A key del­e­ga­tion of HIV re­searchers, pub­lic health ex­perts and drug de­vel­op­ers will come to­geth­er next week in Rwan­da for the bi­en­ni­al In­ter­na­tion­al AIDS So­ci­ety con­fer­ence on HIV sci­ence.

But as 3,000 of the field’s lead­ers gath­er in Ki­gali to dis­cuss the lat­est ad­vance­ments, in­clud­ing a twice-year­ly pre­ven­tion shot, there’s a scarci­ty of new biotech com­pa­nies to car­ry for­ward R&D.

The ones that al­ready ex­ist are strug­gling to gath­er funds. Much of the de­vel­op­ment is in the hands of three long­stand­ing com­pa­nies: Gilead Sci­ences, GSK’s Vi­iV Health­care and Mer­ck. Each of the com­pa­nies will be pre­sent­ing re­search at the con­fab.

In­dus­try in­sid­ers who spoke with End­points News point to a con­flu­ence of fac­tors be­hind the pauci­ty of star­tups, in­clud­ing fi­nanc­ing bar­ri­ers, avail­abil­i­ty of ap­proved prod­ucts, US gov­ern­ment fund­ing cuts and a small scope of ex­it op­por­tu­ni­ties.

Capri­cor Ther­a­peu­tics said on Fri­day it re­ceived a Com­plete Re­sponse Let­ter from the FDA for its lead cell ther­a­py for Duchenne mus­cu­lar dy­s­tro­phy (DMD), cit­ing the agency was not sat­is­fied with its clin­i­cal da­ta and cer­tain man­u­fac­tur­ing com­mit­ments.

The agency cit­ed a lack of clin­i­cal da­ta show­ing the ef­fec­tive­ness of the cell ther­a­py, named de­ramio­cel, and has re­quest­ed fur­ther in­for­ma­tion, ac­cord­ing to a re­lease. Capri­cor’s BLA was sup­port­ed by da­ta from its Phase 2 tri­al called HOPE-2, which in­ves­ti­gat­ed the cell ther­a­py in 20 pa­tients with DMD. Those mid-stage da­ta showed clin­i­cal­ly mean­ing­ful preser­va­tion of heart func­tion over four years com­pared to a place­bo.

An­tag Ther­a­peu­tics is tak­ing an un­usu­al, al­though not un­known, ap­proach to obe­si­ty.

Where drugs like Eli Lil­ly’s Zep­bound and oth­er com­pounds from Roche and Viking Ther­a­peu­tics have mech­a­nisms part­ly based on GIP ag­o­nism, An­tag is pur­su­ing GIP block­ade.

Com­pa­nies, in­clud­ing Pfiz­er and He­licore Bio­phar­ma, are al­so look­ing at this ap­proach, but the clear prece­dent is Am­gen’s Mar­i­Tide, which com­bines GLP-1 ag­o­nism with GIP an­tag­o­nism. This drug has prompt­ed side ef­fect wor­ries, and Am­gen in­tends to use low­er dos­es in its Phase 3 tri­als than in ear­li­er stud­ies.

So, what makes An­tag think the GIP block­ade will work? And if it does, why do sev­er­al drugs achieve weight loss by do­ing the op­po­site?