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With Hopes High for New H.I.V. Prevention Pill, Merck Takes Steps to Ensure Access
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Companies in Africa and India will make generic versions of the pill that could cost as little as $5 per person per year. But access to the drug and other new products in much of Latin America remains uncertain.
NY Times July 24, 2026
The pharmaceutical company Merck said on Friday that it would license seven generic drugmakers to produce a low-cost version of a new monthly H.I.V. prevention pill that has generated significant optimism about the role it could play in ending the H.I.V. epidemic.
The decision is intended to make stockpiles of the drug immediately available in developing countries if clinical trial results next year live up to expectations for the pill.
The company’s announcement on Friday comes as a major international AIDS conference begins in Rio de Janeiro, against a backdrop of disappointment with limited progress on cutting H.I.V. infection rates.
The new drug, alimatravir, is a pill taken once a month for what is called pre-exposure prophylaxis, or PrEP. It is being tested in a late-stage trial involving young women in three sub-Saharan African countries, and in a separate trial in countries across Latin America, Asia, Europe and Africa that involves transgender people and men who have sex with men.
There were 1.2 million new H.I.V. infections in 2025, according to UNAIDS, a United Nations agency. More tools to prevent infection are available, but they are not reaching many of the world’s most vulnerable people. Slow but steady progress toward the goal of lowering H.I.V. transmission rates was derailed over the past 18 months by sharp reductions in funding from the United States and other major donor countries.
A recent analysis by the Clinton Health Access Initiative found a 42 percent decline in the number of people who were started on oral PrEP in 2025 in 10 sub-Saharan African and Asian countries with high rates of H.I.V. infection, compared to the year before.
Merck’s deal will allow generics to be produced for 129 low- and middle-income countries. The company said it would also manufacture a bridge supply to be sold to those countries at a no-profit price, before the generic product comes to market and gets regulatory approval. The company would not disclose the price.
Merck will give a royalty-free license to four generic companies in India, and to three in sub-Saharan Africa - drugmakers in Uganda, Kenya and South Africa - in a boost for regional manufacturing efforts. That has been an African Union priority since the continent was largely shut out of access to Covid vaccines until a year after the rest of the world.
Because production of alimatravir uses a small quantity of its active pharmaceutical ingredient, and because it is a standard oral formulation, companies could produce it profitably at scale and sell it to national health systems for as little as $5 per person per year.
The timing of Merck’s announcement, coming well ahead of final clinical trial results, is unusual, and appears to be an effort to avoid problems that have dogged the introduction of other PrEP products.
Advocates for H.I.V. treatment and care are advising Merck on how to ensure access to the drug, if the trial results show it works.
full publication:
https://www.nytimes.com/2026/07/24/us/politics/merck-hiv-pill.html?unlocked_article_code=1.0FA.2V9e.-4qdHZ6DbosS&smid=nytcore-ios-share
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