Twice-yearly vaccinations could help eradicate AIDS, but only if everyone who needs it is reached.

MEXICO CITY (AP) — This is said to be the closest the world has ever come to developing a vaccine. AIDS virus.

of Shooting twice a year Studies in women found it 100% effective in preventing HIV infection, and results published Wednesday showed it was nearly as effective in men.

Pharmaceutical company Gilead said it would allow a cheaper generic version to be sold in 120 poor countries with high rates of HIV infection, mainly in Africa, Southeast Asia and the Caribbean. But almost all of Latin America has been left out, where infection rates are much lower but rising, raising concerns that the world is missing out on a key opportunity to stop the disease.

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“This is unprecedented and far superior to any other prevention method we have,” said UNAIDS Executive Director Winnie Byanyima. She credited Gilead with developing the drug, but said the world's ability to stop AIDS depended on its use in at-risk countries.

In a report released to mark World AIDS Day on Sunday, UNAIDS said the number of people dying from AIDS last year – an estimated 630,000 people – was the lowest since its peak in 2004, and said the world is now at a “historic crossroads”. , suggesting that the country is in a critical situation. A chance to end the epidemic.

A drug called lenacapavir is already being sold under the brand name Sanlenca as a treatment for HIV infection in the United States, Canada, Europe and other countries. The company plans to apply soon for approval to use Sunlenca for HIV prevention.

While there are other ways to prevent infection, such as condoms, daily pills, vaginal rings, and bimonthly injections, experts say Gilead's twice-yearly injections may be harmful to gay men or those who seek care, such as having sex. It is said to be particularly useful for marginalized groups who are often afraid of workers and young women.

“It will be a miracle for these groups, because if they come to the clinic twice a year, they will be protected,” said UNAIDS's Byanyima.

So did Luis Rubalcaba, a 32-year-old man from Guadalajara, Mexico, who participated in the recently published study. He said he was afraid to ask for the preventive medicines provided by the government every day for fear of being discriminated against as a homosexual. Because he participated in the study, he will continue to receive injections for at least another year.

Dr. Alma Minerva Pérez, who recruited and enrolled more than a dozen study volunteers at a private research center in Guadalajara, said, “There is still a lot of stigma in Latin American countries, and patients are embarrassed to ask for medicine.'' ” he said.

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It remains unclear how widely available the vaccine will be through Mexico's health system. Health officials declined to comment on plans to buy sunlenka for the public. Daily pills to prevent HIV became freely available through the country's public health system in 2021.

“We believe that once the possibility of using generic drugs opens up, Mexico can participate,” Perez said.

Byanyima said that in addition to Mexico, which participated in the study, other countries such as Brazil, Peru and Argentina are also excluded from the generic drug agreement. “To deny now that drugs are unconscionable,” she said.

Gilead said in a statement that it remains “committed to supporting access to HIV prevention and treatment options where the need is greatest.” The 120 countries eligible for the generic version include 18, mostly African countries, which account for 70% of the global HIV burden.

The company said it is also working to establish a “fast and efficient pathway to bring lenacapavir to all people who need or want it for HIV prevention.”

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On Thursday, 15 advocacy groups from Peru, Argentina, Ecuador, Chile, Guatemala and Colombia sent a letter to Gilead, citing “alarming” inequalities in access to new HIV prevention tools while infection rates are high. requested that generic Sunlenka be made available in Central and South America. It was rising.

Countries such as Norway, France, Spain and the United States pay more than $40,000 a year for Sunlenka, but once generic production scales up to cover 10 million people, it could be produced for as little as $40 per treatment. Experts estimate that it is possible.

Dr. Chris Baylor, director of Duke University's Institute for Global Health, said it would be extremely helpful if Sunlenca were available in the hardest-hit countries in Africa and Asia. But he said rising rates of HIV infection among groups, including gay men and the transgender population, constituted a “public health emergency” in Latin America.

Hannya Daniel Torres, a 30-year-old trans woman and artist who participated in Mexico's Sunlenka study, said she hopes the government finds a way to provide vaccines. “Mexico may have some of the richest people in the world, but it also has some of the most vulnerable people living in extreme poverty and violence,” Torres said.

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Another pharmaceutical company, ViiV Healthcare, also excluded much of Latin America when it allowed generic versions of its HIV shot in about 90 countries. The bimonthly injection, sold as Apritude, is about 80 to 90 percent effective at preventing HIV. It costs about $1,500 a year in middle-income countries, more than most people can afford.

Asia Russell, executive director of the advocacy group Health Gap, said that with more than 1 million new HIV infections occurring worldwide each year, established prevention methods are not enough. She called on countries such as Brazil and Mexico to issue “compulsory licenses,” a mechanism by which countries suspend patents during health crises.

This is a strategy some countries have adopted with previous HIV treatments, including in the late 1990s and 2000s, when AIDS drugs were first discovered. More recently, in April, Colombia issued the first-ever compulsory license for the leading HIV drug Tibikai without permission from pharmaceutical company ViiV.

Dr. Salim Abdul Karim, an AIDS expert at the University of KwaZulu-Natal in South Africa, said he had never seen a drug that appeared to be as effective as sunlenka in preventing HIV.

“The missing piece of the puzzle right now is how do we get it to everyone who needs it,” he said.

Chen reported from London.