I was watching the “MIT Breakthrough Technologies for 2025” on YouTube recently. I don’t take their selection too seriously. Predicting the future is risky, and it is even riskier if you start from the present day!

I picked one prediction that caught my mind – long-acting HIV prevention medication.

Over 1 million people worldwide become infected with HIV every year.

Effective preventative drugs exist, but they have an Achilles’ heel. Folks must take them every day, or even more challenging, they must be taken ahead of a possible infection.

A new long-acting drug, Lonette Capovilla, is more convenient. It is administered by injection once every six months. Despite the title of this blog, I won’t go into the ‘how’ it accomplishes this.

A drug trial in Uganda and South Africa involving 5,000 women and girls demonstrated that the drug was 100% effective in preventing HIV infection. No, that wasn’t a typo. What could possibly be ‘a better way?’ This is what caught my mind’s attention.

Currently, approved forms of this Lonette Capovilla drug cost $40,000/person/year. Obviously, this isn’t going to work in low and middle-income countries, let alone rich countries.

A better way, not the best way, has been adopted. Manufacturing has been licensed to other businesses to make generic copies. They can sell it in 120 low-resource countries with a high incidence of HIV.

These manufacturers are not allowed to sell this generic drug in middle-income countries. It is worth noting that these countries probably couldn’t afford the current $40,000 yearly per person price tag.

There must be a better way.

Unfortunately, I don’t know what that way is. However, a few thoughts might realistically give a starting point for our thinking. I think of smallpox. At one time, it was a worldwide killer. Rich countries had effective vaccines. I remember getting a scratch on my left shoulder as a young child. I just checked in the mirror and can still see a circular scar. Smallpox no longer exists on this planet except in a few laboratories around the world. How did we find a better way?

At the United Nations level, representing almost all the countries in the world, there was enough consensus to eradicate it. The Achilles’ heel of this infection was that it needed to live on humans. If we could eliminate it for one second of time from all humans, the war on smallpox would be won. At one point, a small group of people headed off into the jungles of an African country to deal with the last known outbreak of smallpox.

Smallpox vaccinations were no longer needed anywhere in the world.

The key was not to find a solution but to first agree that a solution was worth finding.

Please give this a bit of a think. What is one problem in your neighbourhood that poses a challenging issue to solve? Who are the stakeholders that need to come together to agree that the problem is worth addressing? What is needed to get these key folks together to focus on building a consensus?

I am curious about your thoughts. Please comment below or send me an email with your bit of a think.

Photo by Olav Ahrens Røtne on Unsplash

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glenn.walmsley@icloud.com