{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:19:47Z","timestamp":1791271187619,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The proven effectiveness of injectable cabotegravir (CAB\u2010LA) is higher than that of any other HIV prevention intervention ever trialled or implemented, surpassing medical male circumcision, condoms and combination antiretroviral treatment. Based on our own analyses and experience with the South African oral pre\u2010exposure prophylaxis (PrEP) programme, we review the supply and demand side factors that would need to be in place for a successful rollout of CAB\u2010LA, and delineate lessons for the launch of other long\u2010acting and extended delivery (LAED) antiretroviral drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>On the supply side, CAB\u2010LA will have to be offered at a price that makes the drug affordable and cost\u2010effective to low\u2010 and middle\u2010income countries, especially those with high HIV prevalence. An important factor in lowering prices is a guaranteed market volume, which in turn necessitates the involvement of large funders, such as PEPFAR and the Global Fund, and a fairly rapid scale\u2010up of the drug. Such a scale\u2010up would have to involve speedy regulatory approval and WHO pre\u2010qualification, swift integration of CAB\u2010LA into national guidelines and planning for large enough manufacturing capacity, including the enabling of local manufacture. On the demand side, existing demand for HIV prevention products has to be harnessed and additional demand created, which will be aided by designing CAB\u2010LA programmes at the primary healthcare or community level, and involving non\u2010traditional outlets, such as private pharmacies and doctors\u2019 practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CAB\u2010LA could be the game changer for HIV prevention that we have been hoping for, and serve as a useful pilot for other LAEDs. A successful rollout would involve building markets of a guaranteed size; lowering the drug's price to a level possibly below the cost of production, while also lowering the cost of production altogether; harnessing, creating and sustaining demand for the product over the long term, wherever possible, in national programmes rather than single demonstration sites; and establishing and maintaining manufacturing capacity and supply chains. For this, all parties have to work together\u2014including originator and generic manufacturers, donor organizations and other large funders, and the governments of low\u2010 and middle\u2010income countries, in particular those with high HIV prevalence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26106","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T07:10:16Z","timestamp":1689232216000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["What will it take for an injectable ARV to change the face of the HIV epidemic in high\u2010prevalence countries? Considerations regarding drug costs and operations"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0439-381X","authenticated-orcid":false,"given":"Gesine","family":"Meyer\u2010Rath","sequence":"first","affiliation":[{"name":"Health Economics and Epidemiology Research Office (HE<sup>2<\/sup>RO), Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"Department of Global Health Boston University School of Public Health  Boston Massachusetts USA"},{"name":"The South African Department of Science and Innovation\/National Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) Stellenbosch University  Stellenbosch Republic of South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2354-4580","authenticated-orcid":false,"given":"Lise","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office (HE<sup>2<\/sup>RO), Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"The South African Department of Science and Innovation\/National Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) Stellenbosch University  Stellenbosch Republic of South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogan","family":"Pillay","sequence":"additional","affiliation":[{"name":"Department of Global Health Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00538-4"},{"key":"e_1_2_8_3_1","unstructured":"Delany\u2010MoretlweS HughesJP BockP DadabhaiS GadamaD. 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