A firm is blocking access to its miracle drug

Gilead’s lenacapavir could help transform the fight against HIV — but only if millions more patients are allowed to obtain it

- MICHAEL HILTZIK COLUMNIST

WILL CEO Daniel O'Day ever reveal why Gilead Sciences is blocking a full global rollout of its lenacapavir?

(ANDREW HARNIK Associated Press)

By most accounts, the HIV drug lenacapavir is so effective in preventing infection and treating HIV-positive patients that it could revolutionize the fight against AIDS.

“Lenacapavir could be transformative,” says Peter Maybarduk, director of the access to medicines program at the nonprofit organization Public Citizen, “if people can get it.”

What's the main obstacle? It’s the drug company that developed and owns lenacapavir, Foster City, Calif.-based Gilead Sciences. Gilead has so tightly limited access to the drug that millions of people at risk from HIV might not get it, according to Public Citizen.

“We have a technology that could end AIDS, and collectively we're wasting it,” Maybarduk told me.

Gilead’s action became public at the end of March, when the international health organization Médicins Sans Frontiéres, or MSF published an open letter detailing its fruitless yearlong effort to purchase a supply of lenacapavir from the company.

MSF or Doctors Without Borders, says Gilead advised it to obtain the drug from the Global Fund to Fight AIDS, Tuberculosis and Malaria, which will acquire 2 million doses over three years.

That’s a small fraction of what's needed, MSF said in its letter, given that “this allocation is capped, demand far exceeds supply, and every dose directed to MSF is a dose unavailable to another program.”

The last meeting between MSF and the company came on Feb. 18, when the company “made it clear that there was no prospect that they would sell directly to us,” says Melissa Barber, MSF's global health advocacy and policy advisor. “We went through all the reasons why they would say ‘no,’ and they finally said that negotiating supply contracts is ‘a lot of work.’”