World AIDS Conference in Rio: Doctors Without Borders Demands Cheaper Access to HIV Prevention Drug

The background to the demand is the global dimension of the HIV epidemic. According to the Action Alliance Against AIDS, around 1.2 million people worldwide become newly infected with HIV each year, and approximately 570,000 people die from the consequences of AIDS. Infection numbers are currently even rising again; according to estimates, around 1.3 million people are now becoming newly infected with the virus. Low-income countries that are heavily dependent on international support are particularly affected.

Background of the Demand

Scharwey described the international situation as far more dramatic than in Germany. The situation is „Gift und gefährdet die bisherigen Erfolge im Kampf gegen HIV". The demand for lower prices is therefore directed primarily at international donor organizations and at the manufacturer Gilead. Doctors Without Borders argues that only through lower prices and broad production of generics can effective prevention be made possible in the poorest countries.

In Germany, the situation looks somewhat different. Here, around 2,300 people become infected with HIV each year. Since 2010, the number of new HIV infections has fallen by around 43 percent, according to researchers. Holger Wicht of the Deutsche Aidshilfe nevertheless expressed concern: „Wir befinden uns in einer aberwitzigen Situation." He pointed out that AIDS is within reach of being successfully contained. „Wir haben Aids fast besiegt, wir haben alles, was wir dafür brauchen, und es ist uns auch gelungen." Death figures have fallen, illness figures have fallen, infection figures have fallen.

Situation in Germany

Wicht also emphasized the urgency of further efforts: „Wir hätten jetzt nur noch ein paar Jahre weitermachen müssen, um dieser Epidemie wirklich ein Ende zu machen." He also warned against cuts in care. Although care in Germany is very good for most people, „wir erleben gerade, auf kommunaler Ebene und Landesebene, dass viele Angebote gekürzt werden oder von Kürzung bedroht sind", said Wicht.

A central topic of the conference is the drug lenacapavir itself. It is considered a scientific breakthrough and was brought to market in 2025. HIV researcher Stefan Esser of the University Hospital in Essen spoke of a „Meilenstein in der HIV-Behandlung". What is special about the active ingredient is its mode of action. „Das ist eine neue Substanzklasse, und die ist vor allem für Menschen, die Probleme mit der täglichen Einnahme haben, ein Riesenvorteil", explained Esser. Instead of daily pills, two injections per year are sufficient.

Lenacapavir as a Milestone

HIV research has made considerable progress in recent decades. „In den letzten Jahren und Jahrzehnten sind die Medikamente immer effektiver geworden", said Esser. They now cause „deutlich weniger Nebenwirkungen als früher, und sie sind erheblich einfacher einzunehmen". People receiving HIV therapy today have a completely normal life expectancy. However, as soon as therapy is stopped, the virus can become active again.

Angelique Hölzemer also pointed this out. „Schon nach wenigen Wochen oder Monaten sind Tausende von unterschiedlichen Mutationen des Virus in einem Menschen enthalten", she explained. The virus continues to slumber in the cells, in the DNA. In order not to give the virus a chance, it is essential to take the various antiviral medications regularly and reliably.

Research and Chances of a Cure

Research into a cure for HIV remains difficult. Esser reported cases in which a cure was achieved. „Die bisher Geheilten haben alle eine zusätzliche und tödliche Erkrankung gehabt, nämlich Blutkrebs", he said. Because of its risk, however, this therapy is „keine Heilungschance für alle". The stem cell transplantation that led to a cure in some cases only came into question for patients with a simultaneous blood cancer disease.

In the 1980s, the disease AIDS was still an inescapable death sentence. Today, most those affected can live well with an HIV infection, provided they have access to medication. Precisely this access is now the point of contention at the conference. Wicht of the Deutsche Aidshilfe finds it strange that „ein derart hochwirksames Medikament in Deutschland nicht verfügbar ist". He pointed out that „der Hersteller Gilead sich dafür entschieden" habe, „es in Deutschland nicht auf den Markt zu bringen, weil es nicht genug Gewinn versprach".

Pricing Policy and Access

The demand by Doctors Without Borders is aimed at a global solution. In addition to the price reduction, this also includes the establishment of generic production, which could increase competition and permanently lower prices. This would make the drug widely available in low-income countries, where the majority of new infections and deaths are still being recorded.

The conference in Rio de Janeiro brings together researchers, activists, and aid organizations to discuss the future of the fight against HIV. The central question is how the global trend of rising new infections can be stopped. Doctors Without Borders sees the pricing policy of the manufacturer Gilead as a central obstacle and demands a change of course.

Outlook of the Conference

Parallel to the political demands, the scientific debate about the next steps in HIV research is underway. This concerns both improved prevention tools such as lenacapavir and the long-term question of whether a cure for HIV will be possible beyond the rare stem cell transplantations. The conference is intended to provide new impetus in this regard and to increase the pressure on manufacturers such as Gilead to improve access to vital medicines worldwide.