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.
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.
However, the drug is understood to be too expensive for low- and middle-income countries and funders.
“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.”