Live from UNGA with Buddy Shah

And what does that look like? What happens at that point? How does the picture

change? So I think that's the big thing that we're pushing for now.

So as soon as we got the price point, that's just the first part of actually getting a transformational impact.

And then the Chai team started working internally to say, okay, what would it take for us to actually end the HIV epidemic? How big would we need to go in terms of scale up of Lenacapivir to actually do that now that we have this transformational tool? And so over the course of this year, we've been building this model to think as expansively as possible, which was at odds with the mood after the USAID cuts of actually not having enough.

So there's a scarcity mindset, but we really went into the modeling mode of, well, let's just dream for a second and say like, could we end the HIV epidemic? And basically what we're finding is that if you sustain people on treatment, which is actually going pretty well because of Global Fund, U.S.

government, national governments keeping that as a priority.

Despite the cuts.

Despite the cuts.

It's tracking well, especially in sub-Saharan Africa.

If we get lenacapavir to 9 million target populations across the continent and sustain that for 10 years, you actually get this crash in HIV and reach what's known as the technical end of the epidemic, which is a 90% reduction in new infections from 2010.

And I'd say for someone like me who even entered the field of global health at the height of the AIDS epidemic, that it would just be a generational accomplishment to be able to end HIV as an epidemic in the next 10 years.

And it'll only cost $2.5 billion.

So we did the costing.

About half of that is for the drug costs.

Half of that is for delivery.

And if we're able to reach those 9 million people with Lenacapavir for about $2.5 billion total over 10 years, so $250 million a year, We expect that you'll get 4 million fewer new infections overall, of which you can attribute about a million of those infection reductions to lend a cap of your scale up.

You'll actually save more money than you spend.

You'll avert probably $2.7 billion in treatment costs because fewer people will get HIV.

And you achieve this remarkable thing of ending HIV as an epidemic in a continent where it's had profound effects on life expectancy and economic and societal disruption.

And so the question is, like, can we do that? And one part is a fundraising question.

Can we mobilize two and a half billion dollars over a decade to solve this? And the second is a delivery challenge.

Can we actually identify these nine million people and get the drug to them? And a lot of these are vulnerable populations, men who have sex with men, adolescent girls and young women.

And so there are real delivery challenges.

But I think the point is, once you get the breakthrough drug and then the breakthrough price, the question is, how do you solve these hard things to get it to everyone who needs them in order to drive big, measurable improvements in the world? Can you do it?

I really think we can.