Yet, the introduction of dolutegravir into more health programmes depends on two things: how many generic doses the Colombian government buys — and how quickly.

“It takes some time for generics to be registered,” said Luz Marina Umbasia, director of the Global Humanitarian Progress Corporation in Colombia.

Umbasia explained that the purchasing process typically takes at least six months, although her organisation has encouraged the Colombian government to buy doses “as soon as possible”.

That will allow patients access over the near term, while the drug is still under patent. The rights that ViiV Healthcare holds for dolutegravir in Colombia are set to expire in 2026.

Some advocates, however, doubt Colombia’s ability to coordinate a quick and efficient dolutegravir purchase. They cited a shortage of hepatitis C medicine last year that resulted from delays in price negotiations and supply acquisition.

“We don’t have a good experience with the Colombian government,” said Nestor Alvarez Lara, a pharmacist and president of the advocacy group High Cost Patients.

He called on the Colombian government to undertake a “very well-planned” rollout of the generic dolutegravir to avoid the same dilemmas.

“You have to buy in large quantities,” he said. “There’s a great deal of distrust that, at some point, you might have three months’ supply and then run out of medication.”

In a statement to Al Jazeera, the Colombian Ministry of Health and Social Protection said the government is finalising a negotiation to buy a “continuous supply” of dolutegravir through the Pan American Health Organization (PAHO).

They expect it to become available in the last three months of 2024. Officials plan to start by purchasing more than 800,000 bottles, guaranteeing a year of treatment for about 67,000 people.

Villan considers himself lucky to have switched over to dolutegravir. He only learned it was an option because his husband switched his medications last year, and Villan saw his mental state transform.

“I met my husband again,” Villan said.

Villan added that he has helped friends get dolutegravir when their health insurance ran out. He hopes the new licence will broaden access and eliminate the uncertainty they face.

“You have to be on continuous treatment for it to be effective,” he said. “Having that confidence, that consistency … we can live a completely undetectable life.”