GEOFF BENNETT: The FDA has approved a breakthrough preventative treatment for HIV that could change the course of the AIDS epidemic.

AMNA NAWAZ: But deep cuts to health initiatives both here and abroad could hinder the medications rollout.

William Brangham joins us now with the latest -- William.

WILLIAM BRANGHAM: The drug is called lenacapavir.

And not only does it offer nearly 100 percent protection from HIV, but people only need two injections per year.

Other HIV prevention drugs need to be taken daily or monthly.

So this drug has generated enormous optimism in the HIV/AIDS community.

But getting this drug to those who need it the most is not a sure thing.

For more on this, we are joined by Mitchell Warren.

He's the executive director of the AIDS Vaccine Advocacy Coalition.

Mitchell Warren, so good to have you on the program.

So, a lot of excitement about this new medication, nearly perfect protection.

But, as I mentioned, it's two injections per year.

Can you explain why that timing is so significant?

MITCHELL WARREN, Executive Director, AIDS Vaccine Advocacy Coalition: Thank you so much for having me.

And I'm delighted to be able to talk about this, because it is one of the most exciting moments in HIV prevention, frankly, in 44 years of this pandemic.

Thirteen years ago this month, in fact, the U.S. Food and Drug Administration approved daily oral PrEP, the idea that you described of taking a pill every day to prevent HIV.

It's an incredibly effective product.

It's incredibly safe.

But taking a pill every day for a condition that doesn't exist, for prevention is hard.

And we have seen sluggish rollout for some people and a hard time to adhere to taking a pill every day.

So the idea of only needing to come into the clinic twice a year to get these injections makes it a potentially more feasible intervention for people who are at risk of HIV.

And so there is a lot of enthusiasm.

And then, as you say, the data presented just last year showed near perfect protection in two different trials.

So, at least conceptually, this is our best shot, literally, to prevent infections that we have ever had.

WILLIAM BRANGHAM: So who are the people that are most likely to use this medication?

MITCHELL WARREN: So PrEP is indicated and now approved by the FDA for anybody who is at risk of transmission of HIV.

And that can mean pretty much anybody who's sexually active are people who use drugs, the classic roots of transmission.

The important part of PrEP programs, though, are not just the products, whether that's a daily pill or this injection.

It's really helping people understand their own sexuality, their own risk.

It is certainly going to be used by some gay men and men who have sex with men, transgender individuals, people who inject drugs, sex workers, young women in -- particularly in Eastern and Southern Africa, where we see high rates of HIV.

So it's really about helping people understand their own sexuality, their own sexual risk, and hopefully empowering them to make decisions to pick any of these PrEP products or a condom to be safe in preventing HIV.

WILLIAM BRANGHAM: This breakthrough comes as we have also seen large cuts by the Trump administration to foreign aid.

And given that the U.S. is one of the -- perhaps the world's biggest supporter and funder of HIV care and prevention, what is your sense as to what those cuts mean as far as getting this drug to the people who need it the most?

MITCHELL WARREN: You know, William, this is one of the cruelest ironies.

The FDA approved this product just two weeks ago, and we really should be in a moment of celebration of thinking about now how to do the hard work of rolling this out.

But the degree of difficulty to make this product available with speed and scale and equity has been diminished by what we have seen over the last 5.5 months.

The presidential administration has really dismantled -- and, as you well know, today is the first day we have the absence of the U.S. Agency for International Development, which was gutted by the administration.

Just in December, the program called PEPFAR, the President's Emergency Plan for AIDS Relief, started by President Bush with wide bipartisan support for over 20 years, had agreed with the Global Fund to Fight AIDS, T.B., and Malaria to roll out lenacapavir with a speed and scale that has never been seen before in HIV prevention.

They wanted to reach two million people immediately after the approval of the product.

The ambition is still there.

PEPFAR still exists, and the Global Fund is still committed, but it is going to be significantly harder because the backbone of programs around the world have been funded by PEPFAR to deliver PrEP.

So we have got to really look at how we, in a sense, stabilize the patient, stabilize the PrEP programs that have existed delivering oral PrEP and an earlier injection that you get every two months to now transitioning to this every-six-month injection.

So the will is there.

The commitment from political leadership at country level and certainly at the Global Fund is there.

But in the absence of USAID and with a greatly diminished PEPFAR, it's going to be harder.

And it's coming at such a difficult moment, because the science is so promising.

And we really are on the cusp of turning the tide on this epidemic.

And we are now set back even in the midst of this exciting news.

WILLIAM BRANGHAM: And what about the distribution of the drug here in the U.S.?

I mean, this is an expensive drug.

It's around, I think, $30,000 a year for those two injections.

Congress right now is debating huge cuts to Medicaid, which is one of the biggest insurers that provides HIV care and PrEP across the U.S. Do you think those impediments are going to slow its rollout domestically?

MITCHELL WARREN: I fear that it might.

And, again, it's another one of these cruel ironies.

In this president's first administration, one of the great surprises was his announcement in a State of the Union address in 2019 that he wanted to end the HIV epidemic in this country by 2030.

I would argue that injectable lenacapavir may be our best chance to actually reach that ambitious target that he himself set out in 2019.

And yet in this term of his administration, he's begun to cut the HIV prevention programs at the Centers for Disease Control and Prevention, slowing the release of funding to municipalities, to states and cities that are going to need to deliver PrEP at scale in the United States.

The price that has been named is about $28,000.

It is in line with the other listed prices for other PrEP products.

And we need to really push Gilead Sciences, the company that makes this product lenacapavir, as well as the CDC and this administration, to develop the programs that are going to deliver this product in an affordable way, in a way that we can actually see impact.

And that's going to take creative partnerships both in the United States and around the world.

WILLIAM BRANGHAM: All right, that is Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition.

Thank you so much for being here.

MITCHELL WARREN: Thank you so much for covering this important topic.