Experts gathered at the Aids 2026 Conference in Rio de Janeiro identified lenacapavir, an injectable HIV prevention medication requiring only two annual doses, as a potentially transformative tool for reducing new HIV infections worldwide. The medication, a form of PrEP with 99% effectiveness when used consistently, addresses a significant barrier faced by populations in poverty, rural areas, or experiencing stigma—the need for frequent healthcare visits. A mathematical modeling study estimated that widespread availability could prevent 41% of new HIV infections in South Africa, Zimbabwe, and western Kenya.
However, experts warned that substantial funding reductions are undermining efforts to expand access to this innovation. As of July 2026, investment in HIV prevention has declined dramatically following the dissolution of USAID, which historically provided 73% of donor-funded resources for HIV prevention globally. The timing is particularly problematic, as the World Health Organization recommended expanded access to lenacapavir in the previous year, just as funding mechanisms were being dismantled.
The funding cuts extend beyond medication availability to affect support infrastructure. Organizations have responded to reduced resources by cutting peer outreach workers, closing service locations including mobile units, and reducing direct engagement with high-risk populations. People who inject drugs face particular vulnerability, as they lose both access to trusted local contacts and proximity to services. These service reductions threaten to prevent innovative long-acting injectables from reaching those with the greatest need.
Additional barriers exist outside funding constraints. Gilead Sciences, which provides generic versions of long-acting medications at reduced prices to low- and middle-income countries, excludes several Latin American nations by classifying them as upper-middle-income countries—a designation advocates dispute, particularly given these nations’ contributions to clinical trials. International Aids Society leadership expressed concern that the combination of funding reductions and access restrictions makes achieving the 2030 AIDS elimination goal increasingly unlikely under current conditions.
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