Experts gathered at the Aids 2026 Conference in Rio de Janeiro highlighted the potential of lenacapavir, an injectable HIV prevention medication requiring only two doses annually, to significantly reduce new infections worldwide. The World Health Organization recommended expanded access to lenacapavir one year ago, noting that the drug is 99% effective in preventing sexually transmitted HIV among consistent users. Mathematical modeling suggested widespread availability could prevent 41% of new HIV infections in South Africa, Zimbabwe and western Kenya.
However, funding constraints are creating substantial barriers to implementation. USAID previously provided 73% of donor-funded resources for HIV prevention globally, according to a study in the Lancet Global Health. As of July 2026, multiple reports indicate investment in HIV prevention has declined markedly following dissolution of the agency. The funding reductions affect not only medication availability but also essential support services, particularly peer outreach workers who build trust with high-risk populations such as people who inject drugs.
Organizations are responding to budget losses by closing locations and cutting outreach services, according to reports from the International Network of People Who Use Drugs. These closures force clients to travel further for services and erode local relationships critical to reaching vulnerable communities. Beatriz Grinsztejn, president of the International Aids Society, stated during the conference that the funding cuts are deeply affecting delivery of new prevention technologies and reducing engagement in care and prevention services.
Geographic and economic barriers further complicate access. Gilead Sciences provides generic versions of long-acting medications to low- and middle-income countries at reduced prices but excludes countries classified as upper-middle-income, including Brazil, Colombia, Mexico, Peru and Argentina. HIV advocates dispute this classification, particularly since residents of these nations participated in clinical trials. Despite optimism about lenacapavir’s potential to help achieve UNAIDS’ goal of eliminating AIDS as a public health threat by 2030, experts expressed concern about meeting targets under current funding conditions.
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