Injectable HIV Prevention May Join SUS in 2025

What is cabotegravir and how does it work?

Cabotegravir is an injectable antiretroviral drug that prevents HIV from replicating inside the body. Unlike the daily oral PrEP pill already available in Brazil's public health system, cabotegravir is administered once every two months — making adherence far easier for many patients.

How will it enter the SUS?

The Ministry of Health will submit a formal request to Conitec — the independent national committee that evaluates new technologies for public coverage — next week. Conitec will assess cost-effectiveness and issue a recommendation, but the final decision rests with the Ministry. Health Minister Alexandre Padilha confirmed that negotiations with manufacturer GSK are ongoing, with the company having offered what he called an "adequate price."

Why was lenacapavir ruled out?

Lenacapavir, made by Gilead, offers even longer protection — six months per injection — but was deemed unaffordable. Padilha stated that even when Brazil offered to pay up to ten times the price offered to comparable countries such as Indonesia and Thailand, Gilead still considered it unworkable for a national public health system. Brazil was also excluded from Gilead's voluntary licensing agreement that allows six generic manufacturers to supply lenacapavir to 120 countries. UNAIDS criticized the exclusion, calling lenacapavir central to ending the AIDS epidemic. Gilead said it continues to seek "sustainable long-term access pathways" for countries outside the licensing territory, including Brazil.

What does this mean for HIV prevention in Brazil?

Brazil already saw falling HIV infections and deaths, but funding gaps threaten further progress. Adding injectable PrEP to the SUS portfolio would give at-risk populations a highly effective, low-maintenance option free of charge, potentially accelerating the downward trend.