New HIV vaccine shows unprecedented success in preclinical study
lji.org449 points by codebyaditya 7 hours ago
449 points by codebyaditya 7 hours ago
The most interesting point of the article for me is that this vaccine appears to be a series of shots which act as a curriculum for the immune system. Each one slightly different and targeting a different stage of B-cell development. I've never thought of vaccine series working like that, so it was a new and impressive idea.
The way the HIV evades effective antibodies is by tricking the immune system to generate antibodies for fake decoy targets that the virus will immediately mutate.
So each turn, B-cells are presented with the latest version of the virus, they generate various antibodies to the various parts, and are graded at the end by how well the generated antibodies bind to the virus. The problem is that you have 1 million cells which bind strongly to the fake decoy targets and 1 cell which will bind not as strong to the real effective target. So this 1 cell never gets "promoted".
What this "germline targeting" multi-shot vaccine tries to do is to introduce a series of targets that stimulate that 1 in a million cell which will attack the right part of the HIV virus, so it gets "promoted", so if the real virus appears, the body will still go for the decoy targets, but will also generate a lot of these really effective 1 in a million cells, which got "promoted" previously by the vaccine.
To be more precise, you need to "guide" a lets call it B1 cell that all of us have in our repertoire to mutate into B2 then B3 than B4, because this B4 version will be capable of creating the right antibodies for HIV, the issue being that the intermediary states, B2, B3 are not naturally promoted so you very rarely get to the B4 state without this intervention.
HIV isn't the only virus that generates decoys to trick antibody development, so having techniques that bypass that decoy strategy is very useful.
What's the risk of collateral damage or autoimmune issues from this kind of process, it sounds more difficult to evaluate for safety because it is more complicated.
It's still the body doing the work, the antibodies will still be tested for self-attack in the regular ways, so there shouldn't be any impact. But immunity is super-complicated, so who knows...
This is the way a lot of modern cancer vaccines are being developed. The idea is to create custom vaccines in the future targeting the patients specific cancer. So they are therapeutic vaccines. Obviously some cancers cannot be reach by a vaccine or are so aggressive that they overwhelm the patient before they can help.
I work in pharma and a coworker asked if they could use my code (a model inference server). I asked what they were doing and it's an ML model for determining clinical dosing for a cancer trial. They sequence a person's cancer, then develop custom RNAs that train the immune system to eliminate that cancer (similar to https://www.nature.com/articles/s41392-026-02769-3) which they inject into the patient.
I would like to thank all the scientists who have dedicated all their hard work and ingenuity to eliminating the impact of cancer. Also, fuck cancer.
I'm not aware of cancer vaccines that use this sort of b-cell priming, though I've heard lots about mRNA vaccines, as well as neo-epitope based cancer therapeutic vaccines. Are you analogizing the neoepitope approaches to the B cell progression here? That is somewhat similar, but the chain of new vaccines does seem quite different and novel to me.
I cannot answer those questions as much as I wish I could. My dads papers around the stuff they are working on is here if it’s of any use https://www.sciencedirect.com/author/7005329466/gunnar-kvalh...
Well, they kind of all work that way, it's just that most of the curriculum occurs naturally through interactions with wild pathogens
From what I understand, random interactions with wild pathogens can prime the immune system in the wrong way, leading it down the wrong path. This is why some people can get lucky with immunity and be super resistant to flu, because they happened to luck into a response that targets a common factor in most flu strains. Other people have bad luck and target some area that mutates frequently, and they proceed to get walloped by every flu strain, every year.
This is why it's hard to make a 'super vaccine' for flu, becuase it takes many rounds of shots to retrain some people's immune systems once they've latched on to the wrong recipe for antibodies.
As someone whose had rheumatic fever, your immune system can definitely prime itself for the wrong target.
Right I'm saying it's always path dependent not that it necessarily improves outcomes.
An analogy of this is having the wrong math instruction in middle school could make your math classes harder at the university level.
All vaccines are training data for the immune system, which is a learning machine whose operation is a little bit like a genetic algorithm. It generates and sieves variation using a vocabulary of pre-encoded building blocks to fit the targets it's presented with.
It's an incredible system, and a product of probably a billion years of evolution since the first multicellular organisms had to protect themselves from infection.
I do not see what is impressive here at all. The immune system constantly yields new antibodies targeting different epitopes - all the time. THAT is what is impressive, not multi-vaccines trying to induce shifts towards certain epitopes over others.
Are you saying that the result of millions of years of evolution is more impressive than decades of medical research?
While HIV vaccine research is an exciting field, it's worth pointing out that halting HIV transmission is, practically speaking, a solved problem with oral and injectable reverse transcriptase inhibitors. The ongoing loss of life and health due to HIV could be stopped if we cared enough to invest resources in wide-scale PrEP availability and public health education. Waiting for an HIV vaccine is the domain equivalent of hoping fusion power will solve our energy needs. Other solutions exist already; we just have to use them.
You could say the same about teen pregnancy being a practically solved problem, except there is still the problem of teen pregnancy. Or even something more mundane as driving consistently safely all the time to solve the problem of accidents.
If everyone was disciplined all the time in regard to everything, many problems in the world would simply not exist. But we live in reality where for whatever reason, people don't know to do something, or they do know and they're just not disciplined, or they make a mistake due to extenuating circumstances. And I would expect that the vast majority of people would oppose any idea of somehow punitively "dealing with" people who get some things wrong.
So I would say that it's very evidently not a practically solved problem, because if it were we wouldn't be looking to solve it still.
Within this reality, a vaccine is a great additional tool at solving the problem of preventing the spread of HIV.
> You could say the same about teen pregnancy being a practically solved problem, except there is still the problem of teen pregnancy. Or even something more mundane as driving consistently safely all the time to solve the problem of accidents.
At the risk of derailing this conversation from the original topic, those two things are not remotely equivalent. There's no organized political movement trying to tell people that seat belts and speed limits are immoral, and you should only drive when you're willing to accept the responsibility that comes with the risks.
Where I am from, organised political movements are not a factor of teen pregnancy and were not the least bit in my mind when I made my statement.
And my two examples are completely arbitrary because my point applies to pretty much any problem which would be solved by people being “more careful”.
So, political/religious elements aside, teen pregnancy and road safety are the same in terms of “if people were just more disciplined, there would not be these problems” (i.e. if teens who have easy access to contraceptives planned ahead before giving into impulsiveness; if drivers were more attentive to their behaviour), which I then pointed out is naive because the reality is that people aren’t perfect, they aren’t always disciplined, we’re all only human.
Hence, we need other solutions to help with problems which don’t require ignoring that people are only human and lack perfect discipline.
I agree that some organised movements can be a problem in that they can make other problems worse.
My point is that teen pregnancy very much does have a solution that has empirically worked quite well at preventing it when it's actually practiced (i.e. high quality sex education and ample access to contraceptives), and pushing abstinence as a solution has demonstrably caused teen pregnancy rates in increase whenever it's used as a replacement for that; the only actual impetus for abstinence as a "solution" is ideological. I think teen pregnancy literally would be a solved problem (with instances being essentially a rounding error) in a society embracing what we actually have proven works well at preventing it; I've never seen any similarly successful mechanism at preventing injuries or deaths in automobile accidents be rejected by a society for ideological reasons.
Trying to handwave away the things we know work to prevent teen pregnancy as "just be careful" feels overly reductive, because it's way easier to do correctly than managing to drive without ever having an accident.
Talking about road safety.
In South Africa we have 12,000+ road fatalities a year, by comparison Australia (renowned for strong law enforcement) has 1,200 or something. (And they apparently happen to have about 4,500 teen pregnancies a year.)
Australia’s (or maybe it was New Zealand’s which I visited on the same trip) road safety campaign is called “Towards Zero”, while South Africa’s is called “Arrive Alive”.
A big part of the difference in fatalities is that Australia has much better general law enforcement (such that a lot of foreigners complain about it), while over here it’s dismal with Arrive Alive’s strategy seemingly being to always do the same thing as last year’s holiday season except with “trying harder”, while largely ignoring day-to-day traffic offences.
Due to the high chance of being caught for transgressions, Australians tend to way more often stick to the rules of the road, while over here there is horrendous amount of (to put it politely) shenanigans happening almost all the time.
And the impact of this difference in discipline shows in the above stats.
Years ago now, but my now wife spent 10 days in intensive care after a minibus taxi driving on the wrong side of the road head on collided into the car she was a passenger in. My wife was fortunately in a car with good safety features and had a medical aid plan allowing her to receive some of the best care possible in the country, but I’m doubtful that the mini bus taxi passengers (who tend to be in the poor class of the population) sent to public hospitals received care anywhere near as good, I think I heard after this article [1] was published that two people died.
Perhaps road accidents, or at least fatalities, can be reduced more than you realize.
[1]: https://www.citizen.co.za/northcliff-melville-times/222787/2...
derailing further, it's no organized political movement, and they don't call it immoral but in Caucasus region some men avoid using seat belts as "unmanly", and that's a very social thing. Small plugs into a seatbelt socket to shut up the car audible warning are very common, including taxis.
Right, but we know that HIV/AIDS essentially is a solved problem in rich countries, that the mentioned interventions are readily available in rich countries, and the only reason HIV transmission is high in poor countries is because, well, they're poor. We (humanity as a whole) have plenty of money, we could fund these things, we simply choose not to.
I would caution against making an allusion to self control. It would be very cruel to act as if people who get a disease through no fault of their own could have avoided it, and most people who contract HIV could not. You may not have intended to make that allusion, but you did.
> So I would say that it's very evidently not a practically solved problem, because if it were we wouldn't be looking to solve it still.
This is obviously not what is meant by "practically solved problem". Everybody knows it is not actually solved.
I recently read "Everything is Tuberculosis". It describes a similar issue with the rich / poor country divide.
It's quite sad and difficult to read at times.
Tuberculosis is different, in a very dark, utilitarian way. 4% of new TB cases are multi-drug resistant (19% of recurrences).
Once it’s multi-drug resistant, if you’re poor then you get an incredibly depressing choice. Rich countries pay for expensive drug resistance testing.
Poor countries have to answer an impossible question. You either do nothing and see if they live, or you try to guess what drugs will work and give them those. However, if you’re wrong and the treatment doesn’t work then the risk that you’ve just made the strain immune to one or more of the drugs in that cocktail skyrockets.
They get asked to either do nothing, or do the best they can today knowing it will make tomorrow worse.
TB is also shockingly infectious, which is sad. You can at least take steps to dramatically reduce HIV risk, it’s much much harder to avoid TB.
"the only reason HIV transmission is high in poor countries is because, well, they're poor."
This is factually untrue.
Being poor does not equal a HIV transmission rate. There is no 1:1 correlation.
A single protected (condom) sexual act between a male and female averages somewhere around 0.1-0.5% chance of pregnancy, and during the fertile window it could still be around 1% or more even with a condom.
Chance of HIV from one act of unprotected vaginal sex with an HIV-positive partner: ~0.08% male-to-female.
The high HIV transmission rates are NOT correlated with wealth, but social behavior. Unprotected anal sex with many partners? High risk. Now, Africa - the practice of dry sex contributes a ton to HIV transmission. Cultural belief that a dry vagina increases pleasure, hence woman use sand, chalk or bleach to dry out their vaginas, massively increasing HIV risk. Needle sharing of drug users? High HIV risk.
Not a class issue, no reason to punch down on poor people. Poor people have agency and many do not infect themselves with HIV in the first place.
I don't think the original assertion is "punching down" on poor people. While you're correct that poverty isn't the "only reason" for high HIV transmission, poverty certainly contributes to it, via lack of access to health care and lack of access to education. How is it less "punching down" to attribute it to social behavior and culture? Isn't needle sharing associated with poverty, or would you also call that "culture"?
I was poor, grew up in social housing.
I did not use drugs.
"I share needles because I can't afford my own" is an INSANE take. Don't shoot drugs in the first place! Poor people are normal humans, they have willpower, agency. It is a rich people myth that poor people are cattle, devoid of any chance of doing the right thing.
It is culture, behavior, social norms. Being poor does not force you to abandon the nuclear family, does not force you to engage in criminal acts. (there is reverse causality though)
In the early 1960s South Korea had a per capita income lower than those of Haiti, Ethiopia, and Yemen, and about 40% below India's. Did all South Koreans become heroin addicts with HIV?
> Don't shoot drugs in the first place
like insulin? should a diabetic skip the insulin? In poor countries I wouldn't be surprised if the majority of HIV infections are not as preventable as you're imagining.
You can moralize, but even if only 10% of HIV infections are unavoidable, you're not contributing to solving the actual problem. (And by unavoidable I mean, unavoidable without investing in more needles, better sanitation, or prophylactics that the people "responsible" cannot afford.)
assume you have a population of IV drug users. as a society, would you prefer to spend nothing and see them develop HIV, or to spend some and control the HIV?
you don't have to care about the drug users at all. even if you treat them as pests rather than humans, we frequently vaccinate pests for public health measures. pathogens will spill over to populations you do care about, they'll create a drain on the healthcare system, they'll harbor other opportunistic infections. it's not sanitary.
this is completely leaving aside that some drug addicts can and do turn their life around, and that HIV is a horrible illness nobody should have to deal with, even if it's "their fault."
Dry sex in SSA may be one of the contributing factors, but it’s never been truly proven out as a key contributor in any study I have read; they always address it but say more needs to be done to be certain.
Your comment makes it seem like a key factor when it’s not.
In the Global Burden of Disease analyses, sub-Saharan Africa (SSA) had the highest age-standardized STI incidence rate of any world region — around 19,973 per 100,000 person-years, which is roughly double the global average of about 9,536 cases per 100,000.
Forecasts to 2030 expect sub-Saharan Africa to continue having the highest incidence rates of both HIV and other STIs of any region.
How come a specific region of the globe has this issue? "Poverty"?
Many regions in India are poor. Afghanistan. Pakistan.
Love the science based debate here, btw, thank you all for the downvotes. Facts, not feelings.
No, there will always be the threat of teen pregnancy. Conversely, we could wipe out HIV permanently if enough public will across the world was directed toward it.
I fully believe that HIV wouldn’t exist if PrEP had come out in the 80s when public hysteria was at an all-time high and the will to eradicate it was present.
We haven’t even managed to wipe out polio, and that is a cheap, lifelong vaccine.
not only that, people are explicitly trying to bring back measles, and succeeding at it
If we gave every living human on the planet the polio vaccine as soon as they were able to receive it, it would still exist in the wild somewhere.
If new generations are not also given the vaccine, it will eventually return.
Probably the same with HIV, although I could see it being somewhat more difficult for that to make a resurgence. If we inoculated the entire human race against it, it could possibly eradicate HIV for several generations, if not permanently.
Humans are the only reservoir for polio, so that’s not true. We could theoretically wipe out polio just like smallpox because there are no animal reservoirs.
>if PrEP had come out in the 80s when public hysteria was at an all-time high
You mean the time the US admin was intentionally neglecting the epidemic because "it's a gay disease"? Why do you think Reagan would have done anything to ensure such a medication was easily available?
> And I would expect that the vast majority of people would oppose any idea of somehow punitively "dealing with" people who get some things wrong.
Of course, and for good reason. The ones who know for a fact they are right, might in fact be wrong or malicious.
I thought the current panic was that young people (not necessarily teens) weren't having enough kids?
Which is in fact panic that teens are not having enough children, because that's where we have seen big drops...
This whole "panic" seemed weird from the start, but once it becomes clear that it's from the lack of teen pregnancies it takes on an even creepier Epstein-like oddness.
It is entirely possible to believe multiple things at once:
1. The drop is fertility is bad for society
2. The drop in teen pregnancy is good, despite it's contributions to 1
3. We should try to fix 1. without undoing 2.
I agree, but I don't think #3 is possible. For a variety of reasons, both biological and societal, the older people get the less likely they are to have kids, and fewer of them.
Kiryas Joel, New York, has astronomically high fertility, but also extremely low rates of under-18 pregnancy - which proves the combination is possible.
Fundamentalists, and others who abhor birth control, demonstrate pretty regularly that they have no issue with Teen Pregnancy, but rather unmarried teen pregnancy.
They want married teen pregnancy. By their own admission.
No, it's from the cost of living being so high that people are delaying having kids.
Worldwide the main thing that correlates to having less kids is being more educated. High cost of living correlates with more kids, not less.
Worldwide being more educated means higher cost of living. Nowhere in the world is there a country with high cost of living and high birthrates
Taking teen pregnancy as an example: we have the tools to avoid it. We have condoms, we have birth control, we have the morning after pill, we have abortion. We have all the tools -- are more tools really going to help? The fact that teen pregnancy is still an issue is not because we lack the tools to solve it.
HIV prevention is similar. We already have the tools. We have condoms. We have PrEP. Sure, a vaccine would be nice, but if someone is unwilling to go on PrEP, why would they suddenly be willing to get a vaccine?
Another tool isn't going to hurt, obviously. But it also isn't the #1 highest leverage place to be spending our time if the goal is to reduce HIV transmission. (It is, however, a great use of time to develop a vaccine if you're profit-motivated. HIV prevention is a massive business. 1 year of PrEP in the US costs $20-30k, although luckily ACA mandates $0 copay. I could imagine a $50k HIV vaccine being a blockbuster drug especially if ACA also mandates $0 copay - tons of money to be made! Ugh)
Edit: To be clear, I'm excited there's a promising vaccine. However, I am not getting my hopes up that a vaccine will magically cure all of the social/political issues getting in the way of a vaccine actually being widely distributed and administered.
> but if someone is unwilling to go on PrEP, why would they suddenly be willing to get a vaccine?
Because PrEP at even its best and most modern version requires an update every six months for life. If you're well-off and in SF or NYC or London that might be easy, but there's so many externalities such as:
- People who misjudge the risk they're at, so don't go on the meds in the first place
- People who live in regions where getting to a doctor even every six months is a challenge
- The six-month injection is extraordinarily expensive and a life-time treatment, for a disease you don't even have yet.
If instead it becomes a once-in-a-lifetime series of shot, like many other vaccines are already, we can start considering a path to extinguishing the disease, not just teaching people to live with it.
Then there's the financial savings of a series of three shots once vs a lifetime of them.
That's absolutely not correct. Truvada has had the same formulation since it was introduced in 2012. Descovy hasn't changed since it was approved in 2019.
You may be thinking of STD tests and bloodwork that is done every 3-6 months depending on your risk level to ensure that you're still HIV negative and that your kidneys are functioning normally, as kidney issues is a rare but serious side effect, especially for Truvada.
Now, what I believe is correct is that most people on PrEP would love to have a vaccine instead of needing a daily pill or even 2-6 injections per year as long as they remain sexually active.
That's like asking "if someone is unwilling to practice abstinence, why would they be willing to wear a condom, or to flip a magic 'not fertile right at this moment' lightswitch?"
A vaccine is something you do once and PrEP is something you have to continue to do over time and get overcharged out the ass for the entire time and worry about if it will remain available in the future.
It's still killing people like crazy (and spreading) in undeveloped nations. The new drugs are un-cheap.
Also, I believe that we just DOGEd our only vehicle for distributing these to underdeveloped nations.
We did, Musk has sentenced hundreds of thousands, if not millions, to death by dismantling USAID.
Considering his family history and his weird eugenic tirades, perhaps that was the intended effect to complete his fantasy cosplaying as a Roman general.
> Musk has sentenced hundreds of thousands, if not millions, to death by dismantling USAID.
Why haven't other countries stepped up to address this pressing need? I'm sure every other western nation could easily chip in collectively to cover the roughly $34B budget USAID had. Or do they just not care about these millions of people apparently sentenced to death?
France and England are trying.
The problem is money doesn't build supply lines overnight. Nor does it hire experts both locally and globally and get them there. Much of the data collected on patients by USAID can't just be handed over to another government for a myriad of privacy issues. Patients then have to know that their old clinic no longer exists and they have to go to a new one (is it in the same village anymore?). In the meantime viral counts go up, people get sick, infect their partners or newborn children. You can't just "pick it up later" without causing real harm.
> or do they not care
Do we not? Why can't we care, why is it now someone else's problem because Musk is still mad Mandela was let off of Robin Island?
Unfortunately HIV is not a solved problem.
Condoms? They break. More frequently than you might think.
Truvada and Descovy are great and make a big difference, but they require either high adherence to taking pills daily or being able to plan ahead for 2-1-1 (for same-sex relations - it's effectiveness for heterosexual intercourse hasn't been determined).
Apretude and Lenacapavir obviously require getting to a doctor or someone who can give you the injection either every other month or twice a year, is expensive, and can be very painful for some days afterward. And, of course, they're expensive.
A vaccine is the only real option for dealing with HIV for good.
All the tools we have against teen pregnancy need teens making right decisions, or taking corrective actions.
If there were a pill that'd block pregnancy for X years, given at the age of Y, then parents could enforce it and teen pregnancy would be solved (also it'd be very cruel but I'm just trying to make a point so bear with me).
Going back to our topic: People could also forget PrEP, be drunk and forget to wear a condom and so on. If this vaccine (or vaccine series) creates a somewhat permanent protection, it'd make a huge difference.
The US state of Colorado provided young women free IUDs (which are reversible and can last up to eight years) with private funds, and it was wildly successful. I argue teen pregnancy is solved assuming systems remain in place for women to have robust access to contraceptives and reproductive healthcare (which is a systems problem that is never solved completely, but reliant on defending the subject system constantly in perpetuity). The current US administration is rolling back teen pregnancy prevention programs to increase fertility rates in these age cohorts, so there is clearly work ahead to maintain the progress we've made.
If you're sure you don't want kids, or more kids, a bisalp, or bilateral salpingectomy (permanent birth control, removal of both fallopian tubes), is covered by Medicaid or ACA compliant private insurance in the US at 100% with no patient cost sharing as part of the Affordable Care Act federal statute. Doesn't apply to teens imho, but provides protection for 20-39 prime reproductive age cohort for those seeking it. It also decreases the risk of ovarian cancer by 42–77% (https://doi.org/10.5468/ogs.2018.61.5.542).
HIV PrEP in the short term is solved with a twice a year injectable (lenacapavir) until improved options become available (rapid deployment and robust availability of a vaccine given to as many at risk people as possible, as soon as possible). It can be provided for as little as $40/person (HN Search: lenacapavir - https://hn.algolia.com/?q=lenacapavir).
US Government Overhauls Teen Pregnancy Program to Focus on Marriage and Starting Families - https://www.nytimes.com/2026/07/22/us/politics/teen-pregnanc... | https://archive.today/ - July 22nd, 2026
Teen birth rates hit another historical low in 2025, CDC says - https://www.npr.org/2026/04/09/nx-s1-5777587/teen-birth-rate... - April 9th, 2026
Private Money Saves Colorado IUD Program As Fight Continues For Public Funding - https://kffhealthnews.org/health-industry/private-money-save... - August 27th, 2015
(with all of that context shared, all vaccines and medical protocols that improve quality of life, as well as defend and empower the human, are welcome and needed, as quickly as reasonable)
I'm not following the points in the above thread.
- people need to make the right decisions to take oral or injectable reverse transcriptase inhibitors
- people need to make the right decisions to take HIV vaccines
We are comparing two tools, not tools versus discipline.
In some ways these reverse transcriptase inhibitors are like a vaccine, in that they can be taken by people who don't have HIV, for protection.
They are inconvenient, requiring regular injections every few months or timing protocols for the oral versions.
An effective vaccine that lasts years would be much more convenient.
Without a HIV vaccine, the toolkit has a gaping lack; another tool is needed!
No, nothing is being compared. The question being posed is, if there are already tools to prevent HIV transmission (condoms, drugs, etc.) and someone doesn't use them, why would they use a vaccine?
Because a vaccine is much easier for the doctor to administer and manage. My GP won't put condoms on me but they do have a list of shots I get basically once and then never again.
All your arguments are sound, and I'm still missing your point. Pharma is interested in doing pharma, indeed. But who's interested in your solution, assuming you have one? A significant part of the current electorate (internationally, even) seems to abhor sex ed, condoms, abortions and all that. So tell me again please how you suggest we address teen pregnancy - in THIS world.
The person I was responding to says "HIV is not a solved problem" and "we need a new tool to solve it, a vaccine!"
My argument is simply that new tools are great, but it's not what's going to solve the HIV problem. Distribution, cost, access, stigma, etc are the larger problems to deal with. (We need to solve all the reasons why people aren't using the existing tools)
It's a solved problem if you are someone that knows you'll be exposed to HIV in the very near future and you have the money and wherewithal to purchase PrEP before that event (and you can plan the event 7 days out).
The power of a vaccine is you can give it to adults and kids before they are sexually active and protect them, potentially, for the rest of their lives.
I'd also be curious to know if the combination of ART + the vaccine might cure someone of HIV. Which is also a pretty big deal.
This is completely inaccurate. There is PrEP that requires dosing two times a year. You can also get PEP if you engage in a risky activity without PrEP.
Yes, it exists, but how available is it really? If I recall correctly, the injections are also not very pleasant.
"Gilead sells LEN at very high prices (over $28,000 per person per year in the US), severely restricts its supply to certain countries, and refuses to sell it directly to Doctors Without Borders/Médecins Sans Frontières"
Source: https://www.doctorswithoutborders.org/latest/campaigns/acces...
The shots are expensive, but the pills are free in the USA. They do have adverse kidney issues over prolonged use (more for some people than others).
And clearly only the people in the USA matter.
Are you serious? I would bank money on PEP being practically free in sub-saharan Africa.
*PrEP
It... was, until Musk dismantled USAID and Congress defunded PEPFAR.
So many comments by people who have never stepped foot out the Global North making wild assumptions.
I was explicitly referring to PEP. I'm not sure why you would make assumptions about where I have or haven't been when you have absolutely no information.
PEP remains largely free in SSA post-USAID/PEPFAR cuts.