Fourteen countries across Latin America are set to expand their HIV prevention toolkit after the Pan American Health Organization (PAHO) secured a landmark access agreement with U.S.-based pharmaceutical giant Gilead Sciences for lenacapavir, a groundbreaking long-acting pre-exposure prophylaxis (PrEP) administered just twice per year.
The deal covers Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Mexico, Panama, Paraguay, Peru, Uruguay and Venezuela, with Suriname excluded from this specific arrangement. Participating nations will be able to purchase the drug through PAHO’s Regional Revolving Fund, a bulk procurement mechanism that aggregates demand across multiple countries to secure lower prices and more reliable supply of critical health products compared to individual national purchases. Before the drug can be rolled out to at-risk populations, each country must still complete national regulatory approval and program implementation processes.
Unlike traditional oral PrEP that requires daily adherence, lenacapavir is delivered via injection just once every six months. The World Health Organization (WHO) formally endorsed lenacapavir as an additional HIV prevention option in 2025, following clinical trial data published by PAHO showing the drug achieves nearly 100% effectiveness in blocking new HIV infections. This half-yearly dosing model fills a critical gap for people who struggle to maintain daily or frequent dosing schedules required by existing prevention methods.
Public health data underscores the urgent need for expanded prevention tools across the region: PAHO records roughly 140,000 new HIV infections annually in Latin America and the Caribbean. “The Americas have access to increasingly effective tools to prevent HIV, but these innovations only make an impact if they reach the people who need them most,” said PAHO Director Jarbas Barbosa. He noted the new agreement will help narrow gaps in access to lenacapavir and give countries more flexible options to expand their prevention outreach. This procurement arrangement operates alongside existing voluntary licensing agreements for lenacapavir that already cover 24 Latin American and Caribbean nations, as part of a broader global access program reaching 120 countries worldwide.
In a complementary commitment included in the deal, Gilead has agreed to pursue technology transfer to Brazil to enable local manufacturing of lenacapavir in the future. No firm timeline or specific operational structure for local production has been finalized, but PAHO projects that regional manufacturing will boost long-term drug availability and create more sustainable, affordable procurement pathways for the region.
Rollout of lenacapavir into national HIV programs will proceed in a phased, gradual manner. Participating countries will need to update national public health regulations and clinical treatment guidelines, train healthcare workers on administration and patient support, and adapt existing care systems to integrate the new prevention option.
Lenacapavir will complement existing HIV prevention tools currently available across the region, including daily and on-demand oral PrEP, another long-acting injectable option called cabotegravir, and condoms. PAHO frames the expansion of prevention options as a core part of regional efforts to cut new infection rates further and achieve the global target of ending HIV as a public health threat by 2030.