The Access to Medicine Foundation’s 10th biennial index found that pharmaceutical companies are increasingly addressing the affordability and availability of innovative medicines in low- and middle-income countries, including during the development stage. The foundation said access, once often handled through philanthropy after medicines reached the market, is now receiving more attention from senior company leadership. Measures include licensing medicines to local manufacturers so they can produce cheaper generic versions before patents expire.

Lenacapavir, Gilead’s twice-yearly HIV-prevention injection, was cited as an example. Gilead allows manufacturers to produce a version priced at $40 per injection for 120 low- and middle-income countries, compared with an original catalogue price of more than $28,000 per person per year. In South Africa, where about eight million people live with HIV, researchers said wider access could support large-scale prevention, particularly among young women, although the affordable version is still awaited and the current supply of the expensive original remains limited. The foundation also said reduced US aid funding was hindering other HIV-related efforts and called for the approach to be applied to diseases such as cancer and diabetes.