African nations have forcefully demanded fair and affordable access to the latest long-acting HIV medicines, arguing that scientific breakthroughs are meaningless if they do not reach the people who need them most. The unified call was delivered at a high-level UNAIDS meeting in Brazil by Dr. Andrew Mulwa, the head of Kenya’s National AIDS and STI Control Programme (NASCOP).

The issue is critical for Kenya, where an estimated 1.3 million people are living with HIV. While the nation has made strides in expanding access to daily antiretroviral therapy (ARVs), the advent of long-acting injectables—which can replace daily pills with an injection every few months—represents a paradigm shift in managing the epidemic. This innovation, however, comes with a prohibitive price tag in Western markets, sparking fears of a new divide in global health.

The Promise of a Pill-Free Future

In his address on behalf of African member states, Dr. Mulwa emphasized the transformative potential of these new drugs. He noted that they could dramatically improve treatment adherence for individuals who face challenges with daily oral medication due to social stigma, economic instability, or other structural barriers. This is particularly crucial for vulnerable groups where treatment gaps persist.

Key challenges in the current HIV response in Africa include:

• Vulnerable Populations: Pregnant and breastfeeding women often experience treatment interruptions, contributing to mother-to-child transmission.
• Youth Disparity: Adolescent girls and young people remain disproportionately affected by new infections across the continent.
• Treatment Gaps: In Kenya, recent data shows a concerning rise in new HIV infections, with over 20,000 new cases recorded in 2025, underscoring the need for more effective prevention and treatment tools.

Bridging the Affordability Gap

The core of Africa's demand centres on cost. Long-acting injectables like Cabotegravir have a list price in the United States of over $22,000 (approx. KES 2.8 million) per year. Health advocates and bodies like UNAIDS argue that generic versions could be produced for a fraction of that cost, potentially as low as $60 (approx. KES 7,800) per year, a price point that would make widespread access in low- and middle-income countries feasible.

Dr. Mulwa warned that without deliberate action to close this affordability gap, the world risks creating a two-tiered system of HIV care. He stressed that the success of these scientific marvels depends entirely on their timely availability and integration into public health systems across Africa.

The call to action from the Brazil summit places the onus on pharmaceutical companies and global health partners to ensure that geography and economic status do not determine access to life-saving medicine. As Dr. Mulwa articulated, the goal is not just innovation, but innovation with justice, ensuring that the end of AIDS as a public health threat is a reality for everyone, everywhere.