The Trump administration’s announcement earlier this month of investment in lenacapavir — a groundbreaking HIV prevention drug requiring just two injections per year — represents a pivotal moment in HIV prevention. But even as officials work to bring the drug's price down to $100 per person annually by 2025, and eventually to $40 as early as 2027, a crucial challenge remains: How do we ensure this lifesaving medication actually reaches the people who need it most?
The answer lies not just in lowering manufacturers’ prices, but in fundamentally reimagining how medicines move through Africa’s complex supply chains.
Public sector HIV programs across sub-Saharan Africa are already stretched thin, constrained by declining international aid and mounting government debt. While these programs will remain essential, we cannot rely on them alone to sustainably deliver lenacapavir to the millions who could benefit. Already, patients across Africa often turn to private drug shops and pharmacies as their first points of care. Thus, equipping private facilities to play a complementary role in lenacapavir rollout is critical — but only if we can solve the pricing problem that has long plagued pharmaceutical distribution in emerging markets.