciences to consider lowering the price to make the drug more accessible.

Meanwhile, Malawi Health Equity Network (MEHN) Executive Director, George Jobe, described the development as a major boost for developing countries. He echoed concerns about the drug's prohibitive price and called for continued public awareness on the different HIV prevention options available.

"This is good news, but the public must clearly understand the various prevention measures. We have PrEP taken regularly by those at risk, we have post-exposure prophylaxis (PEP), and now injectable PrEP like Lenacapavir taken every six months,” Jobe explained. “All these need to be clearly communicated to avoid confusion.”

Since 2003, Malawi has been a beneficiary of the Global Fund, which provides financial support to countries in the fight against HIV, Tuberculosis, and Malaria.