The Global Push for Long-Acting HIV Prevention at WEF 2025

long-acting HIV prevention
HIV treatment revolution
end AIDS by 2030
Lenacapavir 
Cabotegravir
Accelerating universal access to new, long-acting HIV medicines to end AIDS.

The annual meeting of the World Economic Forum (WEF) in Davos-Klosters in 2025 spotlighted a crucial development in the global fight against HIV/AIDS: the call by the Joint United Nations Programme on HIV/AIDS (UNAIDS) for rapid, universal access to newly emerging long-acting HIV prevention medicines. This appeal is rooted in the push to meet the global target of ending AIDS as a public health threat by 2030, a deadline that feels more urgent each passing year. Among the most promising medical breakthroughs discussed are two injectable drugs with the potential to transform HIV prevention and, possibly in the near future, HIV treatment. One is Lenacapavir, developed by Gilead Sciences, and the other is Cabotegravir, produced by ViiV Healthcare. Although these medicines are not themselves cures or vaccines, they represent a new frontier by significantly reducing the frequency of doses needed for effective prevention, and they may also pave the way for more accessible long-acting treatments for people living with HIV.

For decades, HIV has remained one of the world’s most pressing public health challenges, responsible for millions of deaths and ongoing infections across continents. When antiretroviral therapies were first developed and rolled out in the late 1990s, they transformed HIV from a rapid killer into a chronic but manageable condition for many who could access the medicines. Despite these advances, global health bodies, governments, and civil society continued to grapple with large disparities in treatment availability, especially in low- and middle-income countries. That dichotomy between those who could get the newest, most effective treatments and those living in regions with weaker health systems or fewer economic resources is what UNAIDS seeks to dismantle before the end of this decade. When UNAIDS Executive Director Winnie Byanyima addressed the WEF, she stressed that if pharmaceutical companies, governments, international partners, and community organizations could come together, there might be a genuine chance to finally halt the spread of HIV. Her words carried an unmistakable sense of hope and a sharp warning: it will not be enough to simply develop new drugs; access must be universal and affordable, or the world risks perpetuating the kinds of inequalities that have long defined the HIV crisis.

The conversation in Davos underscored how Lenacapavir has already demonstrated more than 95 percent effectiveness in preventing HIV infection with just two doses administered each year. That level of efficacy, combined with the convenience of receiving only two injections per year, could profoundly change the landscape of HIV prevention. Researchers are also exploring whether there is a way to administer Lenacapavir just once a year, which might further simplify prevention efforts for people who currently struggle with daily pills or more frequent injection schedules. Meanwhile, Cabotegravir, which ViiV Healthcare has been exploring, is administered once every two months. This medication, already in use in some countries, has shown remarkable promise in reducing the risk of HIV infection among users, and it points to a future where a small number of injections could replace complex daily regimens that are prone to interruptions or lapses in adherence. Adherence has long been one of the main challenges in HIV prevention and treatment, so reducing the frequency of doses can translate into far better outcomes at a population level. In real-world settings, any therapy that demands fewer doses or clinic visits often leads to higher uptake and more consistent usage.

The idea of harnessing technology to end AIDS gained further traction with discussions about other prevention tools. There are month-long vaginal rings already in use, which release antiretroviral drugs continuously to help prevent HIV infection among women, as well as new versions of these rings that are designed to last longer. Longer-acting preventive pills are also in development, and researchers are constantly examining ways to optimize antiretroviral delivery systems. The move away from daily oral pills to longer-acting methods is a response to the reality that many people at high risk for HIV infection struggle to maintain consistent pill-taking routines. This might be due to social stigma, the burdens of busy lives, limited access to reliable pharmacies, or even just forgetting. By offering a solution that can be administered bi-monthly or just twice a year, there is hope that the global incidence rate of HIV can be slashed significantly, especially in areas that have been hardest hit by the epidemic. Yet, despite this wave of optimism, there remain significant hurdles that can’t be ignored.

Perhaps the most critical of those hurdles, as UNAIDS underscores, is ensuring that these innovative medicines reach everyone who needs them, regardless of geography or economic status. Historically, new medical breakthroughs have often taken years, or even decades, to reach low- and middle-income countries. Antiretroviral therapy itself was first made widely available in high-income countries, while poorer nations faced astronomical costs and limited supply. It was only through fierce advocacy, global partnerships, and the introduction of generic manufacturing that the prices eventually dropped, improving accessibility for millions of people around the world. The fear now is that the same pattern will repeat with long-acting injectables. Just as the world is inching closer to a potentially game-changing set of tools, the distribution and pricing structures could block the very communities that would benefit the most. UNAIDS is urging faster action by pharmaceutical companies, pressing them to license generics and make pricing more transparent and equitable. If these licenses are slow to roll out, or if they exclude large regions, the chance to halt new HIV infections might be lost to red tape, negotiations, and market barriers.

One alarming signal is that nearly all of Latin America, which is currently grappling with rising HIV infection rates, has reportedly been left out of generics licensing agreements for the new medications. Meanwhile, only six companies have received licenses to produce generic versions of Lenacapavir, and none of these are based in sub-Saharan Africa, the region that continues to shoulder a disproportionately high burden of HIV infections. That shortage of licensed manufacturers can sharply limit how quickly and widely the product can be distributed at an affordable price. If a single region relies on only a few external producers for the medication, supply bottlenecks can develop, pricing might remain high, and local governments can’t effectively plan the kind of widespread vaccination or injection campaigns needed to protect their citizens.

Because of this predicament, Byanyima and other advocates at the WEF spoke about the need for governments to either incentivize pharmaceutical companies to step up or to intervene directly when companies fail to meet the urgency of the moment. Some references were made to the Covid-19 vaccine rollout, where, despite life-and-death stakes, distribution inequalities and intellectual property debates significantly hampered the ability of lower-income countries to secure timely vaccine access. The argument now is that the global community must do better with HIV prevention than it did with the Covid-19 response. In the face of a public health crisis that has spanned four decades, the moral imperative to prevent future infections and deaths should outweigh the desire to maintain exclusive profit margins. It isn’t just a question of altruism; the logic holds that widespread disease control benefits everyone, including wealthier countries that might otherwise face the threat of new variants or surges.

Medical experts and advocates also note that while these therapies show profound promise, they represent just one dimension of the broader HIV prevention and treatment toolkit. There will always be a need for comprehensive strategies that include testing, counseling, harm reduction services for key populations, and strong support networks for people living with HIV. The move toward simpler, long-acting injections cannot, by itself, solve the structural issues that contribute to HIV transmission in marginalized communities. Issues like stigma, discrimination against key populations (such as men who have sex with men, sex workers, or people who inject drugs), and lack of access to quality healthcare continue to hamper efforts to end AIDS. Even with a highly effective prevention injection, people may still be reluctant to come forward if they fear societal repercussions. Governments and civil society groups, therefore, have a responsibility to create enabling environments that encourage people to seek prevention and treatment services without judgment or punishment.

In some ways, the emphasis on these long-acting medicines parallels the history of contraceptive technology. When certain contraceptives became long-acting or required fewer interventions by the user, adoption soared, and public health outcomes improved. A similar phenomenon could unfold in the realm of HIV prevention, provided the new interventions are made widely available at prices that health systems can manage. UNAIDS wants a scenario where high-level negotiations at forums like the WEF translate into practical commitments on the ground. That might mean more generic manufacturers stepping forward. It could also mean philanthropic organizations subsidizing initial costs or governments leveraging international financing mechanisms to purchase large quantities of the new drugs. For instance, the Global Fund to Fight AIDS, Tuberculosis and Malaria has historically played an instrumental role in financing HIV treatments and ensuring large-scale distribution. A strategic use of the Global Fund, along with other partners, could expedite the rollout of these cutting-edge medicines.

Another layer to the discussion in Davos focused on the social and economic benefits of curbing the HIV epidemic. When HIV infections decline, entire communities become healthier and more able to participate in the workforce. Households avoid the catastrophic healthcare costs that can come with an HIV diagnosis in places with inadequate insurance or public health coverage. Communities also avoid losing parents, caregivers, teachers, and health professionals to AIDS-related illnesses, which can set back development for generations. From a purely economic standpoint, the cost of continuing to battle HIV far into the future is seen as far greater than the cost of an aggressive push to end it now. By illustrating these broader gains, UNAIDS hopes to mobilize political will and secure financial commitments, particularly in a meeting place like Davos, where corporate leaders, heads of state, and influential philanthropists converge. The logic is straightforward: investing in long-acting prevention drugs today will reduce the burdens on health systems tomorrow, freeing up resources to tackle other pressing challenges.

Despite the strong momentum, some participants and observers warn about complacency. There is a risk that a single-minded fixation on long-acting treatments could overshadow the immediate needs of people currently on other forms of antiretroviral therapy. Transitioning from daily pills to injections requires thoughtful planning, training for healthcare professionals, and robust monitoring systems. Healthcare workers must be equipped not just to administer injections, but also to track patients’ progress, manage any side effects, and ensure that the schedule of doses is adhered to over the long term. Even if a medication only needs to be administered twice a year, missing a scheduled dose can undo its protective benefits. That’s why many experts argue that these new solutions should be integrated into a broader continuum of care, where people living with or at risk of HIV have multiple options and can choose the approach that best fits their lifestyle or particular medical condition.

Moreover, the scientific community is keen to see results from ongoing trials, including the possibility of once-a-year Lenacapavir injections, to confirm their efficacy and safety. Additional long-acting solutions, such as extended-use vaginal rings or pills, could further diversify prevention methods. This diversity is important because no single product will suit everyone equally. Some individuals might still prefer daily oral pills due to personal comfort, while others might embrace a twice-yearly injection if it means fewer trips to the clinic. The success of rolling out these new technologies will depend in large part on clear communication from public health agencies about how they work, what benefits they offer, and what side effects or precautions might be required. Transparent information helps build trust, which is critical for adoption at scale.

At the WEF’s gathering, conversations about pandemic preparedness, climate change, and economic inequality sometimes overshadowed discussions of HIV/AIDS. Nonetheless, leaders who are directly involved in healthcare policy repeatedly emphasized that ending the HIV epidemic remains not just a moral imperative but also a critical test of the global community’s ability to collaborate on complex, long-term challenges. The very theme of the WEF Annual Meeting 2025, “Collaboration for the Intelligent Age,” implies that success against a formidable virus like HIV will demand innovative thinking, bold partnerships, and the willingness to learn from past mistakes. By highlighting the stark lessons learned from the Covid-19 pandemic—where wealthy nations secured vaccines more quickly and in greater quantities than poorer nations—UNAIDS and its partners hope to avoid a repeat scenario in the

HIV context. They point out that an effective response to a worldwide threat requires an equitable approach to distribution from the very beginning, not as an afterthought.

The stakes are immense for regions like sub-Saharan Africa, where HIV prevalence remains disproportionately high and healthcare infrastructure can be fragile. In many of these communities, an annual injection that prevents HIV could be revolutionary, potentially saving countless lives and enabling families to remain healthy and economically stable. But if production licenses are scarce and pricing remains out of reach, the benefits of these new drugs will be confined to wealthier settings, undermining any chance of ending AIDS globally by 2030. Indeed, the principle of universal health coverage, championed by agencies such as the World Health Organization, includes the idea that no one should be denied life-saving or life-enhancing treatments based on their ability to pay or their location. Byanyima’s statements reflect this principle, urging all stakeholders to seize the opportunity to translate scientific breakthroughs into social impact on a global scale.

Financial mechanisms and international cooperation were thus major talking points among heads of state and philanthropic donors in Davos. There is a clear drive to replicate models that have worked in the past—like pooled purchasing agreements, tiered pricing, and robust generic licensing—but to do so more proactively and more swiftly this time. Some even suggest that global health bodies and large foundations could pre-finance the production of these injectables, ensuring that a certain volume is guaranteed to manufacturers. This approach could bring down the unit cost more rapidly, making the drugs accessible sooner to those in poorer nations. Ultimately, the argument made by UNAIDS is that the cost of inaction would not just be measured in dollars and cents, but in human lives and lost progress on a disease that the world finally has a real chance to conquer.

Another aspect that came under discussion is the role of community engagement. Large-scale health interventions frequently require buy-in from local organizations, activists, and people living with HIV, who know the unique challenges of their communities. These groups can help dispel myths about new medicines, overcome cultural or religious resistance, and ensure that prevention and treatment efforts are integrated into broader healthcare services. They also serve as watchdogs, holding governments and companies accountable if promises on access and pricing aren’t met. Global forums like the WEF can generate headlines and commitments, but it’s often local activists and healthcare workers who make sure those commitments turn into action. By fostering strong ties between community leaders and international agencies, UNAIDS aims to create a robust support system that helps deliver these medications safely and efficiently to those who need them most.

International aid organizations also highlight the necessity of aligning policies and regulations so that new drugs don’t get caught in bureaucratic red tape or duplicative approval processes. In past decades, certain life-saving antiretroviral drugs were delayed in some countries for years due to a combination of local regulatory hurdles, lack of resources, and complex patent laws. Speeding up the approval process, while maintaining rigorous safety standards, could accelerate the adoption of long-acting HIV prevention. That said, oversight is crucial to ensure that new therapies are properly vetted for safety and efficacy in diverse populations, including women, adolescents, and individuals with comorbid conditions like tuberculosis or hepatitis. The clinical trial data needs to be robust and inclusive so that no group is left guessing how a particular treatment might work for them.

Because the 2030 goal to end AIDS is less than five years away from this 2025 forum, there is a palpable sense of urgency driving these discussions. Ending AIDS by that date was once seen as an aspirational target, but scientific progress and decades of implementation experience have shown that it’s within reach if the political will and financial resources align. The phenomenon of “ending AIDS” means drastically reducing both new infections and AIDS-related deaths, such that HIV is no longer a major threat to public health. Practically, it involves sustaining a combination of prevention, testing, and treatment efforts that keep transmission rates extremely low. The introduction of long-acting injectables could be the catalyst that propels global efforts over the finish line, especially if they’re deployed in the communities with the highest incidence rates. Over time, a decrease in new infections could lead to a scenario where fewer people require lifelong treatment, easing the strain on health systems and budgets.

At Davos, a consensus seemed to emerge among health experts, activists, and policymakers that a new era in HIV prevention might be on the horizon—one that’s defined by simplified, more user-friendly treatments and a commitment to universal access. Yet, that era won’t be realized if pharmaceutical companies are allowed to move slowly, if governments don’t enact policies that encourage (or force) fair pricing and licensing, or if the global community fails to finance these initiatives. The decade-long struggle to reduce HIV infections and deaths has always been about more than just medicine; it has been a barometer of international cooperation, compassion, and political focus. The calls from UNAIDS at WEF 2025 reinforce the notion that scientific innovation can only be as effective as the systems and policies that make it widely accessible.

By evoking the example of Covid-19 vaccines, where wealthier nations quickly secured vast supplies and many poorer nations were left waiting, Byanyima reminded everyone that the story need not repeat itself. With enough foresight, planning, and moral resolve, the world can avoid the pitfalls of inequitable distribution and seize this “shot to end AIDS.” Her words at Davos ring with a certain finality: either the international community learns from past mistakes, or it risks condemning millions more people to preventable HIV infections. By framing the need for widespread access to these medicines as both a humanitarian responsibility and a wise economic move, UNAIDS hopes that the diverse set of influencers gathered in Davos will leave with more than just an awareness of the problem—they will leave with a genuine commitment to be part of the solution.

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