Nobel laureates Françoise Barré-Sinoussi and Joseph Stiglitz, have published an open letter with a call for the price of ground-breaking new HIV medicines to be reduced dramatically so that they can be used worldwide by all who need them.
Former President of Malawi Dr Joyce Banda and former New Zealand Prime Minister Helen Clark, and artists Olly Alexander (singer and actor), Stephen Fry (actor, writer, presenter), Adam Lambert (singer and songwriter), David Oyelowo (actor, producer, director) and Arnaud Valois (actor), business leaders Mo Ibrahim and Paul Polman also joined have joined the call in an open letter.
The open letter published calls on ViiV, one of the world’s largest HIV pharmaceutical companies, to share their technology and know-how to boost production and set their price at a point where all countries can afford to buy these medicines and commit to making enough to meet demand until generic producers come online.
In particular, it calls on ViiV to tackle the barriers to access by announcing a lower price for the long-acting injectable ARV for prevention, CAB-LA, as close as possible to that of other HIV prevention medicines (PrEP). The current best PrEP option is approximately $60 per person per year. Make the price public and transparent, and include the cost of the accompanying syringe.
Asks them to quickly finalize licenses to produce generic versions of this long-acting ARV through the Medicines Patent Pool. License across the world’s low- and middle-income countries on a non-exclusive basis, with a broad geographic scope for both treatment and prevention. As well as share know-how and technology by enabling producers in Africa, Asia, Latin America, Eastern and Central Europe and beyond to seek transfer and begin producing.
“While many in the global North are getting access to long-acting HIV prevention tools and medicines, Africans are overwhelmingly denied the opportunity,” said Lilian Mworeko, Regional Coordinator of the International Community of Women Living with HIV Eastern Africa (ICWEA).
“It is worse for groups who continue to be left behind like adolescent girls and young women. As long as the price is unaffordably high for our governments and for funders to purchase, we will continue to be locked out from being able to access them. They are vital to preventing new HIV infections and they could become transformational in treatment. Our message is simple: all of our lives matter.”
The AIDS pandemic continues to take a life every minute, and new HIV infections are rising in too many communities.
The breakthrough long-acting medicine only has to be taken every few months and is proving to be one of the most effective methods to prevent HIV transmission. In addition to the prevention tool available now, long-acting antiretrovirals could one day be part of revolutionizing treatment to prevent deaths.
But these medicines are currently only available in high-income countries at a price of tens of thousands of dollars – far out of reach for people and governments in low- and middle-income countries.
People in these countries need them most. These long-acting HIV medicines could enable millions of adolescent girls and young women in sub-Saharan Africa to protect themselves from acquiring HIV. They could enable people from marginalised communities including gay men, transgender people, and sex workers, to receive a discreet injection every few months to protect themselves.
As the global HIV response has come under strain from the COVID-19 crisis and the Ukraine war, ensuring rapid, affordable and equitable access to these medicines has become even more urgent. The signatories to the letter stressed that they can and must be made available to everyone, regardless of the passport they hold or the money in their pocket.
These new medicines present a remarkable opportunity to avoid the scientific and policy mistakes that defined the early years of AIDS. After the first antiretroviral HIV drugs received approval, prohibitive costs meant they were out of reach in the global South. Millions died. These failings were not due to scientific or technical limitations. They were the result of conscious choices about how medical innovation and access to health tools are organized and financed.
“It is within ViiV’s power to ensure that millions more people around the world are able to benefit from the incredible technical advances that have gone into this new medicine,” said Deborah Gold, CEO of the National Aids Trust. “If countries know that it is available at an affordable price, they will be able to prioritise the purchase of it from their health budgets and to make it available to all who need it.”
The International AIDS Conference, taking place in Montreal from 29th July to 2nd August, offers an historic opportunity for ViiV to stand with world leaders, civil society and people living with and at risk of HIV from around the world and pledge actions that will save lives and accelerate efforts to end AIDS as a public health threat by 2030. The World Health Organization will release new guidelines on CAB-LA – the new medicines – at the conference.
“There is a choice about how new medicines are launched into the global market in terms of whether they are available to everyone, everywhere,” said Dr Ayoade Alakija, Co-Chair of the Africa Union Africa Vaccine Delivery Alliance for COVID-19.
“The limitations are less to do with scientific or technical challenges and much more to do with how medical innovation and access to health countermeasures are currently organized and financed to favour the rich and reinforce inequity. The conference in Montreal provides an opportunity for those leaders who are able to get a visa and travel, to demonstrate that all lives are equal and new health tools are accessible to all.”
The stakes are high. 40 million people around the world are living with HIV today, and around 1.5 million people were newly infected in 2020 alone.
“This is an issue of inequality,” said Winnie Byanyima, Executive Director of UNAIDS. “Will these new medicines help us break down the inequalities driving the AIDS pandemic – affordable and available for those who need them most? Or will they stay out of reach? The pharmaceutical industry has the opportunity to make medicines affordable and accessible to people in all countries – including so-called middle-income countries – through sharing technologies and setting an affordable price today until those generics come online.”
The International AIDS Conference takes place from 29th July to 2nd August. WHO will be releasing new guidelines on long-acting antiretrovirals during the conference.