Two new partnerships announced this week are expected to bring the price of the much-awaited HIV prevention drug lenacapavir down to $40 per year, per person — the same price as a year’s course of daily oral preexposure prophylaxis, or PrEP.
The first partnership is between the Gates Foundation and the Indian pharmaceutical company Hetero Labs. Gates is providing upfront funding and volume guarantees for the purchase of the drug.
The second partnership is between Unitaid, the Clinton Health Access Initiative, South African-based research institute Wits RHI, and Dr. Reddy’s Laboratories, another Indian manufacturer. Unitaid will provide the finance, while CHAI will take the lead on technical support.
The news comes on the heels of the U.S. government’s announcement a couple of weeks ago that it will provide Gilead’s twice-yearly injectable — shown in trials to be highly effective in preventing HIV infection — to 2 million people through PEPFAR, the U.S. flagship global HIV/AIDS initiative, in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria.
While welcome, that announcement came with a set of frustrations. Reaching just 2 million people isn’t enough, activists said. It was also unclear what Gilead’s pricing will be, though the company said it will provide the shots at no profit as part of the U.S. initiative.
The new partnerships help raise ambitions for lenacapavir. The Gates Foundation hopes it and its partners can reach 10 million people with the drug, the foundation’s global health president, Trevor Mundel, tells my colleague Sara Jerving.
But there are still some caveats. The earliest the generics could be available is in 2027, and not all countries are covered by Gilead’s voluntary licenses — some excluded include Argentina, Brazil, Mexico, and Peru, according to activist groups that have launched a global campaign on the sidelines of the 80th U.N. General Assembly in New York to legally challenge Gilead’s patent and certain countries’ exclusion from the cheaper price plan.
Read: New partnerships bring price parity between lenacapavir and oral PrEP
ICYMI: US announces support for HIV prevention game-changer with mixed reactions
Heart habit to break
Here are some heartbreaking data for you.
The World Health Organization finds that 1.4 billion people globally were living with hypertension in 2024, a leading cause of noncommunicable diseases, or NCDs. The agency says it’s costing low- and middle-income countries trillions of dollars — approximately $3.7 trillion from 2011 to 2025. And high blood pressure is killing over 1,000 people every hour from strokes and heart attacks.
NCDs are the subject of a high-level meeting at UNGA today, which will result in a declaration. But John Hewko, general secretary and CEO of Rotary International, offered his advice earlier this week: Invest in prevention.
During a panel session at Devex Impact House on the sidelines of UNGA, Hewko said, “It’s significantly cheaper to prevent a chronic disease than to have to treat it. And I’m concerned that perhaps there just hasn’t been enough focus on the prevention side of things.”
Also concerned with prevention? Air pollution experts who were dismayed that the declaration on NCDs being presented today doesn’t include recommendations about air pollution, despite the fact that it’s thought to be the largest risk factor in premature death and disease.
“It has been baffling to us why air pollution has had so little visibility on the international stage, given how large a percentage of deaths it causes every year,” said Jane Burston, CEO and founder of the philanthropic foundation Clean Air Fund.
Read: Experts push for action in tackling NCDs crisis
Further reading: Air pollution gets ignored in UNGA noncommunicable disease declaration
ICYMI: NCDs political declaration risks watered-down ambitions
‘Wake up’
“Hey, head of state, wake up. Examine the facts. Examine the cost of not doing anything, and the opportunity of major investment in this space.”
— George Vradenburg, chair, Davos Alzheimer's CollaborativeFor the first time, mental health — which is now affecting over 1 billion people — is being recognized at the high-level meeting on NCDs. Vradenburg and several experts said during a panel session at Devex Impact House that it’s critical for governments and other sectors to take brain health more seriously — especially as many populations, including in Europe, see a decline in their working-age populations. But they shouldn’t just be looking at it from an economic perspective.
“The brain that you’re born with is the same brain you die with, and you better both take care of it and foster its growth during the course of life,” Vradenburg said.
Read: Brain health needs bold investments, not just sympathizers, experts say
ICYMI: More than 1 billion people are living with a mental health disorder
One big number
$912 million
—That’s how much the Gates Foundation is pledging to the Global Fund for its work over the next three years — the same amount the foundation promised the fund during its seventh replenishment in 2022. The funding will be used to roll out game-changing innovations such as lenacapavir to countries. But Bill Gates admits the foundation’s donation won’t be able to make up the gap left by government cuts. The United States, which has been the fund’s biggest donor, has not made any commitments yet, and the White House’s budget request back in June did not include any allocations for the fund.
Other initiatives pledged to the fund this week, including Bono’s Product RED with $75 million, and the Children’s Investment Fund Foundation with $50 million.
Background reading: Trump budget request and rescission plan slashes global health funding
Eyes eyes baby
Philanthropists are certainly making bold pronouncements this week in New York. Michael Bloomberg’s own charity, Bloomberg Philanthropies, said on Wednesday it is investing $75 million to help address vision impairment in the U.S. and five low- and middle-income countries.
It’s the first time the charity is addressing vision impairment, an often neglected and underfunded health issue that affects an estimated 2.2 billion people.
Dr. Kelly Henning, the charity’s public health program lead, told me the investment complements their other health programs, such as road safety — where poor vision has been linked to car accidents.
“This is a fundamental need for both children and adults in many countries where reduced vision is impairing both educational achievement as well as the opportunity to work and earn a living. So it seemed like a win, win, win to us,” she said.
Read: Bloomberg Philanthropies makes landmark investment in eye health
+ How does a major corporate player such as MSD — known as Merck & Co in the U.S. and Canada — structure its global health and social impact work? And where are there opportunities for collaboration? Find out in our Oct. 7 Devex Pro event with MSD senior officials. Save your spot now.
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Wait, wait, don’t tell me!
There are lots of reports coming out this week, but one from Impact Global Health in particular caught my attention. The authors found that 90% of the global health funding that came from 44 high-income countries between the years 2007 and 2023 actually went to domestic institutions.
The funding was spent to find lifesaving innovations for diseases affecting low- and middle-income countries. But it flowed to universities, government agencies, and nonprofit organizations within the high-income countries themselves. In fact, the authors found that only 10% went directly to low- and middle-income countries.
That created jobs in high-income countries, but also helped crowd in private sector capital. And the report projects that the investments will lead to billions of dollars of economic impact in the countries where the funding originated.
This could potentially be encouraging for governments to continue spending on global health research and development despite pressures on their aid budgets. But report authors argued that more funding should go to low- and middle-income countries to help develop their R&D infrastructure, clinical trial networks, and regulatory systems.
Read: 90% of rich countries’ global health R&D goes to domestic institutions
A ‘closed’ matter?
A recent Republican proposal to reform the U.S. State Department sent alarm bells in Addis Ababa, Ethiopia, where the Africa Centres for Disease Control and Prevention is headquartered. Their beef? That the bill puts the African Union and all its affiliated entities, including Africa CDC, on a list of bodies to be prohibited from taking part in U.S. bilateral global health compacts with countries.
But it seems their worries were quickly assuaged, Sara reports, with an Africa CDC spokesperson telling her that the body has since received clarification from the U.S. government that it “remains firmly committed to working with Africa CDC” in the implementation of the Trump administration’s “America First” global health strategy.
Further, a senior Republican aide told Sara that while the bill says the African Union and its affiliates cannot be a party in the bilateral compacts, it doesn’t prevent the U.S. from working with the Africa CDC in other ways.
But the aide also mentioned that one of the reasons the bill proposes to exclude the Pan-African public health organization was data security concerns because it receives Chinese government contributions. The Africa CDC spokesperson responded that the organization takes data protection “extremely seriously.”
Read: What role will Africa CDC play in an ‘America First’ global health vision?
What we’re reading
U.S. President Donald Trump linked the use of acetaminophen — the main ingredient in Tylenol — during pregnancy to autism. But doctors are pushing back, saying research does not support his claims. [BBC]
New U.N. plan proposes that UNAIDS sunset by 2026. But the organization has also settled on a massively downsized operating model. [Devex]
Investing in health is investing in climate resilience, says WHO envoy. [Devex]
Former NIH chief spotlights “most powerful force” for health funding. [Devex]
About the author
Jenny Lei Ravelo@JennyLeiRavelo
Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
