Switzerland is currently experiencing a worrying shortage of the only generic drug prescribed and reimbursed for HIV PrEP. This situation extends beyond the pharmaceutical sphere, posing a genuine public health challenge. In these uncertain times, information sharing, mutual support, and adapting prevention strategies become crucial. This crisis is part of a broader global LGBTQIA+ context, where community health issues are gaining international significance.

An Interruption in Deliveries Announced by Mepha

The Swiss laboratory Mepha has reported a nationwide supply disruption for its Emtricitabin-Tenofovir. As of now, it is the only generic drug permitted and covered for HIV pre-exposure prophylaxis (PrEP) under mandatory health insurance in Switzerland.

According to information shared with prevention agencies and health professionals, deliveries to pharmacies, hospitals, and medical offices might halt as early as March, with no promise of resumption before summer.

In practical terms, many individuals may face challenges accessing their preventive medication in the upcoming weeks.

A Core Tool in HIV Prevention

The issue is significant: HIV PrEP is among the most effective means of preventing the virus’s transmission. A prolonged access interruption could weaken the prevention strategies carefully implemented in recent years.

The most at-risk populations, particularly men who have sex with men and some trans individuals, could be especially affected. A prolonged shortage poses a real risk of increased infections.

PrEP in Switzerland: Recent Progress but Vulnerable

Since July 1, 2024, the inclusion of PrEP under mandatory health insurance, in accordance with OPAS (art. 12b let. i), has marked a major advance in HIV prevention in Switzerland. Under certain conditions defined by the Federal Office of Public Health (OFSP), both treatment and medical follow-up can now be reimbursed.

According to SwissPrEPared program data, more than 7,000 people have benefited from at least one consultation within this framework over the past twelve months.

However, the Swiss model has a structural weakness: only one generic medication is listed with the necessary indication for reimbursement by LAMal, meaning access to PrEP effectively depends on a single manufacturer.

This dependency highlights the fragility of a device that is essential for public health and the communities involved.

Maintaining an Effective Protection Strategy

In this scenario, one fundamental principle remains: anyone having sexual encounters outside an exclusive relationship should maintain an effective HIV prevention strategy.

While PrEP is an incredibly effective tool, it is neither the only option nor fixed in use. Temporarily adjusting habits can help maintain both individual and collective protection.

Practical Advice for People on PrEP

1. Adjust Usage Patterns

According to Swiss recommendations, a “demand-driven” method is possible, limiting intake to planned or probable sexual activity periods (for example, a visit to a sauna, a meeting set up via an app, or an outing to a bar or club).

To ensure effectiveness:

– Take two tablets between 2 and 24 hours before the first sexual encounter;
– Continue with one tablet per day as long as sexual activity continues;
– Continue with one daily tablet for at least two days after the last encounter for cisgender men, and at least seven days for other individuals.

If no sexual encounter occurs during the last two (cisgender men) or seven days (other individuals), it’s possible to temporarily pause intake. These breaks allow saving tablets while maintaining adequate protection. If new sexual activity is anticipated or possible, two tablets should be resumed beforehand.

If an unexpected encounter occurs without prior PrEP intake, other non-penetrative sexual practices remain possible. For penetrative encounters, a condom serves as a highly effective fallback solution, provided one is available.

2. Obtain Medication Abroad

Swiss legislation allows the import of medicines for personal use, limited to one box per month.

People living near a border can typically obtain the treatment from foreign pharmacies upon presenting a Swiss prescription. However, insurance may refuse or limit reimbursement if the medication is more expensive abroad than in Switzerland — often the case.

You can also order from abroad with caution:

– Favor reliable sites, based on recommendations from community or prevention organizations;
– Verify that the medication contains both essential molecules: Emtricitabine (FTC) and Tenofovir (TDF or TAF);
– Anticipate delivery delays.

Even when certain platforms offer sales without a prescription, medical monitoring is vital: check for contraindications, monitor effects on the body, ensure hepatitis B immunity, and conduct regular HIV and syphilis screenings.

Solidarity as a Collective Response

In the face of the shortage, community solidarity plays a decisive role. Individual choices have collective repercussions.

Simple acts can help mitigate the impact:

– Take only one box at a time to conserve supplies;
– Support those temporarily without treatment.

Hoarding unused reserves offers no added protection but can deprive someone of an essential tool. Caring for oneself also means looking out for others.

A Shortage Highlighting a Broader Issue

Drug supply disruptions are not limited to PrEP. Drug shortages are multiplying in Switzerland, including in a country at the heart of the global pharmaceutical industry.

In the case of PrEP, dependency on a single product is a clear structural weakness. Globally, several alternatives exist: different oral options are available, and long-acting injectable forms are gradually being developed.

Injectable preventive treatments every two months (Cabotegravir LA) or every six months (Sunlenca) are recommended by institutions such as the World Health Organization (WHO), the European AIDS Clinical Society (EACS), and the Centers for Disease Control and Prevention (CDC).

Cabotegravir LA has been authorized by international regulatory agencies like the European Medicines Agency (EMA). It is gradually being integrated into national policies, especially in the United States, Canada, United Kingdom, and France since February 26, 2026.

Turning Concern into Mobilization

This crisis reminds us that progress in community health is never fully secured.

PrEP has significantly reduced HIV transmissions in many countries, including Switzerland, particularly among gay, bisexual, and other men who have sex with men.

In the current context, several actions are required:

– Temporarily adapt individual practices;
– Strengthen solidarity within communities;
– Advocate at a political level to ensure the future availability of treatments and diversify the options authorized and reimbursed in Switzerland.

Preserving one’s health also protects others. Maintaining informed and supportive community prevention is more essential than ever.

For updates on the situation, follow @DrGay_fr on social media (Instagram, Facebook) and subscribe to the SwissPrEPared newsletter.

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