Nobel laureates, business leaders, former premiers and celebrities have urged a UK pharmaceutical company to lower the price of its groundbreaking HIV prevention drug and ensure it is not kept “out of reach” of the world’s poor.
In a letter signed by dozens of high-profile figures, including Sir Richard Branson, the singer Olly Alexander, the economist Joseph Stiglitz and Helen Clark, the former prime minister of New Zealand, the pharmaceutical company ViiV Healthcare is praised for having developed the first of a new kind of HIV prevention drug.
But, the letter says, the “transformative effect” that cabotegravir (CAB-LA), a long-acting injectable, could have on the global Aids pandemic would be restricted to high-income countries unless ViiV lowers the price.
“If CAB-LA is not widely available and affordable, it will deepen the inequalities that both fuel the Aids pandemic, and that are exacerbated by it. Access to life-saving science cannot and must not be dependent on the passport you hold or the money in your pocket,” the letter warns.
Signatories also include Winnie Byanyima, executive director of Unaids, Mo Ibrahim, the billionaire businessman, Joyce Banda, the former president of Malawi, actors David Oyelowo and Stephen Fry and the singer Adam Lambert.
The World Health Organization estimates that more than two-thirds of people living with HIV are in Africa and that 460,000 people on the continent – 67% of the global total – died from HIV-related causes in 2020. Although mortality has dropped by almost 50% since 2010, the Covid pandemic severely disrupted services, diagnoses and treatment.
Approved in the US in December and in the UK the following month, cabotegravir is an injectable, long-acting medicine that needs to be taken only every few months, as opposed to the daily pills that characterise most pre-exposure prophylaxis (PReP) regimes.
It is proving to be one of the most effective methods to prevent HIV transmission and the ease of taking it means it “could be a lifeline for so many, including young women who fear of stigma if they are seen taking medication for HIV, gay men and transgender people facing repression and homophobia, and sex workers who need better options”, says the letter.
However, the drug is understood to be too expensive for low- and middle-income countries and funders. ViiV, a subsidiary of GSK based in Brentford, west London, entered into voluntary licensing negotiations with the UN-backed Medicines Patent Pool in May and insists it is moving “at speed” towards finalising a deal that could see other manufacturers produce generic – and likely cheaper – versions of the drug.
But the global health community is concerned that the process could still take years, particularly given the complexity of the drug, during which time, it says, many lives could be saved by more “equitable and affordable access” to cabotegravir.
ViiV has pledged that, until a generic becomes available, it will supply the drug “at a non-profit price for public programmes in low-income, least developed and all sub-Saharan African countries”. But fears remain that the non-profit price will still be too high for much of the world.
“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.”
A GSK spokesperson said: “We have a strong track-record of working with the global HIV community to achieve our common goal of making our HIV medicines widely available around the world for those who could benefit from them, irrespective of where they live.
“We are committed to helping to enable expanded access to our newest medicine, cabotegravir long-acting for PrEP, which we believe has the potential to be a gamechanger in HIV prevention, and we are working at speed with partners to find solutions, including rapidly finalising a voluntary licence agreement with the Medicines Patent Pool.”
It is understood that an agreement is imminent.
