It was 1982. I was writing a new People’s Pharmacy book while Terry was completing a post-doctoral fellowship in medical anthropology at the University of California at San Francisco. It was a glorious year for us. One day Terry came back from a lecture to tell me about the mysterious disease that was becoming known as AIDS. The professor described it as almost assuredly caused by a virus, though they had not yet identified HIV (human immunodeficiency virus) as the cause of AIDS (Acquired Immunodeficiency Syndrome). We still have no cure for AIDS after 40 years, but the FDA has just approved a twice-yearly shot called lenacapavir (Yeztugo). It could be a game changer!
The Yeztugo Clinical Trial That Could Change the World:
On June 18, 2025, the FDA announced approval of lenacapavir (Yeztugo). Two shots a year could pretty much end the HIV pandemic…if it were affordable and available around the world.
Jon Cohen wrote an in-depth article for The New Yorker (June 24, 2025). It was titled:
“The Drug That Could Revolutionize the Fight Against H.I.V.“
He writes about a clinical trial in South Africa and Uganda involving thousands of women. Moupali Das heads HIV prevention research for the drug company, Gilead:
“When she reviewed the data, at her company’s sprawling campus in Foster City, California, she had to move closer to her computer’s screen to confirm that she was reading the numbers correctly. She was dumbstruck: What she thought was a zero really was a zero. More than two thousand teen girls and young women had been injected with the drug, which stays in the body for an astonishing six months. In the first year of the trial, each received two shots, and none of them became infected with H.I.V. ‘It was phenomenal,’ Das told me. ‘We thought it was going to work, but none of us thought it was going to be one hundred per cent.'”
Another trial tracked over 3,200 people. The effectiveness was 96%. Such results are truly astounding!
PrEP and Yeztugo is A Big Deal:
There are already some preventive measures that can keep people from contracting the infection that leads to AIDS. Doctors call them Pre-Exposure Prophylaxis, or PrEP.
- Truvada (emtricitabine plus tenofovir disoproxil fumarate) got the FDA green light in 2012. It is an oral pill.
- Descovy (emtricitabine and tenofovir alafenamide) received FDA approval in 2019. It is also oral and has to be taken daily.
- Apretude (cabotegravir) was approved by the FDA in 2021. It is an injectable drug and must be administered every two months.
The issue ahead is how many people at risk for AIDS will be able to get the benefits of the new drug. Gilead plans to sell it for more than $28,000 a year. This will put it out of reach for many people even in the US, especially as Medicaid coverage is cut.
Will Yeztugo Be Available Where It Is Needed Most?
If Yeztugo gets approval around the world, will it be affordable? People in poorer countries will have great difficulty accessing its preventive power, since USAID and PEPFAR have been mostly dismantled.
These organizations previously provided the primary infrastructure through which people in Africa were able to receive AIDS treatment and HIV prevention. Experts estimate that in 2023, more than a million people world-wide became infected with HIV.
Having a drug that prevents transmission of the human immunodeficiency virus more than 40 years after HIV was first identified is a major accomplishment. Can the world figure out a way to take advantage of this discovery?
