In her insightful 2nd October 2024 article (Nolen Article), Stephanie Nolen of The New York Times highlights Gilead’s recent decision to allow six generic pharma companies to make and sell their preventive HIV shot, lenacapavir, at low cost to over 120 low-income countries, including many in sub-Saharan Africa. But while the plan will surely benefit individuals in countries with the highest rates of HIV, Nolan astutely raises our awareness of some of the hidden costs and challenges that accompany these benefits. These include: 1. exclusion of most middle- and high-income countries (such as Brazil, Colombia, Mexico, China and Russia) that ‘together account for about 20% of new HIV infections’ ; 2. charging higher prices for the drug in excluded countries; 3. shutting out access to affordable lenacapavir in excluded countries for marginalized groups within which HIV spreads rapidly; and 4. effectively banning the potential importation of these low cost versions of lenacapavir from any of the six  generic pharma companies. Together, as Nolen states, these hidden costs serve to widen the gap in access that is eroding healthcare systems for people in the middle.

At Bio Usawa, Inc. (www.biousawa.com), we are committed to addressing the vast inequities in low and middle income countries (LMICs) through building biosimilar manufacturing capacity in Africa, which will depend on leveraging the power of global partnerships.  Forming cross-border and - agency relationships will also be at the forefront of the discussions at the upcoming World Economic Forum (WEF) in Davos (Jan 20-24, 2025). We believe that continued collaboration between governments, the private sector, and civil society is essential to achieving health equity and overcoming global health risks that affect all. 

We look forward to further discussions on these critical issues at forums like Davos, where the world’s top leaders converge to shape a more equitable future.