Latin America Shut Out of key HIV Drug Access Agreement, Raising Public Health Concerns
Nearly all of Latin America has been excluded from a critical agreement that would allow access to affordable generic HIV medications, prompting urgent calls for pharmaceutical companies to prioritize public health over profits. Teh exclusion threatens to reverse hard-won gains in the fight against HIV, particularly as new cases rise and access to preventative treatments remains uneven across the region.
The concerns were initially raised by Winnie Byanyima, head of the United Nations Program on HIV/AIDS (UNAIDS), who reported the widespread exclusion from an agreement facilitating access to antiretroviral medicines without patent licenses. This announcement preceded a direct appeal to Gilead, urging the company to waive patent restrictions on its latest drug, Lenacapavir, a twice-yearly injectable solution offering a important advancement in HIV treatment.
“Ther is a strong increase in new cases in the region affected by the lack of agreement to release patents,” Byanyima stated, underscoring the urgency of the situation.
The issue of access to Lenacapavir was further discussed during an impact study event in Mexico, hosted by the AHF Institute for Global Public Health. Dr.georgina Morales,from the Mexican Social Security Institute (IMSS),confirmed Mexico’s readiness to implement the drug,with pilot tests authorized and trained personnel available. Though, she cautioned that long-term implementation requires sustained commitment. “These types of strategies require time. Precisely as thay must remain if the authorities are no longer there tomorrow. We have the experience and the disposition, but not the access. These strategies must complement oral PrEP (Pre-Exposure Prophylaxis),not replace it,” she explained.
Guillermo Bustamante Vera, manager of the country program at the AIDS Healthcare Foundation (AHF), characterized the exclusion as a demonstration of “a lack of sensitivity on the part of pharmaceutical companies.” He added, “Unluckily, they make excuses for changing certain molecules to be able to keep the patent and continue selling medicines at higher prices. It is
concentrated market for HIV-related treatments and supplies limits competition and openness. According to data analyzed by PODER, 85% of public funds allocated to HIV care in fiscal years 2024 and 2025 were channeled to just five providers: INTERMET SA de CV, the National Institute of Respiratory Diseases (INER), the National Institute of medical Sciences and Nutrition “salvador Zubirán”, WALA Servicios México SA de CV, and Abbott Laboratories de México SA de CV.
INTERMET received the largest share, with 368 million pesos, followed by INER and the Institute of Nutrition (340 million pesos combined), WALA Servicios (174 million pesos), and Abbott (308 million pesos).
“It is not a matter of political will, but of structure: the purchasing system is supported by fixed operators, and that leaves out those who could offer more agile or lower-cost solutions,” explained Guillermo Bustamante Vera, a specialist in hospital management. He warned that this dependence on a few suppliers hinders Mexico’s ability to proactively plan for and respond to potential drug shortages, a recurring issue in the country’s medical units. “Mexico cannot speak of health sovereignty if it depends on a single laboratory to acquire critical tests or reagents.”
This reliance creates a system where the international market dictates supply, and the national market operates with technical and financial dependence. Bustamante Vera argues that the current system prioritizes a perceived efficiency that doesn’t translate into timely access for patients. “The problem is not that there is a lack of medicines in the system, but that they do not reach patients on time. Distribution is centralized and purchases are made without foreseeing contingency scenarios, which generates constant ruptures in care.”
The exclusion of Latin America from generic drug access agreements, coupled with the concentrated supply chains in Mexico and a lack of transparency, signals a troubling trend: the fight against HIV is increasingly becoming a negotiation between governments and corporations, rather than a rights-based public health policy.
